Open Access Original Research Article

Diagnosis and Treatment Outcome of Smear Positive Pulmonary Tuberculosis: Retrospective study in Kpando Municipal, Ghana

Desmond O. Acheampong, Richard Opoku, Alex Boye, Daniel S. Agyirifo, Isaac Dadzie, Prince A. Barnie, Godwin Kwakye-Nuako, Francis Nyandzi

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/JAMMR/2018/40156

Background: Smear microscopy remains the primary tool for the detection of tuberculosis in Ghana. Laboratory diagnosis of active tuberculosis cases by sputum smear microscopy is a critical component of Directly Observed Treatment, Shortcourse (DOTS). Effective control of tuberculosis in Ghana at the rural level therefore hinges on the quality of local laboratory to provide accurate and reliable direct acid fast bacilli microscopy testing for diagnosis, treatment and monitoring.

Method: A retrospective trend analysis of laboratory entry records of tuberculosis (TB) cases from the Anfoega Catholic Hospital of the Kpando Municipal District in the Volta region from January 2013 to December 2015 was conducted. Patients were diagnosed according to the National TB programme Control guidelines. Data were computed into statistical software and analyzed for descriptive statistics, odds ratio and chi-square at 95% confidence interval. A p-value < 0.05 was considered statistically significant.

Results: Of the 116 cases recorded during the study period, 54 (46.6%) were found to be smear positive pulmonary tuberculosis and was highest among 21-40 year group. Annual prevalence generally decreased during the study from 31 (57.4%) to 11 (32.4%) with corresponding increase in treatment success rate. The proportion of new smear positives decreased from 27 (50.0%) in 2013 to 11(20.4%) in 2014 and 2015 respectively while new smear negatives also reduced from 19 (30.6%) in 2013 to 15 (24.2%) in 2014 but rose to 18 (29.1%) in 2015. High smear positivity was observed among males 33 (61.1%) than in females 21 (38.9%). 113(97%) of the 116 patients had their HIV status tested. Of these, 24 (21.2%) were HIV positive. 9 (7.9%) out of the 113 were found to be co-infected with Pulmonary tuberculosis.

Conclusion: Treatment outcome was statistically associated with age group but not with sex and was more successful among TB only patients compared to patients with TB/HIV co-infection, and HIV prevalence among smear negatives were higher than smear positives.

Open Access Original Research Article

Obstetric Admission into the Intensive Care Unit (ICU) of the University of Port Harcourt Teaching Hospital: A Ten-Year Review

K. I. Green, N. C. Orazulike

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/38256

Background and Aims: This study examines the spectrum of diseases, booking status of women, surgical interventions and maternal outcome of obstetric patients admitted to the intensive care unit (ICU) in the past 10 years.

Methodology: A 10-year retrospective review of all obstetric admissions into the ICU from January 2006 to December 2016. The ICU records and case files of the patients were used to extract relevant information.

Results: A total of 1548 patients were admitted into the ICU during this period, and 302(19.5%) were obstetric patients. The obstetric patients admitted into the ICU represented 1% of all 31,200 deliveries within the study period.

Majority of patients admitted (51.79%) were of the 21-30-year age bracket. Similarly, unbooked patients contributed majority (59%) of admissions. Hypertensive disorders, e.g. Severe pre-eclampsia and Eclampsia constituted the most frequent obstetric diagnosis with a rate of 31.6%. Majority of these patients (65%) had caesarean sections, about 21% had an abdominal hysterectomy and 15% had laparotomy with uterine and bladder repair. The unbooked mothers had a statistically significant incidence of complications which include hypertensive disorders (severe PET, Eclampsia), ruptured uterus compared to the booked obstetric patients. Also, the unbooked mothers were more likely to die than the booked mothers. The maternal mortality was 28.99% of total admissions, amongst which the unbooked mothers accounted for 94% of these deaths and booked mothers 6%.

Conclusion: Obstetric patients admitted into the ICU especially the unbooked ones had a high mortality rate and severe morbidity rate in our environment. Therefore, the adoption of the safe motherhood principles remains a key tool in reducing maternal morbidity and mortality, especially in unbooked patients.

