Journal of Advances in Medicine and Medical Research

Cryptosporidiosis is the chief AIDS-defining infection in no more than 2% of HIV reported cases.

Aim of the Study: This was carried out to assess the efficacy of two diagnostic methods for the detection of Cryptosporidiosis among HIV  individuals in Osogbo. 

Methodology: A total of 188 HIV seropositive patients attending Institute of Human Virology, Nigeria (IHVN) Clinics, Ladoke Akintola University of Technology Teaching Hospital (LAUTECH), Osogbo, Nigeria and 60 HIV negative individuals were selected for the study from January to December, 2016 by random sampling technique. Stool samples were collected and examined for oocyst and antigen of Cryptosporidium protozoan using Ziehl-Neelsen (ZN) and Ensyme Link Immunoassay (ELISA) methods respectively. Data were analyzed using SPSS version 16.0 and P value < 0.05 was considered significant.

Result:  Prevalence of 28.7% (54/188) and 35.1% (66/188) was obtained by ZN and ELISA respectively in HIV-positive subjects while that of HIV negative was 1.7% (1/60). There was a significant association between Cryptosporidium infections and diarrhoea for different age groups (P<0.05), but no significant association between Cryptosporidium infection and different sex (P> 0.05).

Conclusion: Cryptosporidium infection was highly prevalent among HIV seropositive individuals in Osogbo, an indication of active infection that is likely to emerge as major human pathogen in a poor social economic setting. This study re-emphasized the need for inclusion of Cryptosporidium screening and treatment in HIV seropositive subjects since it is a major cause of morbidity and mortality.

Adequate knowledge of cervical cancer and the patronage of available screening services in developed countries resulted in a drastic reduction in the morbidity and mortality associated with the disease.  In Ghana, cervical cancer is the leading cause of gynaecological cancer-related deaths and this calls for early detection and treatment of the premalignant lesions. The aim of the study was to assess the knowledge and acceptability of cervical cancer screening practices among female students.  This was a cross-sectional descriptive study among female students in the Tamale campus of the UDS. Data was collected randomly using self-administered structured questionnaires.  The analysis was done using SPSS Software. Statistical associations between variables were determined by Fisher’s exact test.  A total of 300 students were interviewed with a mean age of 23.0 (SD ±2.4). Majority of the students were aware of cervical cancer 262 (87.3%, P<0.001), with the electronic media as the main source (37.7%). Many of the respondents identified the major risk factors of cervical cancer as multiple sexual partners (80.0%, P<0.001), HPV Infection (75.0%, P<0.001) and immunosuppression (71.0%,P<0.001). The great majority of the study population have never been screened for precancerous cervical lesions (91.3%, P<0.001).  The reasons for the poor patronage of the screening services were lack of screening centres, the distant location of centres and the high cost of screening. The majority (77.7%, P<0.001) of the participants were willing to undergo screening in the future. The study revealed a high level of cervical cancer awareness among respondents, but low patronage of the available screening services. The majority were, however, willing to undergo the screening if the service is made accessible and affordable. 

Background: Cadmium is a toxic metal and a known endocrine disruptor capable of altering sex hormone levels especially in the occupationally exposed persons. Some phytochemicals including green tea (Camellia sinensis) may prove to be beneficial in reducing blood cadmium levels and the associated adverse health effects.

Aim: This study assessed the levels of blood cadmium and male sex hormones in automobile workers as well as the effect of subsequent green tea supplementation.

Methods: The study was carried out in two parts; the cross-sectional and intervention study. 124 subjects comprising of 62 automobile workers and 62 age-matched occupationally unexposed control subjects in Emene, Enugu State, Nigeria were recruited for the cross-sectional study. Subsequently, 28 out of the 62 automobile workers received green tea supplement daily (2 green tea bags soaked in 150 ml of freshly boiled water for 5 minutes) for two months. 5mls of venous blood samples were collected from all subjects before the intervention (baseline) as well as after one and two months of green tea supplementation for the determination of blood cadmium, serum testosterone, follicle stimulating hormone (FSH) and luteinizing (LH) levels.

Results: The mean blood cadmium and serum FSH and LH levels were significantly higher in the automobile workers (2.41 ± 0.26 µg/dl, 11.64 ± 4.31 iu/l and 7.67 ± 2.82 iu/l respectively) when compared to the control (0.14 ± 0.02 µg/dl, 9.09 ± 2.90 iu/l and 5.54 ± 1.54 iu/l respectively) (p<.05) while the mean serum testosterone level was significantly lower in the automobile workers (6.96 ± 2.07 ng/ml) when compared to the control (8.99 ± 2.95 ng/ml) (p<.05). Following supplementation with green tea, blood cadmium and serum LH levels reduced significantly (2.19 ± 0.38 µg/dl and 7.67 ± 2.82 iu/l respectively), serum testosterone increased significantly (7.75 ± 2.18 ng/ml) whereas serum FSH level did not differ significantly when compared with the baseline values (p>.05). 

Conclusion: This study indicates that blood cadmium level is elevated and sex hormone levels are altered in automobile workers, and two months supplementation with green tea reduced the blood cadmium and regulated serum testosterone and LH levels with no significant effect on serum FSH level.

Gradual recovery from a prolonged coma through vegetative state and different types of mutism are detected in one-third of patients with a severe brain injury. Event-related potentials (ERPs) could be used as correlates of mental functions.

