Journal of Advances in Medicine and Medical Research https://journaljammr.com/index.php/JAMMR <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.&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 Postpartum Psychopathological Disorders https://journaljammr.com/index.php/JAMMR/article/view/5425 <p>Pregnancy and the postpartum period are times of psychological vulnerability. The postpartum period is particularly prone to complications. The objective of this article is to provide an overview of psychopathological disorders during the postpartum period.</p> Y. Bouguermouh F. Manseur Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-04-13 2024-04-13 36 5 153 156 10.9734/jammr/2024/v36i55425 Gene Therapies in the Fight against Liver Disease: A Comprehensive Review https://journaljammr.com/index.php/JAMMR/article/view/5413 <p><strong>Introduction: </strong>The field of hepatology is rapidly evolving, with new treatments being investigated using gene therapy. Gene therapy involves using a patient's genetic code and altering it to create a desired phenotype/genotype.</p> <p><strong>Methods: </strong>Within this emerging domain, there is a multitude of delivery mediums used to alter genes. It is essential to understand the mechanisms of genetic therapies and the risks and benefits associated with them. This review aims to break down the mechanisms of action of gene therapies, describe current research conducted, and discuss future implications for the field of hepatology.</p> <p><strong>Discussion and Conclusion: </strong>Different methods of gene therapy include gene editing, gene silencing, gene transfer, and mRNA therapy. These genetic modulations are achieved through several modalities. Examples include zinc finger nucleases (ZFNs), transcription activator-like effector nucleases (TALENs), cluster-regulated interspaced short palindromic repeats with associated cast 9 proteins (CRISPR/Cas9), SiRNA particles, antisense oligonucleotides (ASO), and synthetically engineered mRNA. Initially, the method for gene therapy included injecting genetic code, usually in a vector, to create phenotypic production in gene-deficient states. Recently, gene therapy has included more precise editing of the genome with technologies such as CRISPR-Cas9 and silencing of pathogenic genes.</p> Phillip Leff Majd B. Aboona Silpa Choday Qumber Ali Karn Wijarnpreecha Naim Alkhouri Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-03-27 2024-03-27 36 5 38 58 10.9734/jammr/2024/v36i55413 Etiology, Diagnosis and Treatment for Puncta and Canalicular Obstruction: A Comprehensive Analysis https://journaljammr.com/index.php/JAMMR/article/view/5419 <p>Puncta and canalicular obstruction is a common ophthalmological condition that can lead to significant morbidity and impaired tear drainage. This comprehensive analysis aims to provide an overview of the etiological factors and risk factors associated with this condition, along with a detailed examination of the anatomy of the lacrimal drainage system. Diagnostic techniques for assessing puncta and canalicular obstruction, including clinical evaluation, patient history, imaging techniques, and tear drainage tests, are discussed. Additionally, various treatment options for managing this condition are presented, including the management of specific etiological factors such as inflammation, infections, neoplastic conditions, and anatomical abnormalities. The article also addresses potential complications and provides insights into the prognosis of puncta and canalicular obstruction. By elucidating the multifaceted aspects of this condition, this comprehensive analysis aims to contribute to the understanding and management of puncta and canalicular obstruction, ultimately improving patient outcomes.</p> Foivos Papadopoulos Ioannis Asproudis Theodora Tsourouki Ioannis Ntountas Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-04-06 2024-04-06 36 5 95 108 10.9734/jammr/2024/v36i55419 Intestinal Obstruction as a Manifestation of Metastatic Gastrointestinal Neuroendocrine Tumor – A Case Report and Literature Review https://journaljammr.com/index.php/JAMMR/article/view/5418 <p>Neuroendocrine tumors (NETs) are rare tumors that are capable of secreting hormones into the bloodstream. They can affect any organ but are most commonly found in the digestive system, particularly in the small intestine.</p> <p>Neuroendocrine tumors (NETs) are often identified in later stages due to the emergence of nonspecific symptoms.&nbsp; Chromogranin A serves as the primary biochemical indicator for NETs. Evaluating the extent of the disease typically involves conventional imaging techniques such as CT scans and MRIs, as well as isotopic imaging methods.</p> <p>Curative surgery remains the gold standard in the management of small intestine neuroendocrine tumors (SI-NETs). It should be considered as soon as possible, even in cases of metastatic stage.</p> <p>Somatostatin analogs (SSAs) are pivotal in both managing symptoms and therapeutically addressing metastatic Neuroendocrine Tumors (NETs).</p> <p>we present a case of a neuroendocrine tumor with intestinal obstruction along with a literature review.</p> Yasser El Brahmi Mahmoud Dabbagh Ballouch Mohamed Noufou Fodiya Moctar Walid Chair Mohammed Najih Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-04-05 2024-04-05 36 5 90 94 10.9734/jammr/2024/v36i55418 Spin Analysis in Randomized Clinical Trials of Physiotherapeutic Treatment for Temporomandibular Disorders: A Systematic Review Protocol https://journaljammr.com/index.php/JAMMR/article/view/5423 <p><strong>Objective:</strong> To investigate whether clinical trials of physiotherapeutic interventions for treating temporomandibular disorders (TMD) contained spin and whether there was consistency between the abstract and the full text.