Open Access Case Study

Idiopathic Sclerosing Encapsulating Peritonitis Revealed by Intestinal Obstruction

Haithem Zaafouri, Emir Ariane, Amine Lahmidi, Dhafer Haddad, Ahmed Bouhafa, Anis Ben Maamer

Journal of Advances in Medicine and Medical Research, Page 1-3
DOI: 10.9734/BJMMR/2016/24552

Sclerosing encapsulating peritonitis (SEP) is a very rare entity characterized by encasement of small intestine by a fi­brocollagenous membrane. It is divided into primary (idiopathic) which is named as abdominal cocoon and secondary forms. The preoperative diagnosis is difficult and most cases are diagnosed intraoperatively. A conservative treatment approach is the most suitable management strategy in asymptomatic idiopathic SEP.

In this paper, we aimed to present a case of idiopathic SEP revealed by intestinal obstruction.

Open Access Case Study

Painless Limbs and Moving Extremities Syndrome: A Variant of Painful Moving Limbs and Extremities

Sandip Kumar Dash

Journal of Advances in Medicine and Medical Research, Page 1-4
DOI: 10.9734/BJMMR/2016/24712

Painless limbs and moving extremities is a rare condition. Only few case reports or short series of cases are reported. It is believed to be a variant of painful legs and moving toes. It can affect the lower limbs causing painless moving legs and toes or can affect the upper extremities causing painless moving hands and fingers. Various mechanisms of this condition have been postulated, but it requires further studies regarding the exact mechanism of this type movement and the treatment of choice for this condition. Here a case of painless moving lower extremity and upper limb is described, who showed a good response to combination of clonazepam and gabapentine.

Open Access Short Research Article

Parameters of Systemic Inflammatory Response in Patients with Passing Infringements of Brain Blood Circulation

Natallia V. Halinouskaya, Maria N. Starodubtseva, Evgenii V. Voropaev, Nadzeya M. Halubykh, Sergey V. Samsonau, Vasiliy B. Smychek

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/24901

Aims: The paper aims at revealing the difference in the change of Systemic Inflammation (SI) parameters in blood plasma of patients with Passing Infringements of Brain Blood Circulation (PIBBC) and stroke during 10-day acute period.

Study Design: Prospective cohort study.

Place and Duration of Study: Department of Neurology and Neurosurgery of the Gomel State Medical University, Stroke Unit of the Gomel Regional Veterans Hospital, between May 2013 and March 2015.

Methodology: This study included 108 patients (35 men, 73 women; age range is 46-90 years) and 20 volunteers over 45 years (11 men, 9 women, mean age is 54.3±1.6 years). We compared the parameters of systemic inflammation (blood plasma concentrations of interleukins (IL-6, IL-8, IL-10), tumor necrosis factor α (TNFα), C-reactive protein (CRP) and stable metabolites of nitric oxide (nitrite- and nitrate-ions, NOx) in patients with PIBBC including transient ischemic attack (TIA) and cerebral hypertensive crisis (CHC), patients with lacunar stroke (LS) on the first and tenth day of patient staying in the hospital and in volunteers of a control group.

Results: On the first day, the IL-6 and CRP levels for PIBBC and LS groups was found to be significantly higher than the corresponding parameters for a control group. An increase in IL-6 level during the 10-day therapeutic period was observed only in blood plasma of the LS group persons. The TNF-α level was about zero level for all the studied groups except for the LS group on the tenth day. On the first day, for the patients with LS the IL-8 level was significantly decreased comparing to that for the control group and PIBBC groups and the NOx level was significantly lower than that for CHC group. Both parameters increased in values during the 10-day therapeutic period. No difference between the parameters (NOx and IL-8) for PIBBC and control groups was detected on the first day. Coefficient of reactivity characterizing the systemic inflammation level in patients of all the studied groups was nonzero level and it increased in the LS patients during the therapeutic period. 

Conclusion: The obtained data showed an important role a number of inflammation markers (NOx, IL-6, IL-8, TNF-α, CRP) in the pathogenesis of different stroke episodes. Absence of specific neuroimaging changes in TIA and CHC group and nonzero coefficient of reactivity (kR) suggests that systemic inflammation is not a result of the focal brain ischemia but its intrinsic cause. The differences in the concentration of IL-8, and NOx in the blood plasma of patients with CHC and LS on their admission to the hospital will help to identify sanogenetic reserves in the case of PIBBC.

