Open Access Minireview Article

Anatomic Variations and Anomalies in Mandibular First Premolar Teeth

Bharti Sharma, Kamal Nabhi, Shajah Hussain Sheikh, Pooja Mehra

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2018/38633

Mandibular Premolars have been reported with complex anatomical variations making them one of the most difficult teeth to manage endodontically. A clear knowledge and understanding of the anatomy of human teeth is an essential requirement for all dental procedures especially in the case of root canal treatment that deals with the management of tooth’s internal anatomy. The purpose of this article is to call attention to the internal and external variations associated with the mandibular first premolar, an awareness of which will contribute to increased success of endodontic therapy.

Open Access Original Research Article

Identification, Antibiotic Susceptibility Patterns and Biofilm Detection of Isolates in Orthopaedic Implant Infections

Shazia Benazir, Dalip K. Kakru, Syed Khurshid, Asifa Bhat, Umar Nazir, Shaista Nazir, Naseer A. Mir, Lenah Bashir

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/JAMMR/2018/38988

Background: As orthopaedic implants are being increasingly used, managing the implant-associated infections has become a challenge. The aim of this study was to evaluate the bacteriological profile with antibiotic susceptibility patterns and biofilm detection in orthopaedic implant-associated infections.

Study Design:  Cross-sectional prospective.

Place and Duration of Study: The study was conducted in the department of Microbiology and Orthopaedics, Sher-i-Kashmir Institute of Medical Sciences (J&K) India, a tertiary care institute from August 2014 to February 2016.

Methods: The study was conducted on 100 patients having orthopaedic implant infections. Demography and patient parameters were recorded. Microbiological workup by microscopy, culture, antimicrobial susceptibility testing and biofilm detection was conducted as well.

Results: 100 cases were analysed out of which 86 cases revealed a positive culture and 14 cases revealed a negative culture. From these culture positive cases, 11 cases were observed as polymicrobial and a total of 97 isolates were recovered. 53 (54.6%) isolates were Gram-positive cocci and 44 (45.4%) were Gram-negative bacilli. The predominant Gram-positive organism observed was Staphylococcus aureus. Among the Gram-negatives, Citrobacter spp. was more prevalent, followed by Acinetobacter spp. 37(38.1%) isolates were found to be multidrug resistant. Gram-positive organisms demonstrated highest susceptibility to Linezolid (100.0%) where as Gram-negative isolates were highly sensitive to Imipenem(88.6%) and Polymyxin-B(93.2%) but showed high resistance towards Cephalosporins. 15.5% of the isolates were strong producers of biofilm. Staphylococcus aureus was the predominant biofilm producer and 57% biofilm producing organisms were multidrug resistant.

Conclusion: Orthopaedic implant–associated infection puts a great financial burden on patients as well as on hospital resources and leads to increased morbidity. Appropriate microbiological interventions will help in reducing the magnitude of the problem.

Open Access Original Research Article

Analysis of Motor Complications in Parkinson’s Disease Phenotypes

Nargiza Mansurova, Q. Khaydarova Dildora

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/37797

Patients with PD were enrolled in the research study and underwent examination on movement disorder and drug-induced motor complication by UPDRS III and IV. Hoehn and Yahr scale was used to describe the intermediate course of disease. All antiparkinsonian drugs were calculated on theoretical equivalence to L-dopa. 208 patients were divided into three subgroups: tremor-dominant 50,4%, akinetic-rigid 41,9% and mix type 7,7%. All patients were treated with L-dopa, and about three quarters were in combination with a dopamine agonist.Regarding disease duration and developing of wearing off, there was significant difference according to clinical phenotype. AR and mix subtype of PD develop wearing off earlier within 3 years compare to TD. 72,4% TD type develop wearing off after 6 years and further while AR and Mix type develop earlier. It should be also noted that when gender was included in the analysis, we didn't found a positive association with wearing off as well as LID. Peak dose is the most found dyskinesia type in patients. The same no association with average LED with LID. Our findings support the hypothesis that tremor dominant type manifests with a bit benign clinic and complication.

