Open Access Case Report

Spontaneous Extrusion of Lens in Fungal Scleral Abscess

S. C. Reddy, M. Satyavani

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2017/34220

Infection is an uncommon cause of scleral inflammation and it heals with appropriate treatment in majority of patients. However, necrosis of scleral tissue occurs in severe microbial infections resulting in abscess rarely. We describe a case of 45- years old female patient who presented with pain, redness in left eye and swelling of left eyelids of four days duration. There was no history of trauma to the eye. Left eye had only perception of light.  There were signs of central leucoma and abscess in upper nasal quadrant of sclera in left eye. Patient was started on topical and systemic antibiotics. Eye swab culture did not grow any organisms. The slough excised from the scleral abscess was positive for fungus in Grams stain and potassium hydroxide preparation; and Candida albicans was isolated in the culture. The patient was treated with topical and systemic antifungal drugs. Five days later, scleral perforation was noted with partially transparent lens in the scleral abscess area which was extruded spontaneously due to movement of the eye. After complete healing, the eye became phthisical and blind. This case is reported in view of the rare occurrence of spontaneous extrusion of the lens in a patient with fungal scleral abscess.

Open Access Case Study

Thoracolumbar Paraspinal Heterotopic Ossification (H.O)

Mohammadreza Etemadifar, Mohammad Hossein Jamalaldini, Rasoul layeghi

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2017/32285

A rare disorder in the skeletal system is the fibrodysplasia ossificans progressive (FOP) that is a sever, disabling disease, autosomal dominant, occasionally sporadic, ectopic ossifying condition and involvement of the muscles together with malformation the great toe.

We report a case of the thoracolumbar heterotopic (H.O) in the 16 years Old Iranian female student. The patient presented with about a history of the back pain and restriction of the lumbar motion especially in the flexion and bilateral short hallux valgus.

This is the first report of an atruamatic thoracolumbar paraspinal H.O in the our center. We don’t the awareness from fibrodysplasia ossificans progressiva.

The understanding and awareness of the FOP is essential for the physicians according to the extra-skeletal heterotropic bone formation and the congenital hallux.

Open Access Original Research Article

Prevalence of Kidney Dysfunction among Orthopaedic Patients in Northwestern Nigeria

S. M. Adamu, A. M. Wudil, A. J. Alhassan, M. N. Salihu, Y. A. Koki, S. Adamu, A. M. Musa, S. A. Abdullahi, B. R. Usaini, I. U. Muhammad, A. Ibrahim

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/JAMMR/2017/31640

Kidney dysfunction in orthopaedic cases may be as a result of kidney injury due to fracture, burns, osteomyelitis, spinal injury, spinal tuberculosis, sickle cell disease and various forms of arthritis. This study aimed at evaluating the biomarkers of kidney dysfunction among patients attending National othropeadic hospital Dala Kano. It is a hospital based prospective study conducted on a total of one hundred (100) subjects; sixty (60) orthopaedic patients and forty (40) apparently healthy individuals between the ages of 20-80 years among both sexes. Serum urea, creatinine, uric acid and chloride were estimated by spectrometric methods; sodium and potassium by flame photometric method; bicarbonate by titrimetric method while eGFR and BMI were calculated. The number of males 43(71.7) was higher than that of females 17(28.3).The overall prevalence of kidney dysfunction is 1.7%. Kidney dysfunction was found among gouty arthritis patients within the age group of 61-80 years, however none was found among 20-40 and 41-60 years. There was significant difference (p<0.05) in mean serum potassium (4.0±04 and 3.8±0.4 mmol/L), eGFR (188±54 and 152±33 ml/min/1.73m2) and BMI (21.28±4.4 and 25.48±5.6 kg/m2) between males and females. The prevalence of Kidney dysfunction in orthopaedic patients was found to be higher in males than females and increasing with age {(20-60 (0%); 61-80 (10%)}, however, most of the biomarkers of kidney function are irrespective of gender.

Open Access Original Research Article

Comparison of Mantoux Reactivity in Smear Positive Pulmonary Tuberculosis Adults and Controls in Yenagoa, Nigeria

P. O. Ikuabe, J. Jumbo, I. D. Ebuenyi, E. A. Solomon

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/JAMMR/2017/34166

Background: Tuberculin skin tests (TST) are long established screening methods for tuberculosis (TB). We aimed to compare Mantoux test (a TST) in smear positive pulmonary tuberculosis adults and control subjects. From January to December 2015, 131 patients with smear positive pulmonary (mean age 36.9 years) were given the Mantoux test. The results of the test group were compared with those of 121 control subjects (mean age 33.5 years).

Methods: Mantoux test results of all the 131 patients with smear positive pulmonary tuberculosis, aged above 15 years without HIV were collated and then analysed. These results were compared with results from 121 control subjects who were attending the chest clinic for other conditions, who were also smear negative with normal chest radiograph.

Results: Mean Mantoux reaction (mean±SD) for the test group was 9.31+10.6 mm while the mean reaction in the control group was 8.22±6.4 mm giving a p-value of 0.80 (Z-test). Thus there was no statistically significant difference between the test group and the control.

Conclusion: We conclude that the Mantoux test has limited usefulness as a screening or diagnostic tool.

Open Access Original Research Article

Cultural Myths and Perceptions Regarding the Usage of Nasogastric Tube amongst Adult Maxillofacial Surgery Patients of a Tertiary Health Centre in Nigeria

B. I. Akhiwu, O. D. Osunde, K. U. Omeje, A. A. Efunkoya, O. I. Amole

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/JAMMR/2017/34464

Background: Nasogastric tubes (NGT) are used in the clinical setting for the management of patients who require nutritional support amongst others. Knowledge of the perceptions and Myths about NGT use would help address the problem associated with its use so that patients care can be optimal.

