Open Access Minireview Article

Antioxidant Supplementation and Free Radicals Quelling; the Pros and Cons

B. K. Myke-Mbata, S. C. Meludu, C. E. Dioka

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/JAMMR/2018/39938

An antioxidant is a substance that inhibits oxidation of biomolecules by free radicals. Its primary role is to decrease or inhibit synthesis, scavenge and neutralise the effects of free radicals. A delicate balance is often maintained between antioxidant and free radical. Free radicals being highly active, can react with various important classes of biological molecules such as nucleic acids, lipids and proteins, altering their normal redox state leading to an aberration in their role in cellular metabolism/regulation and tissue structural architecture ultimately leading to cellular injury or death which is known to be deleterious to health. However, free radical is also beneficial to health, if this balance is maintained. Therefore, this review will be throwing light on the relationship between antioxidant and free radicals. Some insight into the benefits of free radical were discussed.

Open Access Original Research Article

Irritable Bowel Syndrome among Paramedical Students, King Abdulaziz University, Jeddah, Saudi Arabia

Nahla Khamis Ibrahim, Shatha Mateab Al-Jamhoor, Nshwa Mahmod Ashor, Amjaad Ahmed Alsulami, Dania Adnan Bukhari, Ahlam Mohammad Al-Bloshi, Traji Tarik Fathi

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2018/39233

Aim: The study was done to determine the prevalence and associated factors of Irritable Bowel Syndrome (IBS) among paramedical students from faculties of Nursing, Dentistry, Pharmacy, and Applied Medical Sciences, King Abdulaziz University (KAU), Jeddah, Saudi Arabia.

Methods: A cross-sectional study was done during at KAU during the academic year 2016/2017. A multistage stratified random sample method was used. A total of 525 paramedical students were selected. A standardized self-administered data collection sheet was used. It contained the validated scales of Rome III Criteria, Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI).

Results: One-third of the paramedical students were diagnosed as having IBS, based on Rome-III criteria. Nursing and dentistry students had a higher prevalence of IBS than others. IBS-Mixed (IBS-M) and IBS-Constipation (IBS-C) were the commonest sub-types. In bivariate analysis, IBS was significantly associated with female gender, the educational specialty, positive family history of IBS, family income, presence of chronic medical conditions, food hypersensitivity, traveler’s diarrhea, poor sleep quality, stress, anxiety, and depression. After controlling of confounding factors, logistic regression analysis revealed that female gender (aOR: 1.83; 95% CI: 1.12-3.28) was the first predictor of IBS, followed by exposure to stress, depression, family history of IBS and poor sleep quality.

Conclusion: The prevalence of IBS was relatively high among the paramedical students from KAU. IBS was predicted by gender, presence of stress, depression, poor sleeping, and family history. Screening for IBS and psychological problems is required. Conduction of stress management courses, and IBS educational programs are recommended for paramedical students.

Open Access Original Research Article

Changing Pattern of Genitourinary Injuries in the Niger Delta Region of Nigeria

Onyeanunam Ngozi Ekeke, Chinedu C. Anyadike

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/JAMMR/2018/39232

Background: The prevention of injuries is a daunting task, and it is even more challenging in developing countries where resources need to be managed prudently. The aetiology of genitourinary injuries varies according to the geographical region. Injuries that were previously uncommon are now encountered in our practice. Changing social lives seem to have affected the pattern of the injuries that are presented by the patients in our practice.

Aims and Objectives: This study was aimed at documenting the new pattern of genitourinary injuries in patients who presented to our hospital from December 2007 to October 2017.

Materials and Methods: A retrospective study was conducted. Patients with genitourinary injuries who presented within the study period were identified. The information was retrieved from patients’ case files, the unit’s audit register, the main theatre operations’ register and the accident and emergency theatre’s register. The number of injuries, site of injury, cause of injury and management of injury were recorded. Data were entered using Microsoft Excel 2010 and analysed using SPSS version 17.0.

