Mucocele of the paranasal sinus is accumulation of the mucoid secretion within the sinus caused by obstruction of the sinus ostium. We report a case of paranasal sinus mucocele presented with proptosis in right eye, diplopia, visual impairment and headache. Magnetic resonance imaging(MRI) revealed a polyp in right anterior ethmoid sinus and nasal cavity resulted in mucocele of the sphenoid, ethmoid and right frontal sinuses.
Aims: The aim of the current study was to assess the clinical efficacy of the FlaxAid dressing for the treatment of chronic venous wounds in a patient unresponsive to previous treatment protocols. Presentation of Case: A 50-year old male patient presented with recurrent venous ulcers of the lower extremities. All of the ulcers had lasted for 5 years and their size was increasing despite clinically relevant local therapy. FlaxAid dressing were applied to the wound area in three stages consisting of FlaxAid dressings wetted with: isotonic salt solution; oil emulsion; and seedcake extract. Discussion and Conclusion: After 12 weeks of therapy with the newly developed FlaxAid bandages, all of the patient’s ulcers had been cured. After 6 months of follow-up, the sites of the patient’s ulcers were found to still be in a healthy state.
Aim: The aim of this study was to assess the knowledge and usage of ITNs among pregnant women attending antenatal clinic in a referral health facility in Nigeria. Materials and Methods: This was a cross-sectional study carried out at the antenatal clinic of the Federal Medical Centre Azare, North-East Nigeria between October and December 2012. A structured questionnaire was administered on consenting consecutive pregnant women until the sample size was reached. Data obtained were analysed and associations were compared using χ2 and Fisher’s exact test where applicable, with P-value <0.05 considered significant. Results: A total of 197 pregnant women were recruited and interviewed. The maternal age ranged from 17-45 years with mean age of 24.2±5.5 years while the parity ranged from 0-11 with multipara constituting 95 (48.22%) and grand multipara, 29 (14.72%). While only 31 (15.74%) of the respondents had tertiary level of education, 64(32.49%) and 15(7.61%) of them had secondary and primary levels of education respectively. Twenty five (12.69%) had no formal education. Majority of the clients, 162 (82.23%) were unemployed, 14 (7.11%) were civil servants and 17 (8.63%) were petty traders. Although most of the women, 189 (95.94%), had knowledge of ITNs, only 132 (67.01%) owned them and much less, 97 (49.24%), used them. Para 5 and above were significantly more likely to use ITNs than para 1-4 and para 0 (χ2=21.118; P=0.03). Age, educational status, occupation, ethnic groups and religion (χ2=1.084; P=0.30) did not influence the use of ITNs. Thirty two (32.00%) and 23 (23.00%) of the ITN non-users gave heat and poverty respectively, as reasons for non utilization. Conclusion: Only few of the clients studied utilized ITNs mainly because of heat and poverty. Education of pregnant women to correct the myths associated with the use of ITNs will improve compliance rate.
Aims: This study aimed to assess the levels of dental anxiety among dental, medical, and pharmacy students at AL Quds University and to find out the sources of dental fear among them. Study Design: Retrospective study. Place and Duration of Study: AL Quds University, between June, 2012-July, 2013. Methodology: Dental anxiety scale (DAS) and Dental Fear Survey (DFS) were completed by four hundred and five students (113 males and 292 females). The population included undergraduate dental (n=198), medical (n=114) and pharmacy students (n=93). Ages ranged from 18 to 27 (the mean age of the subjects was 22.5±2.1 years). Results: Dental students were significantly less anxious (using the dental anxiety scale) compared to the other groups (medical and pharmacy students) (P<0.05). Dental students were significantly more relaxed in the dental treatment as assessed by DFS than other groups (medical and pharmacy students (P<0.05)). Fear of seeing the anesthetic needle (39.2%) and feeling the needle injection (46.2%) were the most common sources of dental fear reactions among the study population. The Pearson correlations (rp) between the measurements DAS and DFS mean scores were evaluated and the correlation is significant (P<0.05). Conclusions: Dental students have a significantly lower level of dental anxiety than medical and pharmacy students. Females showed higher fear scores than males. Seeing the anesthetic needles and feeling the anesthetic solutions injection were the major stimuli of dental fear.
