Open Access Case Study

Craniofacial Reconstruction of the Skull in Anterior Plagiocephaly: A Case Report

Peter Spazzapan, Roman Bosnjak, Tomaz Velnar

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/28075

Anterior plagiocephaly is the third most common form of non-syndromic craniosynostoses and results from the premature unilateral fusion of the coronary suture. The main features consist of forehead, supraorbital arch and anterior cranial fossa deformation with orbital asymmetry. The treatment is surgical and the goal the relief of the compressed brain tissue and an acceptable aesthetic effect. We report a case of unilateral anterior plagiocephaly where an extensive craniofacial reconstruction was performed.

Open Access Original Research Article

Dental Problems Associated with Hepatitis C Infection: A Report from Iran

Nima Mahboobi, Leila Jafargholizadeh, Seyed Moayed Alavian

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/BJMMR/2016/24324

Background: Infection with hepatitis C virus is a problem with global importance. Patients with HCV infection experience a wide spectrum of extrahepatic manifestations, a number of which occur in the oral cavity. Despite a large number of reports exist on the association of some oral conditions with HCV infection, little is known about dental problems of HCV infected patients.

Objectives: This study aimed at assessing dental problems in patients with HCV infection.

Materials and Methods: A questionnaire was used to collect patients’ demographic, oral health and HCV infection associated data. Plus, a routine dental screening was performed to obtain dental health status by using decayed teeth, missing teeth and filled teeth (DMF) index.

Results: Seventy-three patients enrolled in this study. More than 40% of the participants brushed their teeth less than once a day and only 18 participants used dental floss. None of the participants routinely visited a dentist for dental checkups. Almost 40% of the participants expressed that they have not informed their dentist of their HCV infection and/or they would not do it in future. DMF index showed an average of 17.5 counting 5.8, 3.2 and 8.5 for decayed, missing and filled teeth respectively. History of drug abuse as well as brushing teeth showed significant association with DMFT in patients with HCV infection (P<0.05).

Conclusion: The results of the current study showed poor oral health status among HCV infected individuals in Iran. Patients education about dental common conditions associated with HCV might help in improving their oral health status. Routine periodical dental check up in patients with HCV is recommended.

Open Access Original Research Article

Sapium ellipticum (Hochst.) Pax Leaf Extract: In-vitro Antioxidant Activities and Lethal Dose (LD50) Determination in Wistar Rats

O. M. Ighodaro, O. A. Akinloye

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/8253

Prior to this investigation, the LD50 and antioxidant activities of Sapium ellipticum leaf extract have not been reported, hence; the focus of this study. The LD50 of the extract was determined through three routes of administration using the method of Lorke. The Intraperitoneal (i.p) and intramuscular (i.m) LD50 values were determined as 979.80 and 1,341.60 mg/kg body weight (BW) respectively. Oral administration of the extract (to a dose of 45,000 mg/kg BW) did not cause any negative behavioral changes in the animals, and no mortality was recorded within and after 24h of the experiment. The antioxidant properties of the extract was assessed in vitro in terms of its free radical scavenging, metal chelating and reducing power activities as well as its ability to inhibit the formation of malondialdehyde (MDA), an index of lipid peroxidation. The total phenolic content of the extract was determined as 74.23±3.12 mg GAE/g. Data obtained indicate that the extract exhibited appreciable free radical scavenging activity (IC50 = 0.128 mgmL-1) and strong reducing power in comparison with butylated hydroxyl toluene (BHT, IC50 = 0.118 mgmL-1) and ascorbic acid (IC50 = 0.120 mgmL-1) used as reference antioxidants. The inhibition of linoleic acid induced-lipid peroxidation by the extract was comparable to that of BHT and greater than that elicited by ascorbic acid. In terms of metal chelating activity, ethylene diamine tetraacetic acid (EDTA) used as positive control elicited a significantly (p≤0.05) higher activity than the extract at all concentrations used. Findings from this study credit Sapium ellipticum ethanol leaf extract with significant antioxidant properties. The plant material may therefore be of immense relevance in combating oxidative stress and its related ailments.

Open Access Original Research Article

Investigation of Urine Samples for Isolation, Identification and Antibiotic Susceptibility Analysis of Bacterial Pathogens from Suspected Urinary Tract Infected Patients of Bangladesh

Tanzina Akter, Kaniz Fatema, Md. Razibul Alam, Md. Anowar Khasru Parvez, Shamsun Nahar, Muhammad Ekhlas Uddin, Safirun Pervin, Tasmia Farzana

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/28576

Urinary tract infection (UTI) is the most common community-acquired bacterial infection affecting people of all age groups and both sexes. 

