Open Access Case Study

Acute Interstitial Nephritis in a Patient Using Herbal Product

Emma Purón-González, Fernando De la Garza-Salazar, Rogelio Maya-Quinta, Edgar Ulises Coronado-Alejandro, Héctor Lopez-de la Garza

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2017/36146

Aims: Acute interstitial nephritis is one of the most common causes of acute kidney injury. Many herbal products have been associated with kidney damage but the Melaleuca product has never been reported in medical literature.

Presentation of Case:  A 59-year-old woman arrives to the emergency department with nausea and generalized discomfort. Relevant medical history of hypertension with captopril and a non-specified anxiety disorder with paroxetine and clonazepam. Patient mentioned Melaleuca’s Recover AI® consumption and ciprofloxacin suspended 10 days before arriving to the emergency department. The rapid deterioration of renal function in the context of a previously healthy patient made it necessary to take a biopsy to establish a diagnosis and start treatment with immunosuppressant’s, obtaining a good response with a favorable clinical evolution.

Discussion: The use of herbal products is increasing in many countries and patients do not consider these as potentially harmful. These products have been associated with liver damage and in rare cases, such as ours, to kidney damage.

Conclusion: Physicians are obligated to interrogate intentionally about the consumption of herbal products and always consider them as a possible etiology of acute kidney injury secondary to acute interstitial nephritis.

Open Access Original Research Article

Effects of Commercially Available Herbal Mouthrinses on the Color Stability of Different Resin-based Composite Restorative Materials

Nehal Suresh Sonawane, Anay Aurangabadkar, Sunil Rao, Roopa Babannavar, Sunil Kumar, Nikhil Sathawane

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2017/34263

Colour match is one of the most important physiognomies of aesthetic restorative materials. Functional maintenance of colour throughout the lifetime of restoration is significant for durability of treatment.

Objectives: Aim of this  study  is  to assess  the  changes of  three commercially available  herbal  mouthrinses to keep a record on color permanency  by using  four different composite restorative materials.

Methods:  specimens (10x2 mm) were prepared in disc shape from each of the following materials: All composites containing nanohybrid particles:

Tetric N-Ceram (Ivoclar Vivadent, India), FiltexZ250 (3M/Espe), Solare X (GC, India Dental), Charisma (Heraeus Kulzer, India).

After preparation of specimen they were kept in distilled water at 37°C for 24 hours. With the help of colorimeter initial change in color values of each specimen were recorded. After recording the initial change in color, 10 specimens from each group were immersing in 1 of the 3 mouth rinses and distilled water was kept as control. The specimens were stored in 20 mL of each mouth rinse (Oramint herbal, Hiora-K, Dentobac herbal) for 12 hours. After immersion, the color values of all specimens were re recorded, and the color change was ΔE*ab was observed and calculated.

Results: All specimens exhibited color changes after immersion, and there was slight difference that was noticed among restorative materials and mouth rinses (P<.05).

Conclusion: According to results of present study, effects of oramint 3mouth rinses caused more color change of the materials used. And among those, FiltexZ250 composite material retained more stain. 

Open Access Original Research Article

Factors Associated with Successful Smoking Cessation in Tunisian Smokers: Findings from the Smoking Cessation Clinic in the University Hospital of Sahloul, Sousse, Tunisia

Jihene Sahli, Salwa Khefacha Aissa, Latifa Merzougui, Mohamed Ben Rejeb, Ons Ghali, Hela Ghali, Lamine Dhidah, Houyem Said Latiri

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/JAMMR/2017/35713

Aims: To identify the determinants of successful smoking cessation among the attendees of the smoking cessation clinic of the University Hospital of Sahloul.

Place and Duration of the Study: The smoking cessation clinic of the University Hospital of Sahloul and the the Department of prevention and safety of care, University Hospital Sahloul, Sousse, Tunisia.

Type of the Study: Retrospective study.

Methodology: This study included all the attendees of the smoking cessation clinic of the University Hospital of Sahloul (n=423) from 2009 to 2014. The monitoring of the attendees was performed until October 2015 in order to verify their smoking cessation status at one year.