Open Access Original Research Article

Does the Moderate Altitude Environment Impair the Words of our Memory?

R. Ruffini, N. Cera

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/BJMMR/2016/25558

ntroduction: It is known that hypoxia affects human physiology and consequently impairs cognitive functions. In particular, low memory performances are common in a hypoxic extreme altitude environment.

Aims: The aim of our study was to evaluate the effects of moderate hypoxia on the specific words of memory and the persisting effects after hypoxia exposure.

Place and Duration of Study: The study was carried out in the Neurophysiology Laboratory in the Department of Neuroscience Imaging and Clinical Science (University of Chieti) in two distinct times: before and after the departure for the Ararat mountain expedition.

Methods: Seven (7) volunteers climbed to a moderate altitude and underwent a cognitive assessment before and after the expedition, by using the 15-Rey Words test. Descriptive statistics (mean and standard deviation) and two tailed t-tests were used. Data were analyzed with STATISTICA-Soft 8.0.

Results: Our results suggested a relevant impairment of words and verbal memory as well as a false recognition of words after the expedition. No significant results were found in the recognition of words memorised.

Conclusion: The moderate altitude hypoxia affects the memory of words for one week. In accordance with previous investigations, we could deduct that altitude-hypoxia is an important experimental model to study human cognitive impairment.

Open Access Original Research Article

Pattern of Ultrasonographic Breast Findings in Jos University Teaching Hospital

A. J. Salaam, S. M. Danjem, A. A. Salaam

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/23793

Introduction: Radiological examination of the breast is established as an essential part of the modern multidisciplinary approach to effective investigation and management of breast disease. Ultrasonography of the breast plays a prominent role in radiological management of breast lesions.

Methods: The study was a retrospective analysis of all the breast ultrasound scan at the Jos university Teaching Hospital (JUTH), Jos, Plateau State. Over a one year period of January 2nd 2013-January 2nd 2014.All the breast ultrasound scan results were retrieved from the archive of the department after necessary approval. Information soughts for included patient age, sex, indications for the scanning and outcome of the scanning.

Results: Women constituted 88.56% of the 201 patients scanned. There was an increase in the age of the patients to the age group of 20-29 after which, there was a steady decline? Fibroadenoma was the highest indication and the second highest finding. There was a good relationship between indications and findings, with a p value of 0.001

Conclusion: It was noted that younger age groups had more breast US, in which benign lesions constituted the major abnormal findings. Most of the males US scans were abnormal compared to females. The clinico-radiological correlation was significant.

Open Access Original Research Article

Glucose Enzymatic Modulation by Vernonia amygdalina in Streptozotocin- Diabetic Wistar Rats

Anthony Emeka Ojieh, Anthony C. Okolo, Lawrence O. Ewhre, Ikenna P. Njoku, John C. Igweh, Patrick C. Aloamaka

Journal of Advances in Medicine and Medical Research, Page 1-14
DOI: 10.9734/BJMMR/2016/24900

The present study examines the effect of some bioactive constituents of Vernonia amygdalina crude extract and fractions on enzymes involved in glucose metabolism and treatment of Diabetes Mellitus. Fresh Vernonia amygdalina leaves were extracted using ethanol. Four fractions from this extract were obtained by liquid-liquid fractionation technique using solvents of varying polarity and the bioactive compounds were identified by Gas Chromatography–Mass Spectrum (GC-MS) analysis. Resultant fractions were administered at 300 mg/kgBW to streptozotocin (60 mg/kg) induced diabetic wistar rats. The results shows that various fractions produced a fall in the fasting blood glucose level in diabetic rats; Chloroform (65.85%), ethyl acetate (69.65%) Benzene (45.59%) and Butanol (37.31%) and all fractions showed increase in the activity of glucose metabolic enzymes (hexokinase, pyruvate kinase, Glucose-6-phosphate dehydrogenase (G6PDH) and Diaphorase (NADPH) between 20–81%, significantly higher than that of the metformin (reference drug at 50 mg/kg). Administration of Crude ethanolic leaf extracts of Vernonia amygdalina at dose of 300 mg/kg produced a fall (81.45%) in the fasting blood glucose level and subsequent increase in glucose metabolic enzyme activity (hexokinase, pyruvate kinase, Glucose-6-phosphate dehydrogenase (G6PDH) and Diaphorase (NADPH) (20–35%) in the diabetic Wistar rats after 28 days of treatment. GC-MS analysis showed that the plant and its fractions possess hypoglycaemic bioactive constituents such as Phytol, Palmitic acid, stearic acid and oxirane. The findings suggest that Vernonia amygdalina extract reduced the hyperglycaemic effect of streptozotocin-induced diabetes through its effect on glucose metabolism by promoting enzymes of the glycolytic and the pentose phosphate pathway, a property attributable to its active chemical constituents.

