Open Access Case Report

A Salpingo-Cutaneous Fistula in a Patient after Peripartum Hysterectomy

Alina Krychowska-Ćwikła, Ewa Dmoch-Gajzlerska

Journal of Advances in Medicine and Medical Research, Page 247-254
DOI: 10.9734/BJMMR/2015/15744

Aims: Salpingo-cutaneous fistula is an extremely rare clinical condition that can be seen after pelvic or uterine surgery.
Presentation of Case: A case of an salpingo-cutaneous fistula that developed in a nulliparous woman after peripartum hysterectomy is described. The fistula tract was depicted on computed tomography, and to verify the diagnosis nuclear magnetic resonance was made. At laparotomy fistula tract was completely excised along with the enclosing ovary. Postoperative recovery and follow-up were uneventful.
Discussion: Possible mechanisms of development of such a rare condition, and magnetic resonance imagining are discussed.
Conclusion: The MRI has the advantage over CT in the diagnosis of unusual pelvic illness.

Open Access Short Research Article

Prevalence of Allergic Rhinitis Symptoms and Positive Skin Prick Test Results in Children with Recurrent Epistaxis

Alper Yenigun, Servet Akyuz

Journal of Advances in Medicine and Medical Research, Page 241-246
DOI: 10.9734/BJMMR/2015/14758

Background: Allergic Rhinitis is type 1 hypersensitive reaction of nasal mucosa and its primary mediator is IgE. Allergic rhinitis is mostly observed on children and adolescents. To investigate the prevalence of allergic rhinitis symptoms and positive skin prick test results in children with recurrent epistaxis.
Methods: The study included 57 pediatric patients with recurrent epistaxis and a control group of 49 healthy children. Their allergic symptoms and skin test results were assessed and compared with the control group.
Results: Forty-six of the 57 pediatric patients with recurrent epistaxis tested positive for at least one allergen. Nineteen of the 49 healthy children tested positive for at least one allergen. Between two groups, nasal obstruction (p=0.027), discharge (p=0. 001), sneeze (p=0. 013), itching (p=0. 002) and post-nasal drainage (p=0.004) complaints were observed significantly higher in the group having recurrent epistaxis.
Conclusion: Our findings suggest that allergic sensitivity may play an important role in epistaxis of children. Diagnostic and therapeutic approaches to epistaxis in this age group need to be planned accordingly, with allergic etiology.

Open Access Original Research Article

Risk Factors Associated with Children Missing the Fourth Dose of DTaP Vaccination

Zhen Zhao

Journal of Advances in Medicine and Medical Research, Page 169-179
DOI: 10.9734/BJMMR/2015/16117

Background: In 2012, reported pertussis reached the highest number of cases (48,277) in the United States since 1955.
Objectives: Estimate the prevalence of children who missed the fourth dose of DTaP (Diphtheria and Tetanus toxoids and acellular Pertussis vaccine) by parents’ confidences in vaccines and influences from providers, the timeliness of the first through the third dose of DTaP, and selected socio-demographic characteristics; identify the significant risk factors for non-receipt of the fourth dose of DTaP; and evaluate the unadjusted and adjusted risk ratios for missing the fourth dose of DTaP.
Methods: Data from 16,919 children 19–35 months living in the United States included in the 2011 National Immunization Survey were analyzed. Weighted categorical data analysis and multivariable regression in the context of complex sample survey were applied to assess the prevalence and to determine the independent risk factors.
Results: Overall, 14.7% of children missed the fourth dose of DTaP. Children who were late in receiving the third dose of DTaP had significantly higher risk of missing the fourth dose of DTaP than children who were on-time in receiving the third dose of DTaP (adjusted risk ratio (RR) 2.48; 95%CI (1.92, 3.20)). The risk of missing the fourth dose of DTaP was 62% higher among children whose parents reported they didn’t have a good relationship with their child’s health-care providers than children whose parents reported having good relationship. Compared with the risk of missing the fourth dose of DTaP among children whose parents were confident in the value of vaccines, the risk was significantly higher for the children whose parents lacked confidence (adjusted RR 1.41; 95%CI (1.05, 1.89)).
Conclusions: Timeliness in receiving the first through the third dose of DTaP, influences from providers, and parents’ confidence in the value of vaccines are the five significant risk factors for missing the fourth dose of DTaP vaccination. They are all modifiable. Future interventions to improve parental relationships with providers and attitudes toward vaccines could help improve pertussis vaccination coverage.

