Open Access Original Research Article

Alteration in Eosinophil’s Granular Content in Stained Film as an Index for Estimating the Shelf-lives of Modified Leishman Stains: Implications on Disease Diagnosis

K. A. Fasakin, O. D. Ajayi

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2017/31729

Modified Leishman stain is a newly discovered stain which is composed of Leishman powder, absolute methanol and phenol. It is not ususual sometimes in diagnostic haematology laboratories to have improperly stained thin blood films, without any clear-cut reason, leading to misdiagnosis of disease. Notably due to lack of published data on the shelf-lives of modified Leishman stain, we hypothesize that misidentification of cells may be due to expiration of the stain. Four modified Leishman staining solutions were prepared using phenol crystals and liquefied phenols as the sole modifying component ingredient. Thin blood smears were made in multiples of four from  each of the patients requiring peripheral blood film review especially those with high eosinophil counts. The smears were stained with the prepared dyes for a total of 75.0 seconds or 4.0 minutes  and examined for cellular elements of the blood by the researchers. At expiration, while other cellular elements of the blood stained normally, eosinophil granular content altered from orange-red to orange/reddish-brown and shades of brown and that was used to estimate  modified Leishman stains’ shelf-lives. Estimated shelf-lives of the modified Leishman stain were 25 days (21-29 days), ≤ 28 days, up to 52 days and ≤ 18 days  when the first, second, third and fourth methods of preparation respectively were used. Modified stain prepared by initial dissolution of phenol in absolute methanol before using resultant mixture to dissolve Leishman powder has the longest shelf-life- up to 52 days. It was ≤28 days when liquid phenol was used in similar pattern to conventional technique.When phenol crystals were used, the average shelf-life were 25 days (21-29 days) and ≤ 18 days respectively. Conclusively, modified Leishman stain should be prepared and used with the consciousness of the expiry dates. This mystery unfolded prevents misclassification of eosinophils during differential leukocyte counts, thus enhancing disease diagnosis.

Open Access Original Research Article

Relationship between Emotional Intelligence and Self-Concept in Individuals with Spinal Cord Injury

Raquel Suriá

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2017/32769

The present study aims to identify different profiles in emotional intelligence (EI) and self-concept of the participants with disabilities according to functionality of spinal cord injury. In addition, significant differences in self-concept domains among profiles previously identified are also analysed. The Trait Meta-Mood Scale-24 (TMMS-24) and AF5 Self-concept Questionnaire were administered to 98 participants with physical disabilities by traffic accidents (42 tetraplegics and 56 paraplegics). Cluster analyses allowed identifying three different EI profiles: a group of participants with low EI profile, a group with predominance of high emotional repair and regulation and, finally, a group of participants with high EI. Results also revealed significant statistical differences in most domains of self-concept among profiles. Results suggest the need of going in depth on EI knowledge and design enhancement of self-concept programs for people with spinal cord injury.

Open Access Original Research Article

Clinical Pattern of Dermatoses in Patients with Chronic Kidney Disease in Ile-Ife, Nigeria

Mufutau Muphy Oripelaye, Olaniyi Onayemi, Olayinka Abimbola Olasode, Fatiu Abimbola Arogundade, Olumayowa Abimbola Oninla, Fatai Olatunde Olanrewaju, Ogochukwu Ifeanyi Ezejiofor, Olaide Olutoyin Oke

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/BJMMR/2017/33386

Background: Dermatoses are common in patients with chronic kidney disease (CKD). These dermatoses vary from the more common xerosis, pruritus, hyperpigmentations, to the less common manifestations such as nephrogenic systemic fibrosis, bullous dermatosis of haemodialysis. They arise as a consequence of failure of excretory or endocrine functions. Iatrogenic causes may also contribute to the development of these dermatoses. These manifestations impact greatly on the quality of life of patients with CKD by increasing the morbidity and rarely the mortality.

Objective: The objective of this study was to determine the pattern of dermatoses among patients with CKD in Ile-Ife.

Materials and Methods: The study was a cross sectional study involving patients with CKD attending Obafemi Awolowo University Teaching Hospitals Complex, (OAUTHC) Ile-Ife. One hundred and twenty patients recruited for the study had relevant clinical evaluation to confirm the dermatoses and to determine the stage of CKD. Data were analysed using SPSS version 16.

