Open Access Original Research Article

The Role of Metastatic Lymph Node Ratio in Gastric Cancer

İbrahim Ekiz, Cem Emir Güldoğan, Emre Gündoğdu, Murat Özgür Kılıç, Mesut Tez

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/36954

Introduction: Lymph node metastases at the gastric cancer is the one of the important prognostic risk factors. In this study, we evaluate the prognostic importance of the Metastatic Lymph Node Ratio in the gastric cancer cases.

Methods and Technique: In this study, we included 56 gastric adenocarcinoma patient who had curative surgery and evaluated retrospectively. Forty one of them were male (%73.2) and fifteen (%26.7) were female. Statistical analysis of the results of this study was done by using SPSS 17 for Windows. Survey analysis was calculated with Kaplan-Meier test and the multivariant analysis was calculated with Cox proportional hazard model.

Results: In our study the factors that effect the survey were the ratio of number of the metastatic lymph node and the dissected total lymph node (MLR-Metastatic Lymph Node Ratio), stage, number of the not involved lymph nodes, the diameter of tumor and differentiation of the tumor. The multivariant analysis showed that stage and the MLR were the independent prognostic factors.

Conclusion: MLO based staging is a simple, effective, and reproducible method for the evaluating the prognosis of the gastric cancer patients who had curative surgery and had involved lymph nodes.

Open Access Original Research Article

Prevalence of Entamoeba histolytica and Hook Worm Infection in Two Communities of Kwande Local Government Area of Benue State Nigeria

B. N. Iorhuna, E. U. Amuta, A. Onekutu, M. O. Iboyi

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2018/39177

Entamoeba histolytica and hookworm are among the 10 most prevalent intestinal parasitic infections worldwide. They contribute to low productivity, malnutrition, miscarriages, reduced lifespan and sometimes death. A study on the prevalence of these two diseases was carried out in Kwande Local Government Area of Benue State, Nigeria. Faecal samples were collected and examined for E. histolytica and hookworm infections from 325 subjects after the structured questionnaire was administered and filled appropriately. The stool samples were analysed using the direct wet smear in normal saline and sedimentation techniques while information on age, sex, occupation and location-related prevalence were obtained from the questionnaires. The results were statistically analysed using SPSS version 20 and mini tab 17th edition. On the whole, a prevalence of 25.5% and 6.2% were recorded for E. histolytica and Hookworm respectively. Children between ages 1-10 years had the highest incidence of amoebiasis (35.5%), while persons aged 41-50 years recorded highest prevalence for hookworm infection (12.2%) The infections were statistically significant concerning sex and occupation (p < 0.05). Females were less infected as compared to the males with a prevalence of 20.5% and 35.8% for E. histolytica and 1.9% and 15% for hookworm infection respectively (P<0.05). Farmers had the highest prevalence of 40.3% for E. histolytica and 16.8% for hookworm infection while traders recorded the lowest infection rates of 12.7% and 0.00% respectively (P<0.05). The prevalence of E. histolytica was higher in Mbawer, a farming community (29.6%) while a higher prevalence of hookworm infection was recorded in Adikpo Township (7%), the values, however, were not significantly different (p>0.05). Poor hygiene practices, lack of awareness and basic social amenities, as well as water sources in the study area, contributed to the spread of the infections. This study recommends awareness creation, public enlightenment programs on environmental sanitation and personal hygiene.

Open Access Original Research Article

Precautionary Measures taken by Caregivers against Accidental Childhood Poisoning in Edo and Delta States, Nigeria

Blessing I. Abhulimhen-Iyoha, Ikponmwosa Owie, Ujiro Igbudu

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2018/38874

Background: Accidental childhood poisoning constitutes one of the most vital challenges of child health in contemporary times. It is a major public health issue worldwide. Many childhood poisoning episodes are avoidable but measures to prevent poisoning are usually overlooked by caregivers. Many deaths and disabling complications in children following poisoning could be prevented if more attention were given to implementing preventive measures at home. The strategies undertaken by caregivers (if any) to prevent accidental childhood poisoning in their young children is thus worth evaluating.

Aim: To assess the precautionary measures taken by caregivers and determine factors that influence the precautionary measures against accidental childhood poisoning among caregivers in Edo and Delta States of Nigeria.

