Journal of Advances in Medicine and Medical Research <p style="text-align: justify;"><strong>Journal of Advances in Medicine and Medical Research (ISSN:&nbsp;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. By not excluding papers based on novelty, this journal facilitates the research and wishes to publish papers as long as they are technically correct and scientifically motivated. The journal also encourages the submission of useful reports of negative results. This is a quality controlled, OPEN peer-reviewed, open-access INTERNATIONAL journal.</p> SCIENCEDOMAIN international en-US Journal of Advances in Medicine and Medical Research 2456-8899 Relationship between Refractive Error and Intraocular Pressure in Children Attending the University of Port-Harcourt Teaching Hospital Eye Clinic <p><strong>Objectives:</strong> To assess and compare the refractive status and intraocular pressures of children attending the University of Port Harcourt Teaching Hospital Eye clinic.</p> <p><strong>Materials and Methods:</strong> The study was a hospital-based comparative cross-sectional study in children aged 5- 18 years attending the University of Port Harcourt Teaching Hospital Eye clinic. Participants were sampled in 2 groups of equal numbers: children without refractive error (emmetropes) and children with refractive error. Each group had cycloplegic refraction, intraocular pressure measurement using Pulsair tonometer, and a full ocular examination.</p> <p><strong>Results:</strong> A total of 234 children with 117 in each group. Myopia was the more common refractive error, accounting for 75.2% and 77.8% in the right and left eyes respectively.</p> <p>The mean intraocular pressure was 14.72mmHg for emmetropia, 15.97mmHg for myopia, and 14.93mmHg for hyperopia in the right eye while 15.02mmHg for emmetropia, 16.05mmHg for myopia, and 13.78mmHg for hyperopia on the left eye.</p> <p>A significant positive correlation was obtained between myopia and intraocular pressure (Pearson correlation, r = 0.151, p = 0.010 for the right eye and r = 0.201, p=0.001 for the left eye).</p> <p><strong>Conclusion:</strong> The higher levels of mean IOP seen in myopia compared to emmetropia and hyperopia demonstrates that children with myopia may likely develop glaucoma earlier compared to others. Therefore, more emphasis should be placed on glaucoma surveillance among myopic children.</p> Damiete E. Briggs Godswill I. Nathaniel ##submission.copyrightStatement## 2022-08-08 2022-08-08 1 9 10.9734/jammr/2022/v34i2131518 Evaluation of YKL-40 as a Biomarker of Inflammation and Atherosclerosis in Chronic Kidney Disease Patients <p><strong>Background: </strong>Chronic kidney disease (CKD) has been recognized as a leading public health problem worldwide. In Egypt, CKD approximately affects 13% of the adult population, resulting in significant morbidity, mortality, and health care costs. Patients with advanced CKD (stage 3 or more) experience a high rate of cardiovascular complications compared to earlier stages of CKD.</p> <p><strong>Objective: </strong>To evaluate serum YKL-40 levels in patients with CKD to assess its value as a biomarker of inflammation and its correlation with carotid intima-media thickness (CIMT) as a predictor for early atherosclerosis.</p> <p><strong>Patients and Methods:&nbsp; </strong>The present study was conducted on fifty subjects divided into 2 groups: group I includes 25 patients with CKD (from stage 1 to stage 5 "pre-dialysis") and group II (control group) includes 25 healthy volunteers. The patients were recruited from Internal Medicine Department and Nephrology Unit, Tanta university hospitals in the period between," August 2020 to September 2021 ".</p> <p><strong>Results: </strong>In our study, YKL-40 levels were significantly high in CKD patients(P=0.001). As regards CIMT measurements for the studied cases its median value was 0.90 and1 mm for the right and left carotid respectively. On the other hand, CIMT measurements for the studied volunteers were within the normal range with statistically significant differences between both groups (p=0.001). There is a positive significant correlation between the serum YKL-40 level from the studied cases with each of triglycerides, serum urea, serum creatinine, CRP, ESR, R CIMT, and L CIMT. Systolic blood pressure, triglyceride, cholesterol, LDL, serum urea, serum creatine, e-GFR, ESR, CRP, and YKL-40 were found to be independent predictors for CIMT (P&lt;0.05). Serum YKL-40 is a highly sensitive predictor of atherosclerosis in CKD and its specificity is 74% in CKD cases.