Aims: This study is aimed at identifying the common perceptions and myths surrounding NGT use in adult maxillofacial surgery patients.

Methods: Prospective cross sectional study of adult maxillofacial in-patients of a teaching hospital. The study period spanned from January, 2012 to December 2013. A total of 73 consenting patients were recruited.

Results: 35 males and 38 females participated in the study. The mean age was 39.4±1.42 years. Prior to the insertion of the NGT 52.1% of the patients were of the opinion that the NGT was necessary while the others had a contrary opinion. Despite considering that NGT use was necessary 62% of them did not feel that it could help speed up their recovery. The myths associated with NGT use were that it causes death (n-6, 8.2%), it indicates patient would not recover (n-11,15.1%) and that it slows down recovery (n=27; 32.9%). Education significantly affected the perception of NGT use as an indication of terminal illness; with the higher the educational status the less likely the perception of NGT as an indication of a terminal illness (P = 0.0001).

Conclusion: The identified myths and negative perceptions have to be addressed with adequate counseling to help improve patient acceptance of the procedure.

Open Access Original Research Article

Impact of Nutrient Intake and Physical Activity Level on Nutritional Status among University Students in Ghana

Nafiu Amidu, Peter P. M. Dapare, Yussif Adams

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/JAMMR/2017/33335

Aim: This study assessed the impact of nutrient intake and physical activity level on nutritional status of undergraduate university students

Study Design: Cross sectional study design.

Place and Duration of Study: School of allied health sciences, University for development studies, Tamale, Ghana between January 2015 and May 2015.

Methodology: Two hundred and fifty-two (252) undergraduate students were randomly selected for this study. Data was collected on sociodemographic characteristics using a structured questionnaire, dietary intake using a 24-hour dietary recall questionnaire; anthropometry and physical activity level were recorded. Nutritional status was assessed by computing the body mass index, waist circumference and waist to hip ratio.

Results: The mean age of the studied population was 22±2.24. The population was made of 103(40.87%) females and 149(59.13%) males. The results obtained show that the prevalence of overweight and obesity prevalence ranged from 9.13%-12.30% and 1.19%-2.78% respectively. The prevalence of underweight was 8.33%. Females were generally more overweight (p=<0.0001 and p=<0.0001 for WC and WHR respectively) and obese (p=0.0029 and p=0.0012 for WC and WHR respectively) than males. More males were involved in high physical activity (p=<0.0001) whiles more females were involved in low physical activity (p=<0.0001). The mean calorie intake of the study population was 2005±879.70. Males consumed more calories (p=0.0043) and proteins (p=0.0406) than females. Generally, the prevalence of underweight, overweight, obesity and low physical activity was higher among first year students.

Conclusion: This study highlights the increasing prevalence of underweight, overweight and obesity among undergraduate students. It also brings to bare the higher prevalence of overweight and obesity among female university students as a consequence of reduced physical activity. Prevalence of obesity and overweight as well as underweight tends to be higher among first year university students, a resultant effect of low level of nutritional knowledge.

Open Access Original Research Article

Lipoprotein-associated Phospholipase A2, Lp-PLA2, and Age, are Predictors for Future Cardiovascular Events in Acute Coronary Syndrome Patients

Nguyen Van Khoi, Tran Thanh Vinh, Le Xuan Truong, Nguyen Chi Thanh, Nguyen Quoc Tuan, Le Ngoc Hung

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/JAMMR/2017/33587

Aims: We investigated whether Lp-PLA2 activity of blood samples collected 24 h after hospital admission could serve as a predictor of future cardiovascular events in Vietnamese patients with acute coronary syndrome (ACS). In addition, we correlated Lp-PLA2 with common risk factors of ACS, such as age, HDL, diabetes, BMI, etc. and compared Lp-PLA2 levels of ACS patients with those of a control group.

Methods and Results: Lp-PLA2 activity was measured in serum collected in fasting state within 24 h of hospitalization in 293 ACS patients. The mean [SD] of Lp-PLA2 activity (nmol/min/mL) was higher in ACS patients than in controls (212.7[57.8] versus 182.5[58], p<0.001), the mean difference was 14.2% of mean in ACS group. Both non-ST elevated myocardial infarction (NSTEMI) and STEMI had higher Lp-PLA2 compared to unstable angina (UA) (p<0.017). The 3rd tertile of Lp-PLA2 had a strong correlation with MI (NSTEMI/STEMI) showing ORs of 3.65 and 3.98 in logistic regression analysis compared to the 2 lower tertiles. There were only two factors, Lp-PLA2 and age, serving as best independent predictors for future CV events in multivariate HR analysis. However their effects strongly began to start around 50 days after acute phase of ACS. The future CV event rates had an increasing trend from 1st to 3rd tertile (ptrend=0.011). The HR between 2nd to 1st tertile was 1.71 (p=0.075). The 3rd tertile had nearly a double of adjusted hazard ratio (HR) as 1.92 compared to the 1st tertile (p=0.029). There was weak association of Lp-PLA2 activity with risk factors of CV diseases.

Conclusion: Lp-PLA2 in acute phase of ACS was different between 3 groups of ACS. Both Lp-PLA2 and age were independent predictors for future cardiovascular events in ACS patients.