Open Access Case Study

Case Report: Guillain-Barré Syndrome Secondary to Dengue Virus Infection in Northeast Mexico

Fernando De la Garza-Salazar, Fernando Góngora-Rivera, Hector Lopez-de la Garza, Emma Purón-González, Jorge Alberto Hernandez-Portales

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2017/32875

Aims: Dengue virus is a mosquito-born viral disease that infects about 390 million people each year. The clinical manifestations are fever, arthralgia and myalgia. Guillain-Barré Syndrome (GBS) caused by dengue fever has been rarely reported.

Presentation of Case: A 46-year-old man with no relevant medical history was seen because of progressive quadriparesis, dysautonomia, dysphagia and facial paresia. Ten days before seeking medical care the patient had fever, myalgia, arthralgia, rash, thrombocytopenia, and a positive NS1 dengue antigen. GBS was suspected and immunoglobulin was started while nerve conduction studies confirmed an acute motor axonal polyradiculoneuropathy. According to Brighton criteria, the patient was classified with a level 2 diagnostic certainty, since it was decided to not perform lumbar puncture for CSF analysis. The patient had a good clinical response and was subsequently discharged.

Discussion: Dengue virus is arthropod-borne. It presents with high fever, rash, arthralgia, myalgia, and in rare cases, neurological complications such as GBS. In Mexico, there were 14,112 confirmed cases of non-severe dengue and 3,683 cases of severe dengue or with warning signs in 2016. There are no reported cases of GBS secondary to dengue infection in this country.

Conclusion: GBS following dengue fever should be considered in countries with a high incidence of dengue infection such as Mexico even if there are no previous manifestations of dengue fever.

Open Access Original Research Article

The Spatial Distribution of HIV Prevalence Rates in Nigeria

Olusoji J. Daniel, Olusola A. Adejumo, Kolawole S. Oritogun, Ebunoluwa O. Jaiyesimi, Temitope W. Ladi-Akinyemi

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734//BJMMR/2017/33184

Nigeria has witnessed a gradual decline in the national trend of HIV prevalence from the peak of 5.8% in 2001 to 3.4% in 2012. In spite of the decline nationally, there is a wide variation in the distribution of HIV at the sub-national level. This study therefore aims to explore the spatial distribution of HIV in Nigeria. The study was an ecological study of secondary data of the National HIV prevalence studies conducted between 2008 and 2012. The global Moran’s I and Local Moran’s I (LISA) test were used to measure spatial autocorrelation. A final choropleth map of local Moran’s FDR-adjusted p values was produced and a p value of ≤ 0.05 was regarded as statistically significant. The analysis of the data was carried out in R statistical package version 3.2.3. Twenty seven (73%) states showed decline in HIV while 10 (27%) states showed an increase in the HIV prevalence rate between 2008 and 2012. Global Moran I statistics for the country indicates a significant positive spatial autocorrelation of HIV in 2008 and 2010 however, there was no significant relationship in 2012. The choropleth map identified four hot spot significant clusters of HIV in 2008 which reduced to three states in 2010 and one state in 2012. The study showed a number of significant hot spot clusters for HIV in Nigeria though there was a general significant decline in the national HIV prevalence rate in the country. There is need to further understand the drivers of the epidemic in hot spot areas and target specific localized action to stem the tide of the epidemic focusing the scarce resources in the identified hotspot states.

Open Access Original Research Article

Obesity Effects on Bone Femur Tissue of Animals Subjected to Obesity through High-fat Diet

Cassiane Merigo do Nascimento, Francielly Andressa Felipetti, Ana Lucia Carrinho Ayroza Rangel, Danielle Shima Luize, Maria Lúcia Bonfleur, Sandra Lucinei Balbo, Carlos Augusto Nassar, Patricia Oehlmeyer Nassar

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2017/32947

Introduction: Adipose corporal tissue accumulation may cause alterations in the bone metabolism and might influence its properties. However, there are still many controversies, in addition to how the adipose tissue can cause these changes.

Aims: To evaluate the femur bone tissue behavior of animals submitted to obesity through cafeteria diet.

Place of Study: The Ethics Committee on Animal Experiments and Practical Classes (CEEAAP) of UNIOESTE has approved the project, which was developed at the same university.

