Open Access Original Research Article

Ecotoxicological Impact of Sub-lethal Concentrations of Glyphosate–based Herbicide on Juvenile Clarias gariepinus

C. O. Ujowundu, D. M. Koloseke, N. O. Uba, J. J. Achilike, H. D. Ogbuagu, E. A. Ubuoh

Journal of Advances in Medicine and Medical Research, Page 1-14
DOI: 10.9734/JAMMR/2017/34374

The presence of pesticides in both aquatic and terrestrial ecosystems has become an important issue globally. This study determined the possibility of bioaccumulation of glyphosate, the active compound of Roundup pesticides in muscle tissues of juvenile Catfish (Clarias gariepinus), and the effects of exposure on some oxidative stress parameters. Forty fishes were grouped and exposed to graded (sub-lethal) concentration of Roundup pesticides for two weeks. Pesticides were extracted from the muscle tissues by cold extraction and detection and determination were performed using Gas chromatography- Electron captured detector (GC-ECD). Oxidative stress parameters such as catalase, superoxide dismutase, reduced glutathione, glutathione peroxidase and malondialdehyde were analyzed. Fish tissue glyphosate concentration increased significantly (p<0.05) as dosage increased and residues of organochlorine pesticides such as p-p1DDT, p-p1DDE, HCB, α-HCH, γ-HCH, t-nonachlor and γ-chlordane were detected at concentration far below the provisional tolerable daily intake (PTDI) value. The biochemical studies showed significant increase (p<0.05) in activity of oxidative stress enzymes and lipid peroxidation product of fish groups exposed to Roundup pesticides in a dose dependent pattern.  This study reveals that the use of Roundup pesticides in ways that could expose aquatic environment to its residues could result to adverse biochemical changes. Therefore, the use of this pesticide should be properly regulated and monitored to limit chronic exposure of fish consumers.

Open Access Original Research Article

Association between Snoring and Common Co-morbid Medical Conditions

Michael Fall, Suchit Kumbhare, Musab Nusrat, Charlie Strange, Chitra Lal

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2017/35090

Objectives: Habitual snoring is common in both men and women. Obstructive sleep apnea (OSA) is associated with a higher prevalence of conditions such as coronary artery disease (CAD) and stroke. We hypothesized that snoring may share some of these risks.

Methods: The 2012 Behavioral Risk Factor Surveillance System survey addressed demographic factors, comorbidities, and the snoring status of respondents in 4 states, namely Alaska, Nevada, Oregon and Puerto Rico. Data from 17,492 adults (≥ age 18 years) respondents was analyzed. A chi square test for categorical variables and t-test for continuous variables was used. Logistic regression analysis was used to study the association between comorbidities and snoring. Statistical analysis was performed using SAS 9.4 for Windows (SAS Institute, Inc., Cary, NC, USA).

Results: Snoring was reported by 47% male and 53% female respondents. Snorers were older (54.3 +15.4 years’ vs 50.7 +19.5 years, p <0.001), of male gender (46.8% vs 35.1%, p <0.0001), had a BMI in the overweight to obese range (p<0.0001) and were more likely to be current or former smokers (46.0% vs. 35.9%, p < 0.0001) as compared to non-snorers on bivariate analysis. After controlling for age, BMI and smoking, snoring was associated with a higher odds ratio of CAD/angina, asthma, Asthma-COPD overlap syndrome, arthritis and depression on multivariate analysis, as compared to non-snorers.

Conclusion: Snoring is associated with a higher prevalence of common comorbid medical conditions. Whether co-morbidities are caused by undiagnosed OSA or factors unique to snoring will require prospective, long term interventional studies.

Open Access Original Research Article

Complex Analgesia (Infiltrations and Deep Oscillation) in Patients with Stump Pain and Phantom Pain after Lower Limb Amputation (Double-blind Randomised Controlled Trial of Efficacy)

Ivet B. Koleva, Borislav R. Ioshinov, Radoslav D. Yoshinov

Journal of Advances in Medicine and Medical Research, Page 1-17
DOI: 10.9734/JAMMR/2017/34198

Introduction: Most of amputees feel residual limb (stump) pain, phantom sensations and phantom pain. Our purpose was to remind the wide public of the impact of rehabilitation (including the modern physical modality Deep Oscillation - DO) in the pain management of amputees.