</p> <p><strong>Conclusion: </strong>Serum YKL-40 was significantly high in CKD patients. YKL-40 could be used as a biomarker for inflammation and early detection of atherosclerosis in patients with CKD, but further studies are needed. YKL-40 is an independent predictor of increased CIMT and early atherosclerosis.&nbsp; YKL-40 is highly sensitive to increased CIMT.</p> Omar Ali Abdel Naby El-Ghorab Mohamed Hassan Rashad Elshafey Manal Saad Ahmed Negm Mervat Abdel-Hameed Taha Elkhateeb ##submission.copyrightStatement## 2022-08-08 2022-08-08 10 26 10.9734/jammr/2022/v34i2131520 Endoscopically Assisted Repair of Nasal Septal Perforation Using Platelet Rich Plasma <p><strong>Background:</strong> Nasal septal perforations (NSPs) are nasal septum defects as a result of necrosis to the cartilage or bony tissues in addition to their mucous membrane on both surfaces. the current work aimed to estimate endoscopically assisted repair of medium-sized nasal septal perforation using inferiorly based rotational flap together with Platelet rich plasma (PRP).</p> <p><strong>Methods:</strong> It was a randomized controlled double-blind study recruited on 40 cases with anterior septal perforation for endoscopic repair. Patients randomly were allocated into two equal groups: group A were cases with anterior septal perforation for endoscopic repair using inferior based mucosal rotational and septal flaps only and group B were patients subjected to inferior based mucosal rotational and septal flaps together with PRP. All participants were exposed to thorough history taking, laboratory, clinical examination, and radiological investigation.</p> <p><strong>Results: </strong>Number of patients who had complete or partial closure of septal perforation, was insignificantly different between both groups. Number of patients who had decrease in size of perforation, same size perforation, residual symptoms, and who were asymptomatic was insignificant difference between both groups. Times to disappearance of residual epistaxis and residual crustation were significantly earlier in group B in comparison with group A (P = 0.001 and 0.011 respectively).</p> <p><strong>Conclusions: </strong>Overall, PRP is a promising material for nasal septal perforation. Times to disappearance of residual epistaxis and residual crustation were remarkably earlier in group B in comparison with group A.</p> Mohammed Ibrahim Sharaf Mohamed Osama Tamom Osama Amin Al-Bermawy Mohammed Hamid Asker ##submission.copyrightStatement## 2022-08-09 2022-08-09 27 35 10.9734/jammr/2022/v34i2131523 Risk Factors for Plasmodium falciparum Recurrence in Artemether Lumefantrine Treated Population from Bushenyi District, Uganda <p><strong>Background: </strong>Malaria remains a major Public health problem. In 2019, it was reported that Uganda accounts for 5 % of the total global cases of malaria related deaths after Nigeria and Democratic Republic of Congo.Various risk factors may be responsible for poor treatment outcomes. Thus the main aim of this study was to evaluate the Risk factors for <em>Plasmodium falciparum</em> recurrence in Artemether-lumefantrine treated population from Bushenyi district, Uganda.</p> <p>M<strong>ethods: </strong>A descriptive cross-sectional study was conducted in four selected health centers of Bushenyi district<em>, </em>Uganda by using questionnaire, direct observations and laboratory based studies. Data analysis was done using statistical package for social sciences (SPSS version 23 windows) for descriptive statistics. Logistic regression analysis was done to evaluate the association between <em>Plasmodium falciparum</em> recurrence and associated risk factors.</p> <p><strong>Results:</strong> Statistically independent predictor risk factors for <em>Plasmodium falciparum </em>recurrence at <em>p</em><strong>&lt;</strong>0.05 were; Previous Diagnosis used before the current artemether lumefantrine<strong> (</strong>AL) treatment (OR=11.864; 95% CI: 1.477-95.280; <em>p</em>=0.020), Sleeping with animals (OR=0.193; 95% CI: 0.075-0.894; <em>P</em>=00.032), Age (OR=1.435; 95% CI: 0.0825-0.975; <em>p</em>=0.040), Travelling outside the study area (OR=2.324; 95% CI: 0.050-0.699; <em>p</em>= 0.012), Weight (OR =1.543; 95% CI: 0.085-0.987; <em>p</em>= 0.002), Gametocytes on day 0 (OR =0.284; 95% CI: 0.0625-0.735; <em>p</em>= 0.032)9</p> <p><strong>Conclusions: </strong>Monitoring of transmission potentiality after Artemisinin combined therapies (ACTs) treatment is vital in the fight against malaria infection.