Open Access Original Research Article

Eye Care Practitioners’ Perception of Oculomycosis in Ghana

Linda Gyanfosu, George Asumeng Koffuor, Samuel Abokyi, Ben Ababio-Danso

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/25261

Aims: Oculomycosis is a major cause of visual impairment and blindness in the tropical regions of the world. Practitioners’ perception of the prevalence of oculomycosis and its associated risk factors could aid in the prevention of this ocular disorder. This study therefore investigated the eye care practitioner’s perception of oculomycosis in Ghana.

Study Design: A cross-sectional survey.

Place and Duration of Study: Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi,  Ghana, between January and September, 2014.

Methodology: A cross-sectional survey of 120 eye care practitioners in six regions of Ghana was conducted, using a structured questionnaire, to obtain information on their perception regarding the prevalence, seasonal variations and risk factors of oculomycosis.

Results: Optometrists, Ophthalmic nurses, and Ophthalmologists sampled were 43.3%, 42.5% and 14.2% respectively. More than one-third (39.2%) of the respondents reported that oculomycosis was commonly encountered in clinical practice, with the majority 66 (55.0%) stating that the prevalence was higher in April to November i.e. the planting and harvesting periods in the year. The practitioners’ perception of the prevalence of oculomycosis showed strong association with their gender (P = .01), duration of practice (P = .01), profession (P = .05) and facility type (P = .03). Risk factors commonly associated with oculomycosis were trauma from vegetative matter (80%) and non-vegetative matter (50%) and the use of herbal preparations on the eye (41.7%).  

Conclusion: Oculomycosis is a prevalent ocular condition encountered by eye care practitioners in Ghana, especially during the rainy season. Intensification of health education on its risk factors could help minimize or prevent occurrence of this ocular condition.

Open Access Original Research Article

Assessing Pharmaceutical Equivalence of Generic Antibiotics Using in vitro Antimicrobial Susceptibility of Some Hospital Strains in Rwanda

Justin Ntokamunda Kadima, Jean Baptiste Nyandwi, Carole Inyange Kayitana, Albert Mashaku

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/25137

The study aimed at evaluating the pharmaceutical equivalence of generic commercial products containing same common antibiotics by testing in vitro the antimicrobial susceptibility/resistance of common bacterial isolates from patients. In total 35 different generic preparations and brands corresponding to seven antibiotics- Ampicillin, Amoxicillin, Amoxicillin/clavulanic acid, Cotrimoxazole, Norfloxacin, and Erythromycin- were compared by a disc diffusion method against three pathogenic strains- Salmonella typhi, Shigella flexneri and Staphylococcus aureus- isolated from patients. Some brands were presumptively regarded as good quality medicines to serve as gold standards instead of using international references. The pharmaceutical quality of the preparations was checked by visual inspection and identification of active ingredients according to referral pharmacopeias. All products satisfied visual inspection and identification tests. However they exhibited differences in their antimicrobial profiles and potency. Two generic preparations containing amoxicillin/clavulanic acid were out of specifications (<90%) as compared with Augmentin® gold standard. Comparing the susceptibility of bacteria by the diameter (d) of inhibition zone in mm, Salmonella typhi was susceptible to Norfloxacin (d=23.2), low to Augmentin (d=11.5), and resistant to Ampicillin, Amoxicillin, Cotrimoxazole and Erythromycin (d=0). Shigella flexneri was susceptible to all antibiotics (d=31.6 – 42.8) except Erythromycin (d=0) which exhibited the lowest spectrum of activity. Staphylococcus aureus was susceptible to all antibiotics with different potencies (d=20 for Amoxicillin – d=42.6 for Norfloxacin). These findings showed the possibility of using a simple in vitro antimicrobial susceptibility testing to compare the equivalence of marketing antibiotic products in quality and efficacy. The result also could help clinicians choosing the most appropriate antibiotic in treatment.

