Open Access Data Article

Prevalence of Radix Entomolaris in Mandibular First Molars of North Indian Population of Sunder Nagar, Himachal Pradesh

Shweta Verma, Munish Goel, Mahender Singh, Prabhat Mandhotra, Vijay Kumar

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2018/42955

Aim: The present study aimed to find the prevalence of Radix Entomolaris (RE) in North Indian population of Himachal Pradesh using periapical radiographs.

Methodology: The study was conducted at the Department of Conservative Dentistry and Endodontics; Himachal Dental College, Sundernagar, Himachal Pradesh. A total of 260 patients who visited the department for root canal treatment of mandibular first molars over the period of 2 years (May 2016-May 2018) were selected as the study sample. The patients had the bilateral presence of mandibular first molars. Out of these patients, 146 were females and 114 were of males. Hence, a total of 520 IOPAs of these patients were studied for the presence of additional root in mandibular first molars. The age of all the patients was between 18-65 (mean =36) years.

Results: Among all the studied radiographs; periapical radiographs of 24 patients showed an additional root. The prevalence of patients with three-rooted mandibular first molar was 9.23%; 9.59% for females and 8.77% for males. Out of 24 patients with RE; three patients had bilateral RE presentation (1.15%). There were 13 cases with left RE (5%) and 5 cases had right RE (3.08%).

Conclusion: The possibility of encountering RE in the Himachali population was noted in the present study. It should be detected properly and managed adequately.

Open Access Original Research Article

Hyperbilirubinaemia in Predicting Perforated Appendices in Emergency Settings

Ahmed Makki, Saleh Aldaqal, Mahdi Mohammed Abulkalam, Mohammed Abdullah Aldini, Nawaf Turki Ashgan, Abdulrahman Khaild Dafterdar

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/41851

Introduction: Appendicitis is the most common abdominal emergency worldwide. Many standard laboratory tests are used to diagnose appendicitis, but there are no specific indicators. Some studies suggested that hyperbilirubinaemia correlates with appendiceal perforation. The objective of this study is to review the bilirubin level in patients with acute appendicitis (non-perforated appendix) and in those with a perforated appendix, to assess the efficacy of using the bilirubin level to predict if patients will have a perforated appendix.

Patients and Methods: This is a retrospective study of 269 patients who had undergone appendectomy from June 2008 to September 2016 in King Abdul Aziz University Hospital. These cases were classified histologically as acute non-perforated appendicitis and perforated or gangrenous appendicitis. The bilirubin levels of the two groups were compared in terms of the mean, sensitivity, and specificity.

Results: Thirty-six out of 269 patients (13.4%) had perforated appendix; within this group, 23 patients (63.9%) had hyperbilirubinaemia with a mean of 21.38 μmol/l. The sensitivity and specificity of hyperbilirubinaemia in those with perforated appendicitis ere 63.88% and 81.1%, respectively.

Conclusions: Acute appendicitis is a clinical diagnosis, that must be supported by laboratory investigations. In addition to the clinical presentation and other laboratory investigations, the serum bilirubin level is an important indicator in predicting the presence of a perforated appendix.

Open Access Original Research Article

Epidemiology of Tuberculosis and HIV Co-Infection in Butembo, Democratic Republic of the Congo

Junior Leta Baduru, Joel Kambale Ketha, Adelard Kalima Nzanzu, Jean Bosco Kambale Maliro, Jean Paulin Mbo Mukokole, Franck Katembo Sikakulya

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2018/41560

Introduction: TB-HIV co-infection constitutes a real public health problem, and its control constitutes a challenge for African countries and their health services. The aim of this survey was to determine the epidemiological profile of TB-HIV co-infection in the town of Butembo, DRC.

Methods: We undertook a retrospective survey which covered a period of nine years (1/2007-12/2015). We enrolled patients from Katwa referral hospital, Kitatumba referral hospital, MATANDA hospital and Makasi health centre; which are health facilities in charge of the detection and treatment of Tuberculosis in Butembo town.

Results: The prevalence of the co-infection TB-HIV was 18.3%. Female patients were the most co-infected with a sex ratio of 1.27. The age group of 25 to 44 years was the most concerned (20.3%); traders were more co-infected with 51,0% of all recorded cases; the fact single has been found as a risk factor of co-infection (22.1%). Most of the co-infected patients did not respond to tuberculosis treatment, and their Ziehl Neelsen test was negative. The death rate of the co-infection TB-HIV was 22.6%.