Results: There were 186 injuries in 165 patients. One hundred and thirty-three patients (80.61%) were male, and 32 patients (19.39%) were female: the male-to-female ratio was 4.16:1. The modal age was 30–39 years, with an age range from 8 months–82 years. The mean age was 34±13.02 years. Urethral injuries were predominant. The bladder, kidney, scrotum and testis were also involved in the injuries.

The main causes were iatrogenic injuries (30.3%), road traffic accidents (17.0%), domestic accidents (22.4%) and domestic/civilian violence. Most patients had satisfactory outcomes following surgical intervention. Three patients died during the study period.

Conclusion: Genitourinary injuries predominantly affect young persons. The results of our study indicate that injuries associated with civilian violence, domestic accidents and iatrogenic injuries are on the rise in our region. Based on the results of our study, we recommend that attention be paid to social lifestyles, standards of care and existing government policies on safety in order to prevent these injuries.

Open Access Original Research Article

Exposing the Gaps in Awareness and Knowledge of Symptoms, Signs and Risk Factors of Colorectal Cancer among Residents in Peri-urban Olowora Community, South – West Geopolitical Zone of Nigeria

Abudu, Emmanuel Kunle, Akinbami Oluyinka Samuel

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2018/37781

Aim: This study is aimed at exposing the gaps in awareness and knowledge of symptoms, signs and risk factors of colorectal cancer (CRC) among residents in Olowora Community.

Methodology: Data from this cross sectional study were collected through self-administered questionnaire to consenting residents of Olowora community of Ikosi - Isheri Local Government Area of Lagos State, located in South Western region of Nigeria over a period of one (1) month in 2015.

Results: A total of 231 questionnaires were analyzed. Males were slightly over-represented with a male to female of 1.08:1 and a mean age of 30.4 years. The literacy rate was excellent with 79.2% of respondents having post-secondary qualification. Twenty-Eight percent (28.1%) of respondents were knowledgeable of the warning symptoms and signs of colorectal cancer with blood in the stool being the leading worrisome symptom of CRC acknowledged by the respondents (13.4%). Abdominal pain, altered bowel habit, anal itching and anal mass protrusion were other worrisome symptoms of CRC acknowledged by the respondents in 6.5%, 4.8%, 1.7% & 1.7% of cases respectively.  Over forty – three percent of respondents were knowledgeable of the risk factors for colorectal cancer with majority of respondents correctly acknowledged diets rich in fats and poor in fibers as the main contributory factor (20.3%). Other risk factors acknowledged were family history of cancer, smoking, prolonged alcohol consumption and radiation in 14.3%, 4.8%, 3.0% and 0.9% respectively.

Conclusion: This study concluded that the knowledge of symptoms, signs and risk factors of CRC is still low.

Open Access Original Research Article

Assessment of Thyroid Function Parameters among Sudanese Pregnant Women in Different Trimesters

Omer Ibrahim Alamin Hussin, Gad Allah Modawe, Abdelmula M. Abdalla

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2018/39341

Background: The thyroid gland plays an important role in pregnancy outcome as well as in fetal development. The changes caused by pregnancy in the mother establish a new homeostatic equilibrium. Thyroid disorders are common during pregnancy, and adequate treatment is essential to prevent adverse maternal and fetal outcomes.

Objectives: To assess FT3, FT4 and TSH levels in pregnant Sudanese women, and to correlate their levels with the gestation age.

Materials and Methods: This analytical cross-section study was performed at Teanbool hospital obstetrics and gynaecology department in Aljazeera state- Sudan, during the period from January to October 2017. 150 samples were collected from pregnant women (50 in first, 50 in second and 50 in third trimester) as a study group. In addition to other 50 non-pregnant healthy women and age-matched as a control group. The thyroid hormones TSH, FT3 and FT4 levels in both test and control groups, were estimated by automated Cobas e 411 analyzer using electrochemiluminescence immunoassay “ECLIA”.

