Open Access Minireview Article

Telemedicine in Elderly Patients with Chronic Heart Failure: Narrative Review of the Literature with a Focus on Telemedicine 2.0 Projects

E. Andrès, A. A. Zulfiqar, S. Talha, M. Hajjam, J. Hajjam, S. Ervé, A. Hajjam

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/JAMMR/2018/40190

Background: This is a narrative short review of the literature pertaining to telemedicine projects developed in the field of heart failure, with special attention to the remote monitoring project called E-care, a French telemedicine of new generation program to support patients returning home after hospital. This project has been specifically designed to automatically detect situations at risk for heart failure. Prospects for the development of the E-care system in the field of Geriatrics will likewise be discussed.

Results: Numerous telemedicine projects, based on connected objects or information and communication technology (ICT), have emerged over the last five years or are under development in the field of computer science heart failure. This is the case of the E-care telemonitoring project, which fits perfectly within the framework of telemedicine 2.0 projects, including for the first time artificial intelligence (AI). Their potential contribution in terms of mortality or morbidity, in addition to number of hospitalizations avoided, is currently under study or documentation. Their impact in terms of health economics is also being validated, taken into account that the oldest telemedicine projects had already validated the economic and social benefits brought up by telemedicine solutions.

Open Access Original Research Article

Two Port Laparoscopic Cholecystectomy with a Technical Modification of Using Port Closure Needle (The Chalkoo Modification)

Mushtaq Chalkoo, Zahid Mohd Rather, Awhad Mueed Yousuf, Syed Shakeeb Arsalan, Ferkhand Mohiuddin, Aabid Rasool Bhat, Imtiyaz Ahmad Ganie

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2018/45376

Background: Laparoscopy has revolutionised the gall bladder surgery since inception. There have been more than 30 different ways of performing Laparoscopic cholecystectomy mentioned in the literature. The standard 4 port Laparoscopic cholecystectomy has been modified to 3 port, 2 port, single port, SILS, NOTES cholecystectomy. Two port Laparoscopic cholecystectomy has also been modified in many ways using sutures for the traction of fundus and the infundibulum (puppet technique) and using alligator forceps. We became interested to modify two port lap chole by using port closure needle as a rescue instrument.

Objective: To assess the technical ease, safety and feasibility of using a new instrument (port closure needle) in performing two port laparoscopic cholecystectomy.

Materials and Methods: To assess the safety and technical feasibility of 2 port laparoscopic cholecystectomy using port closure needle as a rescue instrument. We selected a group of 50 patients for a prospective study at Govt. Medical College Srinagar, Kashmir India between January 2016 to January 2018. Our modification of 2 port lap chole resulted in no scar for the port closure needle and avoided the time consuming puppet sutures for traction of fundus and infundibulum. The cases were performed by a single surgeon in the unit. The selection criteria for laparoscopic cholecystectomy with 2 port taking assistance with port closure needle were done purely on clinical and Sonographic findings.

Results: The study was performed with a sample size of 50 patients selected purely on radiological findings. Two port laparoscopic cholecystectomy with assistance from port closure needle, offering the benefit of availability of left hand at the operative site was performed in a span of two year. 28 cases were females and 22 cases were males. The age range was between 12 to 50 years with a median age of 25 years. The mean body mass index was 30 (range 25-35). Mean operative time was 20 minutes (range 15-35 minutes) and a follow up period ranged from 6 to 9 months. No cases were converted to open though 4 cases required an additional port which was placed in the umbilicus at its 8 o’clock position.

Conclusion: Laparoscopic two port cholecystectomy taking help from port closure needle gives the benefit of left hand being available to the surgeon, yet avoiding a port and its subsequent scar. It is more convenient, rapid technique over 2 port puppet techniques and 2 port alligator technique. We were satisfied with its good results and patients satisfaction. However, a word of caution is that the port closure needle being a sharp and traumatic instrument needs to be handled carefully even by the expert surgeon.

Open Access Original Research Article

Prevalence of Root Caries in South Canara Population

Mithra Nidarsh Hegde, Mrinalini ., Nireeksha Shetty

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/44638

Aim: Aim of the present study was to determine the prevalence of root caries and associated risk factors among South Canara population.

Place of Study: Department of Conservative Dentistry and Endodontics, A.B. Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangaluru and rural satellite centres.

Duration of Study: MAY 15 2018- JUNE 15 2018 (1 month).

Methodology: 2000 patients were examined for root caries using mouth mirror and explorer under good lighting facilities, followed by a questionnaire to determinethe prevalence of root cariesand associated risks in South Canara Population.

Statistical Analysis: Data obtained was statistically analysed by using IBM SBSS version 24. Differences between variables were analysed by Chi-square test.

Results and Conclusion: Root caries were diagnosed in 7.4% of the patients examined. Root caries was more common in males (63.51%), in the age group of more than 60 years (56.76%) and in the rural population (62.16%). Oral hygiene and diet were also found to be closely associated with root caries. Molars were most affected and mandibular teeth weremore frequently involved with root caries than teeth in the maxilla.

