Open Access Short Research Article

Retrospective Case Series Analysis of Clinical Outcomes Associated with Management of Severe Community Acquired Pneumonia Cases due to K. pneumoniae with CSE-1034

Reema Kashiva, Danish Memon, Ram Agarwal

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/40164

Background: In India, the rapid emergence of multi-drug resistance among community acquired pneumonia (CAP) causing pathogens contributes to the seriousness of these infections and is currently a major treatment-related issue. The objective of this case series was to determine the clinical efficacy of antibiotic adjuvant entity (CSE-1034: Ceftriaxone+Sulbactam+EDTA) in severe CAP cases.

Methods: Severe CAP patients due to K. pneumoniae who were hospitalized and treated with CSE-1034 as monotherapy or combination therapy were screened and further analyzed. CSE-1034 therapy was started in all these subjects based on culture sensitivity (C/s) profile and continued or discontinued depending on clinical response. 

Results: 25 K. pneumoniae culture-positive patients with mean age of 52 years were included in this case series. C/s profile has shown that pathogens isolated from all subjects were completely resistant to amikacin, cefazolin, ceftriaxone, pipericillin-tazobactam (pip-taz) and cefoperazone/sulbactam. Sensitivity pattern of CSE-1034 was 100% and meropenem was 85%. The C/s reports and clinical response to CSE-1034 were in concordance in 92% patients. 23/25 (92%) patients treated with CSE-1034 were cured with CSE-1034 monotherapy and 2/25 (8%) with CSE-1034+colistin combination therapy.

Conclusion: From this case series, it can be presumed that CSE-1034 can serve as effective replacement to BL/BLI combinations and appears to be effective drug for treatment of severe CAP cases.

Open Access Original Research Article

Epidemiological Profile and Risk Factors of Preterm Births in two Referral Hospitals of Butembo, Eastern Democratic Republic of the Congo

Apollinaire Kahindo Saasita, François Katsuva Mbahweka, André Kambale Maliro, Alexandre Amini Mitamo

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/40395

Background: Preterm is defined as babies born alive before 37 weeks of pregnancy are completed.  We distinguish three categories of preterm babies: extremely preterm(less than 28 weeks), very preterm (28 to 32 weeks) and moderate to late preterm (32 to less than 37 weeks). Preterm births constitute a real public health problem that currently needs the attention of pediatricians with their colleagues obstetricians, for it constitutes a leading cause of deaths in children under 5. This study aimed to determine the frequency of preterm birth and linked risk factors, in the two general referral hospitals of Butembo.

Method: it was about a cross-sectional study, carried out in the two referral hospital of Butembo, in the DRC, from January 1st, 2015 to December 31st, 2016. It was observed a sample of 6,253 newborns of two referral hospitals: Katwa and Kitatumba, located in Butembo-DRC, from January 1st 2015 to December 31st, 2016.

Results: The frequency of preterm births was 3.53% in Katwa and Kitatumba referral hospitals. Almost 67% of the preterm births occurred at 32-36 weeks of gestation, and most of preterm newborns weighted between 1000-1499g. There is no significant difference in the distribution of preterm births according to infant sex. Women under 18 and ≥ 35 years old, primiparous and grand multiparous, single, attending to less than 4 antenatal care sessions, and those with a low level of education status were the most concerned with preterm births. Premature rupture of membranes, genital and Urinary tract infections, pre-eclampsia, eclampsia, and hypertension during pregnancy were retained as principal causes associated to the occurrence of preterm births, as well as those multiple-fetus pregnancies.

Conclusion: The prevention of principal causes of prematurity , and the early management of pregnant women at risk of having a premature delivery will lead to the decrease of preterm birth frequency and therefore to the decrease in infant mortality.

Open Access Original Research Article

Psychosocial Factor as a Determinant of Quality of Life in Diabetic Patients Attending an Outpatient Clinic in Lagos Nigeria

Oluwaseun Gabriel Olorunkoya, Suraju Adeyemo, Okeke Chinelo, Abojei Chris, Chinedum Eluogu, Rachael Asagba

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2018/41135

Aim: The management of Diabetes Mellitus have been referred to as the most demanding of all chronic diseases. Due to this adjustment, patients are often faced with challenges which may confer a negative influence on their quality of life. Various psychosocial factors have been reported to affect the quality of life of patients with diabetes mellitus. The study aimed to determine the relationship between meaning in life, life satisfaction and social support, and quality of life in diabetic patients

Study Design: this is a cross-sectional study of the quality of life in patients with diabetes.

