Journal of Advances in Medicine and Medical Research <p style="text-align: justify;"><strong>Journal of Advances in Medicine and Medical Research (2456-8899)</strong> aims to publish research papers, reviews and short communications in the areas of medicine and medical research.&nbsp; JAMMR will not only publish traditional full research reports, including short communications, but also this journal will publish reports/articles on all stages of the research process like study protocols, pilot studies and pre-protocols. JAMMR is novelty attracting, open minded, peer-reviewed medical periodical, designed to serve as a perfectly new platform for both mainstream and new ground shaking works as long as they are technically correct and scientifically motivated.&nbsp;The journal also encourages the submission of useful reports of negative results. This is a quality controlled,&nbsp;OPEN&nbsp;peer reviewed, open access INTERNATIONAL journal.</p> SCIENCEDOMAIN international en-US Journal of Advances in Medicine and Medical Research 2456-8899 Sickle Cell Disease in East African Countries: Prevalence, Complications and Management <p>Sickle cell disease (SCD) is one of the most common life-threatening monogenic disorders affecting millions of people worldwide. The disease has a high prevalence in malaria-endemic tropics, especially in sub-Saharan Africa. Although sickle-cell trait (SCT) offers protective advantage against malaria, it does not apply to homozygous individuals with sickle cell anemia but instead makes them more susceptible to not only malaria but to also other infections, causing a great deal of under-five mortality. Despite the fatal risks and high incidence rates of SCD, little attention is given, in terms of funding, management and surveillance, especially among East African countries. In addition, few works of literature exist, and less has been documented about the disease. This minireview aimed to report the current situation in terms of prevalence, mortality, diagnosis and management of SCD among East African countries; Uganda, Kenya, Tanzania, Rwanda and Burundi.</p> <p>SCD is characterised by retarded growth, chronic pain attacks and severe organ damage leading to fatal complications. This, coupled with limited resources in East African countries, reduces the survival of SCD patients and most die before five years. SCD is detected through a blood test usually by Haemoglobin electrophoresis, and Hydroxyurea therapy, antibiotics and blood transfusion are used to prevent complications. Early childhood detection through comprehensive newborn screening programmes has been implemented in some countries and is key in the management of the disease.</p> Joseph Kawuki Taha Hussein Musa Nathan Obore Shireen Salome Papabathini ##submission.copyrightStatement## 2019-09-13 2019-09-13 1 9 10.9734/jammr/2019/v30i830220 Evaluation of Iron Supplementation Effects on Plasma Lipid Levels in Pregnant Women <p><strong>Backgrounds: </strong>Iron supplementation is most widely used approach of controlling the global problem of iron deficiency anemia especially in pregnant anemic women. Anemia is one of the most frequent complications related to pregnancy. Normal physiological changes in pregnancy affect the hemoglobin (Hb<strong>)</strong>, Epidemiological studies have shown high serum iron concentrations following abnormal levels of blood lipids are risk factors for coronary artery disease and myocardial infarction. Both iron deficiency anemia and dyslipidaemia are widely prevalent public health problems, especially in the Sudanese pregnant women.</p> <p><strong>Objectives: </strong>The aim of present study was to measure the serum level of lipids profile in anemic pregnant women compared to non anemic pregnant women.</p> <p><strong>Methodology and Study Population:</strong> The analytical case control study conducted in obstetrics and gynecology centre, Omdurman city, Khartoum state. One hundred subjects known with 50 pregnant anemic as case groups and 50 non anemic pregnant&nbsp; women as control groups were enrolled in this study, with&nbsp; match age and sex,&nbsp; the age ranged between (20 to 40 years) and their mean (31.7±4.34). The serum lipid profile was analyzed using spectrophotometric method.</p> <p><strong>Results: </strong>The (mean±SD) of Hb, HDL, LDL, TG and TC in anemic pregnant women respectively were (68.15±9.35, 46.06±9.62, 114.14±36.86, 170.38±54.57. 197.16±46.83). While the (mean±SD) of Hb, HDL, LDL, TG and TC in non anemic pregnant women respectively were (79.76±7.22, 47.44±9.65, 140.00±40.76, 189.72±37.89, 224.38±45.09). The concentration of Hb was highly significantly decrease in anemic pregnant compare to non anemic pregnant women with <em>p value</em> (p=0.000). The level serum of LDL, TG and TC were significantly decrease in anemic pregnant compare to non anemic pregnant women with p value (p= 0.001, 0.042, 0.004) respectively.&nbsp; The age of study population were no correlation with serum LDL(r= -0.155, p= 0.283), HDL(r= -0.019, p=0.898) and TC (r=0.68, p=0.640). And also their positive correlation between age and serum TG (r= 0.286, P=0.044).