Open Access Original Research Article

Knowledge, Attitude and Experience of Cardiopulmonary Resuscitation among Medical and Healthcare Professional Students in a Nigerian Medical College

R. N. Ativie, T. O. Awotidebe, O. Omeru, S. A. Ogunyemi, G. T. Olowe, R. A. Adedoyin, E. T. Folarin

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2018/38166

Skills in resuscitation are needed in emergency health care services. However, little is known about level of knowledge of resuscitation techniques among healthcare professional students (HCPS) in Nigeria. This study assessed knowledge, attitude and experience of cardiopulmonary resuscitation (CPR) among medical and HCPS undergoing training in a Nigerian medical college. The cross-sectional study purposively recruited 300 clinical HCPS from a Nigerian university studying in various health disciplines. Socio-demographic data and information on knowledge, attitude and experience were obtained using a validated CPR questionnaire. However, only 261 copies of the questionnaire were completed and valid for analysis yielding a response rate of 87.8%. Data were analyzed using descriptive and inferential statistics. Alpha level was set at p < .05. Results show that the mean age of respondents was 24.6±4.6 years. Students from the Department of Medicine constituted about a third, (30.9%) while less than half, (44.4%) were in year four of study. Less than a quarter, (21.4%) had good knowledge of CPR. A majority, (77.4%) had never practiced CPR, however, (74.9%) had positive attitude towards CPR. There was a significant association between knowledge and department of respondents (χ2=80.973; p= .001) and year of study (χ2=47.799; p = .003). Furthermore, there was a significant association between experience and year of study (χ2=9.195; p =.002). Surveyed medical and healthcare professional students in clinical level had poor knowledge and low level of experience. They however had a positive attitude towards cardiopulmonary resuscitation techniques. Curriculum review detailing practical skills of cardiopulmonary resuscitation techniques among healthcare professional students is recommended.

Open Access Original Research Article

Hormonal Profile and Trace Metal Contents of Blood and Semen in Men with Infertility Attending University College Hospital, Ibadan, Nigeria

Omotosho I. O., Oladiran J., Adebayo S. A.

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/JAMMR/2018/44320

Aims: The aim of this study was to determine the relationship between blood hormonal profile and trace metal contents of blood and semen in men with infertility.

Study Design:  This was a case-control study conducted using 33 male participants. Cases comprised of male patients presenting with infertility and the controls comprised apparently healthy males without any history of fertility problems.

Place and Duration of Study: University College Hospital, Ibadan, Nigeria.

Methodology: Ten millilitres of venous blood samples were collected for the determination of trace metals and male reproductive hormones using Enzyme Linked Immunosorbent Assay (ELISA). Atomic absorption spectrophotometry measurement of the trace elements concentration in plasma samples was done. All analyses were performed using standard laboratory procedures while data were analysed using Statistical Package for Social Science (SPSS) version 20.0.

Results: No significant difference was observed between the dietary history and lifestyle factors between these two groups. There was no significant difference in median cadmium and zinc between cases and controls. Median seminal plasma Zn concentration was significantly lower than controls. The median FSH of infertile men was significantly higher than that of fertile controls.

Conclusion: There was no significant difference in the toxic trace metal content of both serum and seminal plasma between cases and controls possibly because of the similarity in their sociodemographic and environmental characteristics. There was a significant difference in the essential trace metals of both serum and seminal plasma between cases and controls. Oxidative stress due to other factors other than Pb and Cd may be a possible contributory factor to infertility as indicated by similar levels of these metals in both cases and controls and a significantly reduced level of the essential trace metals which are important components of the antioxidant enzyme system in the body.

Open Access Review Article

Reviewing the Concepts of Immune Surveillance of Cancer Cells, Immunogenic Cancer Cell Death and the Role of Medicinal Plants in Anticancer Immunity

Oyiborhoro Onoriode

Journal of Advances in Medicine and Medical Research, Page 1-15
DOI: 10.9734/JAMMR/2018/37235

Current standard treatment of cancer usually involves surgical resection, chemotherapy and radiotherapy. Surgical resection is aimed at eliminating the primary tumour from its anatomical site of origin, while chemotherapy and radiotherapy are meant to target metastatic tumour cells around the primary tumour site and distant parts of the body. Although standard treatment of cancer usually produces some initial positive clinical responses, such responses are often followed by recurrence of malignancy, several months or years later. Consequently, efforts are currently being focused on stimulating a patient’s natural immune responses, to fight against metastasized cancer cells that are mainly responsible for cancer relapse. The role of the immune system in the prevention and treatment of cancer has long been established. In fact, a patient’s response to chemotherapy and radiotherapy has been observed to be largely dependent on the level of competence of the immune system. Despite these observations, little effort is currently being made to boost a patient’s immune response during cancer treatment. The confidence and consequent use of medicinal plants for treatment of many disease conditions is currently growing rapidly and many of these medicinal plants have been observed to possess anti-neoplastic, anti-malignant, immune-stimulatory, and cytoprotective effects, which can all be harnessed, to produce better outcomes for cancer treatment. This review therefore seeks to reawaken the interest of researchers, pharmaceutical giants, clinicians and scientists in investigating and validating the potential use of extracts of medicinal plants as valuable components in the management and treatment of cancer.