Open Access Minireview Article

From Experimental Science to Clinical Medicine- A Historical Overview of Important Milestones in the Evolution of Organ Transplantation

Manik Razdan, Howard B. Degenholtz

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2017/37375

The remarkable progress of transplant medicine in the latter half of the twentieth century has led to an unprecedented demand for donated organs that have historically remained in short supply. Although a clinically effective procedure, organ transplant’s health benefit to the society is seriously limited by the shortage of organs. While the number of donors has been increasing at a steady rate, the number of people who can be effectively treated with a transplant has, far out-paced the supply of organs. It is therefore ironical that the benefits of transplant medicine are limited by the consequence of its own success. And it is this great paradox that makes this issue interesting and challenging.  In this review, we briefly visit the historical developments that resulted in favorable conditions for the evolution of transplant medicine. The brief history of organ transplantation presented here draws attention to the rapid evolution of transplant medicine and the consequent rapid rise in demand for organs. This review is the first of the two-part series. In the second part of this series, we will recount how the society has responded to the increasingly evident need for transplantable organs, as well as, the ethical issues concerning removal of organs from the human body.

Open Access Original Research Article

Assessment of Socio-demographic Factors and Self-esteem among Imo State University Medical Students, Nigeria

J. N. Egwurugwu, M. C. Ohamaeme, E. I. Dike, B. C. Chinko, E. N. A. Egwurugwu, C. R. Ohamaeme

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/JAMMR/2017/37041

This study was conducted to assess socio-demographic factors that influence self esteem among medical in Imo state University, Orlu Campus, Nigeria. A total number of 472 students, 232 males and 240 females, were randomly selected from among the 700 medical students in the University. Self esteem was assessed using 10- item Rosenberg’s Self-Esteem Scale. Socio-demographic data was obtained through a self-administered questionnaire. Data obtained from the research was analyzed using SPSS software version 21. Frequency tables, means and percentages were generated. Pearson’s correlation was used to test for association between self esteem and the variables. The results showed that the mean age of the respondents was 23.58±0.16. The mean score of self-esteem among the students was 22.08±0.25. A total of 429(90.89%) of the participants had high self esteem while 43(9.11%) had low self esteem. The results also showed statistically significant positive relationships between self esteem and primary school attended (r=0.125, p=0.001), learning environment (r=0.137, p=0.007), monthly allowance from the sponsor (r=0.189, p= 0.001), provision of essential materials by the sponsor (r=0.146, p=0.001) and educational level of the sponsor (r= 0.096, p=0.038).

The results revealed that majority of the respondents had high self-esteem, choose to read medicine on their own and were mainly sponsored by their parents. There is significant positive correlation between self-esteem and primary school attended, learning environment, and sponsor’s educational level, monthly allowance and provision of essential items to the students (p<0.05). The high self-esteem among the students may be attributed to the strong family support, effective learning environment and good schools attended.  Therefore it is recommended that government should provide conducive learning environment with adequate infrastructures while parents and/or sponsors should endeavor to provide all the essential needs of the students to ensure sustainable high level of self esteem.

Open Access Original Research Article

Chikungunya, Dengue and West Nile Virus Infections in Northern Tanzania

Novati L. Faustine, Elias J. Sabuni, Arnold J. Ndaro, Eliakimu Paul, Jaffu O. Chilongola

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2017/37234

Aim: We aimed at determine the prevalence of Chikungunya virus (CHIKV), Dengue virus (DENV) and West Nile virus (WNV) in Bondo and Magugu wards in Handeni and Babati districts in Northern Tanzania, in a cross sectional analytical study.

Study Design: This was cross sectional, community based study involving individuals aged 1-80 years of age. Reverse transcription Polymerase Chain Reaction (RT-PCR) was used to detect arboviruses in whole blood samples. Data was analyzed using SPSS 22.0. Chi square and logistic regression analyses were used to determine associations of explanatory factors and arbovirus infection.