Aims: To evaluate the hypothesis that sporadic Creutzfeldt-Jakob disease (sCJD) may be transmitted through ocular tonometry. Background: The infectious agent of sCJD may be present in the cornea prior to clinical symptoms. Cornea infectiousness has been documented by cornea transplants in guinea pigs and humans. sCJD is resistant to complete inactivity by conventional sterilization techniques. Thus contact tonometry equipment is not disinfected sufficiently to kill sCJD. We previously hypothesized that contact tonometry is a sCJD risk factor. Study Design: Population-based case-control study. Place and Duration of Study: Department of Neurology, School of Medicine, Loma Linda University, Loma Linda, CA, USA; 4 years. Methodology: An 11-state case-control study of pathologically confirmed definite sCJD cases, individually matched controls, and a sample of control surrogates was conducted. Ocular tonometry histories were obtained from case-surrogates, controls, and a sample of control-surrogates. Results: The odds ratio (OR) for ever vs never having had an ocular tonometry test was statistically significant for matched and unmatched analyses for 15 through 3 years prior to disease onset, using both control self-responses and control surrogates: ORs were ∞ and 19.4 with 1-sided P-values <0.0001 and 0.003 and ORs=∞ and 11.1 with 1-sided P-values <0.003 and 0.02, respectively. ORs increased as the number of tonometry tests increased during this age period: trend test, 2-sided P-value < 0.0001. For ≥5 vs <5 tonometry tests, the OR was 5.8 (unmatched) and 3.7 (matched), 2-sided P-value<0.00005. Respondents generally could not specify the type of tonometry. There was no indication of increased tonometry testing among cases within 2 years of disease onset. Conclusions: The a priori hypothesis was supported. Contact tonometry, preferred by ophthalmologists, may be capable of transmitting sCJD. Consideration should be given to using disposable instrument covers after each use. The use the disposable covers or non-contact tonometry is preferable in the absence of effective disinfectant processes at this time.
Aim: This study aimed to identify predictors of delayed enrolment to HIV care in Calabar, Nigeria. Study Design: This was a cross sectional observational study. Place and Duration: This study was carried out in a tertiary level hospital in Calabar, Nigeria between February 1st, 2013 and June 30th, 2013. Methodology: We recruited 500 consecutive HIV-infected persons presenting to care for the first time following HIV diagnosis using a validated, semi-structured and pretested questionnaire. The outcome variable of interest was delayed enrolment for HIV care (>12 months after HIV diagnosis). The independent variables included age, sex, marital status, occupation, income, level of education and exposure to risky behaviour. Others were sexual orientation, duration between HIV testing and presentation for care, residential conditions, lack of spousal HIV status disclosure, distance of residence from nearest HIV care centre and being in a long-standing steady partnership. Results: A total of 45 (9.0%) of the participants enrolled for HIV care within twelve months of HIV diagnosis while 455 (91.0%) enrolled for care after 12 months of diagnosis. The average CD4+ count of those who enrolled early was 248cells/µl which was much lower than the average CD4+ count of those who delayed enrolment (310cells/µl). The average distance of participants who enrolled early for care was lower (296km) than those who delayed enrolment (346km). The covariates significantly associated with delayed enrolment on bivariate analysis were sex, occupation, alcohol use and CD4+ count. Three out of the four covariates retained their significance following multivariate logistic regression and they were CD4+ count, male sex and farming. Conclusion: A significant proportion of clients diagnosed with HIV infection delay in enrolling for care in Calabar. The predictors of delayed enrolment are CD4+ count, male sex and farming. A multifaceted approach of advocacy and social mobilization, poverty alleviation strategies and provision of effective health insurance for all is required.
