Open Access Case Report

Oral Fibrolipoma-: A Rare Presentation Case Report and Review of Literature

Rohit Mishra, Neha Bhasin, Anurag Sahu, Sonalika Ghate

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/JAMMR/2017/35854

Lipomas are classified as benign soft tissue neoplasms of mesenchymal origin and comprise 4-5% of benign tumors in the body. They are relatively rare in the oral cavity with a rate of 1/5000 individuals. The buccal mucosa, tongue, and floor of the mouth are among the common locations. Surgical excision is the treatment of choice. The fibrolipoma is an unusual histologic variant of lipoma that is comprised of neoplastic fat cells embedded in condensed collegen tissue.  Clinicians should be aware of these lesions in order to develop better clinical differential diagnoses. This is a report of a rare case of an oral fibrolipoma in an unusual location in the lower labial oral mucosa.  The biological characteristics of the lesion are described.

Open Access Case Study

Infantile Fibrosarcoma- An Unusual Presentation

V. Sibiya, V. Manimekalai, Paramasivam Manikandan

Journal of Advances in Medicine and Medical Research, Page 1-4
DOI: 10.9734/JAMMR/2017/36342

Soft tissue tumours account for ~ 25% of all congenital tumours, among which infantile fibrosarcoma is one of the most common nonrhabdomyosarcoma. Infantile fibrosarcoma is a soft-tissue sarcoma occuring under 1 year of age. Forty percent of infantile fibrosarcomas are observed in infants under 3 months of life, which include congenital fibrosarcoma that is discovered antenatally. The prognosis of this tumour is relatively good compared to adult forms. Here we report an unusual case of congenital fibrosarcoma along the paravertebral region of the new born, which was successfully resected. The infant is now 6 months old with no impaired motor development.

Open Access Original Research Article

Rates and Determinants of Complications Following Trans-Rectal Prostate Biopsy in Enugu, Nigeria

F. O. Ugwumba, I. I. Nnabugwu, K. N. Echetabu, A. D. Okoh, E. I. Udeh

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2017/35523

Aims: Analysis of the complications of trans rectal prostate biopsy to establish their rates and determinants.

Study Design: Retrospective study.

Place and Duration of Study: Departments of Urology University of Nigeria Teaching Hospital, Saint Mary’s Hospital, Mother of Christ Specialist Hospital, Royal Hospital,  and East Side Hospital Enugu between January 2009 and December 2015.

Methodology: One hundred and twenty four patients who had transrectal prostate biopsy were assessed. Complications were graded according to the Clavien-Dindo classification. Grade 1 was regarded as minor and grade 2 classified as major.

Statistical analysis used: simple means and percentages. Categorical variables were analyzed with the Chi square test.  P-value was < 0.05.

Results: Age range was 44 to 90 years, mean (66.6±9.96). Mean PSA value was 13.1ng/ml.

Mean prostate volume was 88.7ml (46 – 210). Minor complications were mostly hemorrhagic, with primary macroscopic hematuria occurring in 43/124 patients (34.6%) and acute urinary retention in 8/124 patients (6.45%).

Major complications seen include urosepsis in 5/124 patients (4.03%) and severe haematuria in 2/124 patients (1.61%).The occurrence of major complications were analyzed by Chi square test against potential determinants; age group, prostate specific antigen (PSA) level and prostate volume (PV).

For age and AUR, there is a significant difference in occurrence of AUR (p=0.01).

For age and urosepsis, the result is significant at (p=0.01). For PSA and AUR, the result is significant at (p=.00). For PSA and urosepsis, the result is significant at (p=.00). For prostate volume and AUR, the result is significant at (p=.00). For PV and urosepsis the result is significant at (p=.03). There was no mortality.

Conclusion: Transrectal Prostate biopsy has a low incidence of major complications.

The occurrence of AUR and urosepsis showed significant associations with age, PSA, and prostate volume.

Open Access Original Research Article

Gestational Diabetes Mellitus: Risk Factors and Perinatal Outcomes in Abha, Saudi Arabia

Mona A. Almushait

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2017/34149

Objective: This study aimed to assess the risk factors associated with gestational diabetes mellitus (GDM) and evaluate its maternal-neonatal outcomes in pregnancies among Saudi women.

Materials and Methods: A one-year retrospective case-control study of Saudi women was conducted at the Abha Maternity and Pediatric Hospital, in Saudi Arabia. All pregnant Saudi women diagnosed with GDM at the time of the study were matched with healthy pregnant women and their newborn babies. Information including socio-demographic data, family history, obstetric history, maternal complications, and neonatal outcomes were collected and recorded from their medical records.

Results: A total of 289 women (159 cases and 130 controls) and their newborn babies were included in the study. Higher rates of maternal and neonatal complications were observed in the GDM group. The factors of advanced maternal age, BMI, family history of diabetes, and previous history of GDM were the main significant factors associated with the development of GDM. Cesarean section, polyhydramnios, and preterm labor were the most common pregnancy outcomes (P<0.001), while hyperbilirubinemia and hypoglycemia were the most common neonatal complications (P<0.001).

Conclusion: The findings confirmed that GDM is a medical disorder of pregnancy that is associated with undesirable maternal and fetal outcomes. Pregnant women at risk for GDM should be identified, and high-quality prenatal care should be offered in order to minimize the complications of GDM both for the mother and the neonate.