</p> <p><strong>Study Design:</strong> Systematic Review Protocol. (PROSPERO ID: CRD42022369637)</p> <p>Methodology: Study selection and data extraction assessments were conducted independently and in duplicate. The sample will be composed of randomized controlled clinical trials of physiotherapeutic treatment for TMD as one of the treatments, regardless of whether it is muscular, articular, or mixed; and have at least pain and mandibular range of motion as outcome measures. Without language restriction, 2010 to 2025 is the year of publication, which allows a comparative analysis between the abstract and the full text. The analysis will be performed independently and in duplicate. In case of disagreement, a third reviewer will be consulted to reach a consensus through discussion. The electronic databases used were PubMed/Medline, EMBASE, CINAHL, CENTRAL, PEDro, SPORTDiscus, and LILACS. A search strategy developed for PubMed/Medline will be adapted for each database. Two checklists will be used to analyze the studies: Consolidated Standards of Reporting Trials (CONSORT) for abstract (CONSORT-A) to evaluate the completeness of reporting of the abstracts and the spin checklist to evaluate the presence and consistency of spin in abstract. The risk of bias was assessed using the PEDro scale independently and in duplicate.</p> <p><strong>Results: </strong>The results will be presented in tables and flowcharts.</p> <p><strong>Conclusion:</strong> Inconsistencies between the abstract and full text require investigation to alert clinicians, researchers, and readers.</p> Lais Silva Ferreira Luciana Cavalcante Urze Prado Fernanda Cardoso Nakamoto Alcylene Carla de Jesus dos Santos Cid André Fidelis de Paula Gomes Fabiano Politti Daniela Aparecida Biasotto-Gonzalez Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-04-09 2024-04-09 36 5 136 144 10.9734/jammr/2024/v36i55423 Pleuroparenchymal Fibroelastosis: A Rare Interstitial Lung Disease https://journaljammr.com/index.php/JAMMR/article/view/5411 <p>Pleuroparenchymal fibroelastosis (PPFE) is a rare interstitial lung disease (ILD) characterized by upper-lobe predominant fibrosis involving of the pleural and subpleural lung parenchyma. It is a relatively newly recognized entity within the spectrum of ILDs. Diagnosing PPFE can be challenging due to its rarity and overlapping clinical features with other ILDs. We report the case of two patients, siblings, of first degree consanguineous parents, 37 and 32 years old, suffering from worsening dyspnea, dry cough and weight loss, the high resolution chest computer tomography objectified a platythorax, a bilateral pleural cap thickening, diffuse sub pleural reticulations with bilateral apical traction bronchiectasis, associated with septal and non-septal lines, the main scannographic lesions spared the lower lobes. After eliminating differential diagnoses, the diagnosis of PPFE in a familial form was made based on the radiological criteria proposed by Reddy and al and on according to the 2013 ATS/ERS consensus. We underline the importance of reporting these 2 cases to learn more about the disease, a rare chronic fibrosing interstitial pneumonia, and its serious prognosis in the absence of therapies.</p> Wiam El Khattabi Salma Msika Wafaa Tahfi Nabil Bougteb Hajar Arfaoui Hicham Afif Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-03-27 2024-03-27 36 5 22 29 10.9734/jammr/2024/v36i55411 End-to-Side Neurorrhaphy Technique: Exploring Neuronal Regeneration to Restore Nerve Function https://journaljammr.com/index.php/JAMMR/article/view/5412 <p><strong>Aims: </strong>To report the case of a pediatric patient with total left brachial plexopathy (TLBP), exhibiting partially restored motor function and impaired sensitivity, who was treated with the End-to-Side neurorrhaphy (ETSN) technique.</p> <p><strong>Presentation of Case:</strong> A 13-year-old female was involved in a car accident. After clinical and imaging evaluation, the diagnostic hypothesis was TLBP with partially restored function and loss of protective sensitivity in the pincer region. A surgical intervention was recommended. Due to case characteristics, ETSN appeared to be the most appropriate technique.</p> <p><strong>Discussion:</strong> ETSN is a technique utilized for repairing nerve injuries. It involves suturing the distal end of a transected nerve to the lateral side of a healthy donor nerve, aiming to restore neurons through peripheral plasticity. The regeneration mechanism promoted by this technique shares some similarities with that promoted by standard techniques, with important roles being assigned to Schwann cells (SC), for example. However, this procedure has its own particularities, which still require further investigation. Generally, ETSN cannot replicate the efficacy of model techniques, but remains valid in select cases, such as instances involving nerve injuries exceeding 3-4 cm or in the absence of donor nerves. Therefore, ETSN stands as a choice and deserves consideration.</p> <p><strong>Conclusion:</strong> The patient progressed with a good prognosis and recovered protective sensitivity in the pincer region. ETSN is efficient for peripheral nerve injuries with inaccessible proximal trunks or long nerve defects. The discussion surrounding ETSN remains controversial, making this study essential for expanding scientific knowledge.