</p> <p><strong>Conclusion: </strong>The anemic pregnant women had a significantly decreased of Hb and serum LDL, TG and TC and also their positive correlation between age and serum TG.</p> Safa F. Omer Suaad Elnour GadAllah Modawe ##submission.copyrightStatement## 2019-09-04 2019-09-04 1 7 10.9734/jammr/2019/v30i830217 Evaluating Electrical Activity of Tibialis Anterior Muscle and Balance in Hemiparetic Patients Following Central and Peripheral Electrical Stimulation - Protocol for a Randomized, Double-blinded, Clinical Trial <p>Concomitant transcranial direct current stimulation (tDCS) is suggested to enhance the functional effects of other physical rehabilitation methods in individuals with motor impairment stemming from a chronic cerebrovascular disease. Thus, the primary aim of the proposed study is to analyze the electrical activity of the tibialis anterior (TA) muscle of the paretic limb in stroke survivors following an intervention involving the combination of tDCS over the motor cortex and peripheral electrical stimulation (PES) administered over the paretic TA. The secondary objective is to analyze the effect on dynamic balance.</p> <p><strong>Methods: </strong>Thirty-six adult stroke survivors will be randomized into three groups: 1) Active tDCS + active PES; 2) Sham tDCS + active PES and 3) Active tDCS + sham PES. TDCS active will be positioned bilateral over the primary motor cortex of the damaged hemisphere (C1 or C2) and the cathode will be positioned over the primary motor cortex of the undamaged hemisphere (C1 or C2) with a current of 2 mA for 20 minutes. For sham tDCS, will follow the same standarts, however, the equipment will be switched on for only 20 seconds. PES will be administered to the paretic TA at 50 Hz for 30 minutes. Evaluations: the median frequency and root mean square (RMS) of the paretic TA will be analyzed using electromyography (EMG) and dynamic balance will be evaluated using the Mini-Balance Evaluation System (Mini-BESTest) at baseline (pre-intervention), after 10 treatment sessions at a frequency of five times a week for two weeks (post-intervention) and 30 days after the end of the interventions (follow up).</p> <p><strong>Discussion:</strong> PES has proven to facilitate the conduction of sensory-motor afferences to the cerebral cortex in stroke survivors. Combining PES with tDCS, which has a direct effect on increasing cortical excitability, could favor motor acquisition and neuronal plasticity in this population.</p> Aline Marina Alves Fruhauf Fabiano Politti Camila Cardoso da Silva David Correa Alves João Carlos Ferrari Corrêa Fernanda Ishida Corrêa ##submission.copyrightStatement## 2019-09-06 2019-09-06 1 10 10.9734/jammr/2019/v30i830218 Pattern of Referral Cases to the Obstetrics Unit of the Rivers State University Teaching Hospital for Maternal Delivery <p><strong>Background: </strong>Formal education, antenatal care, and improved health services still remain the key to a large-scale reduction in maternal mortality in developing countries. Pregnancy and labour complications are most prevalent among unbooked patients compared to booked patients. Prompt and effective treatment will go a long way to reduce these complications.</p> <p><strong>Objective:</strong> To determine the pattern of Obstetric referral cases to the Rivers State University Teaching Hospital (RSUTH) and assess time to response by the hospital.</p> <p><strong>Methodology:</strong> A retrospective review of hospital records of all pregnant women referred to RSUTH for maternal delivery and care in a six months period, 1<sup>st</sup> April to 30<sup>th</sup> September 2015, was carried out. Data on patients’ age, educational level, marital status, gestational age, parity, booking status, time interval between admission and intervention, obstetric diagnoses and outcome were retrieved using structured pro-forma. Data were analyzed using United States CDC Epi Info Version 7.</p> <p><strong>Results:</strong> There were 460 cases referred to the hospital, which represents 42.6% of all maternal deliveries, with a mean age of 28.7±4.6 years and median age of 27.0 years. A majority, 73.7% had secondary education, 55.4% were Primigravidae, 55.4% had term pregnancies and 77.8% were booked elsewhere. Over 60% of diagnoses comprised of difficult labour, Pre-eclampsia/ Eclampsia and prolonged pregnancy. About 75% of the cases had intervention carried out within 12 hours of arrival to hospital.</p> <p><strong>Conclusion: </strong>The pattern of referral cases to our hospital are mainly young educated primigravidae at term, who have had some form of antenatal care and presenting with common complications associated with this group. The intervention response time is good, but we recommend that high risk pregnancies should ab initio be registered at centers properly equipped to handle such cases to avoid calamity.</p> P. A. Awoyesuku D. A. MacPepple ##submission.copyrightStatement## 2019-09-09 2019-09-09 1 7 10.9734/jammr/2019/v30i830219