Place and Duration of study: Endocrine unit of Lagos university teaching hospital, Lagos Nigeria. The study was conducted between June and September 2016.

Methods: 239 participants were enrolled through a simple random sampling method, age range was between 25 and 90 years, 131 were male while 108 were female, most of them were married (n=222). Meaning of life scale, life satisfaction scale, Berling social support scale WHO quality of life scale and socio-demographic questionnaire were used in all participants. Data was analysed using a statistical package of social sciences.

Results: Educational level (r= -.148, p=.05), meaning in life (r=-.169, p=.05), life satisfaction (r=.391, p=.05) and social support (r=.276, p=.05) showed significant relationship with quality of life. Meaning in life, life satisfaction, and social support jointly accounted for 42.2% variance in quality of life among patients with diabetes mellitus, while the remaining 57.8% could be attributed to other factors.

Conclusion: The findings from the current study implies that meaning in life, social support, and life satisfaction plays an important role in the general wellbeing of a patient with diabetes mellitus.

Open Access Original Research Article

The Effect of Previous Cholecystectomy on Stage of Pancreatic Head Adenocarcinoma

Ali Sapmaz, Murat Özgür Kılıç, Serdar Gökay Terzioğlu, Ahmet Serdar Karaca

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/JAMMR/2018/41177

Aim: A relationship between the history of cholecystectomy and risk of pancreas cancer has been previously shown. However, the effect of cholecystectomy on pathological features of pancreatic cancer has not been investigated yet. The aim of the study is to investigate the possible effect of cholecystectomy on tumor stage in patients who underwent Whipple procedure for pancreatic head adenocarcinoma.

Study Design: This is a retrospective clinical study.

Methodology: A total of 116 patients were included in the study. All patients were classified as patients who had a history of cholecystectomy (Group 1) and those without a history of cholecystectomy (Group 2). The two groups were compared with each other in terms of clinical and pathological characteristics.

Results: There were 48 (41.4%) females and 68 (58.6%) males, with an overall mean age of 60.7 years. Twenty-two (19%) patients had a history of cholecystectomy. The patients in Group 1 had a higher T-stage than patients in Group 2 (p<0.001). The stage of tumor was also significantly different between the groups (p<0.001).

Conclusion: This is the first study indicating the possible effect of previous cholecystectomy on tumor stage in pancreatic head cancer. Clinicians should be more careful in the evaluation of such patients to avoid a delay in the diagnosis.

Open Access Original Research Article

Experimental and Mathematical Model for the Hepatoprotective Effect of Methanolic Extract of Moringa oleifera Leaf against CCl4- induced Hepatotoxicity in Sprague Dawley Male Albino Rats

Momoh Johnson Oshiobugie, Adeniyi Michael Olaniyi, Aderele Oluwaseun Raphael

Journal of Advances in Medicine and Medical Research, Page 1-14
DOI: 10.9734/JAMMR/2018/32062

Background: To evaluate the in-vivo antioxidant potential of methanolic extract of Moringa oleifera leaf against CCl4- induced toxicity in rats.

Methods: The phytochemicals present in the plant were determined using standard methods. Male albino rats were made hepatotoxic by orally administered with CCl4 (20% CCl4 in olive oil) twice per week for a period of four weeks. They were orally treated with Moringa oleifera leaf extract (250 and 500 mg/kg body weight) and silymarin (200 mg/kg body weight) once a day for 28 days. Biochemical assays such as: plasma levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), total cholesterol (TC), triglyceride (TG), total protein (TP), lipid peroxidation, catalase, reduced glutathione, superoxide dismutase, glutathione peroxidise and histopathology were used to assess damage caused by CCl4 and the protective effects of the extract on the liver tissues. The mathematical model was analysed using Maple 18.0 software