Methodology: It was used twenty-four 8-week-old male Wistar rats, which were obtained at UNIOESTE’s central vivarium and kept in the Endocrine Physiology and Metabolism Lab of this institution. The animals were divided in: CONTROL group (CG) that received a standard diet and OBESE group (OG) that underwent a high-fat diet, during 28 weeks. We analyzed the obesity parameters, such as body weight and Lee index and femur bone properties like the quantity of osteocytes, the thickness of the cortical bone mass and the epiphyseal line’s thickness. All data were analyzed and evaluated using the Student-T Test (p<0.01). 

Results: The results pointed that the animals that underwent a high fat diet became obese (OG= 624.00±4.00 g vs CG= 466.00±1.50 g). The obese animals presented a statistically significant (p< 0.01) decrease of all analyzed bone parameters, when compared to the non-obese animals, including the amount of osteocytes (OG= 27.20±0.90 vs CG= 30.30±0.70), the thickness of the epiphyseal line (OG= 171.70±0.92 µm vs CG= 175.50±1.07 µm) and the thickness of femur cortical bone mass (OG= 434.10±2.03 µm vs CG= 495.50±2.55 µm).

Conclusions: The obesity had negative influences on the femur bone tissue of the animals that received a high-fat diet, due to a finding of a decrease on all bone parameters analyzed. We could highlight, too, that the applied cafeteria diet was effective to induce obesities in the animals. 

Open Access Original Research Article

Correlation between Retinal Nerve Fiber Layer Thickness and Cup-to- Disc Ratio in Glaucoma Suspects Using Optical Coherence Tomography at University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria

Chidi Gift Nwokocha, C. N. Pedro-Egbe, A. O. Adio, R. D. Komolafe

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2017/32918

Aim: To determine the correlation between retinal nerve fiber layer thickness and vertical cup disc ratio in glaucoma suspects in the University of Port Harcourt teaching hospital, Port Harcourt, Nigeria.

Study Design: Hospital-based observational study conducted between October 2nd, 2012 and January 31st2013.

Methodology: Participants were selected using consecutive allocation of glaucoma suspects as they presented to the glaucoma clinic. Observations were done using the Optical Coherence Tomography machine. Data was analyzed using the statistical package EPI info version 6.04d.

Results: One hundred and twenty participants (n =120) comprising 60 males (50%) and 60 females (50%) with a mean age of 42.8±13.79 were examined; The age range was 19 to 75 years. The average retinal nerve fiber layer was 132.254 µm in the inferior quadrant, 127.504 µm in the superior quadrant, 80.533 µm in nasal quadrant and 61.500 µm in temporal quadrant. Vertical cup disc ratio increased with decreasing RNFL thickness (p<0.05; r = - 0.21). Disc size was noticed to increase with increasing VCDR (p= 0.001).

Conclusion: There was no strong correlation between vertical cup disc ratio and retinal nerve fiber layer thickness among the glaucoma suspects. There was a weak positive correlation between the optic disc diameter and the retinal nerve fiber layer thickness of the subjects.

Open Access Original Research Article

Comparative Evaluation of Fracture Resistance and Microleakage of Reattached Anterior Tooth Fragment Using Two Different Flowable Composites- An in vitro Study

Saumya ., Renuka Dhingra, Anil Gupta, Busi Karunanand

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2017/32526

Aim: To evaluate and compare the fracture resistance and microleakage of reattached anterior tooth fragment using two different flowable composites.

Study Design: In-vitro study.

Place and Duration of Study: The present in vitro study was carried out in the Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, SGT University, between June 2014 and July 2016.

Methodology: The subjects were selected from various sources. A total of 160 extracted permanent anteriors were selected for the study. Teeth were divided into 2 groups, 80 teeth in each group reattached with G-aenial Universal Flo and Esthet X-Flow, evaluated for fracture resistance testing using Universal testing machine. Half number of teeth tested for microleakage using Dye-penetration method. The results obtained from the study were then tabulated and statistically analyzed.