Conclusion: TB-HIV co-infection remains a major problem for public health. The reduction of its prevalence constitutes a challenge in Butembo.

Open Access Original Research Article

The First Study on Locomotive Syndrome in Lower Amputees in Japan

Kei Sano, Yoshiyuki Suehara, Yu Tanabe, Taketo Okubo, Youngji Kim, Midori Ishii, Takayuki Kawasaki, Atsuhiko Terakado, Keisuke Akaike, Kenta Mukaihara, Daisuke Kubota, Naoko Okubo, Yuichiro Maruyama, Tsuyoshi Saito, Kazuo Kaneko

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/JAMMR/2018/40594

Background: In 2007, the Japanese Orthopaedic Association (JOA) proposed the term "Locomotive syndrome" (LS) to describe a condition in high-risk patients with musculoskeletal disease. So far, there are many studies that are designed for non-handicapped people. However, the study using a cohort of handicapped people are limited. In this study, we therefore conducted a study on LS in lower amputees.

Methods and Participants: We surveyed 47 lower amputees. A questionnaire that included the 25-question Geriatric Locomotive Function Scale (GLFS-25) and the Loco-check was distributed to the participants.

Results: According to GLFS-25, the classifications of the amputee patients were as follows: no locomotive dysfunction, n=21 (44.7%); grade I locomotive syndrome, n=17 (36.2%); and grade II locomotive syndrome, n=9 (19.1%). The mean GLFS-25 was 10.4. According to the Loco-check, 43 (91.5%) patients were at risk of LS.

Conclusion: We have surveyed the GLFS-25 and Loco-check to investigate the risk of LS in lower limb amputees. We found that lower limb amputees had unique risk factors for LS, including amputation level, phantom pain, stump wound and frequency of wheelchair use. Both non-handicapped people and lower limb amputees need to be considered in studies on LS and more specific countermeasures are required for LS in lower limb amputees.

Open Access Original Research Article

Effect of Various Disinfectant Solutions on Colour Stability of Acrylic Resin Denture Base Materials” an Vitro Study

Pratibha Katiyar, Ritu Mohindra, Kaushik Kumar Pandey, Abhishek Gaur, Vivek Gautam, Anant Agarwal, Arun Kumar Tiwari

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/JAMMR/2018/42656

Purpose: To evaluate the change in colour of two commercially available denture base resins after subjecting them into three commonly used disinfectant solutions at different time interval.

Materials and Methods: A precise stainless steel die measuring 50mm in diameter and 1 mm in thickness (ADA No. 12)29 was customized and Duplication of the diameter and the thickness of die were achieved by using polyvinyl siloxane impression material after putting it into the die space to prepare testing samples. These polyvinyl siloxane putty samples were then invested to make mold for fabrication of the resin samples. 60 specimens were made using heat cure resins (DPI&TREVALON). 10 additional specimens from each resin specimens were also made as control group. After finishing and polishing, all sample of resin was subjected to colour measurement using computer controlled CM-3310 d Spectrophotometer (MINOLTA), before immersion and after immersion into the three disinfecting solutions at different time intervals.

Results: Both the denture base resins materials DPI and TREVALON have shown significant colour change with all the three disinfectants 0.5% Chlorhexidine (A), 2% Gluteraldehyde (B) and 0.5% Sodium Hypochloride (C) at difference in different time intervals.

DPI & TREVALON has shown significant amount of colour change with 2% Gluteraldehyde (B) disinfectant as compare to 0.5% Sodium Hypochloride (C) and 0.5% Chlorhexidine (A), DPI has shown least amount of colour change with 0.5% Sodium Hypochloride (C) which is not significant and TREVALON has shown least amount of colour change with 0.5% Chlorhexidine (A).

Conclusion: When DPI & TREVALON denture base resins were compared, TREVALON exhibited more colour change than DPI denture base resins regardless of any disinfectant used. Among all the three disinfectants, 2% Gluteraldehyde (B) has shown more colour changes than any other disinfectants, regardless of any denture base material used.