Aims: This study was performed to isolate bacterial pathogens usually cause community-acquired uncomplicated UTI and to evaluate their sensitivity against 9 different antibiotics.

Place and Duration of Study: This study was conducted in Department of Microbiology, Jessore Medical College and Hospital of Bangladesh during the period from November, 2015 to February 2016.

Methodology: One hundred and fifty urine samples were collected from patients who were suspected of having UTI. Pathogenic bacteria were isolated and identified using conventional cultural and biochemical methods. Kirby-Bauer disc diffusion method on Mueller Hinton agar media was used for the determination of sensitivity of the positive isolates to commonly prescribed antibiotics. Statistical Package for Social Sciences (SPSS) software, version 20 was used for statistical analysis.

Results: Our research showed that Escherichia coli was the most common causative agent of UTI (50.68%), followed by Pseudomonas species (17.81%), Streptococcus species (13.70%), Staphylococcus aureus(10.96%), Klebsiella species (4.11%) and Proteus species (2.74%). The number of Gram-negative bacteria (75.34%) was higher than the Gram-positive bacteria (24.66%). In this study, UTI was more prevalent in females (84.93%) in comparison to males (15.07%). Antimicrobial susceptibility results for E. coli are as follows: Cefixime (94.59%), Cephalexin (91.89%), Azithromycin (89.19%), Ciprofloxacin (83.78%), Co-trimoxazole (81.08%), Gentamycin (75.68%), Amikacin (51.35%), Amoxicillin (21.62%) and Nalidixic acid (8.10%). More than 90% of the isolated uropathogens were susceptible to Cefixime (94.52%), Cephalexin (94.52%) and Azithromycin (93.15%) and less than 20% were susceptible to Nalidixic acid (13.69 %).

Conclusion: Among the uropathogens, E. coli (50.68%) was the most predominant bacteria in both gender and different age groups. Cefixime (94.52%), Cephalexin (94.52%) and Azithromycin (93.15%) were the most effective drugs and Nalidixic acid (13.69%) was the least effective drug for the treatment of UTI.

Open Access Original Research Article

Evaluation of Brain Lesions Using Magnetic Resonance Spectroscopy

Mohammed Salih, Mohammed Yousef, Ahmed Abukonna, Abdurrahman Elnour, Asmaa Elamin

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/28984

Aims: This study designed to describe the spectrum of Magnetic Resonance in brain lesions and to show its diagnostic importance in differentiating neoplastic, non-neoplastic and other lesions. Also to show the importance of MRS in differentiating of other brain lesions and correlate MRS findings with histopathological findings.

Study Design: This is a prospective study included 30 patients with intracranial tumors underwent MR imaging, proton MR spectroscopy, and stereotactic biopsy.

Place and Duration: The study was carried out in the Department of Diagnostic Radiology, Royal Care International Hospital, Sudan. June 2015 to June 2016.  

Methodology: MRS studies were performed with 1.5 Tesla Toshiba whole body MR systems using standard imaging head coil. All spectroscopy images were performed through single voxel technique. MR spectroscopic findings were evaluated for the distribution pattern of pathologic spectra (N-acetylaspartate (NAA)/ choline [1] ratio > 1) across the lesion and neighboring tissue.

Results: The result of this study revealed that the characteristic features in malignancy were increased Cho/creatine (Cr) peaks with NAA remains unchanged, the increased Cho/Cr and Cho/NAA ratio also noted with glioma. Furthermore grading of glioma as high or low can be obtained on the basis of Cho/Cr and the presence of lipid/lactate peak. In this study, there was total agreement between MRS, and histopathologicaly results. In addition, the study showed that the specific MR spectroscopic findings for meningioma were the absence or very small peak of neuronal markers NAA and Cr, and markedly elevated Cho.

Conclusion: Diagnosis of primary and secondary brain tumors and differentiating them from other focal intra-cranial lesions based on imaging procedures alone is still a challenging problem, combination of proton MRS and conventional MRI protocol can provide additive valuable information helping in tissue characterization of intra-cranial tumors leading to improved diagnosis and thus reducing biopsies.