Subjects and Methods: The study subjects included 632 caregivers who brought their under-five children to Well Baby/Immunization Clinics of the University of Benin Teaching Hospital (UBTH) and the Central Hospital, Benin City in Edo State and the Federal Medical Centre (FMC), Asaba and Central Hospital, Warri in Delta State, Nigeria. A structured questionnaire was used to assess their biodata, types of potential poisons present in the home, the container for storage, where kept and precautionary strategies adopted by caregivers in order to prevent accidental childhood poisoning.

Results: The common precautionary measures adopted by caregivers to prevent childhood poisoning include keeping household cleaning agents [bleaches (56.6%), detergent (54.1%)] and medicines (65.7%) out of the sight of their children as well as ensuring that these poisons [bleaches (57.6%), detergent (55.1%) and medicines (64.1%)] are above shoulder height. It is important to note, however, that caregivers indulge in risky practices like leaving the poisonous bait meant for rodents to remain on the floor for days when not eaten by the rats (44.8%) as well as leaving children below five years in the care of older children who are below 15 years (38.8%). Some caregivers (42.6%) keep potential poisons in familiar containers like soft drink bottles which is capable of attracting the children to the poisons while others (55.4%) hardly use chemicals stored in child-resistant containers which ought to help in the prevention of accidental poisoning in children. There was no significant relationship between level of education, marital status, occupation and type of apartment of caregivers on one hand and level of precautionary measures taken on the other hand.

Conclusion/Recommendation: Health education of the populace on aspects in which caregivers are deficient is necessary so as to prevent episodes of childhood poisoning. The mass media may be employed to reach a large audience in this regard.

Open Access Original Research Article

The Adjunctive Effect of Topical Application of Metronidazole 15% Gel to Manage of Moderate Distal Pocket on Mandibular Wisdom Teeth Being Treated for Endodontic-periodontal Lesions

Anas Abdullah Q. Khawshhal, Mohammed MA. Abdullah Al-Abdaly, Bassam Abdullah Qasem Khoshhal

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2018/39716

Aim: This study aims to evaluate the adjunctive effect of topical application of metronidazole 15% gel to manage of moderate distal pocket on mandibular wisdom teeth being treated for endodontic-periodontal lesions.

Materials and Methods: This study included thirty mandibular wisdom teeth with endodontic-periodontal lesions and moderate distal periodontal pockets in three equal groups (n=10) selected from the outpatient clinics, college of dentistry, King Khalid University. Endodontic periodontal treatment finished in the first visit (1st) of all patients. The group I was considered as a control group (endodontic and periodontal treatment only). The study groups consisted of endodontic and periodontal treatment plus irrigation with normal saline (0.90% w/v of NaCl, 308 mOsm/L) as placebo therapy in group II and the endodontic and periodontal treatment plus metronidazole 15% gel topical application in group III. Plaque index (PLI), gingival index (GI) and periodontal pocket depth (PPD) were recorded at baseline as first (1st) visit, 4weeks as a second (2nd) visit and 6 weeks as third (3rd) visit. All data collected and analyzed by Friedman test, the comparisons between the groups of the present study was carried out.

Results: There was decreased in PLI among the patients of group III compared to PLI of group I and II in the 2nd  and 3rd  visit moreover; there was reduced in GI among the patients of group II and III compared to group I in the 3rd  visit only. Concerning PPD, there was decreased in PPD among the patients of group II and III in the 2nd visit only compared to 1st visit.

Conclusion: In the end of the study there were no significant differences in the comparison of all clinical parameters between the patients in the present study at all the study intervals except PPD also there were no significant differences in clinical findings in the comparison of the present study groups in 2nd and 3rd visit of distal pocket therapy except PLI of group II and III.

Open Access Original Research Article

Rectal Swabs Demonstrate High Levels of Ciprofloxacin Resistant Escherichia coli among Patients Undergoing Prostate Biopsies in San Fernando, Trinidad and Tobago

Rajendra Sukhraj, Kirk Gooden, Lester Goetz, Satyendra Persaud

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/39284

Objectives: To establish the prevalence of ciprofloxacin resistant Escherichia coli in the fecal carriage of patients undergoing trans-rectal ultrasound (TRUS) guided prostate biopsy.

Methodology: From August 2014 to January 2015, all patients undergoing trans-rectal ultrasound guided prostate biopsy at the San Fernando Hospital had rectal swabbing done. Also, data regarding demographics, recent hospitalization and antibiotic use, prior biopsy, diabetes mellitus and indwelling urinary catheters were prospectively collected. The cultures were incubated in Blood and MacConkey agar and E. coli isolates are tested for antibiotic sensitivity using the Kirby-Bauer method and the Microscan automated system. All isolates of Escherichia coli were tested for sensitivity to ciprofloxacin and other antibiotics commonly used in urological practice. Patients were followed for 4 weeks post biopsy for complications. Data were recorded in Microsoft Excel and analyzed using SPSS version 20.

