Open Access Clinical Practice Article

Alteration in Resistive Index of Renal Vasculature Following Extracorporeal Shock Wave Lithotripsy for Renal Stones

Rahul Jain, Rajandeep Singh Bali, Jagdish Chander, Sushanto Neogi, Anish Gupta

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/27882

Introduction: Extracorporeal Shockwave lithotripsy (ESWL) may be associated with both anatomic and functional injuries to the kidney when used in the management of uncomplicated kidney stones. Assessment of the resistive index (RI) is a non invasive diagnostic modality for studying changes in the arterial system. RI, which is measured by color doppler ultrasonography, reflects resistance of intrarenal arteries that indirectly shows the renal blood flow.

Aim: To assess changes in intrarenal RI following ESWL in the ipsilateral and contralateral kidneys & to study correlation of alteration in resistive index with age of the patient.

Methodology: A total of 38 patients with solitary renal calculus, who underwent extracorporeal shockwave lithotripsy were included in the study. The patients were evaluated for the RI in ipsilateral (diseased) and contralateral kidneys; before, 3 hrs after and 1week after ESWL. Serum creatinine levels & creatinine clearence were measured pre ESWL and 4 weeks after ESWL.

Results: RI in ipsilateral kidney pre ESWL was 0.590 and post ESWL (3 hrs after ESWL) was 0.646, it showed a statistical significant increase with a p value of <0.001. 1week post ESWL resistive index values were comparable to pre ESWL value with no significant difference. ESWL had no effect on serum creatinine & creatinine clearance measured pre ESWL & 4 weeks post ESWL.

Conclusion: Doppler studies of the kidneys treated with ESWL have shown a transient rise of RI in our study, the long term effect of rise in RI after ESWL still remains to be evaluated.

Open Access Case Study

Effective Treatment of Adhesive Capsulitis Utilizing Soft Tissue and Joint Manipulation – A Case Study

Timothy Hui

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/10.9734/BJMMR/2016/29123

Background and Purpose: Adhesive capsulitis is a common condition, but outcomes have been mixed. It is possible that Physical Therapy can be an effective intervention.

Case Description: This case study details a demographically typical patient with adhesive capsulitis who experienced full recovery with Physical Therapy. 

Outcomes: External rotation improved from 45 to 95 degrees in 8 weeks, pain decreased from 8/10 to 0/10, and the patient made a full recovery of ADLs.

Discussion: Unique to this case were three aspects. First, joint mobilization, either through manual therapy or dynamic mobilization, was directed towards placing the head of the humerus into the center of the glenoid cavity. Second, soft tissue manipulation freed tight tissues, reducing pull on the humeral head, enhancing the joint mobilization. Finally, microcurrent injury detection was used to direct treatment and modalities toward injured areas. This case suggests that directed joint mobilization combined with soft tissue mobilization and guided modalities through microcurrent injury detection can be a useful protocol for treatment of adhesive capsulitis.

Open Access Case Study

Tight Hamstring Syndrome Related Lumbar Disc Herniation and Its Rehabilitation Program to Two Case Reports

Emine Eda Kurt, Öznur Büyükturan, Figen Tuncay, Hatice Rana Erdem

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/28749

Tight hamstring syndrome (THS) is a symptom complex which has a varied pathogenesis. The syndrome usually occurs in childhood and adolescent period. It is characterized by tightness of lumbar, ischial and crural muscles.

Case Report 1: 17 year old male was complaining of low back and right leg pain which spread to the back right leg for last two month. He walking with limited forward flexion and right knee flexion. Stright leg raising test (SLRT) was leading to elevation of whole body like a board with painful and patient was suffering from pain when his legs was elevated to 30 degree. Popliteal angle of effected sign was 87 degrees. There was no weakness of lower extremity. MRI of lumbar spine showed L5-S1 right far lateral disc herniation. It was decided that patient’s diagnosis was THS depending on lumbar discopathy. Medical treatment, conventional physical therapy (15 session) and Mulligan traction straight leg raise technique (TSLR) were applied (9 session). After the treatment his complaints were better than the baseline and the results of examination was improved.