</p> Josephat Nyabayo Maniga Mfitundinda Wilberforce Katabazi Aziz Kaweesa Simon Peter Odoki Martin Onchoke Vera Bella Jacqueline Njeri Muchiri Ochweri Albert Saheed Adekunle Akinola Ismail Abiola Adebayo Odda John ##submission.copyrightStatement## 2022-08-09 2022-08-09 62 73 10.9734/jammr/2022/v34i2131524 The Efficacy of Ultrasound Guided Platelet Rich Plasma Injection Versus Perineural Dextrose Injection in the Treatment of Severe Carpal Tunnel Syndrome <p><strong>Aims:</strong> To compare the ultrasound-guided platelet rich plasma efficacy to ultrasound guided 5% dextrose perineural&nbsp;&nbsp; injection therapy in severe idiopathic carpal tunnel syndrome patients.<br> Patients and Methods: This research involved 60 patients with severe idiopathic CTS diagnosed by electrophysiological study. Patients were evaluated at three months after injection&nbsp;&nbsp; clinically, electrophysiological, and US examinations.</p> <p><strong>Patients were divided into 2 groups according to line of treatment:</strong></p> <p><strong>Group I:</strong> 30 patients (34 hands) treated by two ultrasound guided injection with 3 mL PRP two weeks apart.</p> <p><strong>Group II:</strong> 30 patients (35 hands) treated by two ultrasound guided perineural injection therapy with 3 ml of 5% dextrose two weeks apart.</p> <p><strong>Results:</strong> There was significant clinical improvement (BCTQ and, VAS), electrophysiological improvement (DML, AMP, sensory amplitude and sensory conduction velocity of median nerve) and, ultrasonic improvement (CSA and FR) 3 month after treatment as compared to before treatment in both groups with better improvement in group 1.</p> <p>There was significant difference between the 2 groups regarding VAS for pain and VAS for paresthesia 3 months after treatment with better improvement in PRP group. There was significant difference between the 2 groups regarding BCTQ 3 months after treatment with better improvement in PRP group.</p> <p><strong>Conclusion:</strong> Ultrasound guided injection of PRP or dextrose 5% is an effective and safe treatment for severe idiopathic CTS.&nbsp;</p> <p>-Both modalities lead to significant reduction in pain, paresthesia, disability and also significant improvement in electrophysiological and ultrasound parameters of the median nerve with better improvement in PRP group.</p> Manar Elsayed Shandal Shaimaa Ahmed Hablas Amal Mohamed Elbarbary Elham Mohammed Kassem ##submission.copyrightStatement## 2022-08-10 2022-08-10 74 87 10.9734/jammr/2022/v34i2131525 Effects of Clomiphene Citrate Versus Letrozole on Semen Count and Motility in Men with Oligoasthenozoospermia in Osogbo, South- Western Nigeria: A Randomised Study <p><strong>Background:</strong> Infertility is a major cause of socio-emotional and psychological burden world-wide and nearly half of all cases of infertility were as a result of male partner’s related factors of which oligoasthenozoospermia is a major contributor. Currently, different treatments have been developed to manage this deficiency and improve semen parameters but no substantial results have been documented.</p> <p><strong>Aims:</strong> This study therefore aims at evaluating the effects of clomiphene citrate versus letrozole on semen count and motility in men with oligoasthenozoospermia in Osogbo, south-western Nigeria</p> <p><strong>Study Design: </strong>A randomized control study carried out at the gynaecology clinic of LAUTECH teaching hospital, State specialist hospital and Ayomide Women’s Health Specialist Hospital and IVF Centre Osogbo, Osun State.</p> <p><strong>Methodology: </strong>One hundred and forty (140) participants were randomized into the letrozole group and the clomiphene citrate group, with 70 participants in each arm of the study. The outcome measure includes the improvement in sperm concentration and motility (assessed at 4 and 8 weeks) following 3 months of alternate day administration of clomiphene citrate and letrozole by the participants. The study compared the improvement in semen concentration and motility following administration of Clomiphene citrate versus Letrozole among men with oligoasthenozoospermia. Data collected were analysed using Statistical Package for Social Statistics (SPSS-21) software and the level of significance was set at &lt; 0.05.