Open Access Case Study

Kissing Abscess Type Infective Endocarditis Caused by Streptococcus tigurinus: A Case Report

Leslie Soto-Arquiñigo, Manuel Sánchez, Luis Pampa, Milagros Falcón, Rodrigo Zea-Vera, German Málaga

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/JAMMR/2017/35174

Streptococcus tigurinus is associated with infective endocarditis and meningitis. Due to its similarity to other species it has been underreported. We report the case of a 46 years old patient with 3 months of intermittent fever and asthenia and a blood culture positive for S. tigurinus.

Open Access Case Study

A Complicated Case of Dyspnea

Dafne T. Moretta, Christopher Gasho, Laura Denham

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2017/35222

This is the case of a patient initially presenting with productive cough, pleuritic chest pain, and hypoxemia. After a complicated clinical course the patient was eventually diagnosed with mucinous adenocarcinoma of the lung and associated pleural amyloidosis.

The relation between cancer and amyloidosis is still unclear; however it is a very well- known fact that amyloid deposits are linked to malignancy. Gene mutations in cancer can trigger the expression of proteins which can aggregate into amyloid like fibrils.

Open Access Original Research Article

Minimally Invasive versus Open Surgery in Patients with Complete Acute Achilles Tendon Rupture

Rodolfo Gregorio Barragán-Hervella, Miguel Ángel Sánchez-Durán, Álvaro José Montiel-Jarquín, Carlos Alejandro Martínez-Ramírez, Luis Carlos Blanco-Ochoa, Suemmy Gaytán-Fernández, Iván Alvarado-Ortega, Hugo Alejandro Solis-Mendoza, María del Socorro Romero-Figueroa, Daniel Luna-Pizarro

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2017/35073

Introduction: The incidence of Achilles tendon ruptures is 18 per 100,000 habitants, its etiology is mechanical or degenerative, and surgical treatment is required in both cases. Evolution depends on several factors.

Objective: To compare the functional results of minimally invasive and open surgery in Achilles tendon ruptures using the Leppilahti Scale.

Methods: A cross-sectional study of patients with Achilles tendon rupture managed by open and minimally invasive surgery from January 2014 to August 2015. The following variables were studied: surgical time, complications, underlying diseases and functional grade according to the Leppilahti scale.

Results: There were 41 patients, 38 (92.7%) of them men and 3 (7.3%) women. The right side was affected in 22 (53.7%) and the left in 19 (46.3%) cases. 19 (46.3%) patients underwent minimal invasive surgery and 22 (53.7%) open surgery. With the Leppilahti Scale, patients with minimal invasive surgery had excellent functionality in 6 (31.57%) and good functionality in 13 (68.42%) cases while conventional surgery had excellent functionality in 2 (9.1%), good functionality in 12 (54.5%), regular functionality in 6 (27.3%), and bad functionality in 2 (9.1%) patients. Minimally invasive management showed improvement in pain, muscle stiffness, muscle weakness of the tricep sural, range of motion differences between ankles, isokinetic muscle strength, overall outcome, and surgical time compared to open surgery (p ≤0.05).

Conclusions: Minimally invasive surgery offers better surgical results than open surgery for repair of the Achilles tendon.

Open Access Original Research Article

Evaluation of Diagnostic Quality of Chest Radiographs Seen in a Nigerian Teaching Hospital

M. C. Okeji, K. K. Agwuna, U. Abubakar, I. Y. Izge, A. U. Aninworie, I. O. Arogundade

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2017/35114

Chest radiograph is an invaluable tool to the physicians and surgeons for the assessment of the airways, lungs, mediastinum, heart, pleura and chest walls. Radiographs of poor diagnostic quality could lead to poor diagnosis and ultimately to poor management outcome. This study was aimed at assessing the diagnostic quality of chest radiographs in order to evaluate standards and establish causes of repeat. The study evaluated the anatomical details, physical and technical factors. A total of 800 chest radiographs, produced between January 2014 and February 2016, were retrieved from the records of the Radiology Department of University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu State and evaluated. Of the 300 chest radiographs evaluated for year 2014, 16% met all the criteria for good diagnostic quality according to the European guidelines. In 2015, out of 400 chest radiographs evaluated, 14% of the radiographs met all the criteria for good diagnostic quality according to the European guidelines. In 2016, 32% of the radiographs met all the criteria for good diagnostic quality. Inadequate collimation, “scapula not out of lung field”, darkroom processing faults, inadequate penetration and rotation were the major contributors to radiographs of poor diagnostic quality. Knowledge of diagnostic quality of radiographs is desirable for maintenance of standards, improvement in quality and reduction of wastages in our radiology departments.