Aims: To investigate the prevalence and factors associated with development of metabolic syndrome among people with HIV on antiretroviral treatment (ART) in Botswana. Study Design: Cross-sectional study design Place and Duration of Study: Princess Marina Hospital in Botswana (Africa). Only patients that had been on treatment from 1st January to 31st December 2010 were included. Methodology: A structured questionnaire and a data collection form were used to collect data on demographic, socioeconomic, lifestyle, clinical and laboratory data. Bivariate analysis was used to assess characteristics associated with the presence of metabolic syndrome by calculating odds ratios. Results: A total of 190 subjects participated in the study, 141 (74.2%) females and 49 (25.8%) males. The mean age of participants was 42 (±9.04) years, ranging from 24 to 71 with a median age of 40.5 years (IQR: 35 – 49). The overall prevalence of metabolic syndrome in this study was 11%. In the bivariate analysis, the odds for developing MS were higher among participants who were male, obese, 41 years old and older, and those who used ART regimens containing PIs. Conclusion: Overall, the prevalence of metabolic syndrome was 11.1% among the study participants. The factors associated with it were increasing age above 41 years old, male gender, obesity, longer duration of treatment and the use of PIs drugs. It is recommended that patients with such characteristics should be targeted for regular monitoring of parameters defining metabolic syndrome and that a culturally appropriate lifestyle intervention program needs to be designed and implemented for Botswana patients.
Aims: The aim of this study is to analyse the clinical data and management of patients with temporal bone carcinoma and to discuss the management outcomes. Study Design: Retrospective study Place and Duration of Study: Universiti Kebangsaan Malaysia Medical Centre (academic tertiary centre) from January 2002 to December 2011. Methodology: Medical records of nine patients were retrieved for this study. There were seven male and two female patients. The mean age of presentation was 60 years old, with an age range between 49 to 75 years. The clinical presentations, investigations, staging, treatment modalities and outcomes are reviewed. Results: Four patients presented with primary tumour of the temporal bone, while the remaining five were referred from other centres with disease recurrence. Only one out of the five patients that were referred to us had underwent a lateral temporal bone resection (LTBR) at presentation which was however an incomplete LTBR. Three out of the five patients (60%) have died with disease recurrence. One patient remained disease free while another patient was lost to follow up. Two out of the four patients who presented with primary tumour remained well while two others had positive margins due to advanced disease at presentation. Conclusion: Recurrence of disease is likely to occur if aggressive treatment is not offered at presentation or if the diagnosis is delayed. We therefore strongly suggest for early referral to a tertiary centre as aggressive primary surgical treatment with adjuvant radiotherapy shows a better prognosis.
Background: Abdominal obesity once considered an aesthetic rather than a pathological condition is now recognized as a principal risk factor for metabolic syndrome and magnifies the risk of cardiovascular diseases. As the case detection rate of abdominal obesity increases in Nigeria determining its predictors remain relevant for proactive control intervention. Aim: This study was designed to determine the predictors of abdominal obesity among adult Nigerians in a resource-poor environment of a rural hospital in Eastern Nigeria. Study Design: A hospital based case-control study carried out on 700 adult patients aged 18-91 years who were screened for abdominal obesity using the third report of National Cholesterol Education Panel (NCEP) in adult (ATP III) criterion and 350 patients who had waist circumference (WC) ≥102cm and ≥88cm for men and women respectively and met the inclusion criteria were matched for age and sex with 350 non-obese, non-hypertensive and non-diabetic control. Place and Duration of Study: The study was carried out at a rural hospital in Eastern Nigeria between June 2008 and June 2011. Methodology: Predictor variables were assessed using a pretested, structured and interviewer-administered questionnaire. Hypertension and diabetes mellitus were defined using JNC 7 and American Diabetic Association criteria respectively. Results: Abdominal obesity was significantly associated with physical inactivity (p=.002) and family history of obesity (p=.036). The most significant predictor of abdominal obesity was physical inactivity (OR=4.19, p=.001). The abdominally obese patients were four times more likely to be physically inactive compared to their non-abdominally obese counterparts. Conclusion: This study has shown that the predictors of abdominal obesity among the study population were physical inactivity and family history of obesity. The interventional control programs for abdominal obesity should consider these predictive variables alongside the complex of other cardiovascular risk factors.