Open Access Original Research Article

Attitudes of Students towards the Profession of Medical Laboratory Science in Faculty of Medical Laboratory Sciences of Usmanu Danfodiyo University, Sokoto, North-Western Nigeria

K. K. Ibrahim, A. Garba, O. Erhabor, A. S. Mainasara, A. H. Buhari, O. Augustine, M. Sanusi, M. K. Dallatu, M. H. Yeldu, I. B. Aliyu, A. Umar, M. L. Jidda, A. A. Ngaski

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/29096

Aim: To look into the attitudes of Medical Laboratory Science students towards the profession of Medical Laboratory Sciences (Bachelor of Medical Laboratory Science) in Faculty of Medical Laboratory Science, Usmanu Danfodiyo University (UDU), Sokoto, North-Western Nigeria.

Study Design: This is a cross-sectional study designed to address the attitudes of Medical Laboratory Science students towards the profession of medical laboratory science; before and after admission.

Place and Duration of Study: Faculty of Medical Laboratory Science, Usmanu Danfodiyo University, Sokoto, North-Western of Nigeria, between January and April, 2016.

Methodology: A structured self-administered questionnaire was designed and distributed for this purpose. After explaining to the students, the research objectives, how to fill the questionnaire's different components and questions, a self-administered 15-item questionnaire was distributed to them for completion. Five Hundred and Six (506) questionnaires were distributed to the students (from 100 level to 500 level), but only Four Hundred and Eighty-Three (483) were returned completed.

Results: Of the 483 students participated in this study; 331(68.5%) were male and 152(31.5%) were female. About 218(45.1%) students initially (before admission) applied for Bachelor of Medical Laboratory Sciences (BMLS), 210(43.5%) applied for Medicine and Surgery (MBBS), while 24(5.0%) applied for Pharmacy and the remaining 31(6.4%) students applied for the other courses.

Conclusion: Although, This study indicates that, almost half of the Medical Laboratory Science students surveyed in the Faculty of Medical Laboratory Sciences of Usmanu Danfodiyo University initially (before admission) applied for medical laboratory science as their future career, many of the students considered Medicine and Surgery (MBBS) as their future career, because they wanted to be involved in patient care. This may due to lack of awareness to the profession of Medical Laboratory Sciences.

Open Access Original Research Article

Validation of Homegrown Stethoscope Simulator for Cardiopulmonary Training

Tarig Eltoum Yagoub Fadelelmoula

Journal of Advances in Medicine and Medical Research, Page 1-4
DOI: 10.9734/JAMMR/2018/38448

Background: The education of health care professionals is a major contributor for patient safety. Advocates of simulation-based education, claim a particularly important role for this modality. Auscultation with stethoscope is an indispensable tool for optimal management of cardiopulmonary patients. However, the acquisition of sufficient training in cardiopulmonary auscultation is not straightforward because of the technical and ethical problems, I realized a low-cost stethoscope simulator to acquire and maintain the skill of cardiopulmonary auscultation. The aim of this study is to validate a homegrown stethoscope simulator for cardiopulmonary auscultation developed by the author and claimed to be of a low-cost and high-fidelity.

Materials and Methods: The hardware was built from a normal clinical stethoscope and a bluetooth headset, and the software is a single PowerPoint presentation slide with links to cardiopulmonary sounds’ audio tracts. The stethoscope simulator was verified by the inventor, and a panel of experts was asked to evaluate its value as a training tool, relevance to practice, physical attributes, realism of experience, ability to perform tasks, realism of material” and realism of auscultation sounds. The validity of this homegrown stethoscope simulator was assessed by a panel of experts. The members had a session on the simulator and how it works, allowed to physically examine the stethoscope simulator, instructed on how to use it, and then auscultated all its cardiopulmonary sounds. A survey was provided to each member of the panel, and they were asked to rate their responses using a 5-point Likert scale as follows: strongly disagree (1), disagree (2), neutral (3), agree (4), and strongly agree (5).

Results: Experts in cardiology, respiratory medicine and respiratory care agreed upon the characteristics and attributes of this stethoscope simulator and the observed average of the “global assessment” of the stethoscope simulator was acceptable. The cost of fabrication of one simulator of this type was approximately 100 USD.

Conclusion: Primary evidence suggests that this homegrown stethoscope simulator is a useful tool that can be integrated into bedside teaching and clinical skill lab to facilitate teaching and learning cardiopulmonary auscultation for undergraduate learners.