Open Access Original Research Article

Therapeutic Effect of Hydatid Cyst Liquid on Melanoma Tumor Growth in Mouse Model

Hossein Yousofi Darani, Seyedeh Maryam Sharafi, Fariborz Mokarian, Morteza Yousefi, Sayedeh Ala Sharafi, Rasool Jafari

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/27220

Introduction: Hydatid cyst is the larval stage of Echinococcus granulosus which develops in various human and livestock animals tissues. This hydatid cyst composed of several layers. Previous investigations have shown that the prevalence of hydatid cyst in cancer patients is significantly lower than in healthy individuals. In animal models preventive effect of the hydatid cyst antigens in reduction of tumor growth has been shown. Due to the effect of live protosculex and hydatid cyst antigens on reducing the growth of cancer cells in culture medium, in this study therapeutic effect of hydatid cyst liquid on the growth of melanoma tumor in mice (C57 black) has been investigated.

Methods: In this Experimental study, the population studies were C57 black mice. Six groups of mice were injected with 106 melanoma cells in their chest site subcutaneously. Then the mice were injected with hydatid cyst fluid either with or without albendazole. From the second week, the tumor size was measured using a calipers and tumor area was calculated and the mean tumor area compared with those of control groups using One-way ANOVA test.

Results: The mean tumor area, in groups which injected with hydatid cyst fluid (case groups), was less than the mean tumor area in the control groups and this difference was statistically significant.

Conclusion: This study showed that hydatid cyst fluid may have therapeutic effect on melanoma cancer growth.

Open Access Original Research Article

Mentoring Prevalence and Need among Pre-clinical and Clinical Medical and Dental Students in a Nigerian University

Oluwaseun Taiwo Esan, Oluwadare Esan, Davies Eyimife Toluhi, Adeyinka Caroline Adepoju, Damilola Ruth Oyelakin, Omesi Blessing Odia, Ife Stephen Adesina, Surajudeen Lekan Quadri

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/BJMMR/2016/28597

Aims: Having a mentor is critical to having a successful career. Despite the known benefits of mentoring, studies have shown a low prevalence among students in the medical and dental schools particularly in developing countries. This study compared the level of awareness, prevalence and degree of need for mentoring relationships among pre-clinical and clinical students at a Nigerian medical and dental school as well as the extent to which this need has been met. 

Study Design: Analytical cross-sectional study.

Place and Duration of Study: College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria between March and June, 2015.

Methodology: We interviewed 151 and 224 pre-clinical and clinical medical and dental students respectively, selected via a multi-stage sampling technique. Data was collected with a pre-tested self-administered questionnaire and analyzed using descriptive and inferential statistical tools of the SPSS version 20 with statistical significance set at P<.05.

Results: Findings showed a 97.3% awareness of mentoring overall that was higher among clinical students, (P=.018). Prevalence of mentoring was a low 30.9% overall, though higher among pre-clinical students with =.453. However, the odd that a pre-clinical student will have a mentor was >1 (OR=1.19) while it was <1 for the clinical students (OR=0.84). The degree of need for mentoring was also significantly higher among the pre-clinical students, (P=.027). None of age, sex and awareness of mentoring was significantly associated with having a mentor or the degree of need for mentoring. The need for mentoring is yet to be met for >50% of the pre-clinical (P=.024) and clinical (P=.002) students.

Conclusion: Pre-clinical students demonstrated higher need for mentoring. An institutionalization of an effective mentoring program with particular focus on the pre-clinical phase may help meet this great need for mentoring and thereby increase its prevalence among medical and dental students in Nigerian training institutions.

Open Access Original Research Article

Atosiban– Its Impact on Uterine Activity in Preterm Labour

Sadaf Shaikh, Rahul Mayekar, Archana Bhosale, Yogeshwar Nandanwar, Bhupesh Dewan

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/28846

Aims: To study the effect of Atosiban on Uterine activity using tocodynamometer and to evaluate the extent to which the delivery was delayed with the administration of oxytocin receptor antagonist.

Study Design: Open label, prospective, non-comparative study.

Place and Duration of Study: The study was conducted at a tertiary care centre, Lokmanya Tilak Municipal Medical College and Hospital, Sion, Mumbai, India over a period of 1 year.

Methodology: A total of 60 women with established preterm labour were enrolled in the clinical study. The enrolled patients were administered Atosiban - an oxytocin receptor antagonist, as a 48 hours infusion with concomitant administration of corticosteroids. The frequency, amplitude and duration of uterine activity were recorded on admission, at 24 hours and after completion of the treatment. The efficacy of Atosiban along with maternal and fetal safety was evaluated.

