Open Access Case Report

Case Series of Cutaneous Adnexal Tumours; a Voice to the Existing Literatures, a Tertiary Hospital Experience in South-South Nigeria

E. Imasogie Dele, T. Azeke Akhator

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2018/40650

Introduction: Cutaneous adnexal neoplasms have limitless morphologic varieties. Their clinical appearance is typically non-specific. To make a specific diagnosis of cutaneous adnexal neoplasm is important because some benign cutaneous adnexal tumours are markers of multiple endocrine neoplasms (MEN); others have a confirmed risk of transformation into malignant neoplasm. We noticed a paucity of data on the subject matter in our environment in particular and in Nigeria in general. This report is a case series of the histopathological types of cutaneous adnexal tumours over a 10 year period at the University of Benin Teaching Hospital (UBTH), Benin City, Edo state, Nigeria.  

Methodology: It was a 10-year retrospective case series of cutaneous adnexal tumours seen in UBTH from January 2004-December 2013. Histology slides were retrieved, studied and lesions characterized using the World Health Organization classification of cutaneous tumours. The data obtained from this study was analysed using the Statistical Package for Social Sciences, version 16 (SPSS 16, SPSSInc. Chicago, Illinois, United States of America).

Reports of Case Series: Cutaneous adnexal tumours (CATs) are rare in our own environment and accounted for 1.6% of all cutaneous (skin) tumours during the period under review. They occurred more commonly in males giving a male to female ratio of 5:1. There was neither a case of malignant CAT nor was there a case of cutaneous tumour of follicular or sebaceous differentiation reported. The benign cutaneous sweat gland tumours had a prevalence of 100% of the CATs. Eccrine poroma was the most common benign cutaneous sweat gland tumour and by extension the most common CATs.

Conclusion: Cutaneous adnexal tumours are relatively rare with their composition skewed in favour of the benign cutaneous tumours in general and benign cutaneous sweat gland tumours (eccrine and apocrine differentiation) in particular. Multicentre studies may help in giving a more acceptable conclusion for the Nigeria population.

Open Access Original Research Article

Evaluation of Serum Copper (Cu), Serum Iron (Fe) and Serum Copper (Cu) / Iron (Fe) Ratio in Oral Submucous Fibrosis in Karachi

Haya Muhammad Khan

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2018/40845

Aims: To evaluate serum copper, serum iron, and copper/iron ratio in oral submucous fibrosis disease in Karachi.

Study Design: A cross-sectional study.

Place and Duration of Study: Ziauddin Hospital (Dental OPD), Karachi, Pakistan. In between the period of January 2014 to August 2015.

Methodology: This cross-sectional study included 130 oral submucous fibrosis patients, which were divided into 50 stage 1 OSMF, 50 stage 2 OSMF and 30 healthy individuals between the age range of 6-60 years (91 males and 37 females). Detailed questionnaire followed by sample collection of serum copper and iron from each patient was administered. Colorimetric assay analysed the samples.

Results: Mean age of OSMF patients was 34 years (15- 44 years). Most of them were males (70%), and less were females (30%). The highly affected group was of Muhajirs (Urdu speaking people) with the frequency of 40.8% as compared to other ethnicities. In the present study, the mean serum levels for copper (Cu) and iron (Fe) in healthy individuals were found to be 87 ± 20.2927 µg/dL and 73.7 ± 29.594 µg/dL respectively. In stage 1 OSMF patients, mean serum copper and iron levels were 149.56 µg/dL ± 10.8009 and 28.32 µg/dL ± 3.04 respectively. In stage 2 OSMF patients, mean serum copper and iron levels were 178.58 µg/dL ± 6.60887 and 18.82 µg/dL±2.21. Copper/ Iron ratio was also compared among different stages OSMF patients and healthy individuals. Among healthy individuals, copper/iron ratio was 1.2 which rose to 5.3 in OSMF stage 1, and the highest ratio was found in OSMF stage 2 with 9.5. It showed that the copper/iron ratio significantly increased with the severity of the disease (p < 0.0001).

Conclusion: Copper (Cu) and iron (Fe) could be used as biological markers in oral submucous fibrosis. Serum Cu to Fe ratio could be a helpful tool and a reliable biomarker in the diagnosis and prognosis of OSMF disease.