Aims: We focused on the correlation between ERP within first three months after severe traumatic brain injury (sTBI) and the degree of mental recovery one year, and several years later (up to 15 years after sTBI).

Place and Duration of Study: Burdenko National Medical Research Center of Neurosurgery, Moscow, Russia. Between 2000 and 2015.

Methodology: Dynamic examinations were carried out in 22 patients (53 studies) with sTBI followed up by a prolonged coma. During the first ERP session, patients were in a vegetative state, mutism, or had an unstable contact with the environment. The follow-up was up to 15 years after sTBI.

ERPs were recorded with and without the instruction to count target tones regardless of conscious recovery or the presence/absence of verbal contact with a patient. The amplitude and latency of components N100, N200 and P300, recorded in reply to both deviant and standard tones, were calculated. The topography of P300 was analysed.

Results: The connection between P300 lateralisation in the vegetative state and the outcome was revealed. Mere eliciting P300 recorded without instruction was considered to be a favourable prognostic factor. Although the full deficiency of P300 was unfavourable, it was not a rigorous criterion, as one-third of patients without P300 had mental recovery up to clear consciousness.

Conclusion: It can be concluded from the study that the analysis of N100, N200, P300 amplitude/latency and P300 topography recorded with and without instruction could be used for predicting mental recovery in patients in a vegetative state and mutism after sTBI.

Aims: The aim of this retrospecive study was to compare the outcomes of T2 protected and T2 included video-assisted thoracoscopic sympathectomy for palmar hyperhidrosis.

Place and Duration of Study: Department of Thoracic Surgery, Selcuk University Medical Faculty, Research and Educational Hospital, between January 2007 and January 2018.

Methodology: 278 patients were reviewed who got surgical sympathectomy for hyperhydrosis. They were divided into two groups, in first group we transected sympathic chain on level the third rib (T3) and we preserved the sympathic chain on level the second rib (T2), in second group we transected the sympathic chain totally on T2 and T3 level. For all patients blood tests were studied for endocrine diseases such as hyperthyroidism, pheochromocytoma and Cushing’s syndrome. The surgery was performed by opening the parietal pleura, identifying the sympathetic chain and dividing communicating branches using cautery. Postoperative complications were recorded.

Results: The mean follow-up period was 9 months. Most of the patients presented an improvement in palmar hyperhidrosis, without any difference between the groups. The initial satisfaction rate was 97,7% (n=176) in T2 protected group while in T2 included group was 96,9% (n = 95). Postoperatively, compensatory sweating was present in 13 (13,2%) patients of the T2 included group and in 10 (5,5%) patients in the T2 protected group. In addition, compensatory sweating was less severe in the T2 protected patients. There were no mortality or significant postoperative complications in this study.

Conclusion: Both techniques are effective for treating palmar hyperhidrosis, but T2 protected sympathectomy decreases the rate and severity of compensatory sweating.

The study aimed to determine both the association between perceived racial discrimination and acculturative stress, and the role of social support serves in the association of discrimination with acculturative stress using data on 3,268 immigrants from the National Latino and Asian Study.

Perceived racial discrimination was measured by nine items asking how often the respondent experienced discrimination. Acculturative Stress was defined by nine items designed to measure the stress felt as a result of adapting one’s own culture with a host culture. Buffering effects were determined by the statistical interaction within the multiple linear regression models while controlling for the demographic variables.

While Latin American immigrants were less likely to perceive discrimination than Asian American immigrants did (p=0.0309), they had higher acculturative stress (p=0.0005) and higher levels of social network (p<0.0001). However, there was no significant difference in family cohesion between races/ethnicities. In both groups, acculturative stress was positively related to discrimination and conversely, negatively associated with a social network. Higher levels of social network were significantly related to less acculturative stress in both groups. Our study also found that neither social network nor family cohesion served a role to buffer the effect of the relationship between discrimination and acculturative stress among Asian American immigrants. However, family cohesion alone buffered the relationship between discrimination and acculturative stress among Latin American immigrants (p=0.0184).

Since we found that family cohesion served as a buffering factor in reducing the acculturative stress that is associated with discrimination among Latin immigrants, future social programs designed to enhance social support may reduce acculturative stress among Latin immigrants experiencing high levels of discrimination.

Introduction: Foreign body (FB) impaction in the aero-digestive tract constitutes a common emergency in otolaryngology practice worldwide.  Prompt and appropriate management would limit the morbidity and possible mortality that may arise therefrom.

Objectives: The study was aimed to re-establish the prevalent foreign bodies in the oesophagus, the preferred management procedure and how social and cultural practices affect the foreign bodies involved. 

Materials and Methods: The study was a retrospective review of all the oesophageal foreign bodies retrieved surgically under anaesthesia by endoscopy over 10 years.

Results: A total of 90 patients were studied which consisted of 53.3% children and 46.7% for adults. A variety of foreign bodies were recovered of which dentures (24.44%), metallic objects (15.56%) and fish bone (14.44%) were the most common foreign bodies recovered. No FB was found in 12.22% of the cases. Rigid oesophagoscopy was the favoured and effective method of treatment.

Conclusion: Dentures, metallic objects and fish bone topped the list of FB retrieved. Rigid oesophagoscopy was effective in the extraction of the foreign bodies. Social and cultural leaning played out in the variety of foreign bodies in different parts of the country.