Open Access Case Study

Retinoschisis in Congenital Hypopituitarism with Short Stature: A New Clinic Entity?

Sami Toyran, Sinan Bilgin, Fahrettin Akay

Journal of Advances in Medicine and Medical Research, Page 1-4
DOI: 10.9734/BJMMR/2016/27379

Herein we report a short stature man with unilateral retinoschisis associated with optic disc anomaly. The patient presented to our clinic after 5 years of gradually decreased vision in his right eye. He had flat retinoschisis with large round-shape break of the inner retinal layer in the right eye. There was also perifoveal retinoschisis. Fundus examination revealed peripapillary chorioretinal atrophy, tilted and hypoplastic optic disc, ‘frosted branch’ or ‘dragged’ appearance of temporal retinal vessels. SD-OCT revealed an unusual entity of retinoschisis likely connected to the optic disc anomaly. Our case does not show previously reported characteristics of the eye involvement with syndromic short stature, and may represent a new clinical entity.

Open Access Minireview Article

The Role of Twist1 in Stem Cell Differentiation through Mechanical Cues: A Review and Hypothesis

Yinqiu Yan, Zeyun Tian, Qiuyue Guan, Ding Bai, Jing Zhang, Xianglong Han

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/27348

Due to the pivotal role of stem cell differentiation in regeneration and disease cure, the study of it has always been a research highlight during the recent years. Stress microenvironment has a great impact on cell growth, proliferation, differentiation and apoptosis. Twist1, as a core epithelial-mesenchymal transition (EMT) regulatory factor, plays an important role in these processes. Moreover, Twist1 gene can express in alveolar bone – periodontal ligament interface and the expression can be regulated by changes in the occlusal force. In this article, we will present a review of Twist1 gene, especially in the aspect of the biological functions in stem cell differentiation under mechanical signals and explore whether Twist1 involved in tissue remodeling in alveolar bone - periodontal membrane interface under stress.

Open Access Original Research Article

Fetuin A: A Newer Marker for Pre Diabetes

Sukhraj Kaur, Mridula Mahajan

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/26644

Objective: To evaluate the role of Fetuin A levels in predicting glycemic outcome in individuals with impaired fasting glucose.

Research Design and Methods: A total of 742 young individuals were recruited for the study out of which 177 had impaired fasting glucose, 468 had normoglycemia and 97 individuals with diabetes. These individuals were offsprings of diabetics (either mother or father or both) and were siblings amongst themselves belonging to age group of 18-35 years. Various biochemical investigations such as fasting plasma glucose, glycosylated Hb, serum insulin, C-peptide and Fetuin A were carried out. People with impaired fasting glucose were followed and analyzed according to glycemic outcome and quartile of Fetuin A level.

Results: A total of 66 individuals with prediabetes reverted back to normal, 28 progressed to diabetes and 83 remained with prediabetes over a mean±S.D follow up of 24±4.1 months. People in the highest quartile of fetuin A had the highest Insulin, Insulin Resistance, Increased loss of beta cell activity, decreased sensitivity to insulin and a higher rate of progression to diabetes (relative risk 11.96, 95% CI 5.9 to 24.01, p<0.001) and a significantly lower rate of reversion to normoglycemia (relative risk 5.62, 95% CI 3.16 to 9.9, p<0.001) than those in other Fetuin A quartiles.

fetuin A correlated positively with Insulin (r= +0.289, p<0.001), C-peptide (r=+ 0.177, p<0.001), %β cell function(r= -0.368, p<0.001), insulin resistance (r= +0.436, p<0.001) and glycosylated Hb (r=+0.958, p<0.05) and negatively with % sensitivity to insulin( r= -0.287, p<0.001). Cox regression analysis showed that baseline fetuin A, insulin levels and fasting glucose levels were predictive of reversion to normoglycemia.

Conclusions: Increased fetuin A levels had an adverse impact on glycemic outcomes thus suggesting that fasting plasma glucose and Fetuin A can be used as a tool to determine the susceptibility of an individual to develop pre-diabetes and thus diabetes mellitus.

