Open Access Case Study

Combination of Platelet Rich Fibrin with Hydroxyapatite in Treating a Large Periapical lesion-Case Report of Young Patient

Sonu Acharya

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2015/19049

The primary goal of any dental treatment is the maintenance of the natural dentition in health and for optimum function, and esthetics. Successful treatment for periapical lesion depends on removal of lesion along with causative microorganisms. In cases where conventional root canal therapy fails to eliminate the lesion surgery is the last alternative. Peri-apical surgery aims to eliminate the pathology and thus aims to achieve complete wound healing. There have been many attempts to devise a wonder material which can achieve healing and regeneration and platelet rich fibrin is one such material. Platelet rich fibrin (PRF) is a wonderful tissue engineering product and has gained much popularity due to its promising results in wound healing bone induction. The platelets release growth factors which lead to rapid healing and regeneration. Along with the addition of hydroxyapatite this combination can achieve regeneration and repair in no time. This case report illustrates the use of this combination in a 16- year- old male for better and faster healing.

Open Access Case Study

A Case Report of Invasive Meningococcal Disease in an Adult without Identifiable Risk Factors

Somaya A. M. Albhaisi, Tehmina Khan

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/BJMMR/2015/19436

Meningitis is the most common manifestation of invasive meningococcal disease (IMD), occurring in approximately 50% of all cases. It is characterized by sudden onset, very rapid progression, and a high case fatality rate even with early and appropriate treatment. The purpose of this case report is to increase the awareness of health care professionals about the seriousness of IMD, so it should be considered in differential diagnosis with top priority in certain cases even in absence of risk factors, and emphasize that excellent outcome can be achieved by early employment of appropriate therapy. In this case report, we review an adult male, with no past medical history of significance, who presented with IMD, and was successfully treated in the intensive care unit with prompt initiation of IV antibiotics, ventilation support and multidisciplinary approach in management.

Open Access Original Research Article

Effect of Physiological Loading on Fretting Corrosion of Zimmer® Trabecular Metal™ Coupled Tibial Cones Interacting with Tibial Baseplates

Mehul A. Dharia, Steven M. Humphrey, Keith A. Roby, Greg D. Stebbins, Ray Zubok, David Lewallen, Todd Sekundiak, Louis Kwong

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2015/16954

Aim: To evaluate possible micromotion between the existing design of the Zimmer® NexGen® Legacy Constrained Condylar Knee (LCCK) tibial baseplates and the Zimmer NexGen Trabecular Metal™ (TM) tibial augments, as well as with newly designed Zimmer NexGen LCCK TM coupled tibial cone augments.

Study Design: Fretting corrosion testing, in a simulated accelerated corrosion laboratory environment, of the TM tibial half-augment (control sample) was conducted to provide a baseline for possible micromotion and subsequent debris generation between TM augments and tibial baseplates. Identical methodology was applied to the newly designed TM coupled tibial cone augments. Samples were disassembled after load testing. Qualitative visual inspection was used to evaluate the amount of fretting and corrosion (ranked on a 0-4 scale with 0 being no observed corrosion and 4 being the most extensive/severe corrosion).

Place and Duration of Study: Zimmer, Warsaw, IN. April 4-20, 2012.

Methodology: Testing was conducted on 2-axis servo-hydraulic test machines at 10 Hz. The entire tibial component was continuously immersed in 0.9% NaCl solution while 10 million cycles (Mc) of loading was applied. The selected test loads were based on the average patient body weight (BW) for the selected implant size and elevated by a factor of 1.7. Five samples were evaluated for each test group. All samples were visually inspected without magnification and under a microscope at 17x. Ranking was performed for the extent/severity of both abrasion and corrosion for both the control and new design groups.

Results: After 10 million cycles of fretting corrosion testing, the ranking evaluation of almost no abrasion and no observable corrosion or debris is consistent with a stable fixation mechanism under aggressive loading conditions.

Conclusion: Newly designed TM coupled tibial cones will not create a new risk of potential micromotion between the TM component and the tibial baseplate in a clinical situation.