Results: Phytochemical screening of Moringa oleifera shows the presence of secondary metabolites like tannin, anthocyanine, steroid, anthraquinones, terpenoids and saponin. The extract does not have any effect on the hematological parameters. The results showed that oral administration of M. oleifera significantly reduced (P<0.05) the elevated plasma levels of AST, ALT, ALP, GGT, TC, TG and the level of malondialdehyde in the rats liver that were induced with CCl4. Treatment with the extract was also found to significantly increase (P<0.05) the TP level, the activities of SOD % inhibition, SOD unit, CAT and GPx, as well as increase the GSH content in the liver of the animals. Liver histopathology also showed that the extract reduced the incidence of liver lesions induced by CCl4. Mathematical model analysis shows that treating the rats with Moringa oleifera leaf extract gives an optimal result just like the standard drug which is in conformity with the experimental result of the bench work.

Conclusion: The result suggested that M. oleifera exhibits potent hepatoprotective effects on CCl4-induced liver damage in rats due to the increase of antioxidant-defence system activity and the inhibition of lipid peroxidation.

Open Access Original Research Article

Prevalence of Irritable Bowel Syndrome and Its Imprint on the Quality of Life of Undergraduate Students at a Malaysian Medical University

Chitra Govindaraja, Annamalai Chandramouli, Than Winn, Aung Ko Ko Min, Heethal Jaiprakash, Ameeta Patil, Sunil Kale, Sharmila Vedhavathy Sornam

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/JAMMR/2018/41013

Background: Albeit not life-threatening, symptoms of irritable bowel syndrome (IBS) interfere with routine activities and compromise the quality of life (QOL).  Except for one survey on the prevalence of IBS among students in Malaysia a decade back, there are no other reports. QOL in IBS is yet to be investigated in this region. 

Objective: To determine the prevalence of IBS and its impact on QOL among students at a Malaysian medical university.

Methodology: A cross-sectional, questionnaire-based, self- reported study was conducted among 1104 students. The IBS-QOL questionnaire based on Rome III criteria and a demographic questionnaire were used.

Results: The overall prevalence of IBS was found to be 45.3%, with a female preponderance of 49.8%. It was also found to be predominant among Chinese 55% and physiotherapy students 61.7%. IBS Mixed type (IBS-M) was found to be common among all students (78.6%). The mean score for QOL for all IBS symptom positive students was 74.2±22.3. 

Conclusion: The overall prevalence of IBS has escalated, particularly in Chinese, females and physiotherapy students with IBS-M type being the commonest.  Chinese, IBS Diarrhoea type (IBS-D) and those with low-grade symptom severity enjoy a better QOL. Routine screening for IBS symptoms, mindfulness-based stress reduction, encouraging physical activity and reviewing curriculum overload will go a long way to improve the QOL in IBS.

Open Access Original Research Article

Impact of Socioeconomic Status on Spirometry Reference Values among Children and Adolescents of Karachi

Sara Sadiq, Syed Tousif Ahmed, Nadeem Ahmed Rizvi, Muzna Shah, Muhammad Fazal Hussain Qureshi, Mahira Lakhani

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2018/41660

Aim: The aim of the study is to assess the influence of socioeconomic status on the lung function among the children and adolescents of Karachi.

Study Design: The current study is a cross-sectional study.

Place and Duration of Study: Sampling was started in April 2017 and ended up in October 2017. The data were collected from different primary, middle, secondary and higher secondary schools of Karachi.

Methodology: The study participants enrolled were between the age group of 7-18 years. A modified form of International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was used. All the spirometry variables were measured and interpreted, these including forced vital capacity, forced expiratory volume in 1 second, FEV1/FVC, peak expiratory flow rate, forced expiratory flow between 25% and 75% expired volume. ANOVA was applied to evaluate group variation while intragroup variations were analyzed by using Post-Hoc Tukey’s test.

Results: The pulmonary variables like FVC, FEV1, PEF and FEF25-75 had a significant value with socioeconomic status, on the other hand, the ratio of FEV1/FVC was presented as non-significant but fortunately it persisted higher than 90% among all groups. After applying Post-Hoc Tukey’s test all the spirometry variables showed significant intra-group variations as P value was less than .05 mentioned.

Conclusion: It is concluded that the socioeconomic status of children should be considered during evaluation of lung function, especially in the settings of developing countries.