Open Access Original Research Article

Effects of a 12-week Minimum Program for Preventive Medical Purposes

Michael Despeghel, Karsten Krüger

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/27358

Current study aimed to investigate the effects of a minimal training program combined with a nutritional intervention, an introductory health seminar and an individual health coaching on parameters for cardiovascular health in adult office workers.

Methods: 49 healthy male and female subjects were recruited from a cohort of office workers and performed a 12-weeks intervention program. The program included a lecture about the health consequence of a lack of movement. Exercise training was performed home based and included two times per week endurance and two times per week strength training for a duration of totally 80 minutes. Nutrition intervention encompassed eating a more Mediterranean style and the record of calorie consumption. Subjects were continuously supervised and motivated online. Body weight, body composition, and metabolic parameters including blood lipid profile were measured before and after intervention.

Results: During the intervention a weight loss (5.7±13.6 kg, p<0.01), a reduction of body mass index (BMI) (from 27.5±3.7 to 25.8±3.3 kg/m², p<0.05), a reduction of overall cholesterol levels (from 205.8±29.8 to 192.7±29.1 mg/dl; p<0.01), a decrease of low density lipoprotein (LDL) (from 124.0±29.0 to 113.3±24.6 mg/dl, p<0.01), a decrease of triglyceride levels (from 144.2±74.5 to 123.0±69.1 mg/dl, p<0.01) and a reduction of uric acid levels (from 6.4±1.1 to 5.5±1.1 mg/dl, p<0.01) occurred. 

Conclusion: A moderate adjustment of personal lifestyle within a 12 week prevention program is effective in improving various risk factors for cardiovascular disease. The knowledge about the minimum time requirements might help to overcome a central barrier of being active.

Open Access Original Research Article

Assessing the Uptake of Services for Preventing Mother-to-child Transmission of HIV in Benin City, Edo State, Nigeria

T. Ashipa, A. N. Ofili

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/26926

Introduction: Mother-to-child transmission of HIV remains a leading cause of morbidity and mortality in children below five years of age in Nigeria.

Aim: The aim of this study was to assess the uptake of services for preventing mother-to-child transmission (PMTCT) of HIV in Benin City.

Methods: A review of the  National PMTCT registers was conducted across seven health facilities in Benin City that provide comprehensive services for preventing mother-to-child transmission of HIV. The period of review was from 1st January, 2010-31st December, 2010. A data form was used to collect data on the National PMTCT service indicators from the different registers at the sites.

Results: 13, 907 pregnant women registered for antenatal care across the seven sites during the period reviewed. Of these, the proportion of pregnant women counselled for HIV was 89.1%, the proportion of pregnant women who accepted HIV testing was 87.9% and the proportion of women, counselled, tested and who received results  was 87.2%.

569 of the new antenatal care attendees (4.66%) tested positive for HIV. Of these, 520 (91.4%) received antiretroviral prophylaxis to prevent mother-to-child transmission of HIV. Three hundred and seventy-six babies were delivered by HIV positive women across the sites during the period reviewed. Of these, 367 (97.6%) were delivered alive and 339 (92.4%) received Nevirapine prophylaxis. Four of the seven sites had records of HIV testing for HIV-exposed infants. The records from these sites indicated 672 HIV-exposed infants were tested for HIV of which 46 (6.84%) tested positive for HIV using DNA polymerase chain reaction.

Conclusion: The uptake of most PMTCT services across the seven PMTCT sites in Benin City was above 80.0%. The uptake of partner counselling among partners of HIV positive women in this study was 15.1%. The rate of mother-to-child transmission of HIV in this study was 6.84%.

Open Access Original Research Article

Assessing the Effect of Oleic Acid on Markers of Hepatocyte Transplantation in Wistar Rat Model of Induced Liver Damage

Maryam Asadi, Masoud Darabi, Leila Roshangar, Nosratollah Zarghami, Mohammad Nouri, Bita Taghizadeh, Naser Hashemi

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/27776

Aims: Hepatocyte transplantation is an alternative to liver transplantation for acute liver failure (ALF). Hepatocyte therapy is limited by several factors including limited homing of transplanted cells and liver functional improvement.  Since beneficial effects of monounsaturated fatty acids on liver function and metabolism have been reported previously, our aim was to study oleic acid effects on hepatocyte transplantation outcome.