Open Access Original Research Article

Alteration of Sex Hormone and Semen Parameters in Adult Males with Subclinical Hypothyroidism

Dipti Sarma, Uma Kaimal Saikia, Darvin Vamadevan Das

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2017/35043

Aim: To investigate the correlation between subclinical hypothyroidism (SCH) with serum testosterone levels and semen parameters (sperm count, total motility and morphology) in men seeking medical care for sexual dysfunction and infertility.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Endocrinology, Gauhati Medical College and Hospital, Guwahati, India. Study done from November 2015 to December 2016.

Methodology: The patients in study were grouped into two groups: Group I – Men with subclinical hypothyroidism (n=35) and group II – Euthyroid males serving as controls (n=27). The medical history, clinical examination, semen analysis, total thyroxine (T4), total triiodothyronine (T3), thyroid-stimulating hormone (TSH), Luteinizing hormone (LH), Follicular stimulating hormone (FSH), Total testosterone (T) and prolactin (PRL) were obtained. Patients with diabetes mellitus, hypertension, chronic diseases, any testicular or pituitary diseases and prior chemo-radiotherapy were excluded from study.

Results: The age of the patients ranged between 24 and 42 years with mean age 31.57 years. The cases had significantly lower levels of mean serum total testosterone and free T4 and higher serum prolactin levels compared to controls (P< .01). Linear regression analysis showed TSH levels independently associated with low testosterone levels. Also men with subclinical hypothyroidism had lower total sperm motility with preserved sperm count and morphology. Conclusion: We found that SCH is associated with reduction in testosterone levels and total sperm motility. Our study data conclude that SCH may be a contributing factor for hypoandrogenemia and sexual dysfunction in men.

Open Access Original Research Article

Endocrine Effect of Beta Cypermethrin on Female Albino Rats

Victoria Chinenye Obinna, Hope Delesi Kagbo

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2017/33455

Pyrethroids are among the common pesticides frequently used in agriculture and in homes, and have been named among the endocrine disrupting chemicals (EDCs). Cypermethrin, a broad spectrum insecticide being extensively used for pest management and animal husbandry practices is a type II pyrethroid. Previous studies have shown that cypermethrin has adverse effect on female reproduction with no adequate information on its effect on sex hormones. The present study was highlighted to evaluate the effects of Beta cypermethrin, β-cyp, on the estrous cycle and the serum sex hormones of adult female albino rats. Twenty female albino rats were randomly assigned into four groups and they were treated by oral gavage with β-cyp, at doses of 0, 15, 30 and 50 mg/kg body weight for fourteen consecutive days. The estrous cycle was determined; and hormonal assays for estrogen, progesterone, LH and FSH were done using Enzyme-Linked Immunosorbent Assay (ELISA). There was no significant (p>0.05) change in the serum sex hormones and the estrous cycle in treated groups relative to the control. This study demonstrates that the endocrine effect of β-cyp on female albino rats is not significant. However, the altered levels of hormones recorded in this study suggests that β-cyp, could be a potential endocrine disrupting chemical (EDC) to those exposed indiscriminately to it.

Open Access Original Research Article

Comparison of Various Phenotypic Methods for the Detection of Metallo-beta-lactamases in Pseudomonas aeruginosa

Sulmaz Reshi, Nargis Bali, Munazah Manzoor, Suhail Farooq, Dalip K. Kakru

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2017/28865

Aims: To evaluate the screening antibiotic and phenotypic test that can be used to confirm metallo-beta-lactamase (MBL) production in clinical isolates of Pseudomonas aeruginosa and to find out the prevalent MBL gene in them.

Materials and Methods: Three hundred and six isolates of P. aeruginosa were screened for resistance to meropenem (MEM), ceftazidime (CAZ) and imipenem (IMP). Isolates resistant to any of these were taken as screen test positive for MBL production and subjected to double disc synergy test (DDST) and combined disc synergy test (CDST), using MEM, CAZ and IMP with and without EDTA. Broth microdilution with MEM and IMP with and without EDTA was done to confirm MBL production (four fold reduction in minimum inhibitory concentration, MIC). Polymerase chain reaction (PCR) for blaVIM and blaIMP was done to find the prevalent gene in P. aeruginosa isolates.

Results: MEM picked up the highest number of MBL positive isolates 28.8% (n=76). CDST using MEM confirmed all the 76 screen test positive isolates to be MBL producers. Sensitivity of CDST using MEM, CAZ and IMP was 100%, 92.7% and 88.4% respectively. MIC by microbroth dilution for MEM and IMP was done for 76 MEM and 70 IMP positive isolates. For MEM maximum number of isolates had an MIC of 16 µg/ml and for IMP maximum number of isolates had an MIC of 32 µg/ml. blaVIM was the predominant MBL gene in P. aeruginosa isolates.

Conclusion: Meropenem was found to be a better screening as well as confirmatory agent for MBL detection. blaVIM was the predominant MBL gene in P. aeruginosa in our hospital.