Open Access Original Research Article

Antioxidant Activity and HPLC Fingerprinting Profile of Ethanolic Extract of Euphorbia cotinifolia Bark from Bangladesh

Tanzir Ahmed Khan, Md. Mahfuzur Rahman, Md. Alamgir Kabir, Shaikh Emdadur Rahman, Proity Nayeeb Akbar, Hemayet Hossain, Ismet Ara Jahan

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2018/19593

Aims: The present study was designed to investigate the antioxidant activity and High Performance Liquid Chromatography (HPLC) fingerprinting profiles of the ethanolic stem bark extract of Euphorbia cotinifolia growing in Bangladesh.

Methodology: In-vitro antioxidant activity of the ethanol extract was carried out using ABTS (2, 2'-Azino-Bis-3-Ethylbenzothiazoline-6-Sulfonic Acid) radical scavenging activity, reducing power assay, total antioxidant activity, total phenolic and flavonoid content determination. The polyphenolics content in the ethanol extract was identified and quantified through HPLC with Diode-Array Detection method.

Results: The ABTS radical scavenging activity demonstrated an IC50 (Inhibitory concentration 50) of 18.50 ml, while the maximum absorbance of reducing power was found to be 0.1148 at 250 ml, respectively. The total antioxidant capacity, total phenolic and flavonoid contents were found at significant level (347.8 mg of ascorbic acid/g, 56.24 mg/g of gallic acid, and 137.4 mg/g of quercetin equivalent), respectively. Catechin, caffeic acid, epicatechin, p-coumeric acid, ellagic acid and quercetin were quantified in the ethanol extract by reverse-phase HPLC (175.50, 4.61, 67.73, 4.01, 558.31 and 4.35 mg/100g of dry extract, respectively).

Conclusion: These results may be due to the higher polyphenolics content of the ethanol extract of Euphorbia cotinifolia bark, which also accounts for the significant antioxidant activity observed.  Hence, it can be suggested that bioactive polyphenolics compound in Euphorbia cotinifolia might be responsible for the antioxidant activities.

Open Access Original Research Article

Medicaid-serving Health Maintenance Organization-Federally Qualified Health Center (HMO-FQHC)-School of Public Health Collaboration to Provide After-Hours Pediatric Urgent Care: A One Year Demonstration Project

L. S. Fischer, C. E. Begley, S. Azadeh ., A. M. Dangre, A. P. Giardino

Journal of Advances in Medicine and Medical Research, Page 1-15
DOI: 10.9734/JAMMR/2018/42214

Aim: To demonstrate the collaboration of Medicaid-serving Health Maintenance Organizations (HMOs) and Federally Qualified Health Centers (FQHCs) supported by the design and evaluation skills of a School of Public Health in providing pediatric after-hours urgent care in a large urban metropolitan area, and to study the implications of implementation of this collaborative effort in reducing the Emergency Department (ED) patient load.

Study Design: Prospective evaluation using pre-post comparison study design.

Methodology: Three FQHCs located in the Houston area were selected to participate in this demonstration project in collaboration with the city's three largest Medicaid-serving HMOs. The HMOs conducted a marketing campaign directed at members living in 24 zip codes in the intervention area for the availability of after-hours pediatric care at the three FQHCs. The University of Texas School of Public Health (UTSPH) supported the project team with design and evaluation expertise, obtained and analyzed enrollment, service use, and cost data from the HMOs for the project’s pre-intervention period, August 1, 2009 through July 31, 2010 and from the project’s post-intervention period, August 1, 2010 through July 31, 2011.  The primary objective of the study was to determine if there were any differences in pre-post service use and cost patterns in the Medicaid and Children’s Health Insurance Program (CHIP) HMO enrollees in the Houston neighbourhoods targeted by the intervention compared to enrollees in non-targeted areas. 

Results: The evaluation study found that the proportion of enrollees in the intervention group having an ED visit decreased from 17% to 12% whereas the proportion of enrollees in the comparison group stayed the same for ED visits (18%). The proportion of enrollees in the intervention group having a physician office visit decreased from 73% to 72% whereas the proportion of enrollees in the comparison group having a physician office visit decreased from 64% to 57%.

Conclusion: The evidence suggests that patterns of ED and physician office visits and costs of Medicaid/CHIP enrollees changed after the first year of implementation of an after-hours project. These results are encouraging for a strategy of working with community-based providers such as FQHCs in making clinic services available in evenings and on weekends, along with promoting the availability of those services, as a way of lowering rates of ED use and costs in the Medicaid/CHIP population in the Houston/Harris County area.