Results: Mean value for fracture resistance in Group I were observed (89.07 ± 32.46) whereas in Group II were observed (64.63 ± 40.33). On statistical analysis result found to be highly significant (p = 0.001). Out of 40 teeth, in Group I -16 observed no penetration whereas in Group II -10 teeth were observed no penetration. On Enamel-Dentin microleakage in Group I found to be in 6 teeth, whereas 14 teeth showed the same Enamel-Dentin penetration in Group II. But on statistical analysis, overall result found to be non-significant (p = 0.19).

Conclusion: Among the tested flowable composites, G-aenial Universal Flo showed highly significant fracture resistance than Esthet X-flow. Microleakage shows no significant differences between nanohybrid and microhybrid flowable composites.

Open Access Original Research Article

Evaluation of Blood Banked Fibrin Glue versus Blood Banked Platelet Glue as a Local Hemosatic Agent and a Healing Promoter in Patients with Acute Leukemia Undergoing Tooth Extraction

Suzan Salem, Islam Saad

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/BJMMR/2017/33470

Aims: The purpose of this study was to compare the effectiveness of blood banked platelet glue and blood banked fibrin glue as a local hemostatic agent after tooth extraction in patients diagnosed with acute leukemia with concomitant thrombocytopenia.

Study Design: Randomized clinical trial.

Place and Duration of Study: Hematology Unit, Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt between June 2015 and July 2016.

Methodology: 21 patients who underwent 60 dental extractions diagnosed with acute leukemia with concomitant thrombocytopenia; age between 25-45 years were included in this study. Patients were randomly allocated into three groups: Group I (control group) patients had underwent platelet transfusion before tooth extraction and was continued after the extraction if re-bleeding occurred, Group II (Fibrin Group) Fibrin glue used as a local hemostatic agent after tooth extraction; and Group III (Platelet group) platelet glue used as a local hemostatic agent after tooth extraction. Immediate and delayed evaluation by monitoring time to hemostasis (secs), postoperative complications; fever, localized gingival inflammation, disintegrated blood clot, wound dehiscence, wound infection and time in days for healing.

Statistical software SPSS v.17.0 was used for statistical analysis.

Results: Time to hemostasis (secs) was 12.57 ± 1.51 sec, 9.57 ± 2.57 sec, and 9.43 ± 2.44 sec for group I, II and III respectively, significant difference at P- value (P≤0.05) was found between three groups. Wound healing time was 16.00 ± 3.51 days, 10.00 ± 1.00 days and 7.29 ± 0.95 days in Group I, Group II and Group III respectively, significant difference at P- value (P≤0.05) was found between three groups.

Conclusion: Blood banked platelet glue has excellent hemostatic action and can be used successfully as a local hemostasis after tooth extraction.

Open Access Original Research Article

Short Term Rehospitalisation or Death and Determinants after Acute Heart Failure Admission in a Cohort of African Patients in Port Harcourt, Southern Nigeria

Okechukwu Iheji, Maclean R. Akpa

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2017/33614

Background: Heart failure [HF] is a major health burden globally and contributes significantly to morbidity and mortality related to cardiovascular disease. The aim was to determine the outcome and factors that determine these outcomes of patients admitted for acute HF and followed up for six months.

Methodology: A hospital-based prospective study. Subjects consisted of consecutive patients with confirmed diagnosis of acute HF admitted into the medical wards of the University of Port Harcourt Teaching Hospital [UPTH] in Nigeria over 1 year. All had full physical examination and relevant investigations including echocardiography. Subjects were followed up for six months and reassessed for outcome/endpoint which were rehospitalisation or death. Factors that predicted these outcomes were also determined.

Results: There were 160 subjects, 84 females and 76 males, age range 20 to 87 years, mean 52.49±13.89 years. Sixteen (16) subjects (10.0%) were lost to follow up, 66(41.3%) showed improvement clinically, 57(35.6%) were rehospitalised while 21(13.1%) died. Determinants of rehospitalisation were New York Heart Association (NYHA) class, heart failure type, haemoglobin level at presentation and the estimated glomerular filtration rate (e GFR). Determinants of mortality were NYHA class and left ventricular ejection fraction at presentation.

Conclusion: Heart failure rehospitalisation and mortality rates of 35.6% and 13.1% respectively is high compared to developed countries.