Open Access Original Research Article

In vitro Enhancement of Pancreatic β Cells MIN6 Proliferation by Insulinotropic Gymnema sylvestre Aqueous Extracts: Evidence-based Regenerative Therapeutic Capacity of a Medicinal Herb

Violet Kasabri, Fatma U. Afifi, Yasser Bustanji, Sundus Mashallah, Randa Naffa, Hala S. Mehdi

Journal of Advances in Medicine and Medical Research, Page 180-194
DOI: 10.9734/BJMMR/2015/12681

Aim: To show that Gymnema sylvestre (Roxb.) Asclepiadaceae not only has antidiabetic propensities, but it most likely works by regeneration of pancreatic β cells which is imperative in anti-obesity-diabetes therapeutic applications of medicinal plants.
Study Design: The present study design investigated the effects of G. sylvestre leaves crude aqueous extracts (AEs), traditionally utilized in diabetes treatment, on the pancreatic β-cell MIN6 proliferation and insulin secretion and extrapancreatic dietary carbohydrate and lipid digestion
Place and Duration of Study: Faculty of Pharmacy, The University of Jordan, 2008-2012.
Results: Comparable to GLP-1 (500 nM) pancreatic proliferative capacity; G. sylvestre AE concentrations (0.01 and 0.1 mg/mL) induced MIN6 monolayers expansion by respective 130.3% and 127.4% (P<0.001 vs. spontaneous control). Like L-alanine (10 mM) insulinotropic efficacy and without exerting cytotoxicity, glucose-stimulated insulin secretion was potentiated by G. sylvestre AEs (5, 10 and 25 mg/mL) (711.0%, 843.0% and 906.5%, respectively, P<0.001 vs. basal control). The potent plants’ insulin secretory bioactivities were abolished in the depleted Ca2+ conditions (P<0.001). Similar to orlistat antilipolytic efficacy, pancreatic lipase IC50 value for G. sylvestre AEs was 106.3±7.2 μg/mL. Unlike acarbose (100 μg/mL) dual inhibition of α-amylase/α-glucosidase, G. sylvestre AE was inactive at used doses. Dissimilar to guar gum (50 mg/mL) diffusional hindrance in a simple dialysis model, G. sylvestre AEs (10, 25 and 50 mg/mL) proved inactive. This in vitro ineffectiveness was mirrored in respective in vivo oral carbohydrate tolerance tests in overnight fasting normoglycemic rats.
Conclusion: This evaluation has revealed that G. sylvestre leaves AEs augmented β-cell expansion and potentiated glucose-evoked Ca2+-regulated insulin secretion; combined with impressive antilipolytic activity. These actions depend on the bioactive water soluble phyto-principles intact absorption in vivo. Future directives may assess the potential of G. sylvestre as a new alternative for anti-obesity-diabetes pharmacotherapy and prevention.

Open Access Original Research Article

Evaluation of TLR2 and TLR4 Polymorphisms in Chronic HBV Infection

Ayse Gul Zamani, Mehmet Emin Erdal, Hatice Gul Dursun, Ozlem Inci Ay, Onur Ural, Tuba GökdoÄŸan Edgunlu, Ebru Tuncez, Mahmut Selman Yildirim

Journal of Advances in Medicine and Medical Research, Page 195-202
DOI: 10.9734/BJMMR/2015/10648

Aims: Toll-like receptors (TLRs) play a central role in initiating innate response by mediating inflammatory reactions against a wide range of pathogens. We aimed to determine if TLR2 Arg753Gln, TLR4 Asp299Gly and Thr399Ile polymorphisms are associated with chronic hepatitis B (HBV) infection.
Study Design: A case-control study.
Methodology: Genomic DNA was obtained from peripheral blood of 100 patients with chronic HBV infection and 108 healthy volunteer controls. The TLR2 and TLR4 polymorphisms were genotyped by the polymerase chain reaction-restriction length polymorphism (PCR-RFLP) technique.
Results: The distribution of the TLR2 Arg753Gln, TLR4 Asp299Gly and TLR4 Thr399Ile variants were not significantly different between patients and controls (P = .05).
Conclusion: Our results showed that there is no association between TLR2 Arg753Gln, TLR4 Asp299Gly and TLR4 Thr399Ile polymorphisms and chronic HBV infection.