Results: The subjects aged between 18 and 84 years with a mean age of 50.76 (±18.6) years. Seventy six (63.3%) males and forty four (36.7%) females participated in the study. The occurrence of dermatoses was observed in the study to be 57.5%. The observed dermatoses did not vary significantly with stage of CKD (p=0.780). Xerosis was the commonest dermatoses observed in 26.7% of patients. Other dermatoses observed in these patients included, pruritus(13.3%), hyperpigmentation(12.5%). Pallor together with ‘half and half’ nails accounted for 10.8% each.Fungal infections and icthyosis also constituted 6.7% each.  Plantar hyperkeratosis, follicular hyperkeratosis, chronic leg ulcer,arteriolar shunt dermatitis, alopecia, bacterial infections and Mee’s lines were also documented.

Conclusion: This study shows a high prevalence of dermatosis (57.5%) among CKD patients. The observed prevalence was comparatively lower than the previously reported prevalence for this environment presumably due to improving access to better care.

Open Access Original Research Article

An Evaluation of Risk Factors for Cerebral Palsy in Children in Jos, Nigeria

Emeka U. Ejeliogu, Augustine O. Ebonyi, Collins John, Esther S. Yiltok, Bose O. Toma

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/BJMMR/2017/33226

Aim: To evaluate the incidence of risk factors for cerebral palsy (CP) in children at Jos University Teaching Hospital, Jos, North-Central Nigeria.

Study Design: This was a case control study.

Place and Duration of Study: Pediatric neurology clinic, Jos University Teaching Hospital, Nigeria between January 2015 and October 2016.

Methodology: We recruited consecutive children with CP attending the pediatric neurology clinic of Jos University Teaching Hospital as cases and children without CP attending the general pediatric out-patient clinic of the hospital as controls. We used structured questionnaires and hospital records to document all relevant information of the patients and their parents. We also conducted detailed physical examination for each patient and performed specialized examinations and investigations if necessary. Data obtained was analysed with Stata software version 14. Ethical approval for this study was obtained from the Health Research Ethical Committee of Jos University Teaching Hospital. Informed consent was obtained from the parent/guardian of each participant.

Results: Majority of the study subjects were males (156, 55.8%) and aged 1-5 years (244, 87.2%). Risk factors that were significantly associated with cerebral palsy were home delivery, birth asphyxia, neonatal jaundice and central nervous system infections. Children with history of home delivery, birth asphyxia, neonatal jaundice and central nervous system infections were more likely than controls to develop CP: adjusted odds ratio (AOR)=3.26 (1.68-5.21), p<0.001; AOR=6.78 (3.52-13.37), p<0.001; AOR=1.87 (1.07-3.29), p=0.03 and AOR=2.69 (1.08-7.16), p=0.03 respectively.

Conclusion: CP in the majority of children in our study was associated with potentially preventable risk factors. Improvement in basic healthcare especially maternal and newborn care will help reduce the incidence of CP.

Open Access Original Research Article

Epidemiology of Road Traffic Crash Injuries as Seen in the Emergency Room of a Tertiary Hospital in Delta State, Nigeria

D. O. Odatuwa-Omagbemi, A. A. Bock Oruma, R. E. T. Enemudo, C. I. Otene, G. C. Iwegbu, M. O. Okeke, E. Akpojevwe

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2017/32752

Background/Objective: Road traffic crashes are an important source of frequent trauma with resultant morbidities and mortalities in Nigeria and worldwide. We aim to highlight important epidemiological characteristics and injury patterns in road traffic crash victims presenting at our centre and make suggestions on possible ways to alleviate the problem.

Patients and Methods: Consecutive adult road traffic crash victims who presented with various injuries at the emergency room in our health facility within the study period and agreed to participate in the study were included. Data on age, sex, type of vehicle and circumstances of crash, types of injuries etc were collected on already prepared forms by attending emergency room physicians. Data analysis was carried out using SPSS version 17 (SPSS Inc. Chicargo, Illinois. USA).

Results: Data were collected for 88 eligible adult road crash victims during the study period. There were 53 males and 35 females (M:F = 1.5:1). Mean age was 37 ± 14 years. Most of the victims fell within the age groups of 20 -29 years (33.3%) and 30 – 39 years (22.7%). Motorcycles were the most commonly involved (40.4%). Sixty five point two per cent (65.2 %) of the crashes involved commercial vehicles. Over speeding was adjudged as the most probable cause of crashes by 30.1% of victims. Passengers were the victims in 46.6% of cases and drivers in 37.5% of cases the rest being pedestrians. The head was injured in more than 40% of cases followed by lower extremity injuries. The victims sustained a total of 58 fractures the tibia and fibula being the most frequently fractured bones. Most of the victims (70.5%) were conscious and stable at presentation. Nearly all the victims (95.5%) were rescued and brought to hospital by other road users, fellow passengers and relatives.