Open Access Original Research Article

Long-term Consumption of Capsicum annuum (Chili Pepper) and Capsaicin Diets Elevates Anxiety but Improves Motor Coordination in CD-1 Mice

A. U. Nmaju, I. E. Joshua, U. E. Okon, S. A. Bisong, A. Nwankwo, E. E. Osim

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/JAMMR/2018/40348

Background: Chilli (Capsicum annuum), an extensively cultivated vegetable, is used to spice many dishes. It contains capsaicinoids, which give it a characteristic pungency. The most active and well known amongst these capsaicinoids is capsaicin (8-methyl-N-vanillyl-6-nonenamide), which is neurogenic and may affect neuronal function.

Aim: It was hence, the aim of this present study to investigate the effects of long-term consumption of capsaicin and chilli pepper diets on anxiety and motor coordination. 

Materials and Methods: Thirty male mice were randomly assigned into three groups of ten mice each, namely; control, pepper-diet (20% w/w) and capsaicin-diet (10%w/w) groups. Drinking water was allowed to all the animals ad libitum. The elevated plus maze and light-dark transition box were used to assess anxiety-related behaviour while the beam walking test was used to determine motor coordination in the mice.

Results: The pepper and capsaicin diet-fed groups of mice had significantly shorter (p<0.001 and p<0.01 respectively) open arm durations compared to their control. While the head dips of the pepper group were not significantly different, that of the capsaicin group was significantly higher (p<0.01) compared to the control. The light chamber durations of both the pepper and capsaicin-diet fed mice were significantly shorter (p<0.01) compared to control.  In the beam walking test to assess motor coordination, the frequency of foot slips for both pepper and capsaicin groups were significantly lower compared to control (p<0.001).

Conclusion: Long-term consumption of capsaicin and pepper diets increased anxiety but enhanced motor coordination in mice.

Open Access Original Research Article

Inguinal Hernias in a Tertiary Hospital in South South Nigeria

A. Dodiyi-Manuel, P. N. Wichendu

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2018/38103

Background: Inguinal hernia repair is the most common operation performed by general surgeons worldwide. Early presentation and elective repair are necessary to eliminate the morbidity and mortality associated with this condition. The diagnosis is based on clinical signs and symptoms.

This study seeks to determine the pattern of adult inguinal hernias and type of repair offered at the University of Port Harcourt Teaching Hospital (UPTH).

Materials and Methods: This is a 4-year retrospective study of all adult patients with inguinal hernias who were admitted into the surgical wards of UPTH. Relevant data were retrieved and analysed using the Statistical Package for Social Sciences (SPSS).

Results: A total of 276 patients were seen. There were 180 males and 96 females giving a male to female ratio of 1.9:1. Majority of the patients were in 31-40 years age group. The hernias were commoner on the right and inguinoscrotal hernias more commonly seen than bubonocele. and funicular types.

All the patients had open herniorrhaphy. Nylon darning was done in 181 (65.6%) and this was the commonest form of posterior wall repair.

Thirty two (11.6%) patients had complications with scrotal haematoma being the commonest accounting for 6.5% of patients.

Six patients died giving a mortality of 2.2%.

Conclusion: Inguinal hernia still remains a common disease and source of morbidity and mortality in our locality. Males were more commonly affected and Nylon darning was the method of choice in the majority of cases operated. It is recommended that early presentation and elective herniorrhaphy be encouraged in order to eliminate the morbidity and mortality associated with this condition.

Open Access Original Research Article

Practices Relating to Dietary Intake of Pregnant Women Attending Antenatal Clinic at Primary Healthcare Centres in Ile-Ife, Nigeria

M. O. Oluleke, A. O. Ogunwale, O. S. Olaleye, I. Tubi, O. S. Arulogun

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/JAMMR/2018/40042

Background: Inadequate dietary intake during pregnancy is a primary proximate determinant of poor maternal and child health. Maternal dietary practices related information is useful for designing appropriate interventions. This study was therefore designed to document dietary intake-related practices of pregnant women attending Antenatal Clinics (ANCs) in Ile-Ife, Nigeria.

Design and Methods: The cross-sectional study involved a total of 530 consenting women attending ANCs in 35 primary health care centers.  A pre-tested questionnaire which included participants’ socio-demographic information and dietary practices measures were used to collect data. Data were analysed using descriptive statistics and Chi-square.

