Open Access Case Study

Button Battery: A Hazardous Nasal Foreign Body and a Cause of Septal Perforation. Two Case Reports

Christos Rokos, Iordanis Sidiropoulos, Nikos Chrysohoidis, Dionysios E. Kyrmizakis

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/BJMMR/2016/19664

Aims: To report to cases of button batteries as nasal foreign bodies and to emphasize the unique clinical characteristics of this condition regarding diagnosis and management.

Presentation of Case: We report two boys, one 5-year-old who was found to have a button battery in his left nasal cavity for a long time and subsequently developed a septal perforation and a 4-year-old in whom the quick removal of the battery from his nose resulted in an uneventful fast recovery.

Discussion and Conclusion: The etiology of septal perforation is presented briefly. The mechanism and management of button battery injury are discussed. The time interval between insertion and removal, the battery’s anode orientation and its thickness were the most important factors identified. The previous two cases highlight the management peculiarities of these rarely described foreign nasal bodies. Early removal and treatment, including antibiotics and nasal toilet, appears to offer the best prognosis.

Open Access Case Study

Dental Considerations of a 4-year-old Girl with Lennox-Gastaut Syndrome. Case Report and Literature Review

Joseph Katz, Matthew Bright, Enrique Bimstein

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/27089

We present the developmental, oral, clinical, radiographic findings and oral treatment of a 4-year-old girl presenting with Lennox-Gastaut syndrome (LGS), which is a severe disabling childhood epilepsy disease that is treated with one or multiple anti-epileptic drugs (AEDs). The child was wheel-chair bound, developmentally delayed, gastrostomy tube (G-tube) fed, and suffered from multiple seizures and infantile spasms. The child’s medical history included an under-developed pituitary gland, gastro esophageal reflux disease, vision and hearing impairment, history of chronic aspiration pneumonia, and allergies. Although the oral findings included no carious lesions, heavy calculus accumulation, spontaneous bleeding from the gingiva, generalized gingival hyperplasia (GH) and abnormal increased mobility in several deciduous teeth. This report describes the comprehensive radiographic and clinical examination and the treatment under general anesthesia.

Open Access Short Research Article

Thoracoscopy as the Method of Choice in Diagnosis of Mediastinal Lymphadenopathy

Yusupbekov Abrorbek Axmedjanovich, Krotov Nicolay Fedorovich, Madiyorov Bakhtiyor Tashpulotovich, Rasulov Abdugaffar Elmanovich

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/26598

Aims: Determining the role of minimally invasive surgery in elucidating and differential diagnosis of patients with mediastinal lymphadenopathy.

Place and Duration of Study: The research was carried out in the National Cancer Research Center, MoH RUz in the period of 2001-2015.

Methodology and Study Design: Results of 45 diagnostic video assisted thoracoscopic operations in lymphadenopathy of mediastinum were retrospectively studied. Men were 17 (37.8%), women were 28 (62.2%). The age of patients ranged from 12 to 62 years, the median age was 38,46±12,1 years. Adequate material for the morphological study obtained in 100% of cases.

Results: In histological examination malignant lymphoma was diagnosed in 23 (51%), mediastinal form of lung cancer in 3 (6.6%), tuberculosis of intrathoracic lymph nodes in 11 (24.4%), sarcoidosis in 8 (17.7%) cases. The mean operative time was 22.9±12,3 min. Narcotic pain medications were not used. No deaths were observed after the procedure.

Conclusion: Videothoracoscopy showed high effectiveness and informativeness in the diagnosis of lymphoproliferative diseases of the mediastinum.

Open Access Short Research Article

Effect of Environmental Factors, Lifestyle, Lipid Profile and Previous Medical Conditions on Semen Quality in Male Partners of Infertile Couples; Evidence from Kumasi Metropolis

A. Opoku, F. Ankobea-Krokoe, K. Bedu-Addo

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/27042

Introduction: Infertility among men is a major public health problem that has mainly been linked to semen abnormalities due to certain background or environmental characteristics, disease and surgical conditions as well as lifestyle. The purpose of this study was to assess the effects of environmental factors, lifestyle, lipid profile and previous medical conditions on semen quality of male infertile couples in the Kumasi metropolis.

Methods: The study was a cross-sectional study conducted between February 2012 and May 2013. The study involved 150 men whose female partners reported to the Obstetrics and Gynaecology Department of Komfo Teaching Hospital (KATH) in Ashanti Region of Ghana for infertility treatment. Semen of the respondents were examined for various characteristics including sperm viability, motility and concentration. The demographic, behavioral and anthropometric data of clients were also taken with the use of structured questionnaires. Associations between the various explanatory factors and semen quality were tested using correlation and regression at significant levels of p<0.05.

