Open Access Case Report

Clinicoradiological Correlation of Crouzon Syndrome – A Case Report

P. Venkatalakshmi Aparna, F. Massillamani, A. Priyadharshini, D. K. S. Lakshminrusimhan

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/JAMMR/2018/38904

Crouzon's syndrome is a rare autosomally dominant genetic disorder with complete penetrance and variable expressivity. In 1912 a French neurosurgeon first described this disorder. There is a mutation in the fibroblast growth factor receptor 2 (FGFR2) gene which causes this syndrome. Crouzon's syndrome is characterised by premature closure of sutures in the skull predominantly involving coronal and sagittal suture resulting in interference in the growth of the brain.

Open Access Original Research Article

Prevalence of Irritable Bowel Syndrome, Psychological Ill-Health and Health-Seeking Behavior in a Population of Nigerian Medical Students

Abiodun Christopher Jemilohun, Olukayode Abayomi, Philip Babatunde Adebayo

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2018/39235

Background: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder with considerable morbidity and profound negative impact on quality of life. It has been observed that patients with psychological disturbances relate more frequently with the symptoms of IBS, and they have more debilitating illness than control populations. We examined the prevalence of IBS among a population of Nigerian medical students and its association with two common psychological conditions (anxiety and depression).

Methods: In a descriptive cross-sectional study, we enrolled 321 consenting medical students aged 20 to 50 years. A 34-item self-reporting questionnaire consisting of sociodemographic data, the Rome III IBS questionnaire, the Hospital Anxiety and Depression Scale and two IBS-related health-seeking behaviour questions was administered to the participants. Statistical analysis was done with the IBM-Statistical Package for Social Sciences (SPSS), version 20.

Results: A total of 320 participants were included in the analyses. The mean age of the participants was 26.3 ±4.1 years. The prevalence of IBS among the medical students was 14.4%, and IBS-M was the predominant subtype (58.7%). IBS had a significant relationship with the female gender [OR =2.19 (95% CI, 1.14 – 4.22), P =0.019] and anxiety [OR 1.18 (95% CI, 1.06-1.32), P =0.003]. The disease showed no significant association with other risk factors considered. IBS health-seeking behaviour was significantly associated with depression [OR = 8.89(95% CI, 1.66 - 47.51), P<0.001].

Conclusion: IBS is moderately prevalent among our study population, and it is positively associated with the female gender and anxiety.

Open Access Original Research Article

Knowledge of Diabetic Complications and Practice of Routine Medical Check-up among Type 2 Diabetics in Nigeria

Ogunleye Adeyemi, T. Famakinwa Timothy, Daomi Victoria Oluwanimodimu, T. Oluwafemi Tosin

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2018/38597

Awareness about possible complications and regular medical check-up are essential for prevention, early detection and treatment of diabetic complications. Data on a pattern of health check among individuals with diabetes mellitus (DM) is scarce; thus we aimed to assess the practice of routine medical check-up.

Methods: A total of 105 individuals with type 2 DM attending a diabetic clinic at the State Specialist Hospital Ondo, Ondo state, Nigeria, participated in this descriptive, cross-sectional study. Participants were interviewed using a pre-tested structured questionnaire to assess knowledge and self-declared practice of routine medical check-up. Data analysed using SPSS version 21, were significant at p<0.05.

Results: Participants were aged 56±9.9 years with a male to female ratio of 1:1.5 and DM 6.7±7.1 years. 90.5% of the participants were aware of possible DM complications.

Specific knowledge about the diabetic foot was highest with 90.5% having good knowledge. 84.8%, 79.0%, and 61.9% of participants also demonstrated good understanding of retinopathy, neuropathy and cardiac complications while participants’ knowledge of cerebral damage, erectile dysfunction and nephropathy were inadequate in 61.9%, 63.8% and 60% respectively.

All participants had their blood pressure checked regularly while only 36.2% (38) ever had other routine medical check-ups. Among these, 25.7% (27) tested their eyes, while 11.4% (12) have checked kidney functions at least once, out of which only 7.6% (8) verified within the last one year.