Case Report 2: 19 year old male was was complaining of left leg pain which spread to the back left leg last four month. SLRT was leading to elevation of whole body like a board with painful and patient was suffering from pain when his legs was elevated to 40 degree. He was standing and walking with limited forward flexion and increased flexion at left knee. it was also decided that patient’s diagnosis was THS depending on lumbar discopathy. Medical treatment, conventional physical therapy (15 session) and Mulligan TSLR technique were applied (9 session). After the therapy, his toe touching distance was 25 cm and SLRT was negative. Low back range of motion (ROM) was full.

Conclusion: As well as developing technologies and treatment approaches, we believe that early diagnosis of THS and its reason can prevent additional surgeries. Our cases which diagnosed THS related lumbar disc herniation improved with early intervention.

Open Access Short Research Article

Fragile X Syndrome Testing and the Limitations Associated with Current Maternal Cell Contamination Testing Strategies

Philippa A. Dryland, Annet Damhuis, Douglas I. Rosendale, Kimberley Hughes, Elaine Doherty, Donald R. Love

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/28769

Aims: To assess the level of maternal cell contamination (MCC) that can be detected in the molecular determination of triplet repeat expansions in the FMR1 gene.

Place and Duration of Study: Department of Diagnostic Genetics, LabPLUS, Auckland City Hospital, Auckland, New Zealand, between June 2013 and July 2015.

Methodology: We assessed the sensitivity of a fluorescence-based assay for determining the number of CGG repeats in the FMR1 gene in a simulated MCC using spiked samples of known concentrations. This assay was applied to a prenatal case to resolve the question as to whether the CGG alleles detected in the fetal sample were inherited or due to MCC.

Results: The simulated MCC study showed that detection levels range from 0.5% to as low as 0.1%.

Conclusion: Collectively, our data support the view that future MCC guidelines should address the need for increased MCC testing sensitivity to accompany Fragile X syndrome prenatal testing.

Open Access Original Research Article

Prevalence, Risk Factors and Predictors of Diabetes-related Sexual Dysfunction

Ambrose Atosona, Christopher Larbie, Marina A. Tandoh, Kwabena Nsiah

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/28186

Background: The prevalence and complications of diabetes are currently on the rise, so this study investigated the prevalence, risk factors and predictors of diabetic sexual dysfunction (SD).

Methods: The study was cross-sectional multicentred. Patients were randomly selected from the Korle Bu Teaching Hospital, Komfo Anokye Teaching Hospital and Tamale Teaching Hospital. Socio-demographic, medical history, lifestyle and physical characteristics of subjects, as well as sexual dysfunction (SD) characteristics were investigated, using a structured questionnaire.  Blood samples were also taken from subjects and analyzed for total cholesterol (TC), triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), serum  creatinine and serum urea. Estimated glomerular filtration rate (eGFR) was also determined, using the serum creatinine. Statistics were performed using SPSS version 22.

Results: Of the 100 people with diabetes, 31% were males and 69% were females. The mean age was 53.82±13.754 years. It was found that 54.8% of the males and 68.1% of females had diabetic SD. The prevalence of severely abnormal SD was 6.5% and 4.3% in males and females, respectively. In a univariate analysis, none of the independent variables was associated with SD in both men and women.

Conclusion: This study has shown that the prevalence of SD is high among diabetics.