Open Access Original Research Article

Mobile Phone Use and Risk of Adverse Health Impacts among Medical Students in Jeddah, Saudi Arabia

Amal A. Hegazy, Bahaa Aba Alkhail, Nabil J. Awadalla, Mahdi Qadi, Jawaher Al-Ahmadi

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/BJMMR/2016/24339

Background: Internationally, there is growing concern about the adverse health effects of mobile phone use by young people.

Aim: To determine the pattern of mobile phone use among medical students and determine the potential association between degree of use and self-reported health impacts.

Methods: A cross-sectional study was carried out on 472 medical students in King Abdulaziz University. Self-administered specially designed questionnaire was used to collect data regarding the following: Socio-demographic characteristics, pattern of phone use and self-reported health complaints.

Results: The students’ median duration of mobile phone use was 330 min/day and was significantly higher in females (P= 0.04). A positive significant correlation was observed between the health complaints score and the average daily duration of use (r =0.139, P=0.002). Adjusted multiple logistic regression analysis revealed that heavy mobile use was significantly associated with self-reported sleep disturbances, headache (AOR=4.76), fatigue (AOR=4.67), depression (AOR=2.63), nervousness (AOR=1.64), musculoskeletal pain (AOR=2.14) and visual problems (AOR=2.40).

Conclusion: mobile phone use occupies a significant part in the daily life of medical students. The heavy use of mobile phone in calling and non-calling activities was associated with a high level of subjective health complaints with dose dependent pattern. After controlling for other important predictors, heavy mobile use was associated with sleep disturbances, headache, depression, nervousness, eye and musculoskeletal problems. Excessive use of mobile phones should be avoided and social awareness increased through health education activities. In addition, employing a speaker-phone device for longer daily use and recommended parental procedures are taken to prevent young people being woken by their mobile phones.

Open Access Original Research Article

Association of Aminotransferase Levels with Severity of Obstructive Sleep Apnea

Moein Foroughi, Forough Soltaninejad, Majid Malekmohammad, Parisa Adimi

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/24763

Background: Obstructive sleep apnea (OSA) is associated with several metabolic disorders. The hypoxia due to OSA can alter liver function and increases the risk of nonalcoholic fatty liver disease and hepatic necrosis. Serum aminotransferase levels are predictive factors for liver injury. In this study we aimed to evaluate association between serum aminotransferase levels and severity of OSA.

Materials and Methods: Sixty six patients who their OSA disorder was confirmed with PSG entered the study. All patients had Body Mass Index (BMI) above 30. Serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in a group of 33 patients with severe OSA (AHI≥30) were compared to 33 patients with mild OSA (5<AHI<15). We also searched for correlation between factors of hypoxemia such as apnea hypopnea index (AHI), Oxygen Desaturation Index (ODI) and percentage of time spent with SPO2<90% (%T<90) with serum aminotransferase levels.

Results: Mean levels of AST were (21.33±8.62) and (21.15±9.39) in severe and mild group respectively. Mean levels of ALT were also measured as (24.24±14.07) and (19.82±9.74) in severe and mild group respectively. The levels of AST and ALT were not significantly different in these two groups (P-value=0.935), (P-value = 0.142). Mean ODI in severe and mild group was (56.33±26.97) (14.00±10.46) (P-value <0.001) and T<90% was (33) 100% and (14) 42.4% (P-value <0.001) respectively which were significantly higher in severe group.

Conclusion: The results from this study showed no significant correlation between serum aminotransferase levels and severity of OSA.