Neither duration nor participants’ knowledge of DM complications correlated with routine check-up (p=0.313).

Conclusion: The practice of regular medical check-up was poor among type 2 DM, and this may be associated with inadequate knowledge about specific diabetic complications. Awareness should be increased on diabetic complications and need for routine evaluation among type2 DM patients.

Open Access Original Research Article

Restoration of Insulin Productionin Induced Diabetic Rats, by Wakouba an Extract of Local Plant

Kouame Felix, Tiepka Justine, Bahi Calixte, Coulibaly Adama, Lucien Boga

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2018/38099

Background: Wakouba is an extract of a medicinal plant used by the local populations of Côte d'Ivoire for the treatment of diabetes

Aims: Develop a new drug from the medicinal plants of our country Cote d'Ivoire that will be able to treat emerging diseases like diabetes.

Materials and Methods: The antidiabetic effects of wakouba were evaluated in Mice. The decrease as well as the production of insulin were determined by the enzymatic immunometric chemiluminescent method of Raufman and al. in 1992.Blood glucose was also assessed by the Tietz enzymatic method in 1987. Diabetes was induced with streptozotocin (STZ).Histopathological sections studies of the pancreas were made according to the method used by Agbor and et al.

Results: The results show that the production of insulin decreases significantly during the diabetes whereas the same rate increases during the treatment of the diabetic animals by Wakouba. At the same time, blood glucose decreases and normalizes. Besides, Wakouba restores the integrity of the Beta cells of Langerhans cells which had been destroyed during the induction of diabetes by streptozotocin.

Conclusion: Wakouba restores the integrity of the Beta cells of Langerhans cells which had been destroyed during the induction of diabetes by streptozotocin. Wakouba may be responsible for conversion of pancreatic α cells into pancreatic β cells. This may be confirmed by further researches.

Open Access Original Research Article

Retrospective Analysis of Malarial Parasitemia and Bacteremia in Febrile Episodes Seen at Tertiary Hospital at Nguru, Nigeria

K. O. Okon, M. Y. Bularafa, S. Pius, S. T. Balogun, R. T. Akuhwa, B. A. Zanna, J. O. Onah

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2018/38781

Background: Febrile episode remains the common clinical presentation responsible for hospital admission among children aged less than 5 years in sub-Saharan African. The overlapping of clinical signs and symptoms, with diverse aetiological agents implicated in febrile illness, tends to compound effective diagnosis and management approach in a low-resource healthcare setting.

Objective: We retrospectively analysed malaria parasitemia and bacteremia results of febrile patients seen at a tertiary hospital in Nguru, Yobe state, Nigeria.

Study Design: A retrospective study analysed malarial parasitemia and bacteremia of febrile patients aged less than 12 years.

Place and Duration of Study: The study was conducted at the federal Medical center Nguru in the department of Medical Microbiology and Paediatric that spanned between January and December 2014.

Methodology: Thick and thin blood smear examination for asexual malarial parasite, blood culture technique for bacterial pathogens isolation, and antibiotic susceptibility testing were employed for the study.

Results: Malarial parasitemia was detected in 44(32.6%) cases, bacterial pathogens isolated in 51(37.8%) and co-infection prevalence of 16.3% respectively. Five different bacterial pathogens were isolated, Staphylococcus aureus accounted for 34(66.9%), Salmonella spp 10(19.6%), Escherichia coli 4(7.8%), Coliforms 2(3.9%) and Streprotococcus pneumoniae 1(2.0%) respectively. The significant statistical difference was observed between clinical details and microbiological indices, malarial parasite (P<0.001) and bacterial pathogens (P<0.0001). High malarial parasitemia and bacteremia was observed within the age-group of 1-11 months and >60 months. The bacterial pathogens demonstrated high resistance pattern to ampicillin and cotrimoxazole.