Results: 100 patients had rectal swabs taken, and 70 cultures were positive for Escherichia coli with 36 (51%) being resistant to ciprofloxacin and 58% (21/36) of these isolates being multi-drug resistant as defined by resistance to 3 or more classes of antibiotics. Resistance to other antibiotics commonly used in urological practice was also identified: gentamicin 28% (19/67), amoxicillin/clavulanate 34% (24/70), piperacillin/tazobactam 11% (8/70), trimethoprim/ sulfamethoxazole 28% (17/61) and ceftriaxone 27% (16/60). There was a trend towards increased resistance among patients with indwelling catheters and recent antibiotic use.

Conclusion: There is a high prevalence of ciprofloxacin resistant Escherichia coli in the fecal carriage of patients undergoing TRUS guided prostate biopsy and the current prophylaxis policy may need to be revised.

Open Access Original Research Article

Prevalence of Human Papillomavirus Deoxyribonucleic Acid in Cervical Cancer Specimens in Calabar, Nigeria

Godstime I. Irabor, Dominic Akpan, Kenneth A. Omoruyi, Martin A. Nnoli, Edoise M. Isiwele, Uche Amaechi, Olukayode Oshatuyi

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/JAMMR/2018/38971

Aim: To determine the prevalence of human papillomavirus (HPV) deoxyribonucleic acid in cervical cancer specimens in Calabar, Nigeria.

Study Design: This is a retrospective prevalence, a cross-sectional study on archival cervical cancer specimens.

Place and Duration of Study: This study was done at the department of pathology, University of Calabar Teaching Hospital, Calabar, on cervical cancer specimens between 1st January 2009 and 31st December 2014.

Methodology: Paraffin-embedded tissue block of all the invasive cervical cancer specimen received during the study period were collected. Basic socio-demographic data were obtained from the medical records. Sections of the tissue were obtained from the blocks, digested using proteinase K solution and the DNA was extracted. A polymerase chain reaction and DNA enzyme immunoassay (DEIA) was done. The results of the DNA enzyme immunoassay were read, and the samples were categorized as HPV DNA positive or negative.

Results: One hundred and twenty-three cervical cancer specimens were analysed. There were one hundred and ninety-six gynaecological malignancy specimens received during the study period, giving an invasive cervical cancer prevalence of 62.7% among the gynaecological malignancies in the centre. The samples were from female subjects aged from 32 to 75 years. Their mean age was 48.6 ± 10.6 (years). A majority (86) which made up 69.9% of the subjects was below 51 years. The peak age group of the disease among the subjects is 42 – 51 years.
One hundred and thirteen (91.90%) of these samples were HPV DNA positive while ten (8.10%) of the samples were HPV DNA negative. The prevalence of HPV DNA in the samples by age group distribution shows the highest prevalence of 38.6% from the 42-51 years age group followed by those in a 31 - 40 years age group (33.3%), 61 – 70 years (16.7%),  51 – 60 years (10.5%) and the age group with the lowest prevalence is >70 years (1.6%).

Conclusion: There is a need for the precise pattern of HPV DNA prevalence in cervical cancer in every part of the world to be established. The fill of this knowledge gap would help in enhancing the development of strategies targeted at the elimination of cervical cancer globally.

Open Access Review Article

Keloids and Hypertrophic Scars: A Review of Risk Factors, Pathophysiology, Prevention, Management, and Treatments in Dermatology and Surgical Practice

Tanasha Simela, Diana A. Rivers, Ashley Simela

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2018/35975

Introduction: Hypertrophic scars and keloids are the results of a fibroproliferative disorder involving an aberrant wound healing response to dermal injuries that lead to the development of these benign lesions. Careful consideration of the patient populations that are most prone to developing keloids and hypertrophic scars has revealed that genetics may play a role in developing these pathological scars. The clinical distinction between these two lesions has classically relied on the characteristics of the scars borders with hypertrophic scars remaining within the borders of the original wound and keloids extending beyond the original wound borders.

Conclusion: The most important factor in hypertrophic scar and keloid formation is prevention. A key strategy for prevention of hypertrophic scarring and keloid development is to identify those patients predisposed to this wound healing response and to control the Inflammation that can trigger these scars. Primary goals of treatment include reducing the cosmetic appearance of these lesions and preventing their recurrence once treated.