Conclusion: Road traffic crashes frequently affect males and the most productive age groups with its attendant dire consequences on the socio-economic life of the people. Human related factors such as over speeding significantly contribute to its occurrence. There is almost non-existence of rescue and pre-hospital care in our environment. The need for drivers / road user’s education, road maintenance and putting in place a well organized rescue and pre-hospital care team is emphasized.

Open Access Original Research Article

Effect of Meloxicam on Hematological and Kidney Histopathological Changes in Male Mice

Najat M. H. Mohammed, Ezzat El-Drieny, Ibrahim S. Eldurssi, Masouda El-Agory

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2017/32315

Introduction: Non-steroidal anti-inflammatory drugs are class of medications that frequently utilized as analgesic and anti-inflammatory therapy. Meloxicam is type of NSAIDs that classified as selective COX 2 inhibitor, which is considered more protective than traditional nonselective COX1 inhibitor. However, meloxicam was approved by other researches in recent years to cause renal damage.

Aim of the Study: Therefore, the present study aimed to investigate effect of meloxicam on kidney of mice related with some blood parameter studies.

Methods: Fifteen male mice were divided into two groups; one group of five mice served as control and received only distilled water. While the second group was treated with meloxicam 0.4 mg/kg which administrated daily by oral gastric gavage for 10 days. After 24 hours of the last dose animals were sacrificed, their kidneys were then removed and processed for histological examination by light microscope. Blood samples were collected by right atria and analyzed for complete blood count. The data of blood studies was presented as mean ±SEM.

Results: Sections obtained from meloxicam treated animals showed focal areas of glomerular sclerosis, shrunken glomeruli appeared with reduction of blood capillaries, presence of acidophilic materials in the capsular space and proliferation of parietal layers of bowman’s capsule forming crescent shape, which further cause obliteration of urinary space. Tubules showed degenerative changes in the form of cytoplasmic vacuolization and nuclear pyknosis, PAS staining revealed depletion of carbohydrate materials of cell coats giving negativity of the stain. There was interstitial mononuclear cell infiltration and hemorrhage. While evaluation of complete blood picture showed non-significant differences (P>0.05) in Hb, HCT, RBCs count, WBCs count, MCV, MCH and MCHC of both treated animals and control group.

Conclusion: It should be concluded that meloxicam is like other traditional non-selective COX 1 inhibitor in terms of their toxic effect on renal tissue.

Open Access Original Research Article

Knowledge and Attitude of Diabetic Patients towards the Oral Complications of Diabetes Mellitus and Factors Associated with Their Knowledge in Khartoum State, Sudan

Muram Hatim Abdelfatah Elsayed, Elhadi Mohieldin Awooda

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/BJMMR/2017/32035

Background: Diabetes Mellitus is a chronic long term condition, affecting all age groups. Uncontrolled diabetes can lead to serious oral complications ranging from acute to chronic, which manifest in several ways and can affect diabetic patient’s overall health.

Aim: The aim of this study was to evaluate knowledge and attitude of diabetic patients towards the oral complications of diabetes.

Materials and Methods: A descriptive cross-sectional hospital-based study, among 6 different hospitals in Khartoum State, Sudan. The study duration was from 1st December 2015 - 31st January 2016. A total number of 164 diabetic patients participated in the study, they were interviewed using structured closed ended questionnaire. It consisted of different parts assessing diabetic patients’ socio-demographic characteristics, knowledge and attitude towards diabetes mellitus oral complications, factors that could be associated with their knowledge, as well as their source of information. Comparison between variables by Chi-squire test with the level of significance set at P ˂0.05.

Results: The average correct response to the knowledge questions was only 47.5%. A Few participants agreed with the statement that “diabetes increases the risk of fungal infection” and majority were denying the fact about the increased risk for dental caries. Participants’ Knowledge on the oral complications of diabetes mellitus was found to be associated with their ages (P = .000), levels of education (= .002), duration of residence in Khartoum state (P = .018) and duration since they have been diagnosed with the disease (P = .007), but there was no significant difference in knowledge concerning gender differences (P = .06).

Conclusion: participants’ knowledge regarding Diabetes mellitus oral complications was found to be limited. It was associated with their ages, levels of education, times since they have been diagnosed and durations of residence in Khartoum state. Efforts should be taken to improve diabetic patients’ knowledge regarding diabetes oral complications.