Open Access Original Research Article

Knowledge and Practice of Exclusive Breastfeeding amongst Mothers Attending Infant Welfare Clinic, Ekiti State University Teaching Hospital, Ado-Ekiti

O. A. Akpor, E. F. Ojo, C. N. Ezeh

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/27329

This study examined the knowledge and practice of exclusive breastfeeding amongst breastfeeding mothers attending Infant Welfare Clinic, Ekiti State University Teaching Hospital, Ado-Ekiti Nigeria. The Self-efficacy theory was used as the theoretical foundation for the study. The research design was non-experimental descriptive research design. The sample size was calculated using the Yaro Yamane formula created in 1967 and the sample size was 120. Data was collected using a self-administered structured questionnaire. Sampling technique was purposive and convenience. Data from the study was analyzed using descriptive statistics with frequency distributions, Tables and percentages. The findings revealed that almost half (48.8%) of the participants’ decision to breastfeed was influence by Doctors/Midwives. Also, more than two-third (86.2%) of the participant indicated that they had access to information on breastfeeding. The majority (63%) of the participants in the study were well knowledgeable as they were able to define exclusive breastfeeding and 66.3% are aware of the benefits of exclusive breastfeeding. Also, almost half (46.3%) of the participants breastfed their babies so as to ensure their wellbeing and 75.0% initiated breastfeeding immediately and within few hours after birth although the majority (58.8%) of the participants weaned their babies between 1-4 months. The socio-economic status of mothers was found to influence their decision to exclusively breastfeed their babies as almost all (87.3%) the participants that are practising exclusive breastfeeding had tertiary education and more than two third (74.6%) are employed with higher family income. The study recommended that Nurses and midwives should create more awareness on the benefits of exclusive breastfeeding to mothers and the community at large.

Open Access Original Research Article

Impact of Dietary Behavior, Lifestyle & Socioeconomic Status on Patients Infected with H. pylori

Jehad H. Elhissi, Hanan El-Modallal, Mazen A. El-Sakka, Adham I. Ahmed

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/24777

Introduction: Helicobacter pylori (H. pylori) is bacterial infection, has become a primary cause for peptic and duodenal ulcers and an etiologic agent in the development of gastric cancer.

Aim: To assess the impact of patient's dietary behavior, socioeconomic factors, and lifestyle on patient's infectivity status by H. pylori.

Methodology: A case – Control study consisted of 100 participants that were divided into two groups n = 46 Cases (IgG Positive), and n = 54 Controls (IgG Negative), conducted on patients with upper digestive tract problems in the endoscopic clinics in Gaza in order to determine the impact of patient's dietary behavior, socioeconomic factor and life style on H. pylori infecting status using an interview questionnaire for data collection after getting consent of the participants, SPSS was used for data entry and analysis.

Results: One hundred patients were assessed, 43.5% male with positive IgG, while female with 56.5% positive IgG. Most of cases 91.3% were < 45 of age, and 58.7% were married. About 21.7% of cases had past family history of H. pylori, while zero percent for controls. Also, 84.4% of cases were suffered from stress with statistical significance.

Conclusion: H. pylori infection is a phenomenon in Gaza Strip, and dietary behavior, socioeconomic status and lifestyle play an important role on patient’s infection.

Open Access Original Research Article

Amelogenesis Imperfecta: Clinical and Consanguinity Study

Ana Cláudia do Nascimento, Eliana Leonardo dos Santos, Lorem Krsna de Morais Sousa, Alerico Dias Vieira, Sérgio Eberson da Silva Maia, Raquel Gonçalves Vieira-Andrade, Carolina Carvalho de Oliveira Santos, Thiago Fonseca-Silva

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/28765

Background: Amelogenesis imperfecta is a complex group of hereditary conditions characterized by malformation of the dental enamel. Although to be well described in literature, this condition may be related to others local and systemic disorders and present a peculiar hereditary character.

Objectives: The aim of this study was to describe a family with several members affected by amelogenesis imperfecta.

Materials and Methods: This descriptive cross-sectional study was performed to show a family with several members affected by amelogenesis imperfecta. A sample of 39 individuals related to one family residing in a city of southern Ceará State – Brazil. Each member was subjected to clinical and radiological examination and the family pedigree was built.