</p> Raiza Rafaela Borges de Oliveira Júlia Santos Maia Ismael Felipe Gonçalves Galvão Davi Rodrigues Leite Hildo Rocha Cirne Azevedo-Filho Fernando Henrique Morais de Souza Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-03-27 2024-03-27 36 5 30 37 10.9734/jammr/2024/v36i55412 PI3K/AKT/mTOR Inhibitor Drug Candidates for the Treatment of Hormone Resistant Breast Cancer: A Systematic Review https://journaljammr.com/index.php/JAMMR/article/view/5421 <p>Breast cancer is the second most diagnosed type of cancer in women, with approximately 2.3 million cases reported in 2020. According to estimates by Brazil's National Cancer Institute, there will be approximately 74,000 new cases in the three-year period 2023-2025. It is divided into 4 molecular subtypes, Luminal A, Luminal B (hormone-positive), HER-2 and triple-negative. Regarding treatment, particularly for the luminal subtypes, hormone therapy is fundamental, since they grow from estrogen stimulation. However, processes can occur that lead to therapeutic resistance, such as mutations in the PI3K/AKT/mTOR pathway, which acts in the regulation of various cellular functions. The search for drugs that inhibit this pathway as an alternative treatment may play a key role in overcoming this resistance. This systematic review aimed to study new candidate drugs for inhibiting the PI3K/AKT/mTOR pathway as an alternative treatment in cases of resistance to hormone therapy. The study was conducted in accordance with the PRISMA guidelines, using the PubMed database with the following terms: "breast cancer", "PI3K/AKT/mTOR", "immunotherapy" without restriction of year and language. A total of 36 articles were found and 3 were included in this review. The drug candidates presented promising results in terms of inhibiting the PI3K/AKT/mTOR pathway, as well as some advantages such as a reduction in adverse effects, an increase in the average density of cytotoxic T cells and greater expression of interferon signaling genes, which through their immunoregulatory function lead to an increase in the body's ability to react to tumor cells. Despite this, there is still a need for more studies on the subject, especially in vivo studies that can assess the biosafety and efficacy profile, with the aim of compiling sufficient data to make the introduction of these new drugs in breast cancer therapy a reality.</p> Lucas Bernardim de Oliveira Bárbara Mendes Paz Chao Ana Carolina Dorigoni Bini Maria Elvira Ribeiro Cordeiro Emerson Carraro Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-04-06 2024-04-06 36 5 120 127 10.9734/jammr/2024/v36i55421 Comparative Cardiovascular Efficacy & Safety of NSAIDs: A Systematic Review and Meta-analysis of Randomized Controlled Trials https://journaljammr.com/index.php/JAMMR/article/view/5427 <p>NSAIDs, or nonsteroidal anti-inflammatory medications, are popular and efficient analgesis and frequent mainstay treatements for inflammatory disorders. However, their cardiovascular safety is questionable. The aims of the current study were: (1) to evaluate the comparative cardiovascular efficacy of NSAIDs; (2) to investigate the cardiovascular safety and risks associated with NSAID use; (3) to highlight the importance of alternative therapies for patients who display contraindications to NSAID. A number of digital databases were explored to retrieve relevant studies. These consist of ClinicalTrials.gov, PubMed, Google Scholar, ScienceDirect, etc. The final sample consisted of 17 primary studies.A total of 12/17 (71%) studies advocated the efficacy and safety of NSAIDs. The remaining 2/17 (11%) showed that there was no discernible difference between the NSAID and non-NSAID groups in terms of mortality, cardio-respiratory morbidity, and cardiovascular risk. A forest plot was created using data from eight distinct studies. The results for the incidence of cardiovascular events were found to be statistically significant. The heterogeneity was calculated to be Tau2= 0.15; Chi2=117.67; df=6; I2=95%. The overall effect size was found to be Z=0.08 (p&lt;0.94); the Hazard Ratio was found to be 0.84, CI=95% (CI, 0.72 = 0.98). Certain agents have a higher risk of causing unfavorable cardiovascular events, although other agents might have a safer profile. Clinicians must have this comprehensive knowledge to balance the therapeutic benefits of NSAIDs with any potential cardiovascular hazards when making judgments.</p> Arhum Mahmood Raheel Chaudhry Mustafa M. Moazam Mohammed T. Zahee Imdad Ullah Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-04-15 2024-04-15 36 5 177 192 10.9734/jammr/2024/v36i55427 IL-6 Gene (174G/C) Single Nucleotide Polymorphism as an Indicator of COVID-19 Severity in Egyptian Patients https://journaljammr.com/index.php/JAMMR/article/view/5409 <p><strong>Background: </strong>The viruses' direct damage plays a part in the disease's beginning, the cytokine storm brought on by COVID-19 is crucial to the emergence of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). This study aimed to investigate the correlation between IL-6 and its IL- 6 gene (174G/C) single nucleotide polymorphism with the pathogenesis of COVID-19 severity in Egyptian patients.</p> <p><strong>Materials &amp; Methods: </strong>Egyptian patients proved to be COVID-19 positive were classified into three groups; Group 1 (mild cases), Group 2 (moderate cases) and Group 3 (severe and critical cases). Complete blood count, liver function tests, renal function tests, CRP, and coagulation profile, serum ferritin, D-dimer, procalcitonin, lactate dehydrogenase and detection of serum interleukin 6 levels, and IL-6 gene polymorphism were investigated for all enrolled 135 patients.