Open Access Short Research Article

Cervical Cancer Knowledge and Screening among Schooling and Uneducated Females within Tamale-Ghana

K. S. Asante, A. G. Mohammed, A. A. Delle, A. N. Mumuni

Journal of Advances in Medicine and Medical Research, Page 1-15
DOI: 10.9734/jammr/2019/v29i130051

Background: Cervical cancer, one of the gynecological cancers, is a serious health concern in Ghana. To improve the chances of survival and treatment outcomes for this condition, early screening and detection is the best remedy. Comprehensive knowledge and positive attitude highly influence acceptability and uptake of screening methods.

Objective: To assess the knowledge about cervical cancer and screening practice among females in secondary and tertiary institutions and uneducated females in Tamale-Ghana.

Methods: Females (n = 300) between the ages of 15 and 49 years, comprising 100 participants in three categories (senior high school, tertiary institution and the non-educated) were recruited into the study. Data was gathered through a semi-structured questionnaire, and analyzed by descriptive statistical methods.

Results: Approximately 61.3% of the participants have heard about cervical cancer, 33.1% and 29.9% of them got the information from school and the media respectively. Of those who have heard about cervical cancer, only 19.3% had considerable general knowledge about the condition. A significant association (p = 0.02) was observed between educational level and knowledge about cervical cancer. Meanwhile, only 5.3% of the 300 participants were previously screened for cervical cancer. Lack of information about cervical cancer was the most reported reason (46.6%) for not attending cervical cancer screening.

Conclusion: Proactive intervention is required in the study area towards preventing new diagnosis through mass education, establishment of cervical cancer control programs, as well as screening and treatment centers.

Open Access Original Research Article

Accuracy of Demirjian’s Method to Estimate Chronological Age in 5‒17-Year-Old Iranian Population

Mahnaz Sheikhi, Ali Dakhilalian, Faranak Jalalian

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/jammr/2019/v29i130048

Introduction: To detect physiological maturity of a child, use of dental and skeletal development can be helpful. The Demirjian’s Method is one of the commonly used methods to estimate dental age. The aim of the present study was to evaluate the validity of Demirjian method in Iranian population with different races.

Materials and Methods: The present cross-sectional study was performed on a randomly selected sample of panoramic radiographs of 3073 patients aged 5‒17 years. The chronological age (CA) was calculated by subtracting the date of birth from the date on which the radiographs were taken. Estimated age (EA) was performed by Demirjian method using seven left mandibular teeth. Paired t-test was used to compare differences between chronological and estimated age.

Results: The mean of CA was 11.14±2.61 years whereas the mean EA was 11.35±2.62; therefore, EA was calculated 2.5 months more than CA. According to paired t-test the difference between CA & EA was significant (P≤ 0.001). Pearson’s correlation coefficient showed a strong linear correlation between CA and EA in total (r=0.891, P≤0.001), in girls (r=0.895, P≤ 0.001) and in boys (r=0.876, P≤ 0.001). The new regression line equation based on Iranian standards would be CA=1.08±0.89EA in total, CA=1.09±0.89EA in girls and CA=1.12+0.88EA in boys.

Conclusion: Using Demirjian’s Method overestimated dental age in the Iranian population. A new regression line equation based on Iranian standards was obtained according to the results of the present study.

Open Access Original Research Article

Comparative in vitro Activities of Different Antibiotics against Clinical Isolates of Gram-negative Bacilli

Sachin H. Jain, Pradnya Joshi

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/jammr/2019/v29i130050

Objective: The local anti-microbial susceptibility profile plays a very critical role in guiding clinicians to choose the appropriate empiric therapies. This study was conducted to assess the pathogen characteristics and the in vitro susceptibility of different Gram negative isolates to commonly used antibiotics in our hospital settings.

Methods: A total of 110 Gram negative isolates were included in the study.  A retrospective, observational analysis of antibiogram data was performed for four antimicrobial agents including CSE-1034 (ceftriaxone-sulbactam-EDTA), piperacillin-tazobactam (pip-taz), cefoperazone-sulbactam and meropenem. 