Results: Out of 128 participants recruited, 10 (7.8%) and 1 (0.8 %) were positive for CHIKV and DENV, respectively. None of the participants recruited was positive for WNV. Most cases of arboviruses were detected in Magugu with 8 (12.31%) and 1 (1.54%) individuals being positive for CHIKV and DENV respectively. Male sex was associated with CHIKV infection (χ2=9.126, p=0.003), with five times more odds of having CHIKV infection compared to females (OR: 5.30;(95%CI: 1.21-23.17), P=0.027). No WNV case was detected in any of the sites.

Conclusion: CHIKV is the most prevalent arbovirus in the Northern part of Tanzania. Magugu site has more arbovirus transmission than Bondo site. WNV could be a rare virus in the Northern part of Tanzania. Male sex is associated with higher CHIKV infection rates, with older children being more affected.

Open Access Original Research Article

A Report on the Practice of Day Case Surgery at the Federal Medical Center, Owerri, Nigeria

J. K. Aguocha, C. C. Onoh

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2017/36438

Introduction: Day case surgery is described as admitting a patient to the hospital for a selected elective surgical or diagnostic procedure followed by recovery under observation, then discharging the patient, when stable, to home care. The procedures usually do not require extended recovery time and are performed under local anesthesia, However, if available, general anesthesia can also be provided.

Purpose: This study was performed to determine the nature and number of the various surgical procedures performed in our hospital’s same day surgical service.

Methods: This was a hospital-based cross sectional study of 138 patients treated between July 2007 and June 2008. Data was collected from the time of the registration, during the clinical examination and collection of samples for laboratory study. The data generated was entered into Microsoft Excel 2016 and transported into Statistical Package for Social Sciences (SPSS) version 22.0 Inc. (Chicago, IL, USA). Results were presented as frequencies and percentages for categorical variables.

Results: The General Surgery service had the most cases (86 cases, 62.3%), followed by Pediatric Surgery (17 cases, 19.6%). Orthopedic surgeries were the least number of procedures performed (11 cases, 8.0%). In terms of procedures performed, the most frequently performed procedure was lesion excision (65 cases, 47.1% followed by excision biopsy (20.3%), then herniotomy, herniorrhaphy, hydroceletomy at 10.9%, 4.3%, 3.6% respectively.

Conclusion: Hospital facilities management of resources, staff, hospital infrastructure, continued improvement, and sustainability can be helped by continued self-assessments to aid in choosing and investing in the most relevant technology to control costs and, at the same time, continue to improve clinical care.

Open Access Original Research Article

Comparative Effects of Antiepileptic Agents Dichrostachys glomerata Ethanol Extract and Carbamazepine on Seizures and Anxiety in Mice

Udemeobong Edet Okon, Peter P. Erigbali, Eme Effiom Osim

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/JAMMR/2017/36654

Aim: Treatment for neurological disorders have been sought through both herbal and orthodox medicine, therefore this present study compared the antiepileptic effects of Dichrostachys glomerata (D. glomerata) and Carbamazepine (CBZ) on Pentylenetetrazole (PTZ) induced seizures in mice.

Materials and Methods: Twenty-four Swiss white mice of 20 – 30 g body weight were randomly divided into four groups of six mice. They were treated with normal saline (0.1 ml/10 g body weight i.p) for control, PTZ (65 mg/kg body weight i.p), D. glomerata (4.5 mg/kg body weight i.p) and CBZ (40 mg/kg body weight i,p). The seizure assay was carried out and the light-dark box and elevated plus maze were used to test for anxiety. Treatment was for seven days. On the experimental day, tests were conducted 15 minutes after PTZ administration. CBZ served as the reference drug.

