Open Access Case Study

Peri-apical Sinus, A Leading Edge of Gorlin–Goltz Syndrome: Case Report

V. D. Tripathi, A. K. Nagarajappa, V. S. Chauhan, K. T. Chandrashekar, R. Mishra, S. K. Tripathi

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2017/32469

Gorlin–Goltz syndrome is an autosomal dominant disorder, with mutations in the patched tumor suppressor gene (PTCH1) leading to a wide range of developmental anomalies and neoplasms of cutaneous, dental, osseous, ophthalmic and neurological origin. It commonly presents as multiple keratocystic odontogenic tumors (KCOTs) of the jaws, basal cell carcinomas (BCC) of skin, calcifications of the falx cerebri, ocular hypertelorisms, palmar-plantar pits, bridging of sella turcica and macrocephaly. In addition to these major criteria, more than 100 minor criteria have been described. We hereby, present one such case of Gorlin-Goltz syndrome reported to our dental clinic in Jabalpur, India. A 20 year old male patient presented with complaint of foul fluid discharge from a peri-apical sinus of an over retained, mobile Deciduous Maxillary left canine tooth. Patient’s general physical examination revealed macrocephaly, wide nasal bridge, ocular hypertelorism, numerous naevi and a sebaceous cyst. Panoramic and CT examinations revealed presence of multiple keratocystic odontogenic tumors (KCOT) in both the jaws, bridging of sella turcica, patchy calcifications of falx cerebri and tentorium cerebelli.

Though, multi-disciplinary examination revealed no evidence of neoplasm, multi-disciplinary treatment along with genetic counseling was provided to the patient. Lifelong surveillance was offered to prevent future morbidity and mortality associated with this syndrome. This case, illustrates the importance of thorough dental and physical examination including examination of draining oral sinuses, missing teeth, deciduous teeth, macrocephaly and frontal bossing. Additionally, detailed investigations in patients with lesions suggestive of aberrant phenotypic characteristics are mandatory.

Open Access Short Research Article

Honey: Nature’s Wonder of Healing

Vikram Singh, Pratiksha Hada, Shilpa Sharma, Akanksha Tiwari, Ashutosh Dutt Pathak, Sakshi Sharma

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2017/32358

Aim: Aim of this present study is to quantify, evaluate and assess the therapeutic benefits of honey on the treatment of recurrent apthous ulcer.

Materials and Methods: Sixty patients with minor oral ulcers were attended by Dept. of Oral Medicine and Radiology for treatment for oral ulcers. A double blinded clinical trial was carried out by topical application of honey or placebo therapy and the reduction in size and duration of complete elimination of ulcerations were noted.

Results: The ulcers had reduced in size considerably after 3 days of treatment by honey dressings, some with complete remission after another 3 days.

Open Access Original Research Article

Relationship of Perceived Stress and Life Satisfaction among Medical Students: A Cross-sectional Study

Tan Xin Hui, Umar Bin Mohd Ramzan

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2017/31693

Aims: To determine the relationship between stress and life satisfaction and also to correlate other factors that affect life satisfaction among medical students.

Study Design: Cross-sectional study.

Place and Duration of Study: This study was conducted in Melaka-Manipal Medical College, Muar, Johor, Malaysia from April to May 2016.

Methodology: 265 self-administered questionnaires were distributed to medical students of Melaka-Manipal Medical via universal sampling. The questionnaires consisted of socio-demographic characteristics, Quality of Life Enjoyment and Satisfaction Scale (14 items) and Perceived Stress Scale (4 items). Data were analysed using SPSS version 17.

Results: A total of 242 medical students participated in this study (a 91.3% response rate). There was a significant negative correlation between perceived stress and life satisfaction (r = -0.366, P < 0.001). Multiple linear regression analysis also showed a significant relationship between perceived stress and life satisfaction with regression coefficient of -1.445.

