Open Access Data Note

Screening of Random Blood Sugar in Women: A Critical View

Madhura T. K., Sadanand B. Patil, Mohd Suhaimi Bin Ab Wahab, S. B. Javali

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/BJMMR/2017/31749

Diabetes mellitus is a group of metabolic disorders of carbohydrate metabolism in which glucose is underused, producing hyperglycemia. 250 million people currently have diabetes, by 2025 this number will reach 280 million. 80% among these live in developing countries .Analysis of the 2005-2006 National Health and Nutritional Examination Survey (NHANES) using both fasting glucose and oral glucose tolerance test (OGTT) shows prevalence of diabetes in US in persons 20 years of age and older of 12.9%. The prevalence of diabetes mellitus increases with age, and approximately half of all cases occur in people older than 55 years. Diabetes is the fourth common cause of death in the developed world.

Because early detection and prompt treatment may reduce the burden of type 2 diabetes and its complications, screening for diabetes may be appropriate under certain circumstances. This position statement provides recommendations for diabetes screenings performed in physicians' offices and community screening programs. This position statement does not address screening for type 1 diabetes or gestational diabetes mellitus (GDM). Because of the acute onset of symptoms, most cases of type 1 diabetes are detected soon after symptoms develop.

Open Access Case Report

An Unusual Case of Extra-oral Pyogenic Granuloma

Rohit Mishra, K. T. Chandrashekhar, Vandana Dubey Tripathi, Richa Agrawal, Neha Bhasin

Journal of Advances in Medicine and Medical Research, Page 1-4
DOI: 10.9734/BJMMR/2017/32972

Pyogenic granuloma is a moderately common, benign mucocutaneous lesion. It is a tumor-like proliferation to a non specific infection. It is non-neoplastic in nature and presents in different clinical and histological forms. In appearance, they are typically solitary and vascular usually seen in the oral cavity.  It is an oral disease which appears in the mouth as an overgrowth of tissue in response to irritation, physical trauma or hormonal factors. The name for pyogenic granuloma is misnomer because of the fact that it is not a true granuloma. Skin of the face and neck, upper and lower extremities, and mucous membranes of nose and eyelids are common areas for extraoral involvement. The clinical diagnosis of extraoral variant of this lesion being an uncommon occurrence can be quite challenging and misleading as they sometimes may mimic more serious lesions. The purpose of this article is to report an unusual case of pyogenic granuloma occurring on lower lip.

Open Access Original Research Article

Trace Elements Levels and Blood Pressure in Ghanaian Women Using Depot Medroxyprogesterone Acetate Contraceptive

Justice Afrifa, Samuel Essien-Baidoo, Eric Gyamerah Ofori, Albert Abaka-Yawson

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2017/32565

Background: The benefit of depot medroxyprogesterone acetate (DMPA) (an injectable contraceptive) relate to the fact that it has a very high efficacy in pregnancy prevention.

Aim: We investigated the effect of the hormonal contraceptive, DMPA on the levels of trace elements: (Selenium (Se), Copper (Cu), Zinc (Zn)) and blood pressure.

Materials and Methods: Fifty (50) women on DMPA and thirty (30) controls (who were not on DPMA) were recruited from the Kasoa Polyclinic in the Central Region of Ghana. Blood was collected for the estimation of trace elements using mass spectrometry. Blood pressure was measured and body mass index (BMI) calculated.

Results: Serum levels of Cu was found to be significantly elevated among participants on DMPA compared to healthy controls (P=0.002). Se levels were however slightly but insignificantly reduced (P=0.316) among participants on DMPA. There was also a significantly elevated diastolic blood pressure (76.00 ± 11.95 mmHg, P=0.03) among DMPA users compared to the controls. Serum Cu correlated positively with Zn(r=0.463) (P=0.001) among the DMPA users.

Conclusion: DMPA users had an increase in Cu with reduced Se levels as well as an increased blood pressure. However, no change in serum Zn concentration was seen among DMPA users compared to the controls.

Open Access Original Research Article

Dipeptidyl Peptidase-4 Inhibitors and Cardiovascular Risk: Retrospective Study of 50 Type 2 Diabetic Patients with Chronic Heart Failure

Narcissse Ateba Assene, Patrick Hassler, Cecile Deharvengt, Ahmadou Musa Jingi, Monique Gladin, Emmanuel Andrès

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2017/22039

Objectives: The choice of antidiabetics in patients with heart failure is a major clinical concern. Some antidiabetic agents such as thiazolidinediones, more or less sulfonamides and insulin increase the risk of exacerbation of heart failure. There is controversy with regard to the cardiovascular risk associated with dipeptidyl peptidase-4 (DPP-4) inhibitors. The aim of this study was to evaluate the cardiovascular risk in patients with diabetes and heart failure treated with these medications.

Patients and methods: A retrospective study was carried out from January 2014 to April 2015 at the Centre Hospitalier de Haguenau. The frequency of re-hospitalizations was studied (primary endpoint), as the duration of hospitalization and death in patients with type 2 diabetes and heart failure. Patients were divided into 2 groups, those treated with DPP-4 inhibitors (cases) and those not treated with DPP-4 inhibitors (controls).

