Journal of Advances in Medicine and Medical Research

Introduction: Thyroid carcinoma is a relatively uncommon disease with an estimated incidence of less than 1% of all cancers. Most of the thyroid carcinomas are papillary or follicular while medullary and anaplastic cancers are rare. The mainstay of treatment is total thyroidectomy, radioiodine and radiotherapy.

Aim: To review the clinico pathological features and management of thyroid carcinoma as seen in university of Port Harcourt Teaching Hospital.

Patients and Methods: This is an 8 year retrospective study of all patients with thyroid carcinoma managed at the University of Port Harcourt Teaching Hospital from 1^st January 2008 to 31^st December 2015. Relevant data extracted from the records were analysed using the Statistical Package for Social Sciences (SPSS) version 16.

Results: Thirty two patients with thyroid carcinoma were analysed out of 222 cases of thyroid diseases seen within the study period. There were 10 males and 22 females giving a male to female ratio of 1:2.2. Their ages ranged from 24 to 64 years with a mean of 46.6±3.4 years and peak age incidence was in the 7^th decade. Follicular carcinoma was the commonest histological type. All patients had subtotal lobectomy or thyroidectomy and post operative complications were observed in 7 (21.9%) patients. Mortality rate was 3.1%.

Conclusion: Carcinoma of the thyroid was most commonly seen in the 7^th decade of life and predominantly in females with follicular carcinoma being the commonest histological type encountered. In order to reduce the incidence of follicular carcinoma, we advocate widespread introduction of dietary iodine supplementation.

Introduction: Cancer patients usually will not ask for psychological support. To increase the proportion of patients who may benefit from psychological support, an encounter was implemented in our hospital, within days following the announcement of a breast cancer diagnosis. In the current study the interest and the efficiency of such an intervention on the distress across the stages of the oncological treatment was assessed.

Methods: A longitudinal design with an intervention group and a control group that did not receive the visit of the psychologist was performed. Sociodemographic and disease information, distress, coping, and patients’ needs were assessed on three occasions (diagnosis, treatment and end of treatment).

Results: A significant decrease in depression (p < .05), in needs of medical information (p < .05) and a mobilization of distractive coping (p < .05) was found only in the encounter group.

Conclusion: Current research indicates that an encounter with the psychologist can be helpful to cope with cancer. It also highlights the importance of coping from cancer patients. Hence, although the intervention of a psycho-oncologist is not always necessary, a systematic encounter is an adequate time where a possible psychological consultation is proposed.

Background: For several reasons, the use of traditional medicine (TM) related to complementary and alternative medicine (CAM) has been rising globally. Therefore, the extent to which people are involved in TM/CAM therapies needs regular studies around the world.

Objective: This cross-sectional study aims to estimate prevalence and explore public knowledge, attitude and practice (KAP) of TM in Al-Aziziah, Riyadh city.

Methods: A self-designed questionnaire was administered to 276 Saudi adults living in Al-Azziziah.

Results: Only 19.9% of participants had used TM during the past 6 months preceding the study. Most of the participants did not seek help from conventional medicine (CM) practitioners for the treatment of their disease. Furthermore, no significant association was found between education and seeking or belief in TM. Most of the responders opined that the traditional remedies have limited use in some diseases.

Conclusion: The findings of this study have important implications for physicians dealing with public beliefs concerning TM and for health planners to adopt strategies to address a growing rise in traditional medicine use by healthcare users in the Kingdom of Saudi Arabia.

Aims: The study assessed the prevalence of hypertension and obesity and their associated risk factors among diabetics in the Tamale Metropolis.

Study Design:  Cross-sectional study.

Place and Duration of Study: Diabetic Clinics of the Tamale Teaching Hospital, Tamale West Hospital and the Tamale Central Hospital, Ghana, between January to June 2016.

Methodology: A self-designed structured questionnaire was used to collect data on socio-demographic information, medical and family history of 122 Type II diabetic patients. Anthropometric measurements were determined using standard protocols. Data from the participants at the diabetic centers of the various hospitals were evaluated regarding their association with the outcome variables: general obesity, abdominal obesity and hypertension using logistic regressions. The odds ratio and its 95% confidence interval for the univariate and multivariate models were reported with the level of significance set at 5%.