Aims: This study’s primary purpose was to determine whether earlier findings suggesting an association between sporadic Creutzfeldt-Jakob disease (sCJD), a transmissible spongiform encephalopathy of humans and specific dietary components could be replicated. The a priori hypotheses were that consumption of (i) foods likely to contain organ tissue and (ii) raw/rare meat are associated with increased sCJD risk. Study Design: Population-basedcase-control study. Place and Duration of Study: Department of Neurology, School of Medicine, Loma Linda University, Loma Linda, CA, USA; 4 years. Methodology: An 11-state case-control study of pathologically confirmed, definite sCJD cases, matched controls, and a sample of control-surrogates was conducted. Ninety-six percent (106/110) of the case data was obtained in 1991-1993, prior to variant CJD publicity. Results: Using control self-responses, consumption of hot dogs, sausage, pepperoni, kielbasa, "other" canned meat, poultry liver, any stomach/intestine, beef stomach/intestine, any organ tissue, and beef organ tissue was individually associated with increased sCJD risk; odds ratios (OR) ranged from 2.4 to 7.2 (0.003 <p<0.025). Rare/raw meat consumption was associated with sCJD (OR=2.0; p<0.05). Greater consumption of hot dogs, bologna, salami, sausage, pepperoni and kielbasa was associated with significantly higher risk. The OR for gizzard consumption was 7.6, p<0.04. Bologna, salami, any liver, beef liver and pork stomach/intestine were marginally associated with sCJD: ORs ranged from 1.7 to 3.7; 0.05 <p< 0.10. Brain consumption was not associated with an elevated risk. Analyses using control-surrogate data indicate that use of the control self-responses did not bias the results away from the null hypothesis. Conclusions: The a priori hypotheses were supported. Consumption of various meat products may be one method of transmission of the infectious agent for sCJD.
Aims: With the progress of development of 0.025-inch guidewire (GW), various treatments with 0.025-inch GW have become possible. To date, however, there has been no multicenter cooperative prospective study using 0.025-inch GW VisiGlideTM as the versatile GW. This time, we decided to examine the result of the use of 0.025-inch GW VisiGlideTM as the first choice in the endoscopic retrograde cholangiopancreatography (ERCP)-related procedure without selecting the patient in a multicenter cooperative prospective study. Study Design: Multi-center single arm prospective study. Methodology: The 0.025-inch GW VisiGlideTM was used in the patients with biliopancreatic diseases requiring ERCP as the first choice to examine the accomplishment rate of procedure and the incidence of accidental symptom. Results: The accomplishment rate of procedure was 92.8% (180/194). The accidental symptoms of ERCP-related procedures were observed at 4.6% (9/194) and GW perforation was observed as a GW-related accidental symptom at 2.1% (4/194) but all the accidental symptoms resolved conservatively. Conclusion: The 0.025-inch GW VisiGlideTM has a high accomplishment rate of procedure and a low incidence of accidental symptom in its use in the ERCP-related procedure, and it was suggested that it may be available as a versatile GW. Clinical Trial Registry (UMIN000008180).
Aims: The radioprotective effect of Telfairia occidentalis aqueous extract (TOE) against gamma irradiation induced oxidative damage and altered sperm parameters in rats. Study Design: Randomized controlled experiment Place and Duration of Study: Experimental Animal Unit and Department of Anatomy, University of Ibadan between January and April, 2012. Methodology: Male Wistar strain rats were divided into six groups and pretreated with TOE (400, 800 and 1600 mg/kg of b.wt.) and vitamin E (VE) 50 mg/kg of b.wt prior to whole body gamma irradiation exposure of 2Gy. Sections of the testes were taken for the assessments of biochemical markers of oxidative stress: Lipid peroxidation (LPO), Superoxide dismutase (SOD), Catalase (CAT) and Glutathione (GSH) and histopathological variations. Results: Exposure of animals to 2Gy gamma radiation resulted in decreased sperm characteristics and increased sperm morphological abnormalities; significant elevation in lipid peroxidation (LPO) and hydrogen peroxides, and decreased activities of superoxide dismutase (SOD), glutathione-s-transferase (GST), glutathione peroxidase (GSH-Px) and levels of reduced glutathione (GSH) in testes; distorted architecture of seminiferous tubules from day 1 to 30 post-irradiation. The rats pretreated with TOE showed normal sperm parameters, normal testicular histo-architecture and normal antioxidant enzymatic activities. Conclusion: Aqueous extract of Telfairia occidentalis has radioprotective activities.