Results: Atosiban administration successfully delayed the preterm labour by 48 hours and beyond in 86.7% of the patients. The frequency, amplitude, duration and mean uterine activity reduced significantly (p<0.05) at the end of 48 hours.

Conclusion: It can be concluded that Atosiban is an efficacious tocolytic agent with minimal to no adverse effects hence it is recommended as the drug of choice for preterm labour in delaying imminent preterm birth.

Open Access Original Research Article

Performance of Nutritionally Optimized Millet Porridges in the Rehabilitation of Severely Malnourished Children at Mulago National Referral Hospital, Uganda

Barugahara Evyline Isingoma, Mbugua K. Samuel, Karuri G. Edward, Gakenia W. Maina

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/BJMMR/2016/28355

Aim: To evaluate the performance of nutritionally optimized millet porridges against F-100 which is a therapeutic food recommended by World Health Organisation for rehabilitating severely malnourished children.

Study Design: Controlled and longitudinal.

Place and Duration of Study: Mulago Hospital, Uganda from January to March 2014.

Methodology: Severely malnourished children in the rehabilitative stage of their treatment were randomly divided into three groups with 26 to moringa group, 25 to pumpkin group and 25 to F-100 group. In addition to the local diet, the experimental groups were fed on fermented millet porridges of either 7% Moringa oleifera leaf powder or 17% Curcubita maxima flesh powder while the control group was fed on F-100. The children were assessed for weight, haemoglobin, serum iron, zinc and vitamin A levels before and after the controlled feeding.    

Results: Majority of the children were discharged after six days of rehabilitation. By the sixth day, weight gain/kg body weight for moringa and pumpkin groups were 97 and 79% respectively of weight gain/kg body weight achieved for F-100 group. The mean haemoglobin, serum iron, retinol and zinc levels for all groups remained below normal even at the point of discharge. Moringa group however had their mean haemoglobin and serum retinol levels increased significantly from 9.57±0.28 to 10.19±0.30 g/dl and 0.55±0.04 to 0.69±0.06 µmol/l at P =.02 and =.01 respectively, while pumpkin group had only their serum retinol levels significantly increased from 0.58±0.04 to 0.78±0.09 µmol/l at P =.01. F-100 group had neither their haemoglobin nor the other micronutrients levels significantly increased. By day six, all children in F-100 group were discharged while only 97 and 92% in moringa and pumpkin groups respectively were discharged.     

Conclusion: Nutritionally optimized millet porridges performed well compared to F-100. They can therefore be relied upon to avoid relapses in malnutrition conditions after children are discharged.

Open Access Original Research Article

Family Planning Practice in a Nigerian Tertiary Hospital: A Five Year Review

J. O. Alegbeleye, C. O. John

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/28941

Background: Globally, there is an increasing unmet need for safe and effective family planning services. Most women in Africa, just like in many parts around the world, desire to control both the number and timing of births but lack an effective contraceptive method. Utilization of family planning services in developing countries has been found to prevent unintended pregnancies, reduce maternal and child mortality, however, its uptake still remains low.

Objectives: To determine the prevalence and pattern of contraceptive use, and to identify factors influencing use of modern contraceptive methods.                                                                           

Materials and Methods: A retrospective study of 1,060 new clients who accepted a modern contraceptive method at the family planning clinic of the University of Port Harcourt Teaching Hospital, (UPTH) Nigeria, was conducted between January 1, 2011 and December 31, 2015. Information on socio-demographic characteristics, reasons for contraception, and their current method of contraception was obtained from the clinic registers, client cards and theatre records. Data obtained was analysed using the Statistical package for the social sciences SPSS version 20.

Results: Over the 5-year period under review, a total of 1,060 clients accepted a family planning method. The contraceptive prevalence rate was 8.5%. The mean age of clients was 34.22 ± 5.42 years while the mean parity was 3.51±1.47. About half of the clients sought contraception within 6 months of delivery. Implants were the most common method used (38.2%), followed by intrauterine contraceptive device (32%). Information on family planning was mainly from health personnel (39.4%). The contraceptive discontinuation rate was 13.8%, and it was mainly due to the desire for another pregnancy (39.7%). Age, Parity and marital status of the clients were significantly associated with discontinuation of a method (P<0.05). The contraceptive prevalence rate markedly increased over the five year period.

Conclusion: The uptake of family planning services in Port Harcourt, South-South Nigeria is relatively low. There is a need for promotion of family planning methods through female education and dissemination of information by health practitioners and the media.