Results: Seventy-two out of the one-hundred-twenty-two (59%) participants were female with 41% (50/122) being male. The mean age of the participants was 51.9±14.5 years. The prevalence of general obesity, abdominal obesity and hypertension was 19.7%, 49.2% and 55.7% respectively, In a univariate logistic regression analysis, occupational status (OR = 0.3, 95% CI = 0.1-0.9, P =.036) was associated with general obesity; being   female (OR = 10.8, 95% CI = 4.5-26.1, P <.001), smoking (OR = 0.1, 95% CI = 0.01-0.5, P =.010) and drinking of alcohol (OR = 0.3, 95% CI = 0.1-0.8, P =.020) were significant factors for abdominal obesity. Variables associated with hypertension were: age (≤50 years) (OR = 3.7, 95% CI 1.7-7.9, P <0.001), high educational level (OR = 2.2, 95% CI = 1.0-4.6, P =.047) and smoking (OR = 3.7, 95% CI = 1.1-12.4, P =.037). Upon adjusting for age in a multivariate logistic regression being female, smoking and drinking of alcohol were still significantly associated with abdominal obesity

Conclusion: This study highlights the increased prevalence of obesity and hypertension among Type II diabetics. Employed participants were less likely to be generally obese but this is modifiable by age. Smoking and alcohol drinking remained negatively associated with abdominal obesity in the multivariate model, while female sex remained positively associated. Smoking remained as a marginally significant variable regarding the development of hypertension but this is largely modified by age.

Aim: To study the pattern of thyroid functional derangements in patients with metabolic syndrome.

Methods: The current study was designed as a cross sectional descriptive study of 130 patients with metabolic syndrome.

Results: The mean age was 57.5, with 88 [67.69%] females. According to HOMA-IR estimation; 129 (99.2%) of the studied patients were found to have insulin resistance. Subclinical hypothyroidism was diagnosed in 34 (26.15%). There was no age or sex difference between patients with and without subclinical hypothyroidism however a significant higher prevalence of dyslipidemia (high triglyceride, 25[73.53%] vs. 33[34.38%,], p=0.001) and (low HDL-C, 34[100%] VS. 81[84.38%], P=0.01) in patients with compared to without subclinical hypothyroidism respectively. Also, the mean ± SD waist circumference (138.6 cm ± 1.4 vs 118.9 ± 9.9, p=0.001) and waist/hip ratio (1.24 ± 0.08 vs. 1.098 ± 0.09, p= 0.001) were significantly higher in patients with compared to without subclinical hypothyroidism respectively.

There was no statistically significant difference between the two groups regarding HOMA-IR. In addition, there was no significant correlation between HOMA-IR and either free thyroxine (FT4) or thyroid stimulating hormone (TSH). However, TSH was significantly positively correlated with triglycerides; R= 0.2, P=0.02 and negatively correlated with HDL-C; R=-.02, P=0.01. There was significant strong positive correlation between TSH and obesity parameters (waist circumference; R=0.6, P=0.001 and waist/hip ratio; R=0.5, P=0.001), while a significant negative correlation was found between FT4 and fasting insulin; R= -0.2, 0.04, waist circumference; R= -0.2, P=0.01 and waist hip ratio; R= -0.3, P=0.002. The area under the ROC (95% CI) was 0.93 (0.88-0.97), P=0.001 for the waist circumference as a predictor of subclinical hypothyroidism with a sensitivity of 97% and specificity of 81%, while that of waist / hip ratio was 0.86 (0.79-0.91), p=0.001, with a sensitivity of 91% and specificity of 77%.

Conclusion: Subclinical hypothyroidism is prevalent among patients with metabolic syndrome. TSH is significantly associated with metabolic syndrome parameters particularly  dyslipidemia and obesity indicators.

Objective: Alcohol consumption is readily acceptable worldwide, and despite warnings and billions of dollars spent yearly on its deleterious effects; people still to the present day take copious amounts of it.  The study investigated the comparative effects of pure and alcoholic beverages on Wistar rats to ascertain their level of safety.

Methods: Thirty five male albino Wistar rats divided into 7 groups, were administered daily (v/v) pure and beverage alcohol comprising of; 5% (v/v) ethanol, 5.1% beer; 15% (v/v) ethanol, 13% red wine; and 40% (v/v) ethanol, 40% spirit; while the control group was administered saline, by intra-gastric route (IG) for 28 days. On the 29th day, the animals were sacrificed and blood collected for biochemical analysis. The rat brain, liver, kidney and lungs were excised for histopathological examinations and aliquots of the beverage alcohols were subjected to Gas chromatography-mass spectrometry (GC-MS) analysis.

Results: The activity of ALT was not significantly different in treatment groups when compared with controls. The GGT and AST activities of the treatment groups were significantly increased (p<0.05). The rat organ photomicrographs showed that the lungs was most adversely affected, followed by the liver, kidney and brain. The GC-MS chromatograms of the respective beverages contained the following: beer 19, red wine 10 and spirit 16 constituents.

Conclusion: The plasma ALT, AST, GGT activities however, did not indicate excess alcohol consumption in the animals although unusual values were observed. The histological profile on the rat organs showed that there was some form of organ damage implying that these beverages may be injurious to health. In addition, the GC-MS spectroscopy revealed that these alcoholic beverages had different proportions of the chemical constituents which may portend some futuristic threat to health.

We have here studied the relationship between Eustachian tube dysfunction and laryngopharyngeal reflux, evaluating also the results of medical therapy in patients with such problems. Based on clinical, endoscopic and cytological investigations, we found that acid laryngopharyngeal reflux was the basis of audiological symptoms and chronic dysfunction of the Eustachian tube.