Methodology: ALF was induced by acetaminophen (APAP) injection. Hepatocytes were isolated from male rats and transplanted intraperitoneally into female rats (ALF+HT group). Effect of oleic acid was assessed in rats fed an oleic acid rich diet (ALF+HT+OA group). Plasma levels of albumin (ALB), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT) Alkaline phosphatase (ALP) were determined. Detection of Y-chromosome by PCR was used for homing assessment of transplanted hepatocytes. Finally, hematoxylin and eosin staining was used for histopathologic evaluation of liver.

Results: APAP injection resulted in an increase in levels of ALT, AST and ALP. ALT level was decreased to normal range only in ALF+HT+OA group. Oleic acid administration lowered the maximum amount of elevated AST levels compared to ALF+HT group. No significant difference was observed between ALF+HT group and ALF+HT+OA group in ALP recovery. Plasma level of ALB was decreased after APAP injection which was only fully retrieved in ALF+HT+OA group. SRY detection by PCR confirmed successful engraftment of transplanted hepatocytes. H&E staining revealed that OA administration lead to an increase in the number of normal hepatocytes and reduced inflammation in the liver.

Conclusion: In conclusion, our findings suggest that dietary oleic acid may improve hepatocyte transplantation success via improvement of liver function.

Open Access Original Research Article

The Management of Vesico-vaginal Fistula in State Specialist Hospital Maiduguri, Borno State

A. D. Geidam, E. Barka

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/27859

Background: Vesico-vaginal fistula is a common problem that has public health significance.

Aims: To determine the epidemiology, causes as well as the outcomes of VVF repair in the Department of Obstetrics and Gynaecology State Specialist Hospital Maiduguri, Borno State of Nigeria.

Methods: A ten year (Jan 1998 to Dec 2007) retrospective review of the patients’ records, operation theatre records and Gynaecological clinic records of patients with vesico-vaginal fistula.

Results: Three hundred and eighty five (385) VVF repair were done out of 2105 gynaecological operations during the study period, giving a prevalence of 18.3%. Three hundred and forty seven (347) patients records were analysed. Most (51.9%) of the fistulae occurred in women aged 15-24 years. The patients are mostly married (79%), primiparas (56.5%), uneducated (89%) and not salaried employed (99.4%). Obstetrics complication was the commonest cause of VVF. The overall success rate of repair was 59.1%. Success of repair decreases as the number of fistula or complexity of fistula increases (p<0.0001).

Conclusion: Vesico-vaginal fistula is mainly caused by prolonged obstructed labour. Complexity of fistula was associated with poor surgical outcome. Interventions that will improve access to trained delivery attendant will minimise the occurrence of prolonged obstructed labour and that will go a long way to decrease the incidence of vesico-vaginal fistula.

Open Access Original Research Article

Carbonic Anhydrase Inhibition Affect Antioxidant Enzyme Activity in the Blood of STZ Induced Diabetic Rats

S. I. Ibrahim, D. A. Ameh, S. E. Atawodi, I. A. Umar, F. Y. Mohammad

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/26356

Background: Carbonic anhydrase is found in the blood of all vertebrate and thus playing a fundamental role in the maintenance of acid-base homeostasis. Erythrocytes are intrinsically prone to oxidative stress because of their exposure to high oxygen tension.

Aim: The study aimed to investigate the changes of erythrocytes anti-oxidative enzymes in STZ induced diabetic rats and to determine the antioxidant potential of Cadaba farinosa leaves.

Results: The result of the present study showed that inhibition of carbonic anhydrase result in significant decrease in both erythrocyte and plasma catalase activity, whereas erythrocyte and plasma superoxide dismutase activity increased.

Conclusion: Carbonic anhydrase inhibition may alter the activity of anti-oxidative enzymes in vivo.