Results: Of the 200 clinical specimens analysed, Gram negative isolates obtained from 110 samples were included in the final analysis. The most common Gram negative isolates were Klebsiella species (35.5%), E. coli (33.6%) and P. aeruginosa (21.8%). The overall susceptibility was highest to CSE-1034 (100%) followed by meropenem (66.4%), cefoperazone-sulbactam (56.4%) and pip-taz (45.5%). The MIC90 range of CSE-1034 for Enterobacteriaceae was ≤0.5-≤4μg/ml and ≤2μg/ml for susceptible P. aeruginosa isolates. The MIC90 of meropenem for 94.4% of meropenem-susceptible Enterobacteriaceae strains was <0.25μg/ml and 64.3% of P. aeruginosa were having MIC ≤0.25μg/ml. The MIC90 of pip-taz for 82.5% of the pip-taz susceptible Enterobacteriaceae strains was 4μg/ml and 63.6% of P. aeruginosa was ≤8.0μg/ml. The MIC90 of cefoperazone-sulbactam susceptible strains were between ≤8 to ≤16μg/ml and 45.8% isolates of susceptible P. aeruginosa were having MIC between ≤8 to ≤16μg/ml.

Conclusions: Overall, this in vitro surveillance study suggests that CSE-1034 can be considered an important therapeutic option for the treatment of various multi drug resistant Gram-negative bacterial infections and avert the threat of resistance to last resort antibiotics including carbapenems.

Open Access Original Research Article

Assessment of Anaemia in Adolescent Girls Aged between 10-19 Years Old Attending St Therese Clinic

Console Icyishatse, Peris Onyambu, Jean Baptiste Niyibizi

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/jammr/2019/v29i130052

Anaemia is one of the major public health problems worldwide and is associated with morbidity and mortality. Anaemic adolescent girls are at high risk of having physical and cognitive functional disorders. According to the WHO global database, anaemia affects 46% of school children globally. Because of health and socioeconomic problems, the prevalence of anaemia is higher in developing countries than in developed ones with 50% in Africa where children, adolescent girls and pregnant women are the most vulnerable groups to anaemia. In Rwanda, there is little national data on anaemia and its likely causes amongst adolescent girls. This study aimed to assess the extent of anaemia and associated risk factors among adolescent girls aged between 10-19 years old attending St Therese Clinic located in Eastern province of Rwanda. A cross sectional study design was conducted at St Therese Clinic and included 231 adolescent girls aged between 10-19 years old who were conveniently selected from the consented participants. The hemocue apparatus which uses a modified azide-methaemoglobin reaction was used to measure Haemoglobin (Hb) level in the whole blood. Pre-tested structured questionnaires were used to collect data on anticipated risk factors. The prevalence of anaemia was found to be 29% among adolescents girls. Among 67 anaemic girls (29%), 45 girls (19.47%) had mild anaemia while 18 girls (7.79%) had moderate anaemia and 4 grils (1.73%) had severe anaemia. It was found that malaria, menarche, educational status of their parents and meal intake frequency are significantly associated with anaemia, p value <0.05. Anaemia is highly prevalent in adolescent girls. Thus, policy makers has to prevent and control anaemia in this particular vulnerable group through but not limited to Iron/folic acid supplement, malaria eradication and promoting nutrition education programme targeting adolescent girls and their mothers, heads of primary and secondary schools mainly on the utilisation of easily available and affordable iron rich diet.

Open Access Original Research Article

Physicochemical Equivalence and Validation of an HPLC Analytical Method for the Quantification of Glibenclamide and Its Sulfonamide Impurity in Prescribed Glibenclamide Tablets in Nigeria

Josephine Oluwagbemisola Tella, Saheed Oluwasina Oseni, Basheeru Kazeem Adebayo

Journal of Advances in Medicine and Medical Research, Page 1-17
DOI: 10.9734/jammr/2019/v29i130053

Objective: To investigate the physicochemical equivalence of four brands of commercially available glibenclamide tablets in Nigeria and to develop a validation method using HPLC for the quantitative determination of glibenclamide and its sulfonamide impurity present in these tablets.

Methods: Uniformity of weight, friability tests, hardness/crushing strength, dissolution, and disintegration tests were carried out on tablets/drug samples of each brand. Their functional groups were determined and compared with pure glibenclamide sample (reference standard) using Fourier Transform Infrared Spectroscopy (FTIR) between a range of 4000cm-1 to 400cm-1. High-Performance Liquid Chromatography (HPLC) was used to determine the percentage of glibenclamide and its sulfonamide impurity present in each tablet brand.

Results: From the physicochemical evaluation of the four brands of glibenclamide tablets tested, the brands passed all the British Pharmacopeia specifications, but they all failed the hardness/crushing strength tests and one of the brands failed the assay test requirement for drug content. The developed HPLC method had a percentage recovery between the acceptable limit of 95-105% with percentage relative standard deviation (%RSD) of < 3% while the precision of the method was 0.102% and 0.383% for glibenclamide and its sulfonamide impurity, respectively. The Limit of Detection (LOD) and Limit of Quantification (LOQ) of the developed analytical method for the four brands were 0.075µg/ml and 0.227µg/ml for glibenclamide while that of sulfonamide impurity were 0.114µg/ml and 0.345µg/ml, respectively. In addition, the percentage impurity of sulfonamide in all the brands was less than the acceptable limit of 1%.