Results: FT3 and FT4 is significantly decreased (3.9±0.84 verses 4.54±0.65 pmoI/L, p ≤  0.05.12.77±2.54 verses 14.80±1.95 pmoI/L, P ≤ 0.001 respectively), where as TSH is slightly increased (1.86±1.01 verses 1.99±0.95 uIU/mI, P ≥ 0.05) in the study group when compared with the reference group, FT3 is significantly correlated with FT4 (r = 0.47, p=0.001) in pregnant women. According to gestational age FT3 is significantly decreased in the three trimesters (4.1 ±0.18 verses 4.54±0.65, pmoI/L, P ≤ 0.05, 3.8±0.59 verses 4.54±0.65, pmoI/L, P ≤ 0.052, 3.7±0.42 verses 4.54±0.65, pmoI/L, p=0.02), where as FT4 is significantly decreased in the second and third trimesters (3.8±0.59 verses 14.80±1.95 pmoI/L, P ≤ 0.045, 11.28±1.68 verses 14.80±1.95 pmoI/L, p=0.000). In contrast TSH is significantly increased in the third trimester (2.08±0.58 verses 1.99±0.95 uIU/mI, P = 0.05) in the test group when compared with reference one. The study illustrated significant inverse correlation of both FT3 and FT4 with gestation age (r =-0.21, p=0.05, r =-0.39, p 0.02 respectively), whereas TSH is insignificantly correlated with gestation age in the test group (r= 0.14, p = 0.34).

Conclusion: The study revealed a significant decrease in both FT3 and FT4 levels in the pregnant women, with significant negative correlation with gestation age.

Open Access Original Research Article

Mental Morbidity Prevalence, Stigma and Health Care Seeking Behaviors among Non-medical Students in University of Khartoum, Sudan March 2015

Emmanuel Tanyous, Suad Ali, Mustafa Khidir Elnimeiri, Monica Salama

Journal of Advances in Medicine and Medical Research, Page 1-19
DOI: 10.9734/JAMMR/2018/39848

Background: Young adulthood is a critical period in which mental illnesses such as anxiety, mood disorders, and comorbidities such as substance use disorders often first emerge. Mental health problems may lead to disturbed behaviours and can severely impair academic performance. Yet only one-third of young adults with mental disorders seek professional help.

Aims: To study the prevalence of mental health morbidity and the barriers to seeking mental health care among non-medical students in the University of Khartoum.

Study Design:  Descriptive Cross-sectional facility-based study.

Place and Duration of Study: University of Khartoum Central campus, Agriculture and Veterinary campus, and Educational campus March 2015.

Methodology: Study sample included Khartoum university non-medical students, selected using multistage sampling. Sample size 392. Data was collected by distributing self-administered questionnaire. Ethical consent from every participant was obtained. Dependent variables were measured using Standardized tools. Cronbach’s alpha, univariate and bivariate analysis were used.

Results: Study revealed that 57% of students suffered from mild symptoms of depression, 13.7% moderate and 0.5% severe while 61.2% suffered from anxiety symptoms.40% Suffered from moderate to severe stigma. Females were 1.5 times suffering from depression symptoms higher than males OR = 3.4 CI (2.1-5.3) RR = 1.5 CI (1.2-1.7) Pearson Chi-Square = .000 Females were 1.3 times suffering from anxiety symptoms more than males OR = 1.8 CI (1.2-2.7) RR = 1.3 CI (1.1-1.5) Pearson Chi-Square = .008 Students.  Depression symptoms are more likely associated with anxiety symptoms OR = 7.25 CI (4.4 to 11.91) RR = 1.8 CI (1.5 to 2.1) Pearson Chi-Square = 0.000

Conclusion: Majority of university students were found to be suffering from depression and anxiety symptoms, with depression being more prevalent than anxiety. Females were found to be more depressed and anxious than males but less stigmatised. Stigma was a major mental health barrier for seeking medical care.