</p> <p><strong>Results:</strong> There was a significant decrease of platelets count of group II &amp; III as compared to group I. There was a significant increase of total leucocytic count, CRP, ferritin, D – dimer, procalcitonin, blood urea and IL6 of group III as compared to group I &amp; II. There was significant decrease of relative lymphocyte counts % of group III as compared to group I &amp; II. There was significant increase of LDH of group II &amp; III as compared to group I. There were no statistically significant differences were found as regards hemoglobin, SGPT, SGOT, serum creatinine and I.N.R &amp; interleukin-6 174G/C distribution of the different studied groups.</p> <p>There were positive correlations between serum interleukin 6 levels and CORAD scores, ferritin count, LDH, and D- dimer, and blood urea, and only a negative correlation with relative lymphocyte count %.</p> <p><strong>Conclusion:</strong> interleukin-6 plays an important role in the pathogenesis of COVID-19. In addition, it reveals that serum IL6 can be used as a predictor of disease severity in COVID-19 patients, but interleukin-6 174G/C genotype distribution cannot be used as a predictor of disease severity in COVID-19 Egyptian patients.&nbsp;</p> Bsant Safwat Kasem Ragia S. Sharshar Wesam Salah Ibrahim Hesham Ahmed Elserogy Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-03-26 2024-03-26 36 5 1 14 10.9734/jammr/2024/v36i55409 Clinico-pathological Consistency in the Diagnosis of Skin Disorders in a Tertiary Care Hospital in Southern Nigeria: A Descriptive Cross-Sectional Analysis https://journaljammr.com/index.php/JAMMR/article/view/5410 <p><strong>Background:</strong> The histopathological examination of representative skin biopsy specimens is widely regarded as the gold standard for the resolution of dermatological diagnostic dilemmas, especially with good clinico-pathological correlation, and the skin biopsy is the dermatologists’ most requested investigation. Studies on the clinico-pathological consistency in the diagnosis of skin disorders from our part of the world are very rare.</p> <p><strong>Objective:</strong> This study aimed at determining the consistency between the provisional clinical diagnosis and the histopathologiscal diagnosis of skin biopsy specimens.</p> <p><strong>Materials and Methods:</strong> This study was carried out over a six-month period using specimens from the 58 patients who consented to skin biopsy during this time, and comparison was made between the provisional clinical diagnosis and the histopathological diagnosis.</p> <p><strong>Results:</strong> Of the 58 subjects that participated in the study, 29 were males and 29 were females. Their ages ranged between 7 and 68 years, with a mean age of 37.3 years.</p> <p>The spectrum of histopathologically diagnosed disorders included skin tumours and tumour-like conditions (12 cases, 20.7%), psoriasiform disorders (10 cases, 17.2%), lichenoid disorders (9 cases, 15.5%), infectious disorders (8 cases, 13.8%), disorders of epidermal maturation and keratinization (7 cases, 12.1%), spongiotic disorders (7 cases, 12.1%), vesiculo-bullous disorders (3 cases, 5.2%), and others (3.4%). Overall, the histopathological diagnosis was consistent in 19 cases (32.8%), corroborative in 12 cases (20.7%), with clinico-pathological correlation, and inconsistent in 27 cases (46.6%), leading to the issuance of a completely new diagnosis.</p> <p><strong>Conclusion:</strong> The observed degree of clinico-pathological inconsistency in the evaluation and diagnosis of skin disorders in our environment implies that skin biopsy for histopathological examination is highly valuable if patients are to be issued the appropriate diagnoses for the avoidance of inappropriate treatments. The contribution of histopathology to the accuracy of dermatological diagnosis is significantly enhanced by clinico-pathological corroboration.</p> Obahiagbon I. Omatighene E. O. U. Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-03-26 2024-03-26 36 5 15 21 10.9734/jammr/2024/v36i55410 Dimensioning of the Work Environment and Prevalence of Pain in University Staff https://journaljammr.com/index.php/JAMMR/article/view/5414 <p><strong>Aims: </strong>The research aimed to investigate the correlation between musculoskeletal pain and the dimensions of the work environment during sitting posture among university staff.</p> <p><strong>Methodology:</strong> The evaluation of the prevalence of musculoskeletal pain using a recall record. The measurements in the sitting working posture evaluated were: popliteal height, height from elbow to seat, table height, thigh height, hip width and sacral length. The arrangement of the workstation was also evaluated, and the height of the monitor was checked. All measurements were made using a measuring tape, with a 1mm scale. The study comprised university staff from UNICENTRO who voluntarily participated in the research.</p> <p><strong>Results:</strong> The results of measurement vs estimated height, for male there was different in all variables (chair to floor, arm bent to the chair, depth measurement, eyes to the ground and table to monitor), in female group just in chair to floor, arm bent to the chair, depth measurement and table to monitor (p&lt;0.05). The comparation of without pain vs with pain for male, there was difference in measurement from chair to floor and measurement from eyes to ground, in female group just measurement from table to monitor, (p&lt;0.05).</p> <p><strong>Conclusion:</strong> The results suggest that inadequate work station conditions can be linked to development of pain.