Open Access Original Research Article

Lymphocyte Transformation and Nitro-blue Tetrazolium Reduction Rate of Neutrophils among HIV Infected Adults in Sokoto Metropolis

Abdulmumini Yakubu, Mustapha Umar Kalgo

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2017/36033

Aim: The study was aimed at evaluating the functional activity of lymphocytes and neutrophils among HIV positive adults in Sokoto, Nigeria.

Study Design: This was a cross sectional comparative study of HIV positive subjects on HAART, HAART Naïve and apparently healthy control participants.

Methodology: A total of 157 adults were recruited for the study comprised of90 HIV seropositive subjects and 67 age and sex-matched apparently healthy controls.The subjects (HIV infected participants) were further sub-grouped into four different groups based on the revised WHO standard criteria for staging of HIV/AIDS infected adults; as Clinical stage I (n=31), Clinical stage II (n=25), Clinical stage III (n=19) and Clinical stage IV (n=15).The CD4+ cells were evaluated using flow cytometric method, percentage transformed cells were evaluated using culture techniques and neutrophil phagocytic activity was determined using Nitro- Blue Tetrazolium reduction test (NBT). Data were analyzed using SPSS Version 20. A p-value ≤ 0.05 was considered statistically significant.

Result: The CD4count, percentage lymphocyte transformation and Neutrophil ingestion rate of NBT were significantly lowered in HIV infected subjects compared with controls (p<0.05). The CD4+ count, percentage transformed cells and formazan generated by neutrophil was significantly higher among female subjects compared with male subjects (p<0.05).

Conclusion: Our findings revealed a lowered blast formation and neutrophil ingestion rate of NBT indicating a functional derangement in the innate and adaptive immune responses.

Open Access Original Research Article

Ground or Swimming Pool Exercises for Women with Knee Osteoarthritis? A Double-blind Randomized Clinical Trial

R. M. Cardoso, P. H. G. Porto, A. F. Burin, R. B. Daitx, M. B. Dohnert

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/JAMMR/2017/36350

Objectives: To compare the effectiveness of closed kinetic chain (CKC) exercises performed on the ground and in the swimming pool in women with knee osteoarthritis (KOA).

Study Design: Double-Blind Randomized Clinical Trial.

Place and Duration of the Study: Clinical School of Physiotherapy of Ulbra Torres, from March 2015 to June 2017.

Methodology: Thirty-four women with grade 1 and 2 knee knee OA were allocated into two groups. One group received treatment with CKC exercises on the ground (n = 17) and the other group had the same exercises performed in the swimming pool (n = 17) for a period of two months, three times a week, totaling 24 sessions. Subjects were initially assessed prior to randomization, after 12 sessions, after 24 sessions and 3 months after the end of the protocol. The following variables were evaluated: pain, knee joint mobility, hamstring flexibility, hamstring and quadriceps muscle strength and functionality.

Results: There was an improvement in hamstring flexibility with 12 sessions in the pool group and at the end of the protocol in both groups (P<.05). The range of motion of knee flexion increased in both study groups after the intervention (P<.05). The pool group demonstrated a reduction of this gain in the follow-up. Pain decreased similarly in both groups (P<.05). The pool group showed an initial quadriceps strength and left hamstring strength lower than the ground group. However, at the end of the protocol, both groups improved muscle strength in both knees (P<.05). The Lequesne and WOMAC scores reduced significantly with 12 sessions in both groups (P<.05), remaining likewise in the follow-up.

Conclusion: CKC exercises performed both on the ground and in the swimming pool promoted a decrease in pain and joint stiffness, also improving the mobility, muscle strength and functionality of patients with knee OA.

Open Access Original Research Article

Evaluation of Sonographic Detected Fatty Livers: Comparison of Multi Parametric MRI with ARFI Elastography; An Initial Experience

Atul Kapur, Goldaa Mahajan, Aprajita Kapur, J. S. Sidhu

Journal of Advances in Medicine and Medical Research, Page 1-14
DOI: 10.9734/JAMMR/2017/36343

Background: Even as ultrasound based elastography detects changes in liver stiffness with good accuracy  newer emerging tools using magnetic resonance imaging(MRI) are being evaluated to have a global assessment of Non alcoholic fatty liver disease(NAFLD). This study was designed to compare the role Multiparametric MRI (mpMRI) and ultrasound elastography in the assessment of fatty liver detected on sonogram.

Study: 50 consecutive non alcoholic patients with no prior history of chronic liver disease with fatty liver on sonogram had shear wave elastography using acoustic radiation force impulse (SW-ARFI) imaging followed by Mp MRI. The median liver stiffness was assessed on ARFI while liver fat content, iron content along with Mean T1 value of liver determined on MpMRI. The results of   both modalities were statistically analyzed.

Results: Out of 50 patients examined with echogenic fatty livers, 30 were males and 20 females with mean age of 42 years. The median liver stiffness on ARFI was 1.37 m/s while median T1   on Mp MRI was 653.8 msec.  MpMRI showed a sensitivity and specificity of 100%, 91% in detection of liver inflammation with AUC of 1.0 with ARFI.  Statistically significant linear relationship was seen between liver iron content and liver fat content in all groups with T1 maps. 3 patients had abnormal high liver iron content with normal liver fat content but had echogenic fatty liver appearance on ultrasound.

Conclusion: Mp MRI detects changes in liver stiffness based on T1 estimation of liver parenchyma with high sensitivity and specificity with results comparable with SWI-ARFI.  It has advantage over ARFI being more robust and also estimates liver fat and iron content and can be used a single shot test for comprehensive evaluation of echogenic livers.