Open Access Original Research Article

Clinico-pathological Profile of Pyogenic Liver Abscess: An Experience from Tertiary Care Hospital from Kashmir Valley

Mumtaz Din Wani, Mushtaq Chalkoo, Zahid Mohd Rather, Awhad Mueed Yousuf, Syed Shakeeb Arsalan, Zubair Gul Lone, Aabid Rasool Bhat

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/JAMMR/2018/39880

Introduction: Liver abscess is not an uncommon surgical problem seen in day to day clinical practice. It is an important and potentially curable disease entity. It is difficult to diagnose it clinically but is potentially curable, if treated well and reduces morbidity and mortality considerably. The formation of hepatic abscess is related to two distinct groups of pathogens - the pyogenic bacteria and the Entameoba histolytica. Liver abscess is associated with mortality of up to 20%. Surgical drainage of pyogenic liver abscess was the commonest and best accepted modality of treatment in past. Now it is being replaced by minimal access surgical techniques like image guided percutaneous drainage and laparoscopic drainage procedures, but open surgical drainage is still applicable in cases, where the abscesses are secondary to biliary pathology, where percutaneous drainage fails and where abscess has ruptured.

Aims and Objectives: The aim of our study was to evaluate, the various causes of pyogenic liver abscess, commonest micro-organism, various diagnostic modalities in diagnosing pyogenic liver abscess, to evaluate conservative treatment and surgical treatment, and to establish various guidelines for particular therapeutic procedure.

Materials and Methods: The present study entitled “Clinico-pathological profile of pyogenic liver abscess” was conducted in the Department of Surgery SMHS (Shri Maharaja Hari Singh) Hospital Srinagar Kashmir from April 2011 to April 2014. Our study was conducted on 100 patients and following observation was made.

Results: In our study, the maximum age was 67 years and minimum was 6 years. The most common presenting symptom was fever (98%) followed by abdominal pain (76%), and most common sign was fever (98%) followed by right upper quadrant pain (69%).74% of patients have hemoglobin <10 gm. % and 36% had  leucocyte count < 10, 000/ cumm. Blood culture was performed in 72 patients and only 51(70.83%) reports came with positive microbial report and pus culture was performed in 80 patients and 69 (86.25%) reports came with positive microbial report.  The most common organism grown in blood culture was E. coli (Escherchia coli) 33.33%, Klebseilla 29.41% and in pus culture was E. coli 36.23%, followed by Klebseilla 27.53%.USG done in all patients showed right lobe abscess in 72%, left lobe in 21% and in both lobes 7%, single abscess cavity in 75% and multiple cavities in 25% of patients.  CT Scan done in 57 patients showed Right lobe abscess in 64.91 %, left lobe abscess in 28.07 and in both lobes in 7.01%. The various modalities of treatment adopted in our study of 100 patients were open surgical drainage in 21, Percutaneous needle aspiration drainage in 17, percutaneous catheter drainage in 20 and Laparoscopic drainage in 20 and conservative management with intravenous antibiotics in 22 patients. The most common post-operative complications of open surgical procedure was thrombophlebitis in 66.66%, pleural effusion in 23.80%, and in non-surgical procedure complications were  thrombophlebitis of superficial veins, repeated aspiration and pleural effusion,  in 28.07%, 12.28%, 8.77%, 5.26% respectively.

Conclusion: Liver abscess is a fatal disease if early diagnosis and proper treatment is not initiated. Early recognition of clinical features and proper investigation including abdominal USG is very important. Our experience with patients of percutaneous needle aspiration under USG guidance is helpful, and cost-effective for multiple or solitary abscesses of less than 10 cm.  Percutaneous needle aspiration under USG guidance is combined with administration of systemic antibiotics and metronidazole. Patients treated by this technique recover faster and duration of hospital stay is less.