Conclusion: These findings presented local epidemiological data of febrile episode that could optimized febrile illness diagnosis and management approach.

Open Access Original Research Article

In-hospital Imaging Prevalence, Patterns of Neurological Involvement in Cerebral Venous Sinus Thrombosis: Analysis from Pakistan

Fatima Mubarak, Muhammad Azeemuddin, Shayan Sirat Maheen Anwar, Waseem Mehmood Nizamani, Madiha Beg

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2018/38540

Objective: The objective of the study was to calculate in-hospital imaging prevalence and report patterns of neurological involvement in cerebral venous sinus thrombosis patients presenting at a tertiary care hospital in a developing country.

Methods: A cross-sectional analytical study elicited data from the Department of Radiology at the Aga Khan University Hospital from January 2007 until December 2012. Patients of either sex were retrospectively recruited from medical record database. They were included if they presented with or were referred from clinical departments for evaluation of suspected cerebral venous sinus thrombosis. Diagnosis of cerebral venous sinus thrombosis was made on the basis of a combination of Magnetic resonance imaging with Magnetic resonance venogram imaging findings.

Results: A total of 597 scans were reviewed. Mean age was 37.46 ± SD 15.4 years, range: 72 years. Out of the total sample of 66, 28(46%) were males. Infarcts were more pronounced in females. Regarding clinical features, most commonly presenting symptom was a headache and weakness, 16 (26%) and 14 (23%) respectively. The 6 -year in-hospital imaging prevalence of cerebral venous sinus thrombosis was calculated as 11.055%, (66/597), 95% CI [8.54-13.56%] and true positive rate as 10.22%, (61/597), 95%CI [7.79-12.65%]). Patterns of sinus involvement were multi sinus involvement, and the major combination was superior sagittal, sigmoid and transverse 9(15%), sigmoid and transverse 8(13%), all sinuses 5 (8.2%).

Conclusion: There is increasing trend of multi sinus involvement in our population which can be detected early, by contrast, enhanced magnetic resonance venogram.

Open Access Review Article

Coal Fly Ash Aerosol: Risk Factor for Lung Cancer

Mark Whiteside, J. Marvin Herndon

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/JAMMR/2018/39758

Aim: Coal fly ash (CFA) is a major contributor to ambient air pollution in China and India, but it is trapped and sequestered in Western nations. Members of the public chronically exposed to aerosolized CFA are likely to have an increased incidence of respiratory disease, including lung cancer. Our objective is to review the multiple carcinogenic constituents of aerosolized coal fly ash in connection with their potentiality to cause lung cancer.

Methods: We review the interdisciplinary scientific and medical literature.

Results: CFA contains a variety of potentially carcinogenic substances including aluminosilicates, an iron oxide-containing magnetic fraction, several toxic trace elements, nanoparticles, and alpha-particle-emitting radionuclides.  Silica, arsenic, cadmium, and hexavalent chromium are found in CFA and all have been associated with increased lung cancer risk.  Radical generation catalyzed by transition metals associated with the particulate matter in CFA can result in a cascade of cell signaling, transcription factor activation, and mediator release. Ferric iron in the aluminum-silicate glass phase of CFA is a source of bioavailable iron. There is emerging evidence that reactive iron induces cancer stem cells and aggressive phenotypes in lung cancer. The potential pulmonary toxicity and carcinogenicity of aerosolized CFA is suggested by studies of asbestos, a fibrous silicate that also contains iron oxide. CFA contains an abundance of ultrafine particles and nanoparticles, including magnetite (Fe3O4). These tiny particles are toxic to lung cells, capable of producing oxidative stress, cytotoxicity, and genotoxicity. Radioactive elements are concentrated in CFA. CFA can settle deep in the lungs where its alpha-particle-emitting radionuclides pose significant risk factors for lung cancer.

Conclusion: Considering the well-known and manifold toxicities of CFA, the public should be made aware of the potential risks for lung cancer and severe respiratory disease posed by aerosolized CFA including its use in climate alteration activities.