</p> Isadora Pandolfo Bortolazzi Heloise Angélico Pimpão Vinícius Muller Reis Weber Bruno Sergio Portela Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-03-27 2024-03-27 36 5 59 64 10.9734/jammr/2024/v36i55414 Jaundice and Treatment Options: Knowledge, Views and Current Practices among Caregivers of Children Attending a Teaching Hospital in Owerri, Nigeria https://journaljammr.com/index.php/JAMMR/article/view/5415 <p><strong>Introduction: </strong>Neonatal jaundice (neonatal hyperbilirubinaemia), characterized by yellowish discoloration of the skin and sclera of newborn infants is caused by high serum bilirubin levels. Amongst infants, it is an important cause of preventable brain injury, mental handicap, physical disabilities and death; arising from poor understanding that leads to dangerous delays in seeking care and imitating appropriate management.</p> <p><strong>Objective:</strong> To evaluate the perception, knowledge, practices and attitudes of mothers related to neonatal jaundice (NNJ).</p> <p><strong>Methods: </strong>Convenience sampling technique was used to obtain data from consecutive parents who attended the well child/immunization clinic of the Federal Teaching Hospital Owerri, Nigeria, from January 2023 to April 2023. A structured questionnaire was utilized to assess knowledge, attitude and treatment related to neonatal jaundice.</p> <p><strong>Results: </strong>The valid response rate was 80%.Of the participating parents, 92.8% had knowledge about neonatal jaundice and this was associated with class I socioeconomic class (OR 11.88 95% CI:1.85to76.18) while 54.4% of the respondents acknowledged jaundice as an emergency.Knowledge of jaundice as an emergency was associated with a high education level (i.e. university degree or its equivalent; OR=8.33, 95% CI: 2.70 to 25.00, p=0.001), prior education on neonatal jaundice (OR=3.62, 95% CI: 1.64 to 7.99, p=0.001) and male babies (OR=1.71, 95% CI: 1.12 to 2.62, p=0.013). Although 62.3% of the participants recognized blood group/rhesus incompatibility as a cause of neonatal jaundice, 22.5% of them did not know neonatal jaundice was dangerous. Of the 243 whose wards had had jaundice, 78.6% recognized yellow eyes as a sign of jaundice, with 38.8% of them being managed in places other than a health facility. Amongst the participants, 71(45.1%) recognized the two effective treatment methods for neonatal jaundice. Thirteen (4.1%) of the participants knew that awareness could be created through the social media. Modest negative correlations between the knowledge of jaundice, its awareness as an emergency and the eventual outcome were observed (Kendall’s tau-b (t<sub>b</sub>) = -0.187, p =.033 and t<sub>b</sub>= -0.254, p &lt;.001, respectively).</p> <p><strong>Conclusion: </strong>Most of the subjects in this study had knowledge about jaundice and about half recognized it as an emergency. A large proportion of them were unaware of the effective treatment methods. Therefore, there is a critical need for better awareness through targeted public enlightenment and educational programs.</p> Ezeogu Joseph Asinobi Kingsley Okeji Chidimma Noela Chimah Chioma Theresa Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-03-28 2024-03-28 36 5 65 72 10.9734/jammr/2024/v36i55415 Association between Facet Fluid on Supine Axial T2-Weighted MRI and Sagittal Instability on Dynamic Standing Lateral Radiographs in Patients with Degenerative Lumbar Disease https://journaljammr.com/index.php/JAMMR/article/view/5416 <p><strong>Study Design:</strong> Prospective observational study conducted at a large tertiary care center in Karachi, Pakistan.</p> <p><strong>Purpose:</strong> To examine the association between positive facet fluid on T2-weighted MRI of lumbosacral spine and the presence of instability on lateral flexion/extension radiographs, and to determine whether a correlation exists between the quantity of facet fluid on axial MRI and the degree of spinal instability on lateral standing flexion/extension radiographs.</p> <p><strong>Overview of literature:</strong> The presence of increased facet fluid on axial T2-weighted magnetic resonance imaging (MRI) has been proposed as a potential marker for motion segment instability in the lumbar spine. Both facet fluid on MRI and spinal instability on dynamic x-rays are crucial in diagnosing and managing low back pain, guiding decisions on surgical interventions.</p> <p><strong>Methods:</strong> We analyzed the prospectively collected data from patients meeting the inclusion criteria. Facet fluid measurements were made according to Schinnerer's criteria on axial T2-weighted images and anterior translation as a marker of instability was evaluated on dynamic radiographs for all eligible patients. Statistical analysis was performed using IBM SPSS version 23, employing cross-tabulations, chi-square tests, and Pearson correlation. The study utilized a null hypothesis to evaluate the association between facet fluid and spinal instability.</p> <p><strong>Results: </strong>Our findings demonstrated a statistically significant association between positive facet fluid on MRI and the occurrence of instability on lateral flexion/extension radiographs. Moreover, we found a strong positive correlation between the volume of facet fluid on axial MRI and the level of spinal instability on standing flexion/extension radiographs.</p> <p><strong>Conclusion:</strong> Based upon these outcomes, we propose that standing lateral flexion–extension radiographs should be routinely administered to patients exhibiting increased facet fluid signals on MRI, as they may provide valuable information regarding potential spinal instability. Further research will help establish the clinical utility of this approach in managing degenerative lumbar diseases.