Open Access Original Research Article

Hypertension among Type 2 Diabetic Patients in Uyo, South East Nigeria

Umoh, Victor Aniedi, Akpan, Effiong Ekong, Alphonsus Idung

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2018/40604

Objective: The prevalence of non-communicable diseases especially diabetes is increasing in Nigeria. In addition to the other tropical diseases they present an increased load on the healthcare resources of the nation. Diabetic patients with comorbid hypertension are at an increased risk for cardiovascular disease morbidity and mortality. This study was conducted to determine the pattern of hypertension among diabetic patients.

Methods: Patients in the diabetes and metabolic diseases clinic of the University of Uyo Teaching Hospital (UUTH) were recruited for this study. They filled a questionnaire and had their BP measurements taken. Hypertension was defined as having a previous physician’s diagnosis of hypertension or persistent elevation of BP ≥140/90mm Hg.

Results: Three hundred and twenty patients were recruited for the study. There were 177(54.1%) females and 150(45.9%) males. The average age of the patients was 56.2 ± 9.3 years while the average duration of diabetes was 8.3 ± 5.3 years. Two hundred and forty (73.4%) of the patients were previously known hypertensive patients with only 48(20%) having adequate BP control.

Conclusion: The prevalence of hypertension among diabetics is quite high and the control of BP is poor. This puts them at an increased risk for cardiovascular diseases morbidity and mortality.

Open Access Original Research Article

New Agent Ceftolozane/Tazobactam for the Treatment of Superbug - Pseudomonas aeruginosa: Restoring the Miracle

Lubna Jahanzeb, Zahida Memon, Faisal Afridi, M. Owais Ismail, Bina Fawad

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/41573

Objective: To compare in vitro activity of Ceftolozane/tazobactam and Imipenem against multi-drug resistant (MDR) Pseudomonas aeruginosa from various clinical specimens.

Place of Study: Study was conducted in department of Pharmacology, Ziauddin University and isolates were collected from Microbiology department of Ziauddin hospital, Nazimabad campus, Karachi.

Methodology: It was a Quasi experimental study in which total 176 isolates of P. aeruginosa was collected from which 97 isolates was MDR P. aeruginosa MDR Pseudomonas aeruginosa (P. aeruginosa) isolates were collected from various specimens such as pus, tracheal aspiration, wound swab, blood and urine. Samples were processed as per procedures interpreted by Clinical Laboratory Standard Institute (CLSI) guidelines 2018. Susceptibility of MDR P. aeruginosa against Ceftolozane/tazobactam (C/T) and Imipenem was performed by E-test strip method. Results were interpreted by (CLSI) guidelines. Data were analyzed by using Statistical Package for Social Sciences (SPSS) version 21.

Results: The maximum number of MDR P. aeruginosa was isolated from pus (33.1%) followed by tracheal aspiration (20.6%). C/T showed 60% susceptibility whereas Imipenem showed 19% susceptibly to P. aeruginosa. In vitro activity of C/T was found to be superior as compared to Imipenem against MDR P. aeruginosa with E-test strip method (P-value = <0.0001).

Conclusion: In vitro activity of C/T was found to be better against MDR P. aeruginosa compared to Imipenem. This combination has a low tendency to induce resistance, especially against Gram-negative organisms, so it is an initiative of a new phase in the world of complicated infections.

Open Access Original Research Article

Screening for Obesity during the World Health Day in Ogboloma, a Small Rural Settlement in the Niger Delta Region of Nigeria

Oghenekaro Godwin Egbi, Dimie Ogoina

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2018/41219

Aims: To determine the prevalence and correlates of generalized and central obesity in a small rural Ijaw community in the Niger Delta region of Nigeria. This is essential in the primary prevention of diseases associated with obesity.

Study Design: Place and Duration of Study: The study was cross-sectional in design. Participants were recruited through a consecutive sampling of all eligible participants who presented for a screening exercise during the world health day in April 2012. The study site was Ogboloma, a small rural population in Bayelsa State, Nigeria.

Methodology: Socio-demographic data, clinical history, anthropometry and blood pressures were taken. Confidentiality was maintained. Data were stored and analyzed using SPSS version 20.0.

