Open Access Short Research Article

Candida and Other Yeasts as Nail Pathogens in Chronic Paronychia and Onycholysis of Fingernails

Hamida Al-Dwibe, Mohamed Ben Ghazil, Zianib Kalifa

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/JAMMR/2018/44051

Paronychia and onycholysis are the common nail disorders with similar fundamental pathological findings. Fungi especially yeasts are frequently isolated. Seventy six patients with chronic paronychia and onycholysis attending the dermatology clinic in Tripoli Medical Center (TMC) were enrolled in a one year study. A detailed history and clinical examination was taken. The majority of cases were females (97.4%), with female to male ratio of 37.5:1. A history of chronic exposure to water was obtained in 88.2% of cases. Chronic paronychia was more common on the right hand; the right middle finger was the most commonly affected organ. Nail clippings and debris under nails were collected for direct microscopic examination and culture. Candida albicans was the most frequently isolated organism (37.9%), followed by Candida tropicalis (30%); C.parapsilosis (20%) and other yeasts were isolated less frequently. This study revealed that C. albicans and other yeasts were important causes of chronic paronychia and onycholysis in the country.

Open Access Minireview Article

Of Vanishing Retinal Drusen and Oxysterols

Stuart Richer, Sherwin Nassiri, Avni Dervishi, Harsh Patel, Anish Bhandari, William Stiles

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/JAMMR/2018/43776

Aim: Spontaneous resolution of retinal drusen is a common occurrence in ophthalmology, but little is understood about the mechanistic pathophysiology of this phenomenon. Small molecules, taken orally, such as resveratrol (RV) and zeaxanthin (Z), resolve retinal drusen and amyloid protein, yet few clinicians are aware of this molecular, biochemical progress against the major degenerative disease(s) of ageing.

Published Data: We highlight the mechanistic role of resveratrol (RV) in the cytochrome P450 enzymatic pathways of liver detoxification, as well as dosing considerations. RV has demonstrated utility in age-related macular degeneration (AMD) and has application in disorders of cognition (Alzheimer's Disease) and age-related hearing loss. We highlight the clinical evidence for the use of an epigenetic RV nutraceutical matrix called Longevinex®, and the xanthophyll carotenoid zeaxanthin. Longevinex® has been employed against retinal drusen, with resulting normalisation of retinal anatomy, Amsler Grid field loss (scotomas) and distortions of the central visual field (metamorphopsia).

Implications: The published evidence for RV and Z resolving structural and functional deficits in AMD is presented. The xanthophyll carotenoid zeaxanthin has now been demonstrated, in a larger population clinical trial, to resolve drusen beyond normal expectation. Both RV and Z have also both shown to induce denser macular pigment, and such small molecules likely play a role in multisensory degeneration(s) of ageing.

Conclusion: Previously described “spontaneous resolution” of drusen may have an unappreciated biological mechanism(s). The adjunct and complimentary wound healing benefits of RV and Z remain clinically underutilised in age-related retinal and neuro-degeneration associated diseases of ageing, while the complications of chronic ophthalmologic anti-vascular endothelial growth factor intravitreal injections emerge as problematic.

Open Access Original Research Article

Seroprevalence of Hepatitis B and C Viruses amongst Type 2 Diabetic Patients in Dutse, Jigawa State, Nigeria

Bako Hauwa, Muazu, Salisu Babura, Dankoly, Sani Usman, Ahmad, Mohammad Bello, Iliya Sani, John, Noah Onuche, Mustapha, Aminu Saleh, Banya, Richard James

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/43908

Introduction: Viral hepatitis is a liver disease with numerous etiologies. Hepatitis B and C virus infections and co infections are pandemics that constitute a major public health challenge in Nigeria. Diabetes mellitus is sought to be a risk factor for HBsAg and HCV coexistence. The study was aimed at estimating the seroprevalence of HBsAg and HCV viruses amongst type 2 diabetic patients in Dutse Jigawa State, Nigeria.