Results: Fifty regularly followed up type 2 diabetic patients with chronic heart failure were included in this study, of whom 32(64%) were men. Their mean age (SD) was 73.7 (± 7.6) years, ranging between 58 and 85 years. Twenty-four cases (48%) were treated with DPP-4 inhibitors. The rate of re-hospitalizations (primary endpoint) was 33.3% in the cases, and 26.9% in the controls (OR: 1.29, CI: 0.38 – 4.35, p=0.575). The duration of first hospitalization was 11.9 (±8.3) days in the cases, and 9.1 (±6.2) days in the controls (Risk ratio: 1.31, p=0.217). In-hospital mortality was not different between the 2 groups.

Conclusion: Treatment with DPP-4 inhibitors was not associated with an increased risk of re-hospitalizations, duration of hospitalizations, and death in type 2 diabetic patients with heart failure.

Open Access Original Research Article

Screening for Gestational Diabetes Mellitus: Findings from a Resource Limited Setting of Nigeria

Rosemary Nkemdilim Ogu, Celestine Osita John, Omosivie Maduka, Sunday Chinenye

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2017/31966

Diabetes is a growing non communicable disease (NCD) epidemic. Current international guidelines dictate that in pregnancy, universal screening for GDM for early detection is essential to improve feto-maternal outcomes. However in resource limited settings, risk based screening is still in practice. We undertook records-based review of 837 women who accessed antenatal care between November 2014 and October 2015. The aim was to evaluate the pattern of screening and clinical outcomes of GDM in a resource limited setting of the Niger Delta region of Nigeria.

Only 3.7% of the study population representing 31 women was screened for GDM, giving the overall prevalence of GDM among study participants as 3.3% (28 women). A comparison of fetomaternal outcomes between women screened for GDM and those not screened for GDM showed comparable proportions for gestational age at delivery, mode of delivery and fetal outcome relating to hypoglycaemia, respiratory distress and neonatal jaundice. Also, a significantly higher proportion of babies born to mothers who were screened for GDM were admitted into the Special Care Baby Unit (SCBU). There was no significant difference between the prevalence of stillbirths, neonatal jaundice, hypoglycaemia and respiratory distress in babies born to women diagnosed with GDM compared with babies born to women not screened for GDM. Selective risk based screening for GDM may be leading to missed cases of GDM. The need for universal screening is hereby reiterated.

Open Access Original Research Article

Preliminary Study of Somatic Complaints as Psychiatric Symptoms Based on Cluster Analysis of Symptoms in Modified Enugu Somatization Scale

Chidi J. Okafor, Owoidoho Udofia, Essien E. Ekpe

Journal of Advances in Medicine and Medical Research, Page 1-14
DOI: 10.9734/BJMMR/2017/32088

Background: Patients with somatic complaints in Nigeria have received various psychiatric diagnoses using the yardstick (criteria) originally developed in western cultures. There are concerns about the adequacy of such diagnoses.

Aims: To determine whether or not somatic symptoms occur in clusters that could constitute specific syndromes.

Study Design: The study design was cross sectional.

Place of Study: Psychiatric Clinic of the University of Calabar Teaching Hospital (UCTH), Nigeria.

Methodology: This study included seventy-one patients that were seen at the psychiatric clinic of the UCTH on account of non-organic somatic symptoms. Using the Modified Enugu Somatization Scale (MESS), each participant was requested to subjectively endorse a point on a Visual Analogue Scale (VAS) that best described the severity of each somatic symptom contained in the MESS as it applies to him or her. The participants were also interviewed clinically for possible psychiatric diagnoses based on the criteria of the 10th edition of the International Classification of Diseases (ICD – 10). Their responses on the VAS were subjected to cluster analysis.

Results: Depression, Anxiety and Somatoform disorders were the clinical diagnoses made on the patients. Cluster analysis produced six clusters from which five syndromes were identified. These syndromes were different from one another.

Conclusion: Patients with the same syndrome had different ICD-10 diagnoses indicating that the use of the western illness categories may be inadequate for diagnosing Nigerian patients with somatic complaints.

Open Access Original Research Article

Evaluation of Ricketts Frontal Analysis Reference Points on Cone-beam Computed Tomography Images

Anderson Jaña Rosa, Lívia Gonçalves da Silva, Lilian Atsumi Simabuguro Chinem, Beatriz de Souza Vilella, Alexandre Trindade Simões da Motta, Oswaldo de Vasconcellos Vilella

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2017/32451

Aims: The aim of this study was to evaluate the reliability of Ricketts frontal analysis reference points when viewed by three-dimensional images.

Methodology: The points related to the Ricketts frontal analysis were identified at multiplanar reconstructions (MPR) and three-dimensional reconstructions (Rec 3D) obtained from cone-beam computed tomography. The cephalometric landmarks, following the author’s definition, were located by three operators: an orthodontist, a radiologist, and a student coursing the eighth period of the graduation course in dentistry. After two weeks, the landmarks were repeated. The values of X, Y, and Z were obtained for each point, and the intraclass correlation coefficient was calculated.

Results: The intraclass correlation coefficient values were less than 0.45 (poor reliability) at 15 points viewed from the three-dimensional reconstructions and 8 points for the multiplanar reconstructions, including the intra and interobserver assessments. It was not possible to identify the J point on the CBCT images.

Conclusion: The multiplanar reconstructions allow greater reliability in the identification of the anatomical landmarks for both intra and interobserver assessments. To improve its reliability, Ricketts frontal analysis reference points must be defined in the three planes of space before transfer to three-dimensional images, or new anatomical references can be adopted.