Results: Generalized obesity was found in 12.2% of participants while 23.7% were overweight. A total of 47(35.9%) individuals either had generalized obesity or were overweight. Central obesity was more prevalent among females across the three different criteria. Waist hip ratio identified more participants as obese (69.5%) compared with waist circumference (51.1%) and waist height ratio (57.3). The predictors of generalized obesity were age and education while central obesity was predicted mainly by gender.

Conclusion: The prevalence of obesity in this rural community was high and compares with recent trends. There is a need for regular screening of communities for obesity so that affected individuals can be managed properly to minimize the risk of attendant complications.

Open Access Original Research Article

Diastolic Dysfunction in Preoperative Normotensive Normoglycemic Patients Older than 50 years-A Hospital Based Prevalence Study

K. Bhuvaneswari, Bhavani Vaidiyanathan, K. Balamurugesan, I. Joseph Raajesh, Vasanth .

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2018/41081

Introduction: Preoperative assessment of heart function has typically focused on evaluating left ventricular ejection fraction (LVEF) which measures the systolic function of the heart. Recent evidence suggests that diastolic dysfunction is reported in  more than 50% of geriatric patients undergoing cardiac and non-cardiac surgery, which may cause substantial increase in morbidity and  mortality in perioperative period.

Diastolic dysfunction (DD) is usually asymptomatic at rest, but as it progresses with age, it can become unmasked by exercise or when the cardiovascular system is stressed beyond its physiological reserve such as in those undergoing surgery.The aim of our research  was to study the prevalence of diastolic dysfunction with the help classic and new doppler parameters in preoperative  patients.

Methods: Two hundred and sixty patients older than 50 years attending preoperative assessment clinic were divided into three groups, group A 50-60 years, group B 60-70 years, group C 70-80 years underwent transthoracic echocardiography. Two-dimensional (2-D), pulse wave and tissue doppler imaging were performed  according to a standardized protocol.

Results: In the group C, shorter deceleration time, higher velocity of mitral in flow atrial phase (A), and lower early  mitral inflow velocity(E), and (E/A) ratio less than one  were observed and it was statistically significant compared to group A and B. Left atrial volume index was more in Group C and there was no change in ejection fraction between groups.Mitral annular velocity (E/e1) in group C(average 13.2±1.1) was elevated compared to other two groups.

Conclusions: Isolated focus on normal LVEF may not be sufficient to describe the overall heart function in preop patients. DD has been associated with increased perioperative risk so early recognition, is mandatory and possible with modern echographic indices.

Open Access Review Article

Nanotechnology Controlled Local Drug Delivery System for the Treatment of Periodontitisc

Vishal Garg, Kirti Chawla, Simran Kaur Pawar

Journal of Advances in Medicine and Medical Research, Page 1-17
DOI: 10.9734/JAMMR/2018/40828

Nanotechnology is one of the most promising technologies of the 21st century. The remarkable application of nanotechnology for targeted site-specific drug delivery has created significant improvements in the bioavailability and bio-distribution of the drugs. There have been various efforts in designing different drug delivery systems for periodontal diseases based on the functionalized nanoparticles.

The aim of this article is to review the recent information regarding the experimental progress on nanotechnology in the treatment of various periodontal diseases comprehensively. Novel applications of different types of nanomaterials (nanoparticles to 3D nanostructured scaffolds) for treating periodontal diseases are summarized. Moreover, this paper also focuses on basic principles of utilizing the nanomaterials to create better drug delivery systems for treatment of periodontal diseases.

We addressed some queries to electronic databases including, Google Scholar, Google Books, and MEDLINE using the keywords nanotechnology in periodontics, Nano drug delivery in periodontics and we have taken into consideration the articles and monographs in the field of nanomedicine and nanotechnology issued in English until the February 2018. From the collected materials, we have conceived a summary of the data about the design and architecture of nanomaterials, as well as their applications in dental nanomedicine.

By the improvement in the periodontal drug delivery systems, it can be emphasized that the nanoparticles technology which is antibiotic free, mucoadhesive, biodegradable has a huge opportunity for designing a novel, low dose, and effective treatment. It will make possible for Nano dentistry to maintain the comprehensive oral health by employing nanomaterials, biotechnology which includes the tissue engineering and dental nanorobotics. Even though this technology is at a primary stage, it has already made a profound clinical and commercial impact in the field of dentistry.