Methods: The study was randomized and cross sectional conducted amongst type 2 diabetics. A total of 192 consecutive type 2 diabetes mellitus patients attending the endocrine clinic and 120 age and sex matched apparently healthy volunteers who consented to participate in the study were recruited. All the participants were screened for HBsAg and HCV using immunochromatographic test kits and confirmed by ELISA technique for seropositive cases.

Results: Prevalence rates of HBsAg was equal 9(4.68%) for the type 2 diabetics and controls while that of Anti-HCV was 3(1.56%) and 1(0.52%) in the type 2 diabetics and controls (p≤0.05) respectively. Co infection was recorded in the control subjects but not in the diabetes group.

Conclusion: There is a statistical significant association between HCV and type 2 diabetes mellitus with the seropositivity of HCV 3.0 times higher in type 2 diabetic patients compared to healthy controls.

Open Access Original Research Article

Interrelationship of High Sensitive C Reactive Protein and Thyroperoxidase Antibody Levels with Dyslipedemia in Subclinical Hypothyroidism and Overt Hypothyroidism

Anindya Dasgupta, Suparna Roy

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2018/44329

Background and Aims: Antibodies against thyroperoxidase (TPO-Ab) and cholesterol levels are raised in overt hypothyroidism (OH) along with an increase of hsCRP, an early indicator of low grade inflammation. However, hypercholesterolemia and dyslipedemia has been found inconsistently in subclinical hypothyroidism (SCH) in different regions. The present study aimed at elucidating the relative importance of hsCRP and TPO-Ab with altered lipid parameters in both SCH and OH patients in this Region.

Study Design: Hospital-based case control study.

Methodology: Lipid parameters and hsCRP were measured in and TPO-Abs positive 35 OH and 35 SCH patients and 30 control subjects.  Serum TSH, free T4, TPO-Ab, hsCRP levels and lipid parameters were measured by ELISA and standard photometric assays respectively. Post hoc ANOVA, bivariate correlation and multiple linear regression assays were used for analysing the differences between mean values, strength of association between study variables and dependence of LDL cholesterol(LDLc) on hsCRP and TPO-Ab levels.

Results: Mean LDLcandHDLc were significantly increased and decreased respectively in both OH (146 ± 11.4; 29.5 ± 4.6); and SCH (132.4 ± 8.4; 37.6 ± 4.1) when compared with the control groups (90.8 ± 8.1; 44.4 ± 7.7) in graded manner (P < 0.001 between all groups).A similar rise in hsCRP levels (1.14 ± .32 in control, 2.22 ± .40 in SCH and 3.5 ± 1.0 in OH; P < 0.001 between all groups) was observed. Elevation in TPO-Ab levels in OH and SCH groups were significant only in comparison with the control groups (21.2 ± 5.5 in control, 44.8 ± 15 in SCH and 52.4 ± 16.7 in OH group; P < 0.001 against control group for both SCH and OH, but .07 between SCH and OH groups). LDLc was directly correlated with both TPO-Ab and hsCRPlevels in both groups. However, hsCRP levels showed better predictor effect on LDLc levels in both groups (β = .484 and .498; P = .002 and .003 for the OH and SCH respectively) in comparison to TPO-Ab (β = .281 and .200; P = .059 and .206 for the OH and SCH respectively).

Conclusion: Our findings specify the contributory roles of a low grade inflammatory state on altered LDLc metabolism that culminates in atherosclerosis in early thyroid diseases. It is also evident that hsCRP is a better indicator of it compared to TPO-Ab in even TPO-Ab positive hypothyroid patients.  As in the OH group, hsCRP measurement in SCH can also help in initiating restrictive measures to minimise its further progression in OH conditions.

Open Access Original Research Article

Baseline Study of Cancer Patterns in the Department of Pathology of the Tamale Teaching Hospital, Northern Region of Ghana

E. M. Der, M. M. Ibrahim, A. D. B. Buunaaim, S. Naporo, N. Y. Tolgou, E. Yenli, S. Gumanga, T. Adjeso, M. Damah, S. Tabiri

Journal of Advances in Medicine and Medical Research, Page 1-14
DOI: 10.9734/JAMMR/2018/43772

Background: Documentation of baseline data in any newly established academic or health institution is a pre-requisite for future research. The histopathological review aimed to describe the patterns and the relative proportions of the various cancers diagnosed in the Department of Pathology, Tamale Teaching Hospital (TTH) to be used as a baseline data for future research.