Results: About half of the respondents had very low sperm counts (oligospermia), 36.7% had normal sperm concentration whereas 10.7% had no sperm in the semen. The mean sperm motility among the males of infertile couples was 51.0 (SD=30.12). Mumps had significant association with Log of sperm concentration (p=0.025) but not with motility (p=0.333). Extensive use of marijuana was associated with 1.69X106 increase in the log sperm concentration (p=0.020). Extensive use of heroine also had a significant association sperm concentration (p=0.05). Lipid levels had no significant association with sperm quality.

Conclusion: Although the lipid profile showed no significant association with semen quality, positive lifestyles targeted at improving lipid profile might help improve semen concentration since BMI and triglyceride negatively affected sperm concentration and motility though the effects were not significant. The effects of marijuana and heroin use may arise may be due the small number of users in the study group.

Open Access Original Research Article

Effect of Vitamin C Supplementation on Learning and Memory in CD1 Mice

S. A. Bisong, I. O. Ajiwhen, C. C. Mfem, A. O. Igiri

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/26165

Vitamin C (ascorbic acid), an ‘over the counter’ supplement, has numerous physiological functions and it is found in high concentrations in the brain. The effect of vitamin C on cognitive memory and visuospatial memory was studied using the Novel Object recognition task (NORT) and the Morris water maze (MWM) respectively. Twenty Swiss white albino (CD1) mice, within the age of 90-120 days, were randomly divided into two groups of ten mice each. Mice in group 1 served as the control and so received normal saline orally while the other group received vitamin C (200 mg/kg) orally for 21 days. All animals had access to feed and water ad libitum. Behavioural testing started on day 21. There was no significant difference in swim latencies between the control and test groups in the MWM though there was a uniform reduction in swim latency in both groups during acquisition and reversal training days. There also was no significant difference in quadrant duration and swim latencies of both groups in the probe trial and the visible platform task. The habituation index is significantly higher in the test group compared to control in the short term inter trial interval of the Novel Object recognition task (NORT). However there was no significant difference in the index of habituation in both groups in the long term inter trial interval of the NORT. There also was a significantly higher index of discrimination in the vitamin C treated group compared to control in the short term inter trial interval of the NORT. There was no significant difference in the index of discrimination in the long term inter trial interval of the NORT. Vitamin C did not affect learning as both groups learned equally well during training in the MWM. It also did not affect visuospatial memory. However, Vitamin C improved short term cognitive memory in the NORT.

Open Access Original Research Article

The Polymorphism of Regulatory Region of NOS3 Gene (rs2070744, Genotype CC) Protect Patients from Chronic Migraine

Eugene Klimov, Natalia Kondratieva, Kirill Skorobogatykh, Julia Azimova, Alexey Sergeev, Zarema Kokaeva, Elena Naumova, Andrey Rachin, Gyuzyal Tabeeva

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/26738

Aims: There is evidence that endothelial nitric oxide synthase has a role in migraine pathophysiology. In our research, the role of SNP rs2070744 (c.-813C>T) in promoter region of NOS3 gene in the episodic and chronic forms of migraine is considered.

Place and Duration of Study: University Headache Clinic between June 2012 and November 2014 and Department of Genetics, Faculty of Biology of Lomonosov Moscow State University between October 2013 and March 2016.

Methodology: The study included 138 patients with migraine (44 with chronic and 96 with episodic migraine). The control group included 348 unexamined subjects. Genotypes were determined using real-time PCR with allelic discrimination test. Statistical processing was performed using Fisher test and Pearson's chi-squared test.

Results: Our study evaluated the link of CC genotype of rs2070744 with migraine (Fisher’s p=0.026) and episodic migraine (Fisher’s p=0.022).

Conclusion: Genotype CC of SNP rs2070744 in the regulatory region of NOS3 gene is more specific for episodic migraine and may prevents the chronification of migraine.

Open Access Original Research Article

Lipoprotein (a) Particles Characterization by Dynamic Light Scattering

Valentina Pasquetto, Alice Santonastaso, Stefania Grandi, Giuseppe Derosa, Angela D'Angelo, Claudia Scotti

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/27076

Lp(a) is a novel cardiovascular risk factor resembling an LDL particle. It includes a copy of apolipoprotein (a) [apo(a)], whose molecular weight is dependent on the number of genetically encoded kringle IV type 2 (KIV-2) repeats and inversely related with Lp(a) plasma concentration and risk. The reason for this inverse relationship is unclear and, particularly, there are no data regarding the size of Lp(a) particles carrying apo(a) with different molecular weights. The aim of the present work was to explore if a relationship existed between apo(a) molecular weight and particles size in Lp(a) samples carrying 20, 25 and 28 KIV-2 repeats (K20, K25 and K28, respectively). Dynamic Light Scattering (DLS) measurements were performed on affinity-purified Lp(a). A preliminary finding was that particles were typically distributed into three different size groups instead of the single one expected. No difference in average particle size between Lp(a) carrying different apo(a) isoforms was found. However, the percentage of medium-sized particles in each sample was found to be inversely related to the number of KIV-2 repeats (R2=0.99), with a clear predominance in K20 (58.53%). These data deserve further investigations, as they might be potentially relevant to explain the pathogenic role of low molecular weight Lp(a) isoforms.