Results: The participants were predominantly male (n=394, 93.4%). Their mean age was 41.5 ± 13.6 years. The mean number of daily smoked cigarettes is 27.18 ± 14.50 cigarettes. The mean score of the Fagerström test was 6.13 ± 2.39.The smoking cessation rates were 30.70%, 23.40%, 15.10%, 12.8% and 10.4% respectively at one week, one month, three months, six months and at twelve months. In the multivariate analysis, being married, being a smoker for less than 10 years, having an exhaled CO<10 ppm, being confident in quitting and attending the clinic three visits and more were independent factors associated with smoking cessation at 12 months.

Conclusion: Management of smoking cessation consultation needs to take an integrative approach focusing on the identified factors in order to improve current success rates.

Open Access Original Research Article

Electrocardiographic and Echocardiographic Findings in Adolescent Overweight and Obese Secondary School Children in Benin City, Nigeria

Wilson E. Sadoh, Nosakhare J. Iduoriyekemwen, Barbara E. Otaigbe

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2017/35677

Aim: To determine the electrocardiography (ECG) and echocardiography findings in adolescent school children.

Study Design: A cross sectional descriptive study.

Place and Duration of Study: Selected secondary school in Benin City, Nigeria. The study was conducted between May and June 2016.

Methods: Subjects were overweight and obese school children from a private secondary school while controls were school children with normal weight. Overweigh and obesity were defined as   BMI percentiles between 85th and 95th and >95th percentile respectively. Subjects and controls both had ECG and echocardiography evaluations. Analysis was done with SPSS version 20.0.

Results: Forty nine subjects and 49 controls were recruited. Of the subjects, 21(42.9%) and 28(57.1%) were obese and overweight respectively. Six (12.24%) subjects had chamber enlargement compared to one (2.04%) control, OR = 6.0, p = 0.12). The difference in mean left ventricular mass indexed to height (LVM/ht) of obese subjects 99.81 ± 32.80 g/m, overweight subjects 85.96 ± 20.52 and controls 81.63 ± 15.66  24.25 g/m, was significant, p = 0.0091. The LVM/ht was positively correlated with WC, r = 0.34, p = 0.024 and BMI, r = 0.37, p = 0.013.

Conclusion: Overweight and obesity is associated with increase in LVM and other chamber enlargement. Efforts should be stepped up to prevent overweight and obesity amongst school children for better cardiovascular health.

Open Access Original Research Article

Awareness of Hypertension, Blood Pressure Profile, Anthropometric Parameters and Lifestyle of Adults in Urban and Rural Communities of Sokoto State, Nigeria

M. D. Abdulaziz, K. J. Awosan, M. O. Oche, E. U. Yunusa, H. T. Ummar, B. A. Isah

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/JAMMR/2017/35976

Introduction: The increasing prevalence of hypertension and its associated complications have become major health challenges globally despite availability of effective therapies and interventions for the disease. This has been attributed to poor awareness of the disease and the rising prevalence of its risk factors particularly in the developing countries. This study aimed to assess the awareness of hypertension, blood pressure profile, anthropometric parameters and lifestyle of adults in Sokoto State, Nigeria.

Methods: A comparative cross-sectional study was conducted among adults (selected by multistage sampling technique) in rural and urban communities of Sokoto State, Nigeria. Data was collected with a set of pretested, interviewer- administered, semi-structured questionnaire, in addition to blood pressure measurement and anthropometry. Data was analyzed using IBM SPSS version 20 statistical package.

Results: Most of the participants in both the rural (87.7%) and urban (91.3%) groups were aware of hypertension. Seventy one (28.2%) and 75 (29.8%) of the 252 respondents in each of the rural and urban groups respectively were hypertensive. Less than a third of participants with hypertension in both the rural 20 (28.2%) and urban 20 (26.7%) groups were aware that they had the disease. Similarly, less than a third of participants with hypertension in both the rural 21 (29.6%) and urban 22 (29.3%) groups received treatment for the disease. While about a quarter and less of participants in both groups were overweight/obese (rural 26.2%, urban 19.4%), about one-tenth currently smoke cigarette (rural 10.4%, urban 9.9%), and very few engaged in alcohol consumption (rural 0.4%, urban 2.0%). Only about one-fifth of participants in both the rural (17.1%) and urban (20.6%) groups consistently engaged in regular moderate exercise.

Conclusion: Although awareness and prevalence of hypertension were high among the participants in the study, only a few were aware of their blood pressure status, and treatment/control of high blood pressure was very poor among them. Similarly, obesity/overweight and sedentary lifestyle were prevalent among the participants. These findings suggest the need for routine community based screening and intensification of health education on the disease and its risk factors across the populations in the state.