Open Access Original Research Article

Culture, Sun Exposure and Vitamin D Deficiency in Benghazi Libya

Mariam Omar, Faiza Nouh, Manal Younis, Moftah Younis, Nesma Nabil, Marwa Saad, Munyah Ali

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/JAMMR/2018/39562

Background: Vitamin D is produced from sunlight exposure through ultraviolet B radiation of the skin. Several factors affect sunlight exposure include time of day, seasonal variation, lower absorption of vitamin D due to dark skin color, sunscreen use, clothing and coverage for cultural or religious reasons along with behavioral attitudes. There is a dearth of studies looking into socio-cultural and behavioral reasons for vitamin D deficiency in the Middle East particularly in Libya. The aim of this study was to identify sun exposure and cultural influences on vitamin D status among patients attending three out patient clinics in Benghazi.

Methods: A cross-sectional sample of 287 subjects who were attending three polyclinics in Benghazi. 258 females, and 29 males. Data on participants’ attitudes and behaviors in relation to sun exposure, cultural and skin tone preference were collected using interviews and questionnaires.

Results: Duration of sun exposure, use of sun block, wearing long sleeves, believing lighter skin is more attractive than darker and feeling unhappy if the sun made the skin darker were all significantly different between different serum vitamin D level groups and predicted lower vitamin D levels. Vitamin D deficiency was 76.1%, insufficiency was 15.2% and Vitamin D sufficiency was 8.7% in our study.

Conclusion: Culture, attitudes and sun exposure behavior could be major contributing factors to the observed high prevalence of VDD in this study. Circulating concentrations of 25(OH)D was significantly lower in subjects with less sun exposure and in those exhibiting negative attitudes toward sunlight. A more accurate measure for culture, behavior and knowledge and sun exposure in a controlled environment is needed to confirm these findings.

Open Access Original Research Article

Perception of Early Pregnancy Symptoms among Antenatal Women in Port Harcourt, Southern Nigeria

Ikobho Ebenezer Howells, Abam Dagogo Semenitari

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/JAMMR/2018/39931

Background: Early pregnancy symptoms are commonly experienced by most women during pregnancy. While some such as missed periods may serve as an early warning symptom, others may be troublesome, necessitating treatment, and even hospital admission.

Objective: The main objective of this study is to determine the pattern of early pregnancy symptoms among pregnant women in Port Harcourt, Southern Nigeria. Specifically, it would determine the type of symptoms, the period of onset, climax, and when they subside. It would also determine the recurrence rate and the maternal effects in the index pregnancy.  

Materials and Method: A cross-sectional observational study of 616 booked pregnant women who attended antenatal care at the department of obstetrics and gynaecology, University of Port Harcourt Teaching Hospital, from February 2015 to January 2016. The patients were educated about early pregnancy symptoms, and relevant questions and concerns were addressed.  Verbal consent was obtained from those who agreed to participate; a structured questionnaire was then distributed among the participants, which was filled, and data were analyzed. 

Results: The prevalence rate for early pregnancy symptoms was very high 89.6%, the symptoms were commoner among primigravid women 208(33.8%), and they tend to reduce significantly with increasing parity. The recurrent rate among parous women was high 82.6%.

The mean gestational age at onset of symptoms was 4.06 ± 1.64 weeks, and by eight weeks, about 87% of the women have developed pregnancy symptoms. The symptoms were perceived to be worse between 5 and eight weeks, with a mean of 7.20 ± 2.15 weeks, and they started to subside by 9 – 12 weeks, with a mean of 14.06 ± 3.85 weeks.

Amenorrhoea was the commonest symptom 98.6%, followed by nausea and vomiting 52.3%, then breast pain and heaviness 52.3%, low back pain 45.3%, and urinary symptoms 36.4%. Pregnancy symptoms interfered very little with professional and domestic activities, and the hospital admission rate was quite low 8.4%.

Conclusion: Women hardly go through pregnancy without experiencing multiple pregnancy symptoms. The prevalence rate was high, especially among Primigravidas, and symptoms tend to be recurrent among multiparous women. Pregnancy symptoms tend to peak around 5 – 8 weeks and begin to subside by 9 -12 weeks.