Conclusion: The results from the physicochemical evaluation of the glibenclamide brands justified the need for constant monitoring of marketed drug products. The results obtained from the HPLC quantification method developed for this study show that our data is reproducible based on the linearity, precision, and accuracy of data generated for glibenclamide and its sulfonamide impurity in the four brands of glibenclamide tablets prescribed to DM patients in Nigeria, which were judged to be satisfactory at the time of this study.

Open Access Original Research Article

Experiences of Fathers of Babies Admitted into a Neonatal Unit in a Tertiary Hospital in Port Harcourt, Nigeria

P. I. Opara, E. A. Alinnor

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/jammr/2019/v29i130058

Introduction: In time past mothers were regarded as sole caregivers of NICU babies, however the fathers’ role is now increasingly being recognized. Mothers are involved in providing care such as feeding, hygiene, and kangaroo mother care. Fathers are usually called on for medical bills and usually enter the neonatal unit for observational visits. The aim of the study was to determine experiences of fathers during the hospitalization of their babies in the neonatal intensive care unit (NICU) which is referred to as the Special Care Baby Unit (SCBU) of University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria.

Materials and Methods: This was a cross sectional study carried out in the neonatal clinic of UPTH over a period of 10 weeks. Participants were fathers who had brought their babies for follow up. Information obtained using interviewer administered questionnaires included biodata, occupation and experiences during their babies’ stay in SCBU.

Results: There were thirty seven participants, 15 (40.5%) of whom were in the middle socioeconomic class. Generally the experience was described as stressful by 25 (62.5%), confusing by 5 (12%), and pleasant by 7 (18.9%) fathers.

Contributors to stress were financial implications of babies’ care (13: 35.1%), illness in the mother (5: 13.5%), lack of care for other children (16: 43.2%) and worries about procedures and equipment used on their babies (14; 37.8%). Fathers also experienced disruptions in family (14; 35.1%) and social life (22; 55%). Thirty three (82.5%) fathers had family support. Religion and prayers were some of the strategies fathers employed to cope with their stress.

Conclusion: Fathers found the SCBU experience stressful. The financial burden of care contributed to the stress and some fathers resorted to prayers as a coping mechanism.

Open Access Original Research Article

Cardiovascular Risk Assessment among Patients with Hypertension Presenting at a Family Medicine Clinic in Southwest Nigeria

H. T. Ilori, L. A. Adebusoye, O. O. Daramola, O. A. Ajetunmobi

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/jammr/2019/v29i130059

Aims: To determine the 10-year cardiovascular risk (CV) and its association with socio-demographic characteristics of hypertensive patients. 

Study Design: This was a cross-sectional study.

Place and Duration of Study: Family Medicine Clinic of the University College Hospital, Ibadan, Nigeria, between June 2013 and September 2013.

Methodology: We included 345 hypertensive patients (84 men, 261 women) aged 30 years and above with no clinical history suggestive of cardiovascular disease. Data collection was with an interviewer-administered semi-structured questionnaire, physical examination and blood investigation. CV risk was determined by using General Framingham cardiovascular risk profile for use in primary care.

Results: The mean+ SD age of the 345 respondents was 57.4+9.7 years and 75.7% were female. High proportion of the respondents (42.3%) were in the high CV risk category of 10-year risk for cardiovascular disease while 27.0% and 30.7% had intermediate and low CV risk respectively.  CV risk was significantly associated with age (p < .001), sex (p < .001), family type (p= .047), level of education (p=.02), employment status (p<.001) and occupational class (p=.007). Logistic regression showed advanced age (OR=0.014, 95% CI =0.002-0.094) and male gender (OR=26.765, 95% CI = 8.802-81.383) as the predictors of high CV risk.

Conclusion: The findings show that CV risk assessment should be part of patients’ evaluation by physicians and necessary intervention should be instituted on time in order to reduce the burden of cardiovascular disease in Nigeria.

Open Access Review Article

Clinical Concerns in Counseling Clients with Traumatic Brain Injury

Michael F. Shaughnessy, Aaron Johnson, Lela Rucker

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/jammr/2019/v29i130047

Counseling clients who have experienced an open or closed head injury can be quite problematic and present challenges in different realms. This paper explores some of these disparate realms and offers some insights as to counseling strategies that may need to be explored and examined. Realistic goals and objectives are needed and attention to specific areas of concern are examined.