Conclusion: Intervention programs aimed at improving coping skills of the medical students in response to stress should be developed so that they enjoy greater satisfaction in life. This will lead to better academic performance, more efficient learning and reduce stress-related health problems.

Open Access Original Research Article

Urine Abnormalities and Chronic Kidney Disease in Highly Active Antiretroviral Therapy-naive Adults: A Cross-sectional Study

Ruth C. Brenyah, Mildred E. Gborbidzi, Charles Nkansah, Felix Osei-Boakye, Richard K. D. Ephraim

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2017/32355

Objective: This study investigated chronic kidney disease (CKD) and urine abnormalities in highly active antiretroviral therapy naïve (HAART-naïve) human immunodeficiency virus (HIV) infected adults, presenting to two antiretroviral therapy (ART) clinics in the Volta region of Ghana.

Methods: A cross-sectional study of 100 newly diagnosed HIV/AIDS patients attending ART clinics of the St. Anthony’s and Ho Municipal hospitals both in the Volta region was conducted. Vital clinical history and socio-demographic data were recorded from the folder of eligible participants. Blood and urine samples were collected for serum creatinine estimation; urinalysis was performed with dipstick and light microscopy. CKD was assessed with the Kidney Disease Improving Global Outcome (KDIGO) guidelines.

Results: Nine percent (9%) of the participants had CKD (eGFR<60 mL/min/1.73 m2). Prevalence of CKD was higher (88.9%) in females than in males (11.1%). Median creatinine levels were significantly higher in males than in females (P=0.0103). Eighteen percent (18%), 13%, 11% of the participants had proteinuria, pyuria and haematuria respectively. On urine microscopy, we recorded 8% (8/100) crystalluria (7/8 -calcium oxalate and 1/8 -triple phosphate), 9% epithelial cells, 20% pus cells and 7% red blood cells among our participants. Participants with confirmed CKD had more pyuria and haematuria than those without CKD. 

Conclusion: This study revealed a 9% prevalence of CKD among our participants with the condition being more common in females. Urine abnormalities like proteinuria, haematuria, pyuria and crystalluria were common in our participants. Routine urinalysis and screening for CKD in HIV/AIDS patients should be strengthened as it will help in early detection of renal abnormalities.

Open Access Original Research Article

Is There a Causal Relationship between Myopia and Intraocular Pressure

N. E. Chinawa, A. O. Adio, I. O. Chukwuka

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2017/30241

Aims: To determine if there is causal association between myopia and intraocular pressure at the University of Port Harcourt Teaching Hospital (UPTH), Nigeria.

Study Design: A case control study.

Place and Duration of Study: The study was carried out at the University of Port Harcourt Teaching Hospital (UPTH) between November, 2012 and May, 2013.

Methodology: Eighty consecutive patients of myopes (group A) and emmetropes (group B) were sampled in two groups. Group A was subgrouped into low myopia (−3.0D<Spherical Equivalent (SE)≤ −0.5D), moderate myopia (−3.0D≤ SE-< -6.0D) and high myopia (SE ≥ -6).

Intraocular pressures were taken between 9am -12 mid-day by Perkins applanation tonometer (MK2 Model). Autorefraction was carried out with (Carl Zeiss meditec) while Axial length was measured with A scan ultrasound machine (Pascan 300A Digital biometric reader).  Full examination of the fundus was carried out.

Results: 160 eyes of 80 patients each were respectively in groups A and B. The mean age of the myopes was 23.54 ± 12.74 years while that of the controls was 23.62±12.86 years (P=0.968).

Among the myopes, there were 42(52.5%) males and 38(47.5%) females while the control had 32(40.0%) males and 48(60.0%) females. There was no statistical difference in male (p=0.411) nor female (0.416) gender.

The mean axial length of the myopes was 24.03±1.68 mm while that of the control was 23.09±0.87 mm. (P=0.001).