Results: Both CBZ and D. glomerata increased the latency of seizure (p<0.001) but that of CBZ group was significantly higher (p<0.001) compared to DG group. CBZ significantly lowered (p<0.01) the duration of seizure compared to the D.G group. In the light-dark box, CBZ lowered the duration the mice spent in the dark chamber compared to the control and DG groups (p<0.05). In the elevated plus maze, CBZ and D. glomerata significantly decreased (p<0.05) the grooming duration compared to control. CBZ also significantly increased (p<0.05) the open arm entry frequency.

Conclusion: D. glomerata exhibited anxiolytic and anticonvulsant effects in comparison to placebo. Although D. glomerata was effective in reducing seizures in mice, CBZ was observed to be more efficient in alleviating anxiety.

Open Access Original Research Article

Effect of Obesity on Balance Control in Adolescent Females

Anees S. Ghait, Eman A. Elhosary, Amr A. Abogazya

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/JAMMR/2017/37238

Background: Obesity may affect musculoskeletal, locomotor system and quality of life in adolescent females.

Aim: The study was conducted to detect the effect of obesity on balance control in adolescent females.

Methods: Cross section study, sixty adolescent females were selected from faculty of physical therapy, Kafr elsheikh University. Their ages ranged from 15 to 19 years old. Group A, 30 subjects with normal body weight, body mass index (BMI <25 kg/m2) and group B, 30 obese subjects BMI ranged from 30-40 kg/m2. Balance measured by Biodex Balance System (measuring dynamic balance parameter; overall (OA), anterior-posterior (AP) and medial-lateral (ML) stability index scores).

Results: The mean scores of OA, AP and ML in group B were significantly higher in group B (P <.05) than group A.

Conclusion: The study proved that adolescent obese females have poor balance control compared to non-obese group. We concluded that obesity has a negative impact on balance control of young adult obese female.

Open Access Review Article

Chronic Kidney Disease and Hypertensive-Related Complications of Elevated Fibroblast Growth Factor 23

O. O. Omodara, P. P. Mshelia, M. I. A. Saleh, A. A. Madaki

Journal of Advances in Medicine and Medical Research, Page 1-14
DOI: 10.9734/JAMMR/2017/36967

Chronic Kidney Disease (CKD) affects more than 10% of the world population. Treatment methods such as dialysis or transplantation are expensive. Among different factors responsible for the cause and progression of CKD are diabetes mellitus and hypertension. Hypertension is also a consequence of CKD. According to studies, hypertension is highly prevalent among patients with CKD and becomes more severe as the disease progresses. Fibroblast growth factor 23 (FGF-23) is an hormone which is a major regulator of phosphate balance. Vascular dysfunction and hypertension are among the various cardiovascular diseases (CVDs) associated with CKD. Reports suggest that the development of vascular dysfunction and hypertension is mediated by elevated FGF-23 levels in CKD. FGF-23 causes: renin-angiotensin-aldosterone system (RAAS) activation, plasma volume expansion due to aldosterone activities and increased expression of Na+Cl- Co-transporter (NCC) in the renal distal tubule, increased vascular resistance due to the vascular effects of angiotensin II and free radicals. All of which independently result in the development of hypertension in CKD.  In opposition, RAAS inhibition prevents vascular smooth muscle contraction. It has been found in both experimental and human studies that RAAS inhibition may restore renal klotho, which may directly and indirectly improve kidney function and protect the cardiovascular system during CKD. Also, chlorothiazide, an inhibitor of NCC function, decreases blood volume and consequently prevents volume-induced hypertension. Furthermore, treatment with antioxidant agents to scavenge and reduce reactive oxygen species (ROS) or superoxide decreases vascular reactivity, hence, reduces or prevent oxidative stress. Also, oxidative stress is reduced or prevented through caloric restriction and calorie-restriction mimetics which reduce the generation of ROS by stabilizing mitochondrial energy production and efficiency. This review focuses on the role of elevated FGF-23 complications in the development of hypertension in CKD, and how these complications could be ameliorated. In conclusion, this review recommends treatment of hypertension that targets reduction or prevention of elevated FGF-23 complications in CKD and increased klotho expression to prevent CKD progression.