</p> <p><strong>Results: </strong>Letrozole and clomiphene caused significant improvement in sperm motility and concentration with letrozole having higher improvement in both sperm concentration and motility when compared to clomiphene citrate. There was 43.65% increased sperm concentration at 4 weeks and 48.24% increased at 8 weeks post-treatment in the letrozole group, while increased sperm concentration of 17.68% at 4 weeks post-treatment and 26.27% increment at 8 weeks post-treatment in the clomiphene citrate group was observed. Also, there was 33.24% increased sperm motility at 4 weeks and 42.09% at 8 weeks post-treatment in the letrozole group, and 14.30% increased sperm motility at 4 weeks and18.56% at 8 weeks post-treatment.</p> <p><strong>Conclusion: </strong>Sperm concentration and motility in men with oligoasthenozoospermiacan be improved with Letrozole and clomiphene citrate. Higher effect was observed in Letrizole group compared to clomiphene.</p> Akinbowale, Akin Akinyele Akinbowale, Busayo Temilola Akinwale, Oladayo Damilola Komolafe Monisayo Bola-Oyebamiji Shekinat I. Isawumi Adegboye Komolafe Johnson ##submission.copyrightStatement## 2022-08-10 2022-08-10 88 99 10.9734/jammr/2022/v34i2131526 Breathomics of Respiratory Diseases <p>In humans, respiratory disorders are common. Today, rapid, risk-free, and potentially low-cost diagnostics of respiratory disorders detected in the patient's exhaled air are critical. Fractional exhaled nitric oxide (FENO), volatile organic molecules, carbon monoxide, hydrocarbons, and hydrogen peroxide are among the inhaled biomarkers mentioned.&nbsp; Breathomics from exhaled volatile organic compounds and oximeters are also shortly discussed. The use of WO3 in FENO monitors is discussed. They large-scale produced and widely used in medical centers and clinics for diagnostics of respiratory diseases.&nbsp; Promising semiconductor sensors are manufactured from SnO<sub>2</sub>, doped with Pd, Au, or Pt or multi walls carbon nanotubes, gold nanoparticle with single wall carbon nanotubes, quartz microbalance devices with porphyrin, ITO –Zno-Pt films, and surface acoustic wave devices with isobutylene. A combination of VOCs is considered as a “molecular fingerprint” of breath.&nbsp; The electronic nose on metal oxide detectors allows investigating lung cancer and tuberculous.</p> Vladimir M. Aroutiounian ##submission.copyrightStatement## 2022-08-09 2022-08-09 36 47 10.9734/jammr/2022/v34i2131521 Quality of Life Changes in Patients with Osteoradionecrosis and Their Measurement <p>One of the most serious and debilitating complications of radiation therapy (RT) for patients with head and neck cancer (HNC) is osteoradionecrosis of the jaws (ORNJ). ORNJ is defined as radiation-induced ischemic bone necrosis with soft tissue necrosis in the absence of primary tumor, recurrence, or metastatic disease. Even though the incidence of ORNJ has dropped from about 20% to 2–8% as a result of recent advancements in RT techniques, this serious complication is still very challenging to predict, prevent, and treat.&nbsp;It is beyond dispute that ORNJ has detrimental effects on patients' quality of life (QoL). Pain, halitosis, taste disturbance, dysesthesia or anesthesia, trismus, difficulty chewing, swallowing, feeding, and speaking, fistula formation, pathological fracture, and localized or systemic infections are the most frequent symptoms of ORNJ that have an impact on the victim's QoL measures. However, ORNJ-specific QoL studies are scarce in this patient group despite ORNJ's&nbsp;significant harmful effects on the sufferers' physical appearance and functions, mood, and social relationships. By providing readily available information about the physical, social, and emotional effects of ORNJ as measured by general or HNC-specific QoL surveys, this review article aims to serve as a foundation for future studies addressing novel ORNJ-specific questionnaires.</p> Efsun Somay Busra Yilmaz Ahmet Kucuk Erkan Topkan ##submission.copyrightStatement## 2022-08-09 2022-08-09 48 61 10.9734/jammr/2022/v34i2131522