Open Access Original Research Article

Determinants of Modern Contraceptive Uptake among Women in Peri-Urban Communities of Port Harcourt City, Nigeria

Charles I. Tobin-West, Omosivie Maduka, Anthony O. U. Okpani, Bassey I. Okon, Emmanuel N. U. Ezedinachi

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/27655

Aim: The aim of the study was to investigate the determinants of contraceptive uptake among women of reproductive age in semi-urban communities of Rivers State, Nigeria.  The information will be useful in reordering priorities and strategies for family planning interventions in the state.

Study Design: The study was a cross sectional, household-based study, employing a cluster sampling technique proportionate to size, to recruit eligible participants.

Study Location: The study was carried out in September 2013 in five contiguous communities located at the fringes of the Port Harcourt city.

Methodology: Anonymous questionnaires were administered to 772 women of reproductive age normally resident in these five communities. Visitors were excluded. The data was analysed using SPSS version 20 software package. The Chi-square test was performed to determine the association between contraceptive use and demographic and socioeconomic variables, while Logistic regression was used to identify determinants of contraceptive uptake. The level of statistical significance was set at p= .05.

Results: A total of 772 women aged (15-49) years participated in the study and 731 (94.7%) knew about modern contraceptives and their benefits. Young age (15-34 years old), 2= 12.7, df = 3, p= .01) and being single,2=16.270, df=3, p < .01) were significantly associated with contraceptive usage. Younger women had six times higher odds of contraceptive usage than older women; [O.R (95% C. I) = 5.97 (1.56-22.90) and 5.96 (1.63 -21.71)], and women with contraceptive knowledge had 19% higher odds of usage than contraceptive naïve women [O.R (95% C. I) = 0.19 (0.09-0.40)]. 

Conclusion: This study underscores the importance of young age and knowledge about contraceptives in promoting its acceptance among women. We therefore advocate for an early introduction of curriculum-based family planning education in schools, local media campaigns and peer education to create more awareness about contraceptives.

Open Access Original Research Article

Diarrhea Treatment Behaviour among Mothers of Under-five Children Attending Primary Health Care Clinic in Ibadan, Oyo State, Nigeria

C. O. Agbede, J. O. Kio, O. Oladutele

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/27522

Aims: Diarrhoea is a leading cause of mortality and morbidity among children under the age of five years. This study assessed diarrhea treatment behaviour among mothers of under-five attending Ibadan north local government Primary Health Care clinic, Oyo state.

Study Design: The survey design was adopted for the study. Primary data was collected from the participants.

Place and Duration of Study: The study was conducted in Ibadan north local government Primary Health Care clinic, Oyo state, Nigeria in 2015.

Methodology: A structured questionnaire was used to gather data from 370 women randomly selected for the study. Data gathered included socio-demographic, knowledge, treatment behavior, home preparation and use of oral rehydration solution (ORS). Analysis of data was done using descriptive statistics and results presented in frequency tables. The statistical package for social sciences (SPSS version 17) was used for all analyses.

Results: Results obtained from the study showed that the majority of the women were traders (35%), Christians (54%), between the ages of 20 and 30 (61%), married (67%) with children below 3 years of age (54%) and indicated that they have had previous births (51%). Most of the respondents had up to secondary education (75%) and indicated that they experience diarrhoea episodes with their children frequently (55%). almost all the women (98%) have heard of diarrhoea and the major source of information was the health workers. Knowledge analysis showed that the respondents have inadequate knowledge regarding causes and prevention measures for diarrhoea. However, 87% of the mothers knew that watery stool is a sign of diarrhea in children and 62% agreed that they gave their children ORS to drink each time they have episodes of diarrhoea. The most common treatment behaviour among the respondents (92% of respondents) was seeking medical attention from hospital during persistent diarrhoeal episode. Further results showed that respondents have inadequate knowledge of preparation and administration of ORS.

Conclusion: In conclusion this research showed that there is still a knowledge gap as regards preventive healthcare behaviour in the study area. The need for corroborative post-natal child healthcare education to strengthen the efforts of the healthcare service providers in fighting diarrhoea is thus recommended.