Results: Respondents' mean age was 27.0±5.3 years, 44.5% had tertiary education, 70.7% earned below ₦30,000 (about $83) monthly. A majority (97.2%) always take dinner, 96.8% take lunch, and the least taken food was breakfast (95.1%). Pap with beans-cake, Rice with beef stew, and ‘amala’ (yam or cassava flour meal) with ‘ewedu’ (Jute leaf soup) topped the list of foods that were mostly taken for breakfast, lunch and dinner respectively. Most (77.7%) respondents eat more than three times daily and pastries (60.9%) topped the list of snacks they consumed. Significantly, a higher proportion (30.2%) of participants aged 14 - 24 years eat 3 times or less compared with those aged 25- 34 years (18.6%) and 35 and above years (21.6%).

Conclusions: Participants especially older persons eat more than three times per day. However, breakfast was the most skipped meal. Diets often taken as dinner were ‘heavy meals' and snacks often taken in between meals were pastries. Nutrition education interventions are required to address the phenomenon.

Open Access Original Research Article

The Retinal Layers in the Preservation of Visual Acuity in the Early Stages of Idiopathic Intracranial Hypertension

Reşat Duman, Güliz Fatma Yavaş, Esma Norman, Sibel İnan, Rahmi Duman

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/JAMMR/2018/40153

Purpose: To investigate the thickness of the retinal layers in the preservation of visual acuity in the early stages of the disease in patients with papilledema associated with idiopathic intracranial hypertension (IIH).

Study Design: Retrospective clinical study.

Methods: Right eyes of 23 IIH patients and 28 healthy control subjects were included in the study. Peripapillary retinal nerve fiber layer (RNFL) thickness in four quadrants and average ganglion cell layer (GCL) thickness measured by high-definition optical coherence tomography (at a presentation in both groups, and also at 6-months after the presentation in the patient group) were retrospectively analysed.

Results: Mean age was 38.9±11.9 years in the patients and 42.8±10.2 years in the control subjects (p=0.19).  All of the participants were female. Mean RNFL in all quadrants was significantly higher in the patients compared to controls. Mean RNFL in all quadrants was considerably lower at 6-months of presentation compared to that at presentation (p<0.005), whereas mean GCL was similar in both groups.

Conclusion: No changes were observed in the GCL of IIH patients in the early stage, despite significant RNFL changes. This may explain the preservation of visual acuity in the early stages of the disease.

Open Access Review Article

History of Cautery: The Impact of Ancient Cultures

S. M. Alsanad, A. A. H. Asim, I. M. A. Gazzaffi, N. A. Qureshi

Journal of Advances in Medicine and Medical Research, Page 1-17
DOI: 10.9734/JAMMR/2018/40370

Background: Healers around the world successfully practice traditional cautery (in Arabic kaiy) since ancient times. Traditional cautery, centuries of medical practice with unidentified exact origin has survived till today that authenticates its significance and effectiveness in mitigating human sufferings and diseases.

Objective: This overview aimed to describe and synthesise the literature on historical perspectives of traditional cautery.

Methods: The relevant literature published in English prior to 2018 was electronically searched in databases (PubMed, MEDLINE, Google Scholar, and OvidSP) using the Boolean operators and keywords. Manual searches and references of published articles and books were also conducted. A number of pertinent articles and abstracts (N=7490) were retained for extensive appraisal by two independent reviewers, and finally, 82 articles were included in this paper.

Results: The historical practice of traditional cautery is documented in diverse ancient cultures but the earliest references found in Surgical Papyrus (1550BC). The inconsistent data evidenced the origin of cautery, definitions, instruments, anatomical sites and techniques, advancements and research in traditional cautery since antiquity. Cautery was diminished in early 1800 century but revived in late 1800-1900 AD in the world. Presently, traditional cautery with better procedures and aseptic means is used by healers for treatment of a variety of diseases around the Eastern and Western world.

Conclusion: Traditional cautery has a checkered history and is a complementary modality for managing difficult-to-treat medical and surgical conditions. Scientifically more advanced modern types of cautery are used in the treatment of a variety of diseases across the world. This study calls for researching elucidating the underlying mechanisms of actions and effects of traditional cautery.