Materials and Methods: This retrospective review was conducted from 1st June 2011 to 30th June 2016 in the Department. Data were analysed using SPSS software version 23.0 (Chicago). Fisher’s exact test was used to compare common cancers.

Results: A total of 715 cancer cases were reviewed, majority were females 534 [(76.7%), (p< 0.0001)], with female to male ratio of 3:1. The mean age of males was 49.9±21.6 years compared to 48.7±17.5 years for females. Common male cancers were: gastric (17.7%), soft tissue (12.2%), larynx (9.9%), bone (8.8%) and prostate (8.3%); while for the females were: breast (33.5%), cervix (31.1%), ovary (7.3%), gastric (3.9%) and uterus (3.7%). Male genital tract cancers were: prostate (65.2%), penis (26.1%), testis (4.3%) and scrotum (4.3%). Cancers of the female reproductive system were: cervix (70.3%), ovary (16.5%), uterus (8.5%), vagina (2.6%), vulva (1.7%) and fallopian tube (0.4%). A total of 454 (63.5%) cancers occurred in both males and females. Among all the cases, 65.6% were occurred in females (p< 0.0001), particularly in breast [(96.3%), p< 0.0001], the urinary system [(56.0%), p= 0.5721] and conjunctiva/orbital [(62.5%), p= 0.6193].

Conclusion: Cancers were found to be the common among relatively young females. Breast, urinary system and conjunctiva and orbital malignancies were significantly common in females.

Open Access Original Research Article

Platelet to Lymphocyte Ratio for Prioritising Perforated or Gangrenous Appendicitis in a Triage of an Emergency Room

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

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/44906

Aim: Some studies suggested Platelet Lymphocyte Ratio (PLR) is associated with perforated or gangrenous appendicitis. This study aimed to evaluate the effectiveness of the platelet-lymphocyte ratio in distinguishing simple acute appendicitis from perforated or gangrenous appendicitis in the clinical emergency setting

Method: This study was conducted retrospectively in academic tertiary hospital on 302 patients who had undergone appendectomy for a period of eight years from mid of 2008 to the mid of 2016. We divided them according to their histopathological results two to groups simple acute appendicitis and perforated or gangrenous appendicitis.

Results: The study demonstrated that PLR is a useful indicator in diagnosing perforated or gangrenous appendicitis with a cutoff value of 197.57 with sensitivity 63.3% and specificity 38.7% and P=0.057. The risk for developing perforated or gangrenous appendicitis in patients with high Platelet Lymphocyte Ratio (PLR) was 1.5 times higher than those with standard Platelet Lymphocyte Ratio odds ratio (OR): 1.58 (P=0.002).

Conclusion: PLR is a simple, cost-effective is a useful parameter that diagnoses complicated perforated appendicitis.

Open Access Review Article

Induction of Acidic Imbalance by Carbonated Beverages and the Development of Type 2 Diabetes

Ibrahim Salihu Ismail

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/43839

Regular and excessive ingestion of substances that contain or produce acid can increase blood acidity either by building up acid load or loss of bicarbonate; either way can result in mild metabolic acidosis.  Excessive and regular intake of carbonated beverages leads to weight gain and increase sugar and acid load in the body. Major characteristic properties of carbonated beverages are high carbon dioxide content, acidity and high levels of sugar or artificial sweeteners. Cessation of carbonated beverage consumption is commonly recommended as part of lifestyle modifications for patients with type 2 diabetes mellitus. Carbonated beverage consumption can result in a transient decline in stomach pH. In addition, it may also lead to a transient reduction in the level bicarbonate buffer leaving so many bicarbonate depending metabolic processes compromised.

The high acidic and sugar content of some carbonated beverages makes them a good candidate for inducing systemic acid-base imbalance overtime and result in mild metabolic acidosis which have been shown to be one among other factors responsible for insulin resistance. The present review attempts to link excessive consumption of carbonated beverages, insulin resistance and the development of type 2 diabetes.