Open Access Original Research Article

Blood Loss at Caesarean Section: A Five-Year Single Centre Experience in the Niger Delta

E. H. Ikhobo, A. O. Addah

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/JAMMR/2017/30614

Objective: The objective of this study is to review outcomes of our caesarean delivery in terms of:

- amount of intraoperative blood loss and whether this compares favourably with blood loss at other centres.

- to compare the effects various calibers of surgeons and experience impact on blood loss at caesarean section.

- the effects  unbooked emergencies impact on blood loss at caesarean section.

- the impact of the time spent by the surgeon on the degree of blood loss.

- the effect of fetal macrosomia, gestational age at caesarean delivery, previous caesarean section has on blood loss at caesarean section.

- to identify areas where improvements can be made.

Methodology: This was a descriptive, cross-sectional, retrospective study. This study was carried out at the Department of Obstetrics and Gynaecology,  Niger  Delta University Teaching Hospital, Okolobiri, Bayelsa state Nigeria. Eight hundred and forty eight subjects who delivered between January 2008 and January 2013 (both those who registered for antenatal care and those who were referred as emergencies) were recruited into the study. The records of the subjects for the study were extracted from their hospital files and the results so obtained coded into SPSS version 20 for analysis. 

Results: The Mean blood loss at caesarean section for the study was 712.3 ml ± 389.5. There was no statistically significance difference  between group means of blood loss by Consultants, Seniour Residents and Juniour Residents at Caesarean section as determined by one-way ANOVA (F.803= 1.252, P= .721 and .207 ). The mean time duration of surgery for the study was 63.57 ± 18.74 minutes. There was no statistically significant difference between  the means of the time spent by Consultants, Seniour Residents and Juniour Residents as determined by the Oneway ANOVA test (F 1.021= -801, P= .444, .787).

Conclusion: Unbooked emergencies contributed so much to the degree of blood loss amongst other variable factors in this study.  This is an issue that has plagued obstetric practice in sub-Saharan Africa and a major contributor to maternal morbidity and mortality. Caregivers and stake holders alike including governments, non-governmental organizations need to invest money and time including advocacy to reduce this ugly trend.

Open Access Original Research Article

Prevailing Practices of Usage of Oral Anticoagulant in Stroke Prevention in Atrial Fibrillation (SPAF) in Indian Patients: Results of a Multicenter, Cross Sectional Questionnaire Based Physician Survey

Abhay Somani, Vikrama Raja

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2017/35549

Objective: Understanding physician’s opinion on usage and challenges for use of oral anticoagulants (OACs) in SPAF (Stroke Prevention in Atrial Fibrillation).
Materials and Methods: A multicenter questionnaire based survey was conducted among Indian physicians. Questionnaire included items related to number of patients with atrial fibrillation (AF) seen, use of different scoring systems, international normalized ratio (INR) monitoring, issues preventing prescription of OAC, perceived concerns while using vitamin K antagonists (VKA) in SPAF.
Results: Ninety-three physicians participated. Mean number of AF patients seen by doctors per month was 28.05(60.02). Seventy-two (77.4%) and 47(50.5%) physicians reported using “CHA 2 DS 2-VASc” and the “HAS BLED score” respectively. Routine use of VKA and aspirin was reported by 71(76.3%) and 60(64.5%) physicians respectively. Thirty-one (33.3%) physician reported INR monitoring twice per week at the time of diagnosis until patient is stabilized within therapeutic range. During dosage adjustment, INR monitoring is performed twice a month by 38(40.9%) physicians. When the patient is stable on treatment, 47(50.5%) reported monitoring 3-6 times per year. Low diagnosis rate, difficulty of monitoring, low patient awareness and cost are the important limitations for use of OAC for SPAF. Inconvenience and burden of INR monitoring is an important/very important perceived issue by the patients for use of anti-coagulants in SPAF according to 89(95.7%) physicians. Seventy-six (81.7%) doctors reported that dose adjustment is very important/important challenge while using VKA in SPAF.
Conclusion: Burden of atrial fibrillation is high in India. Use of CHA 2 DS 2-VASc is common among Indian physicians. About two third physicians use VKA for SPAF. Poor diagnosis rate, difficulty of monitoring, low patient awareness and cost are the major limitations for using OAC for SPAF.