Results: Of the 39 members, 28 were consanguineous and the amelogenesis imperfecta was detected in 20 subjects (71,42% of consanguineous members). All affected individuals presented a defect in the crystal structure of enamel leads to a mottled enamel with white to brown to yellow colors besides wear of the occlusal or incisal surfaces suggesting the hypomature type of amelogenesis. Radiographically, radiopaque areas inside the pulp (suggesting pulp calcifications) were observed in 20.0% of affected individuals. Additionally, some subjects showed cysts and stones at kidney (25.0%).

Conclusions: The amelogenesis imperfecta, in the studied family, has a dominant genetic character and may be related with kidney changes such as nephrocalcinosis.

Open Access Original Research Article

Influence of Physical Characteristics on Skin to Lumbar Epidural Space Distance in Nigerian Adults

I. U. Ilori, E. K. Djunda

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/28520

Aims: To estimate the skin to lumbar epidural space distance (SLESD) in Nigerian adults and determine the influence of age, height, weight and body mass index on it.

Study Design: It was a cross sectional descriptive study carried out on consenting patients enlisted for surgery with planned lumbar epidural anaesthesia. Patient selection was by a non-probability sampling technique.

Place and Duration of Study: The study was carried out at the Main theatre complex of the University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria from February to April, 2012.

Methodology: One hundred and twenty healthy adults of both sexes consisting of 60 consenting patients each, scheduled for elective surgeries under epidural anaesthesia were recruited. With asepsis precaution, epidural anaesthesia was established in the sitting position using a midline approached at L3L4 interspace. The epidural space was identified by loss of resistance to saline. The SLESD was read off from the centimetre markings on the needle by subtraction of the length of the needle outside from the whole length and rounded off to the nearest 0.25 cm. Pearson correlation coefficient was used to determine the relationship between SLESD and age, height, weight, body mass index (BMI) and the differences between males and females.

Results: The mean SLESD was 5.29 cm ± 0.06 ranging from 4 cm to 7 cm. Females had a slightly longer SLESD (5.37 cm) than the males (5.21 cm). The SLESD was significantly influenced by weight and BMI both having a P value .000. Height showed a negative correlation which was significant in both males and females with P = .01 and .015 respectively. Age had a significant correlation with SLESD only in females increasing with age.

Conclusion: The SLESD in Nigerian Adults is strongly influenced by weight, BMI and height. Age influences SLESD only in females.

Open Access Review Article

Zinc and Its Paradoxes Involving some Human Health Issues on Supplementation

Adegbusi H. Sheriff

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/BJMMR/2016/19886

This paper aims at echoing the health implications of zinc in humans to the scientific world in order to designing a proper means to streamlining its research. The paper looks at some important functions of zinc, some health risks of zinc deficiency and, the boons and ambiguities associated with zinc supplementation trials. Zinc supplementations have, among others, such important health benefits as; improving immune system functions, reducing the duration and severity of diarrhea in children, and of common cold, reducing the incidence of pneumonia and of HIV/AIDS infections, may reducing the incidence of clinical attacks of malaria in children. However, the optimum zinc doses and dosages for these health conditions have not been ascertained for supplementation due to lack of its sensitive nutritional status biomarker and or improper zinc study design. Zinc bioavailability is relatively high in meat, eggs and seafood because of the relative absence of compounds that inhibit its absorption and the presence of sulfur-containing amino acids like cysteine and methionine that improve its absorption. The future of zinc research is promising as it would help addressing such health challenges as malaria, tuberculosis, diabetes, blindness, sexual dysfunction, diarrhea, cancer and others when at the cutting edge.  It is therefore suggested, inter alia, that a sensitive and specific biomarker should be holistically designed for zinc to help detecting marginal zinc deficiency in humans as this will streamline its associated health studies; more and well-designed randomized controlled trials of zinc supplementation should be conducted to determining optimum dosage, formulation and duration of treatment for a specific health condition.