</p> Sadaf Nasir Manzar Hussain Bushra Shamim Fawwaz Bin Shahab Muhammad Yassar Jazaib Ali Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-04-03 2024-04-03 36 5 73 81 10.9734/jammr/2024/v36i55416 Management of Dental Health Services in Selected Upazila Health Complex https://journaljammr.com/index.php/JAMMR/article/view/5417 <p><strong>Objective: </strong>To find out the status of the management of dental health services in selected Upazila Health Complex.</p> <p><strong>Methodology:</strong> A cross-sectional study was conducted between January 2022 and December 2022 at Three Upazila Health Complex (UHC) in Mymensingh District. The study aimed to assess the management of dental health services. A total of 368 respondents, comprising 35 service providers and 333 service receivers, were selected using a convenient sampling method. Relevant data were collected through a pretested semi-structured questionnaire, and an observation checklist was used to identify the available facilities. The collected data were analyzed using SPSS software version 22.</p> <p><strong>Results:</strong> Out of 35 service providers, 51.4% recommended the need for an adequate supply of gloves and masks. 80% of them expressed concern over the inadequate number of service providers, while 68.6% suggested an increase in manpower. Additionally, 17.1% of service providers suggested ensuring an adequate supply of instruments and materials.</p> <p>Among the 333 service receivers, 45% reported being consulted and referred to a referral system. All service receivers would recommend their family, friends, and relatives to visit the UHC for dental health services. Furthermore, 79.9% of service receivers were satisfied with their treatment.</p> <p>However, 75.6% of service receivers did not receive test facilities, 53.2% did not receive all prescribed medicines, and 85.9% did not receive dental health education. About 23.37% of service receivers recommended providing all types of treatment, and 22.28% recommended ensuring an adequate supply of all drugs.</p> <p>Unfortunately, there were no emergency generators and wheelchairs available for severely ill and aged patient.</p> <p><strong>Conclusion: </strong>Continuous improvement is necessary to achieve the ideal dental service. This improvement can be achieved through the enhancement of facilities, utilization of modern equipment, adequate manpower, in-service training, and other means to improve the overall management of dental health services under the Upazila Health Complex (UHC).</p> Samina Akter Sanda Rubena Haque Mst. Fatiha Eyasmin Shipa Lita Bose Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-04-04 2024-04-04 36 5 82 89 10.9734/jammr/2024/v36i55417 Sleep and Awake Bruxism in Pediatric Patients: A Cross-Sectional Study of Prevalence and Associated Factors https://journaljammr.com/index.php/JAMMR/article/view/5420 <p><strong>Aims: </strong>To identify the prevalence and associated factors of dental bruxism in children during the development of occlusion.</p> <p><strong>Study Design:</strong> <em>Cross-sectional</em> observational study.</p> <p><strong>Place and Duration of Study:</strong> Data was collected in two private dental clinics in the city of Maringá - PR. Children treated between 2014 and 2021 were included.</p> <p><strong>Methodology: </strong>417 medical records of children aged between 5 and 12 years old were selected from two dental clinics in the same city. 260 participants answered a questionnaire to identify bruxism complaints. Bruxism was considered possible when those responsible for the patients indicated the occurrence of audible sounds such as teeth grinding and considered probable when there was a report from those responsible for the patients and tooth wear assessed in the clinical examination. 42 children were included in the group of patients with possible bruxism (GB) and 42 in the control group (absence of bruxism - GC). The results were subjected to statistical and descriptive analysis.</p> <p><strong>Results:</strong> A prevalence of possible bruxism of 24.6% was observed and an association was found for the variables: pain in the temporomandibular joints, ringing in the ears, headache, unilateral chewing, joints with pain when chewing, fatigue in the muscles of the face after a long meal, harmful habits such as onychophagia, biting cheeks and pen; snoring, sleeping with their mouth open; behavioral profile: nervousness about new things and lack of motivation with tasks, in addition to the severity of tooth wear.</p> <p><strong>Conclusion:</strong> The prevalence of probable bruxism in children was 24.6%, with manifestations most occurring at night. More clinical studies are needed to develop multidisciplinary approaches for managing childhood bruxism.</p> Juliana Kois Guimarães Tuane Mertz Lucietto Debora Lopes Salles Scheffel Adilson Luiz Ramos Maria Gisette Arias Provenzano Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-04-06 2024-04-06 36 5 109 119 10.9734/jammr/2024/v36i55420 Pilot Study; Estimating Sample Size for the Prevalence of Pre-Clinical Left Ventricular Diastolic Dysfunction Using Two American College of Echocardiography Guidelines in a Semi-Urban Nigerian Population https://journaljammr.com/index.php/JAMMR/article/view/5422 <p><strong>Aim: </strong>To estimate the sample size for the prevalence of pre-clinical left ventricular diastolic dysfunction using two American college of echocardiography guidelines in a semi-urban Nigerian population.