Background: Poor maternal health post delivery can be due to improper dietary intake. Women have special beliefs about dietary habits during puerperium which are deep rooted according to customs of the society. Omitting important food items during this time period of stress may lead to dietary deficiencies of iron and calcium leading to anemia and hypocalcaemia. Mothers need to heal from wounds of episiotomy and caesarean section. The extra burden of lactation demands good nutrition. It was observed that there is a trend of avoiding certain food items during puerperium. Therefore this education program was designed to bring about a change in beliefs/views of women about dietary elements which women were planning to avoid during puerperium. Methods: This study comprised women attending the Qassim University clinic for antenatal visits for a period of 3months from 1st October 2012-31st Dec 2012. A total of 150 women were interviewed to find out their views about avoiding certain food items post delivery. They were later provided health education broachers, and a power point presentation to stress the importance of the dietary components which they were planning to avoid. Pre and post intervention results were compared using chi-square analysis. Results: For meat and poultry, fruits and vegetables, milk and milk products results revealed a significant relationship between pre and post intervention using chi-squared analysis (P value <0.05). For women planning to avoid fish and sea food, results indicated that a significant relationship did exist between pre-education program and Post education program groups; χ2 (1, n = 15) = 15.000, p< .001 However for drinks and juices the relationship was not significant. Conclusion: Health education programs can successfully change the views about dietary components which can bring a healthy change in dietary habits of women in puerperium. Antenatal classes should include health education programs to find out and allay dietary myths to be practiced in puerperium.
Introduction: The importance of cytogenetics in neoplastic processes such as leukemia is known. In 1914, Theodor Boveri suggested that chromosomal abnormalities were cellular alterations that cause the transition from normal to malignant proliferation. Over the course of several decades, different cytogenetic techniques were developed which led to the discovery of an increasingly broad spectrum of chromosomal abnormalities, resulting in a dramatic increase in the knowledge of human cancer. Aim: This article aims to review the role of cytogenetics in leukemia, highlighting its importance for the clinical definition, treatment and prognosis of these neoplasms. Methodology: For this, we carried out a search for scientific articles present in the electronic database PubMed, using the descriptors "Leukemia", "Cytogenetics", "Karyotype", "Fluorescent In Situ Hybridization’’, "Prognosis", "Leukemia, Lymphoid", “Leukemia, Myeloid" and "Leukemia, Chronic Lymphocytic”. Books and specialized sites were also surveyed. Discussion: Cytogenetic analysis not only helps to confirm a diagnosis but it also aids in obtaining data on prognosis, response to treatment and possibility of relapse. The analysis provides a better understanding of the pathways involved in leukemogenesis processes and the development of new types of therapy. This information is essential for the proper management of patients, underscoring the importance of joint work between the medical oncologist/hematologist and the cytogeneticist.
Bioceramics include ceramic materials specifically designed for use in medicine and dentistry. These materials are mainly alumina, zirconia, bioactive glass, glass ceramics, coatings, composites, hydroxyapatite and resorbable calcium phosphates. Dental applications include dental implants, in periodontal treatment, alveolar ridge augmentation, maxillofacial surgery, pulp capping and apexification. The use of alumina and zirconia can be seen for prosthetic devices although calcium phosphate based materials are used for filling bone defects. Bioceramics are biocompatible, non–toxic, do not shrink and are chemically stable within the biological environment. Bioceramic sealers allow the enhanced use of bioceramics. The future of bioceramics is very promising. Recently, bioceramic putty has been introduced for primary teeth along with other fast repair materials.