Open Access Original Research Article

Enteric Adenovirus and Norovirus Gastroenteritis among Under-5 years Children in Owo, Ondo State, Nigeria

Michael Oluyemi Babalola, Georgina Njideka Odaibo, David Olufemi Olaleye, Abel Olumuyiwa Alonge

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2015/14082

Aim: Infant mortality attributable to diarrhea continue unabated, without the precise determination of the viral etiologies. Few studies exist on enteric adenoviruses and norovirus infections in infants and young children in Nigeria. This study was aimed at the detection and determination of the baseline prevalence of enteric adenoviruses and norovirus pathogens among under -5 years children hospitalized for acute diarrhea in Ondo state, Nigeria.

Methods: In a cross sectional descriptive study conducted between November 2013 and April 2014, fifty (50) fecal specimens collected from diarrheic children below 5 years and age matched non-diarrheic controls were screened for the presence of enteric adenovirus and norovirus antigens using a 4th generation quadruple Rapid Immuno- chromatographic Enzyme Immuno Assay kits.

Results: Adenovirus antigen was detected in 9/50 (18%) in November 2013, and February to April 2014 while norovirus was found in 4/50 (8%) of the diarrheic children, in the months of December 2013 to February 2014. The prevalent age at infection were 0-6 months for adenovirus and 31-36 months for norovirus, while the male-to-female ratio was 1.8:1. Co-infection of adenovirus with rotavirus was detected in children between 7-12 months, while co-infection of adenovirus with norovirus was detected in children between 31-36 months old at a rate of 2% respectively. There was no significant difference in the induction of diarrhea in children by each of the two viruses (χ2=1.78), and no significant difference in the rate of adenovirus (χ2=0.605) and norovirus infections (χ2 =1.09) between male and female, in the study population.

Conclusion: The baseline prevalence of enteric adenovirus diarrhea was 18% (occurring in November, February to April), norovirus was 8% (occurring in December to February), dual infection by adenovirus cum rotavirus, and adenovirus cum norovirus was 2% respectively, in children below 3 years in Ondo state Nigeria. The findings suggests that human enteric adenoviruses and norovirus are becoming established etiologies of infantile diarrhea in southwest Nigeria, and vaccines should be developed and vaccination implemented alongside rotavirus.

Open Access Original Research Article

Allergic Rhinitis in Children with Asthma: A Questionnaire Based Study in Lebanon

Bassem Abou Merhi, Shadi Hamze, Fouad Ziade, Mariam Rajab

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2015/17471

Introduction: Allergic rhinitis and asthma frequently coexist but has rarely been evaluated in Lebanese children.

Aim: This prospective study aimed to estimate the prevalence of allergic rhinitis in asthmatic children in Lebanon, and to ascertain whether allergic rhinitis is a risk factor for the severity of asthma.

Patients and Methods: Parents of 124 children aged 1-13 years admitted to the pediatric floor of the Makassed General Hospital between July 2008 and March 2009 and diagnosed as having asthma; parents were interviewed and followed up with a questionnaire concerning allergic rhinitis symptoms and signs with para-clinical data if available. The questionnaire was based on a study done in France by Hammouda et al. (2005). This was modified from an adult score for allergic rhinitis (SFAR).

Results: This well recognized score defines the association of allergic rhinitis and asthma in children. A score of ³ 9 out of 17 total score corresponds to the presence of allergic rhinitis in asthmatic children. The prevalence of allergic rhinitis was recognized in 67 patients out of 124 (54%). This prevalence was evident mainly in the age group 3-5 years.

Conclusion: Allergic rhinitis is prevalent in children of the Lebanese population, the severity of asthma was found to be clearly associated with allergic rhinitis. The SFAR modified for children was found to be a simple and reliable tool to detect allergic rhinitis in asthmatic children.

Open Access Original Research Article

Association of Major Coronary Risk Factors and Gender

Simin Jafaripour, Malihe Dadgarmoghaddam, Mohsen Mouhebati, Ariane Sadr-Nabavi

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2015/16427

Aims:  The  aim  of  this  study  is  to  compare  major  risk  factors  in Coronary Artery  Disease  patients  with significant atherosclerotic lesions in both genders.