</p> <p><strong>Study Design:</strong> Cross sectional, population based.</p> <p><strong>Place and Duration of Study: </strong>Neni, Anambra State, Nigeria on the 18th and 19th December 2023.</p> <p><strong>Methodology:</strong> Fifty subjects with age range of 18—70 years were consecutively recruited after a community awareness creation. Subjects gave informed oral and/or written consent before proceeding for an interviewer administered questioning of their biodata and clinical history. Anthropometric measurements were obtained followed by clinical examination and electrocardiography. Echocardiography was done using the American Society of Echocardiography (ASE) guideline with the left ventricular diastolic function assessed using the 2009 and 2016 guidelines.</p> <p><strong>Results:</strong> Mean age of participants was 54.3±14.0 years consisting of 15 males and 35 females. The prevalence of pre-clinical left ventricular diastolic dysfunction was 16% and 14% using the ASE 2009 and 2016 guidelines respectively.</p> <p><strong>Conclusion:</strong> Prevalence enabling accurate sample size calculation for the main study was obtained. Modifications were made to the research proposal based on lessons learnt.</p> Nneka Clara Udora Ifeyinwa Jennifer Ajulufo Edmund Ndudi Ossai Emmanuel Chukwudi Ejim Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-04-09 2024-04-09 36 5 128 135 10.9734/jammr/2024/v36i55422 Analysis of Pharmacy Students' Learning in Clinical Pharmacy During Internship https://journaljammr.com/index.php/JAMMR/article/view/5424 <p>The internship is the moment when students experience professional practice in a real learning environment, providing the opportunity to acquire knowledge that was lacking during their undergraduate studies. The aim of this study was to assess the knowledge of clinical pharmacy among pharmacy students who had completed an internship in clinical pharmacy during their undergraduate studies. This research was carried out using a quasi-experimental methodology, in which the participants were 23 pharmacy students who had experienced an internship in clinical pharmacy. Data was collected using a questionnaire with answers based on the Likert® Scale, applied before the start of the internship and at the end of it. The variation between answers was the determining factor for the knowledge apprehension metric. From the results found, it was observed that the students increased their positive responses in relation to learning the proposed Clinical Pharmaceutical Services. There was a gain in knowledge during the internship period, demonstrating that this is a favorable resource for teaching clinical pharmacy.</p> Jaqueline de Jesus Aschenbrenner Camila Moraes Marques Beatriz Essenfelder Borges Maria Rosa Machado Prado Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-04-11 2024-04-11 36 5 145 152 10.9734/jammr/2024/v36i55424 Computerized Assessment of Readiness (Focos/Prontos System) and Its Multifactor Screening for Worker’s Fatigue and Productivity: A Case-Control and Cross-sectional Study https://journaljammr.com/index.php/JAMMR/article/view/5426 <p>We present here a brief review of what has been published about fatigue, highlighting its multifactorial nature and the lack of objective markers that make it difficult to establish a consensus on measurement methods and present the Computerized Evaluation of Work Readiness (FOCOS/Prontos System), aiming to assess the correlation between the computerized assessment performance and signs of fatigue, using the Chalder instrument. The study applied the Chalder Fatigue Scale to 552 employees of a Brazilian mining company, with a final sample consisting of 334 individuals divided into a 'clinical group' (G1) with signs of fatigue and a 'control group' (G0) without fatigue. The study aimed to analyze readiness profiles between the clinical and control groups using statistical tests like the Mann-Whitney U-test and Welch's t-test, with significance set at p-value &lt;0.05. Results showed significant differences in daily readiness, cognitive impacts, and risky behaviors before and after self-reporting fatigue. The Prontos System demonstrated predictive value for fatigue-related risks and accident prevention measures, highlighting its role in enhancing workplace safety and productivity. The study highlights the importance of daily and continuous fatigue assessment using the FOCOS/Prontos System to track signs of fatigue, as well as productivity. The system's multidimensional approach enriches fatigue prediction and classification accuracy. Integrating instruments enhances fatigue management, allowing for proactive intervention based on temporal analysis of readiness parameters and behaviors associated with fatigue. The study emphasizes the complexity of fatigue and its correlation with accidents, advocating for ongoing monitoring as a preventive and performance optimization strategy, thus promoting a safer and healthier work environment.</p> Marcela Souza Lima Paulo Hebert Wilson Santos Cabral Jade Kill Wallysson Francis Soares, Me Elisa Smith Barbiero Medeiros Thais Costa Jesus Alexandre Lemos Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-04-13 2024-04-13 36 5 157 176 10.9734/jammr/2024/v36i55426 Cervical Cancer Screening in the Metropolitan Region I, State of Pará, Amazon: A Retrospective Ecological Study on Public Health in Pará https://journaljammr.com/index.php/JAMMR/article/view/5428 <p><strong>Objective:</strong> To analyze the coverage of cytopathological examination of the cervix in women between 25 and 64 years of age in Metropolitan Region I, State of Pará, from 2017 to 2021.