There was no correlation between myopia and IOP (Pearson correlation coefficient: r=0.14, r2=0.02, 95% CI=-0.14-0.18). There was also no correlation between IOP and axial length in both groups. There was however a linear correlation between myopia and axial length(r=0.76, r2=0.57, 95% CI=0.45-0.67.

Conclusion: Myopes have longer axial length than emmetropes in our study, this difference was not accounted for by changes in intraocular pressure.

Open Access Original Research Article

Surgical in- Patient Satisfaction with Services Rendered in a Tertiary Health Facility in Delta State, Nigeria

D. O. Odatuwa-Omagbemi, R. E. T. Enemudo, C. I. Otene, C. I. Elachi, E. Akpojevwe, N. S. Awunor, M. O. Okeke

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2017/32186

Objective: To explore factors determining the level of satisfaction of surgical in-patients with services rendered at the Delta State University Teaching Hospital (DELSUTH), Oghara, Delta State, Nigeria.

Methodology: A descriptive cross sectional study was carried out among 115 adult surgical in-patients using an interviewer administered structured questionnaire (Patient Satistaction Questionnaire Short Form-PSQ-18). Data analysis was done using SPSS version 17 software.

Results: A hundred and fifteen respondents participated in this survey. The mean age of respondents was   40.9 ±16.0 years. Most respondents were male 62 (53.9%). Average overall satisfaction was 63.1%. Of the seven dimensions of patient satisfaction among respondents, financial sub-scale and time spent seeing doctor had the lowest satisfaction ratings of 30.4% and 47% respectively. Technical quality of care (82.6%) was one of the sub-scales patients were most satisfied with. It was observed that it was only with regards to the dimensions of satisfaction with communication, interpersonal aspect of care and satisfaction with access to care that any socio-demographic characteristic showed a significant association with the patient satisfaction.

Conclusion:  Although, many surgical in-patients were satisfied with the technical quality of care and interpersonal relationship with doctors, most of them find it difficult to pay hospital fees and feel they spend too much time in the process of seeing doctors and accessing other services. There is need for a possible downward review of our fees and efforts geared at shortening waiting time.

Open Access Original Research Article

A Study of a Prevalence of Port Site Infections in Laparoscopic Surgery in a Tertiary Care Centre in the Rural Set Up

Nupur Gupte, Jignesh B. Rathod, Vipul D. Yagnik

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2017/33062

Background: Port site infections though rare, shall be evaluated and studied so as to improve the quality of healthcare. The advantages of laparoscopic surgery are well known, but the question is, is it totally free of complications like port site infections?  Does performing laparoscopic surgery guarantee, post-operative period free of infections? Port site complications are known to happen. We, in our study, intend to find out the prevalence of port site infections in patients undergoing various laparoscopic surgeries like Cholecystectomy, Appendectomy, Hernioplasty.

Aims: To study the prevalence & nature of port site infections (PSIs) in cases of laparoscopic surgeries in all age groups in a tertiary health care centre in the rural setup.

Materials and Methods: Patients of all age groups and both sexes undergoing Laparoscopic surgeries during a period of 1 year between June 2013 to June 2014 were followed up and included in the study. Port sites were meticulously examined for any infections, and if suspected, swabs were sent for culture and sensitivity. Patients undergoing Laparoscopic surgeries were documented and studied against set parameters to evaluate the prevalence as also to ascertain the factors affecting the chances of PSI. Regular swab sticks were used to send swabs of those port sites where the infection was suspected.

Results: Out of the total sample size of 100, two patients had port site Infections. Both patients’ portsite was contaminated during the procedure. The rate of PSI was not affected by age, sex, nature of procedure or duration of hospital stay in our study. Neither did the type of surgery or co-morbidities affect the same. Statistical analysis used: Chi-square test.

Conclusions: Port site infection is a rare complication of Laparoscopic surgery. The advent of laparoscopy has reduced the rate of postoperative morbidity. Chances of PSI were found to be significant though if the port site was accidently contaminated.