Study Design: Cross-Sectional study.

Place  and  Duration  of  Study:  From  Aug  2012  to  Dec  2013,  299  consecutive  patients   who  underwent angiography at the coronary angiography laboratory in Ghaem hospital were enrolled in this study.

Methodology: Demographic data was collected by an interviewer based on a checklist. Moreover, a member of our research group examined patients for weight, height, and blood pressure. For each patient a blood sample was taken and angiography was done by an expert. Statistical analysis was performed by SPSS version 11.5, using descriptive statistics, one-way ANOVA, and non-parametric equivalent, Kruskal- Wallis. p<0.05 was considered as statistically significant.

Results: Participants in this study were Iranian and 52.8% were female. The females were older than males (mean age 59±10.14 vs 58±12.4); and the majority of them were married and lived in urban areas. Among 169 patients that were recruited in the study, 95 (55.6%) had a positive history of hypertension (HTN), 77 (46.4%) hyperlipidemia, and 55 (32.5%) type 2 Diabetes Mellitus (T2DM). The observed differences in these parameters between two genders were significant (P<0.001, P=0.001 and P=0.001), respectively. Among the participants, 40 (46.4%) were smokers (at present or in the past).

Conclusion: Our results show that the  prevalence of HLP, HTN and T2DM among Iranian women who belong to the CAD patients’ population is more than men.

Open Access Original Research Article

Work-related Musculoskeletal Disorders among Workers at Gold Mine Industry in Ghana: Prevalence and Patterns of Occurrence

Andrews Kwabena Tawiah, Bertha Oppong-Yeboah, Ajediran Idowu Bello

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2015/18747

Background: Work-related Musculoskeletal Disorders (WRMSDs) constitutes major constraint to optimal performance among workers. However, information about its prevalence and pattern of occurrence among Ghanaians working in gold mine industries remain insufficient.

Objective: To determine the prevalence of WRMSDs among workers of AngloGold Ashanti (AGA)-Obuasi mine.

Materials and Methods: A cross-sectional survey was conducted with 28-point self-administered questionnaire modified from the Standardized Nordic Musculoskeletal Questionnaire. Quota sampling was applied using ratios according to the number of workers in each department. Data were analysed with descriptive and inferential statistics at alpha level of .05.

Results: Two hundred and five (205) workers participated in the cross-sectional survey. 12-month prevalence of WRMSD was 85.5% and low-back had the highest percentage 178 (30.0%) as regards the affected body segments. Fifty seven (30.7%) reported that pain or discomfort had prevented them from working optimally and 28 (13.7%) of the respondents have had to change the area or specialty of their work as a result of WRMSDs. Seventy six (23.1%) and 51 (24.9%) of the respondents indicated accidental falls from a height and working in the same position for long periods as moderate and severe risk factors respectively. Nature of work engagement was significantly associated (χ2 =27.73 P<.001) with the incidence of WRMSDs.

Conclusion: There was a high prevalence of WRMSDs among workers in AGA-Obuasi mine industry. Occurrence of the disorders was observed to be closely linked with the nature of service rendered by the workers. This outcome should therefore inform the preventive strategies required to curtail its occurrence.

Open Access Original Research Article

Discrete Breast Masses in Female Children and Adolescents: Is there a Place for Non-operative Management by Pediatric Surgeons?

A. O. Ademuyiwa, A. O. Lawal, C. C. Anunobi, C. O. Bode

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2015/17514

Background: The treatment of breast masses in female children and adolescents is controversial. While some advocate for early surgical removal others prefer the conservative non operative approach. The aim of this study is ascertain the evidence for the current protocol of early surgical removal in our centre.

Materials and Methods: Retrospective observational study to highlight the epidemiology of discrete breast masses in female children and adolescents <18years seen at the Lagos University Teaching Hospital, Nigeria. Main outcome measure was to find out if there is a malignancy in excised tissue specimens.