</p> <p><strong>Methodology</strong><strong>:</strong> Secondary and public data, registered in the System, were extracted. Cancer Information, considering the historical series from 2017 to 2021.</p> <p><strong>Results:</strong> A total of 150,424 uterine cervix exams were performed by women aged between 25 and 64 years. There was a variation in the offer of exams in the municipalities, with an increase in the years 2017, 2018 and 2019, while in the years 2020 and 2021, the numbers were reduced, without reaching the state goal agreed in most municipalities. Among the cytological changes in the exam, atypical ones in glandular cells predominated with 52.4%, followed by invasive squamous cell carcinoma with 31.1%. As for the type of intraepithelial lesion, a higher proportion of low-grade lesions was identified, with 82.5%.</p> <p><strong>Conclusion:</strong> Weaknesses in Cervical Cancer (CC) screening may be correlated with low supply and demand for the test, as well as the unsatisfactory quality of the collected samples.</p> Thiago Augusto Ferreira dos Anjos Aline Moraes Monteiro Kézia Dias Lopes Raquel Gomes da Silva Marcela Raíssa Asevedo Dergan Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-04-15 2024-04-15 36 5 193 199 10.9734/jammr/2024/v36i55428 Do Dynamometric Variables of the Pelvic Floor Muscles Differ between Women with and without Stress Urinary Incontinence? A Blind, Cross-sectional Study https://journaljammr.com/index.php/JAMMR/article/view/5429 <p><strong>Objective:</strong> The aim of the present study was to compare pelvic floor muscles (PFM) contraction variables between women with and without stress urinary incontinence (SUI).</p> <p><strong>Materials and Methods:</strong> This cross-sectional study evaluated the PFM of 17 healthy women and 17 women with SUI during a single test session using a vaginal dynamometer. Outcomes: peak time (time at which peak force occurred after the onset of contraction), passive force (baseline), maximum contraction force, impulse of contraction, average force and endurance time. Dada was recording during a single test session using a vaginal dynamometer.</p> <p><strong>Results:</strong> The following PFM contraction variables were evaluated: Analysis of covariance (ANCOVA) with the Bonferroni post hoc test was used to compare the dynamometric data between groups (control and SUI), considering age and number of childbirths as co-variables. Significant difference was observed between groups with regard to endurance (F = 4.87, <em>P</em> &lt; .03; ANCOVA test), whereas no significant differences were found for the other variables analyzed.</p> <p><strong>Conclusion:</strong> The endurance time of PFM contraction is shorter in women with SUI, whereas variables related to the intensity of pelvic floor muscle contraction force and time from the onset to peak contraction of these muscles are similar between women with and without stress urinary incontinence.</p> Karina Moyano Amorim Elora dos Santos Silva de Lima Caroline Razera Ferreira Alisson Monteiro de Freitas Luis Eduardo Peixoto Rosa dos Santos César Ferreira Amorim Daniela Aparecida Biasotto-Gonzalez Fabiano Politti Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-04-15 2024-04-15 36 5 200 208 10.9734/jammr/2024/v36i55429 Influence of the COVID-19 Pandemic on Oral and Maxillofacial Care in Health Units in Belém, Brazil https://journaljammr.com/index.php/JAMMR/article/view/5430 <p><strong>Aims: </strong>This study aims to assess the influence of the pandemic on oral and maxillofacial surgical procedures in Dental Specialty Centers (CEOs) within the Metropolitan Region of Belém, Pará, Brazil.</p> <p><strong>Study Design: </strong>A retrospective cross-sectional epidemiological investigation was conducted using a comparative statistical approach.</p> <p><strong>Place and Duration of Study: </strong>Data from 2019 to 2020 on non-urgent surgical procedures in selected CEOs were collected from the DATASUS platform and compared to the number of confirmed COVID-19 cases in Belém, Pará</p> <p><strong>Methodology: </strong>Descriptive statistics and inferential analyses, including ANOVA and t-tests, were used to evaluate the impact of the pandemic on the number of surgical procedures conducted.</p> <p><strong>Results: </strong>The total number of patients treated at the CEOs in 2019 was 30,013, which decreased to 15,952 in 2020, resulting in a 46.8% reduction. The analysis showed that different CEOs exhibited varying trends in the number of procedures performed, with a significant association between the pandemic and procedure numbers. Most surgical procedures experienced a decline from 2019 to 2020. Still, specific procedures showed substantial increases, such as excision of skin and mucosal lesions, treatment of facial neuralgia, and drainage of abscesses in the mouth and appendages.</p> <p><strong>Conclusion: </strong>The COVID-19 pandemic significantly impacted the oral and maxillofacial surgical procedures rate at Dental Specialty Centers in the Metropolitan Region of Belém, Pará, Brazil. While overall procedures decreased, specific non-urgent procedures demonstrated variations, influenced by the evolving pandemic and public health measures.</p> Gabriel Oliveira Aguiar Santos Marilia de Oliveira Coelho Dutra Leal Renato Assis Machado Claudio Roberto Pacheco Jodas Andressa Bolognesi Bachesk Rubens Gonçalves Teixeira Copyright (c) 2024 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-04-15 2024-04-15 36 5 209 216 10.9734/jammr/2024/v36i55430