Open Access Original Research Article

Body Posture in Relation with Musculoskeletal Symptoms amongst Computer Operators

Viktorija Prodanovska-Stojcevska, Jovica Jovanovic, Tanja Jovanovska

Journal of Advances in Medicine and Medical Research, Page 203-210
DOI: 10.9734/BJMMR/2015/15627

Aims: The aim of this paper is to present the prevalence of musculoskeletal symptoms among computer operators and its association with the body posture at the workplace as well as break time usage during the working hours.
Study Design: The paper represents a cross sectional study which includes computer operators.
Place and Duration of Study: Municipality, administrative department in combine, elementary and high schools and IT in software developing company. The duration of the study was 12 months.
Methodology: The survey included 800 computer operators. For detection of musculoskeletal symptoms among computer workers Nordic standardized questionnaire was administrated and Maastricht Upper Extremity Questionnaire (MUEQ) registered the body posture during the working time and the quality of the break.
Results: 28% of participants have claimed musculoskeletal symptoms. As of the total number with registered symptoms, 57% were females and the average age was 41.91±11.72 years. Positive correlation coefficient was obtained between the neck pain and taking the setting same position during working hours, sitting with arms raised for more than 2 hours, performing repetitive tasks, holding the head in a bent position and placement of the body in asymmetric position. During the testing of cross-correlation regarding the musculoskeletal symptoms and the usage of break at work, there is a positive coefficient received between the neck and shoulder pain within the inability to use break of 10 min after 2 hours of work at the computer, not planning the break with the symptoms in the shoulder and wrist, and the insufficient break usage with the shoulder symptoms.
Conclusion: The prevalence of musculoskeletal symptoms in computer operators in Republic of Macedonia show that it is not high leveled. According to the research of muscle-skeletal system disorder at computer workers it is shown that the most frequent are the symptoms in the neck area and shoulders.

Open Access Original Research Article

Association between Socio-Demographic Factors and the Type of Tobacco Consumption among Subjects Attending a Rural Hospital, South India

Khanapure Sneha, Jithesh Jain, S. R. Ananda, S. Supreetha, K. N. Abhishek, M. Shilpa

Journal of Advances in Medicine and Medical Research, Page 211-218
DOI: 10.9734/BJMMR/2015/15135

Aim: To assess the association between socio-demographic factors and type of tobacco consumption among subjects attending a rural hospital in south India.
Methods: A pre-tested questionnaire was designed for recording the relevant data pertaining to selected socio-demographic variables and the details of tobacco consumption. Patients as well as persons accompanying them formed the study sample and they were chosen by systematic random sampling method. Chi-square test was used to assess the association between the variables.
Results: A total of 350 subjects were included in the study. There was statistically significant association between age groups, gender, education, occupation, economic status and the type of tobacco consumption.
Conclusion: The present study revealed a significant association between selected socio-demographic factors and the type of tobacco consumption.

Open Access Original Research Article

Some Haematological Parameters of Symptomatic and Asymptomatic Hepatitis B Positive Patients Attending a Nigerian Tertiary Hospital

A. O. Ajugwo, D. C. Ukaji, T. A. Erhabor, T. C. Adias

Journal of Advances in Medicine and Medical Research, Page 219-223
DOI: 10.9734/BJMMR/2015/15491

Hepatitis B virus is a deadly viral infection that kills slowly if not treated and could be the underlying cause of liver cirrhosis and liver cancer. Some Hepatitis B positive patients may present with symptoms while some others maybe asymptomatic hence, the need to assess their haematological indices. Twenty-five Hepatitis B positive patients (male and female) attending Madonna University Teaching Hospital (MUTH) Elele Nigeria were used as subjects while another twenty five Hepatitis B negative apparently healthy individuals (males and females) served as controls. The positive patients were further divided into symptomatic and non-symptomatic groups. Verbal consent was obtained prior to sample collection. The samples were analyzed using standard manual methods. The research was approved by Madonna University Ethical Committee (MUEC). There was significant (p<0.05) decrease in PCV and Hb and while ESR had significant increase. Most of the Hepatitis B positive patients (17) were asymptomatic while others (8) showed symptoms. When the asymptomatic and symptomatic groups were compared, there was no significant (p>0.05) difference in all the parameters. Hepatitis B positive patients could be at risk of developing anaemia. Management and treatment could be better handled before the onset of symptoms associated with Hepatitis B infection.