Goal: Comparative evaluation of drug, physical (including DO) and combined analgesia in the complex rehabilitation of patients after femoral amputation suffering from stump pain and phantom pain. In the current article we tested the hypothesis that a preformed modality (Deep Oscillation) is able to provide an analgesic effect, to relieve reactive depression and to ameliorate the quality of life of amputees.

Materials and Methods: During last years a total of 63 amputees with stump pain and phantom pain were observed and investigated. The investigation was conducted with consideration for the protection of patients, as outlined in the Declaration of Helsinki, and was approved by the appropriate institutional review boards and ethic commissions. All patients gave written informed consent before undergoing any examination or study procedure.

A simple randomization was used. Patients were sequentially numbered and randomized into three treatment groups of 21 each one.

All patients received a complex rehabilitation programme including physical therapy and patients’ education. In group 1 we applied too drug therapy – paravertebral infiltrations with steroids, lidocaine and B vitamins. Patients of groups 2 received a complex rehabilitation programme, including DO. In group 3 we applied drug and physical analgesia techniques (infiltrations and DO).

For statistical evaluation we used t-test (ANOVA) and Wilcoxon rank test (non-parametrical correlation analysis), performed using SPSS package. The treatment difference was considered to be statistically significant if the P value was < 0.05.

Results: The comparative analysis of results shows a significant improvement of the symptoms of the patients, concerning: pain relief (visualized by the analysis of results of Visual analogue scale, evaluation of stump tenderness), and depression (scales of Zung and McGill Quality of life questionnaire). In all cases we detected reduction of pain sensation and depression; amelioration of the independence in ADL. The drug analgesia in group 1 was fast, but short; the efficacy in group 2 is slow, but stable, and durable. We received best results in group 3.

Discussion: The drug therapy is efficient but with short duration. The physical analgesia with DO initiates its effect slowly, but the results are stable. Best efficacy was observed in case of combination of medication with physical modalities – in the beginning due to the steroid injection, toward the moment of effective «input» of the physical modalities.

Current paper proposes personal opinions on some contemporaneous theories of pain and therapeutic concepts of analgesia, including physical analgesia. We mentioned principal natural and preformed physical modalities, with effectiveness in clinical practice. Authors suggest a conception of mechanisms of physical analgesia, especially in case of application of Deep oscillation.

Conclusion: We could recommend the complex program for treatment of the pain in amputees.

Open Access Original Research Article

Global Quality of Life and Disability amongst Stroke Survivors in North Eastern Nigeria

Mshelia Anthony Ali, Victor Chidi Onyencho, Adebowale O. Timothy, Wakawa Ibrahim Abdu, Pindar Sadique Kwajaffa, Yerima Mukhtar Mohammed, Duwap Makput, Kundi Babagana Machina

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2017/34243

Introduction: Quality of life and disability is commonly incorporated in the overall evaluation of the impact of Cerebrovascular Accident (CVA), this variables could lead to significant decline in the level of functioning of the survivors if neglected.

Aims: To examine the association between demographic characteristics, level of disability and Quality of Life (QOL), also to assess the level of disability among stroke survivors.

Methodology: This is a cross sectional study, accidental sampling techniques was used to select 191 hypertensive out-patients with or without diabetes with CVA from State Specialist Hospital, Maiduguri, Borno State, Nigeria, age ranged from 18-95 years.

Results: This revealed that 87.4% of the respondents had severe disability, QOL was significantly related to level of disability (χ2 (6) =12.1, P = 0.017), marital status (χ2 (8) =28.8, P =0.000), sex (χ2 (2) =9.041, P =0.011), and age (χ2 (4) = 30.188, P =0.000).

Conclusion: The findings revealed the magnitude and correlates of global quality of life and disability among patients with CVA. Therefore, there is need to incorporate post-stroke psychosocial adjustment evaluation, psychiatric and psychological interventions to this vulnerable group to facilitate their rehabilitation and enhance their psychological wellbeing and recovery.

Open Access Original Research Article

Corrective Osteotomy for Residual Lower Extremity Deformities Following Healed Rickets: A Retrospective Study in a Rural Hospital among Nigerian Children

D. D. Mue, P. Denen-Akaa, M. N. Salihu, W. T. Yongu, J. N. Kortor, I. C. Elachi, I. T. Annongu, J. O. Donwa, D. G. Mancha

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/JAMMR/2017/32863

Background: Rickets is the clinical manifestation of a failure of calcification of bone matrix in growing children. Although treatment of rickets is medical, residual deformities following healed/ burnt out rickets may exist requiring surgical correction.