Open Access Original Research Article

Radiologic Pattern of Sputum-positive Pulmonary Tuberculosis (PTB) among Immunocompetent Patients in Gwagwalada, Nigeria

Kolade-Yunusa Hadijat Oluseyi, Bibiana Nonye Egenti

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/25347

Background: The radiologic knowledge of tuberculosis-associated lung disease is an essential tool in the clinical diagnosis and management of tuberculosis, a disease that is still a big challenge to Nigeria and Africa at large. Chest radiogram is cheap and readily available, and usually the first imaging modality for the evaluation of patients with sputum positive pulmonary tuberculosis.

Objective: To determine the radiologic pattern of sputum-positive PTB among immunocompetent patients in Gwagwalada, Nigeria.

Methods: A cross-sectional study spanned sixteen months, involving one hundred adult patients recently clinically diagnosed of pulmonary tuberculosis were recruited and underwent chest radiographic examination with 14 × 17-inch or 17 × 17-inch image sizes for evaluation of pulmonary tuberculosis.

Results: Of the 100 patients that underwent chest radiographs, ten patients (10.0%) had normal chest radiographs while varying degree of abnormal chest radiographic findings were seen in the remaining 90 (90%) patients. Fibrotic lesion were present in 45 (45.0%) of patients. There were 60 male and 40 female patients with eight males with normal chest radiogram. Fibrosis was the predominant radiological feature with 45 (45.0%) of all the patients examined in this study. The prevalence of other findings was: consolidation, 11 (11.0%); lung collapse, (11.0%); cavitation, (11.0%); pleural effusion, (7.0%) and lung infiltrate, (5.0%). Multiple lung cavities and military lesions were not observed in any patient. Cavities were present in 11 (11.0%) and all were solitary and located in the upper lung zone(s).

Conclusion: Pulmonary tuberculosis is endemic in our environment and evaluation of radiology features in immunocompetent individual is encouraged in developing countries. Sequelae of tuberculosis such as fibrosis was frequently seen in this study which points to late presentation, therefore more public health advocacy are needed against pulmonary tuberculosis.

Open Access Original Research Article

Factors Affecting the Surgical Outcome of Primary Exotropia in Children

S. Al Mahdi Huda, Tajummal Asim, Bener Abdulbari

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/25792

 Objective: The objective of current study to evaluate the outcome results of the surgical correction and as well as the effects of some factors on the outcome and surgical response of primary exotropia.

Study Design: Retrospective Clinical Study.

Place and Duration of Study: Hamad Medical Corporation –Tertiary Hospital in Qatar, study done over six months.

Methods: Medical records of patients who underwent surgical correction of primary exotropia procedures between the years 2008 and 2013 were retrospectively reviewed. Patients less than 15 years of age were included in the study and the following data were collected: onset age of squint, age at surgery, type of exotropia, visual acuity, presence of amblyopia, anisometropia, refractive error (spherical equivalent), preoperative deviation, AV pattern, stereopsis, type of surgery and analysis using descriptive statistics, unpaired t- and chi-square statistical tests.

Results: Of 74 patients we studied, 30 Male (40.5%), 44 Female (59.5%), 46 patients (62.2%) had successful surgical outcome, and 28 patients (37.8%) had unsuccessful outcome (all under correction). The response to surgery correlated mainly to with the preoperative angle. A higher response resulted from larger preoperative deviation and it this was better with lateral plus medial rectus muscle recessions than with bilateral lateral rectus recession.

Conclusions: Preoperative deviation was the most important factor in determining better response to surgical correction of primary exotropia, and accurate measurement of the angle of deviation can improve the outcome and response to surgery.

Open Access Review Article

Breast Cancer in Muslim Countries: Risk Reduction Strategies

Sara Rehman Noor, Naushad Noor, Mohamed M. Haq

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/BJMMR/2016/27345

Breast cancer is the most common cancer in women in western countries and is becoming significant in many developing countries. It is the most common cancer and the primary cause of cancer-related mortality in women in Muslim countries. The incidence of breast cancer ranges from low of 20.4 to high of 78.7 cases per 100,000 in Tajikistan and Lebanon, respectively. The mortality ranges from 8.7 to 25.9 cases per 100,000 in Libya and Nigeria, respectively. The incidence in Muslim countries is low compared to the incidence in US which is at 92.9 cases per 100,000, according to World Health Organization (WHO) data from 2012. However, mortality in US remains low at 14.9 cases due to early detection and better treatment. Breast cancer incidence is increasing in Muslim countries. Greater number of patients present at a younger age and a later stage as compared to the western countries. The major risk factors increasing the incidence of breast cancer include dietary habits, physical activity, weight, reproductive patterns, breast feeding, and supplemental hormone use. A significant decrease in the incidence and mortality in Muslim countries can be achieved by a program incorporating simple risk reduction measures, early detection strategies and specific medical intervention in high-risk women. This will require a cooperative effort of the community, physicians and government.