Open Access Original Research Article

Seroprevalence and Factors Associated with Herpes Simplex Virus Type 2 and Chlamydia trachomatis among Women Attending AIDS Care Unit at the Bonassama District Hospital

Koanga Mogtomo Martin Luther, Dongang Nana Roman Rodrigue, Ngono Ngane Rosalie Annie, Assam Asam Jean, Wankam Michel, Embolo Elisée, Amwam Zollo Paul Henri

Journal of Advances in Medicine and Medical Research, Page 224-230
DOI: 10.9734/BJMMR/2015/14829

Background: Infections with Herpes Simplex Virus Type-2 (HSV-2) and Chlamydia trachomatis is the most common cause of genital ulcer disease and cervicitis worldwide. There is little information on the prevalence of these sexually transmitted infections (STIs) in Cameroon. The aim of this study was to evaluate the seroprevalence and behavior factors associated with Chlamydia trachomatis and HSV-2 seropositvity among women attending AIDS care unit in the district hospital in Douala.
Methodology: One hundred and fifty seven consenting women (80 HIV-1 positive and 77 HIV-1 negative) were invited to participate in this study. A structured questionnaire was used for each woman to obtain informations about socio-demographic characteristics and sexual risk behavior. Peripheral venous blood sample were collected, labeled and sent to the laboratory, where the presence of IgG antibody against HSV-2 and Chlamydia trachomatis was detected, using ELISA test. Data management was carried out using the SPSS 16.0 statistical software.
Results: The mean age of women was 37.22±9.13 years (range, 20 to 74 years). Of the 157 women tested, 122 (77.7%) were HSV-2 positive and 60 (38.2%) were positive for chlamydial infection. The prevalence of HSV-2 and chlamydial infections in HIV positive patients were 73.7% and 43.7% respectively versus 81.8% and 32.5% in HIV negative individuals. Women with multiple infections were those belonging to the group aged 30-39 years old, single and having had more than three sexual partners during the six months preceding the study.
Conclusion: HIV status appears tobe a factor in the acquisition of chlamydial infection in our population. These results suggest the need for extension and expansion of the current study in Cameroon.

Open Access Original Research Article

Triple and Quadruple Eradication Therapy for H. pylori in Iraqi Patients with Peptic Ulcer Disease a Comparative Study

Zahraa A. G. Mohammed Ali, Yassir M. Kamal Al-Mulla Hummadi, Akram A. Najeeb

Journal of Advances in Medicine and Medical Research, Page 231-240
DOI: 10.9734/BJMMR/2015/15598

The eradication of H. pylori has become an important issue; since Helicobacter pylori infection can cause chronic gastritis, peptic ulcer, gastric cancer and (MALT) lymphoma. Standard triple therapy efficacy has decreased gradually worldwide during the last decade and quadruple therapy is recommended as an alternate treatment option for the management of H. pylori. The aim of this study was to compare between triple and quadruple therapy for eradication of H. pylori in Iraqi patients with peptic ulcer disease, and to treat the patients who relapsed after triple therapy. In addition to that; response to therapy (triple and quadruple) have been evaluated according to the Body Mass Index (BMI).
A prospective case controlled study was carried on 60 patients who had peptic ulcer disease and positive H. pylori infection confirmed by (histology; stool antigen test and anti-H. pylori IgG antibody test) patients were divided into 3 groups first group involved 38 patients treated with triple therapy (500 mg clarithromycin capsules; 1 g amoxicillin capsules; and 20 mg esomeprazole capsules) for 14 days. The second group involved 22 patients treated with quadruple therapy (pylera)®; (140 mg bismuth sub citrate potassium, 125 mg metronidazole, and 125 mg tetracycline hydrochloride) for 10 days, while third group involved patients un responding to triple therapy treated with second- line quadruple therapy for 10 days.
The results showed that the eradication rate of the per-protocol and intention-to-treat for quadruple therapy was 88.57%, 83.78% respectively which was more than 57.89% per-protocol and 50% intention-to-treat for standard triple therapy with high significant difference (p<0.01). Patients compliance with quadruple and triple therapy was good for the two regimens in spite of the more adverse effect of quadruple regimen compared to triple regimen. On conclusion; the 10 days treatment with quadruple therapy was more effective than 14 days triple therapy that could be attributed to more eradication rate for H. pylori.