Results: Fifty three girls with 76 breast masses were evaluated. Median age at presentation was 16years (4 –17 years). Mean size of lumps was 3.6 cm (±2.1). All the breast masses had benign clinical characteristics and were confirmed histologically to be benign. There was no case of primary or secondary malignancy in any of the histological specimens. Family history, nipple discharge or ingestion of oral contraceptives did not affect presentation, diagnosis and outcome (p>0.05).

Conclusion: This series show that breast masses in children and adolescents are almost always benign. It is advocated that conservative non-operative management (with close follow up with imaging such as breast ultrasound and/or MRI) should be adopted by paediatric surgeons in cases of breast masses in children except when surgery is specifically indicated. These indications which should be individualized include: cosmesis, bloody nipple discharge, persistent history of pain in the mass, rapid growth of the mass and malignancies with predilection for the breasts.

Open Access Original Research Article

Critical Care Nurses’ Attitudes about Influences of Technology on Nursing Care

Sakineh Sabzevari, Tayebeh Mirzaei, Behnaz Bagherian, Maryam Iranpour

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2015/18400

Aims: This paper begins with developing a quantitative instrument to examine the opinions of critical care nurses’ regarding the influences of technology on nursing practice.

Study Design and Methodology: After reviewing related literature, the draft of a 29-items questionnaire was developed. Based on the review of a panel of 3 experts, it was reduced to 23 items because 6 items measured similar criteria. Content validity index (CVI) of this instrument, based on the opinions of another panel of ten experts reached 0.92. Face validity was established via two focused groups of critical care nurses. All of the items were clear, relevant, and simple for these two groups. Principal component factor analysis with varimax rotation resulted two factors which altogether accounted for 52.5% of the total variance. These factors revealed negative and positive aspects of influence of technology on nursing practices. Coronbach’s a coefficient (a= 0.824) Showed acceptable internal consistency for the entire questionnaire and it’s the negative and positive aspects (0.896 and 0.925, respectively). In the next phase of the study, a convenience sample of 200 critical care nurses, in a cross-sectional study, filled the questionnaire.

Results: The mean score for this sample was calculated as 82.21±9.88, indicating this sample of nurses held positive opinions regarding influences of technology on their practice. Younger nurses and those working in intensive care units had significantly higher mean scores in negative subscale compared to others.

Conclusion: Considering the important role of technology in diagnosis, treatment and caring of various health conditions, adequate training of nurses for managing different technological tools and understanding the culture and values of technological care, can help them balance technological and humanized aspects of care, make technological caring more efficient and improve the quality of nursing care.

Open Access Original Research Article

Effect of Parity on FVC and FEV1 during Pregnancy

A. Omorogiuwa, V. I. Iyawe

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2015/18934

Background and Aim: The influence of pregnancy on pulmonary function is well documented. However, the parity of the woman is usually not taken into consideration in studying pulmonary function in pregnancy. This study aimed to assess lung function pattern in all trimesters of pregnancy as parity increases.

Study Design: A longitudinal study.

Place and Duration of Study: St Philomena Catholic Hospital, Nigeria between October 2013 and October 2014.

Materials and Methods: The study consists of recording chest circumference, Forced Vital Capacity (FVC) and Forced Expiratory Volume in one sec (FEV1) in five groups of female subjects with the Primigravida as control, Nullipara, Primipara, Para 2 and Para 3 pregnant women at various trimesters i.e., 13th week, 24th week and 36th week using a tape rule and computerized Spirometer [19] (Spirolab II Italy) respectively. Each group had 40 subjects making a total of 200 subjects for the study.

Results: The study revealed that there was a concomitant increase in FVC and FEV1 as parity increases. FVC and FEV1 were significantly increased (p< 0.001) in Para 3 when compared to the primigravid control subjects.

Discussion: The observed improvement in pulmonary function may be due to a progressive increase in the transverse diameter of the chest from a widened subcostal angle. Again, the lumbar lordosis of pregnancy, which is higher in para 3, can explain the increase in chest wall compliance and pulmonary function.

Conclusion: Increased parity favorably affects pulmonary function.