Objective: To determine the pattern of presentation and outcome of corrective osteotomy in children with residual lower extremity deformities following healed rickets in a rural hospital.

Methods: Retrospective data was obtained over a 5 year period from January 2010 to December 2015. All patients 0-18 years who presented in Nongu u Krestu u i ser u Sha Tar (NKST) rehabilitation hospital Mkar, North- Central Nigeria with residual lower extremity deformities following healed rickets who had corrective osteotomy were included. Thirty eight patients met the inclusion criteria. Data was analysed using SPSS version 21.

Results: The mean age was 8.5±3.1 years. There were 21(55.3%) males and 17(44.7%) females with a male to female ratio of 1.2:1. The commonest pattern of presentation of residual deformity following healed rickets was knock knee deformity occurring in 21 (55.3%) patients. Corrective osteotomy was the main form of treatment. Sixteen (41.0%) patients commenced full weight bearing at 9-12 weeks. The commonest post op complications encountered was recurrence in 2(5.3%) and delayed union in another 2(5.3%) patients.

Conclusion: Knock knee deformity was the commonest residual lower extremity angular deformities following healed rickets in our environment. Recurrence and delayed union were the commonest complications encountered following corrective osteotomy. It was therefore recommended that careful patient selection, proper preoperative planning and meticulous surgical technique are vital in order to achieve satisfactory lower limb alignment, restore lower extremity function and ameliorate morbidity.

Open Access Review Article

The FITT Principle in Individuals with Type 2 Diabetes: From Cellular Adaptations to Individualized Exercise Prescription

Konstantina Dipla

Journal of Advances in Medicine and Medical Research, Page 1-18
DOI: 10.9734/JAMMR/2017/34927

Diabetes mellitus is a complex disease that affects millions of people worldwide. Type 2 diabetes (T2DM) arises from a combination of genetic susceptibility and environmental factors, including physical inactivity and poor nutritional habits. Accumulating evidence suggests that the majority of T2DM cases can be prevented through diet, physical activity, and exercise modification. Acute exercise bouts improve glucose homeostasis by increasing skeletal muscle glucose uptake through insulin-dependent and non-insulin dependent pathways; whereas, chronic exercise training induces alterations in genes’ expression, promoting mitochondrial biogenesis, glucose transporters (GLUT4) expression and protein enhancements, and fiber type transformation. However, individuals with T2DM show a low participation and poor adherence to exercise training. Alterations in metabolic, vascular and neural function induced by T2DM may impede skeletal muscle blood-flow during exercise, contributing to exercise intolerance. Thus, appropriate exercise programs that will improve glycemic control and will be attractive and effective for the individual with diabetes are still needed. The purpose of this article is (i) to present cellular mechanisms through which exercise can improve glycemic control, (ii) to describe the exercise prescription characteristics (frequency, intensity, time, type; FITT) required to achieve optimal benefits in T2DM, and (iii) to highlight the pathophysiological alterations induced by T2DM and obesity that should be considered when designing an exercise program. Genetic predisposition, diabetes/obesity phenotypes, oxidative stress, brain insulin sensitivity, perceived exertion, and initial fitness levels or training experience influence the inter-individual variability in exercise responsiveness. Thus, exercise is prescription should be individualized in order to achieve maximal benefits and high adherence.

Open Access Review Article

An Overview of Mineral Trioxide Aggregate in Apexification

Farzana Haque, Zubaer Ahmed, Shamme Akter Rime, Md. Mossharaf Hossain, A. F. M. Almas Chowdhury, Mohammad Khan

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2017/33609

Aim: The aim of this paper was to present an overview of Mineral Trioxide Aggregate adjacent to apexification, which discover the properties and clinical approach of MTA on apexification in dentistry.

Materials and Methods: This study was to search in six electronic data bases where some keyword combinations were utilized to systematically search for those literatures.

Results: In view of the inclusion and exclusion criteria, of these, we identified 40 articles including original articles as well as literature reviews.

Discussion: Conventional management of a premature non-vital permanent tooth is usually apexification with using calcium hydroxide. Traditionally, calcium hydroxide has been the material of choice for the apexification of immature permanent teeth but MTA holds significant promise as an alternative to multiple treatments with calcium hydroxide.

Conclusion: Mineral Trioxide Aggregate is an outstanding material with innumerable qualities essential of an ideal material. Apexification with calcium hydroxide is comparatively unpredictable and makes the tooth less resistant to fracture.