Open Access Short Research Article

Prevalence and Antibiotic Resistance Profile of Pseudomonas aeruginosa from Hospital Sinks in South Western Nigeria

Olayinka Oluyemi Oluranti, Chiamaka Ifeoma Ubanagu, Olukunle Oluwapamilerin Oluwasemowo, Omowunmi Temidayo Akinola, Yewande Tolulope Nejo, Babatunde Olanrewaju Motayo

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/jammr/2019/v29i230067

Background: Pseudomonas aeruginosa (P. aeruginosa) has been identified as a major pathogen in man, causing both opportunistic and nosocomial infections. Pseudomonas is a ubiquitous organism often isolated from various surfaces, which have the ability to form biofilms, making it a unique organism of medical importance.

Objective: The aim of this study is to determine the prevalence of P. aeruginosa isolated from hospital sinks and their antibiotic resistance profile.

Methods: Swab samples were collected from hospital sinks in five health care institutions and inoculated unto Nutrient agar and sub cultured on cetrimide agar. Isolated P. aeruginosa were subjected to antibiotic susceptibility testing using CSLI guidelines.

Results: Prevalence of Pseudomonas species isolated from the hospitals’ sinks was 56%. High level resistance was recorded against amoxicillin/clavunalate, ampicillin and ceftriaxone. Resistance profile of the isolates clustered into two main clades clade A and clade B, with clade A isolates recording a higher MARI score.

Conclusion: Isolation of multi-resistant P. aeruginosa from hospital sinks calls for improved hospital infection control practices. We advocate for inclusion of environmental surveillance, particularly of opportunistic pathogens in our hospitals.

Open Access Original Research Article

Cross-Sectional Study of Impact of Social Support on Depression among Type 2 Diabetics in a Secondary Health Care Facility in Southwest Nigeria

H. T. Ilori, O. A. Ajetunmobi

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/jammr/2019/v29i230060

Aims: To assess the level of social support and determine the relationship between depression and social support among patients with type 2 diabetes mellitus (DM).

Study Design: This study was a cross-sectional survey.

Place and duration of Study: The study was carried out at the Medical Out Patients (MOP) clinic of Jericho Specialist Hospital, Ibadan between 1st of August and 30th of September 2017.

Methodology: Systematic sampling technique was used to recruit 273 type 2DM patients who were 40 years and above, receiving care at the MOP clinic for at least 3months. Diabetes-related information was collected using a semi-structured questionnaire. Zung self-rating scale and multidimensional perceived social support scale were used to assess depression and social support respectively. Independent t-test was used to determine the relationship between depression and social support and the level of significance was set at p<.05.

Results: Half (50.5%) of the respondents were diagnosed in the past 5 years as having type 2 DM, 79.5% had hypertension as a co-morbidity and 51.6% had good glycaemic control. The prevalence of depression was 27.5%, mild and moderate depression were 26.4% and 1.1% respectively and none had severe depression. One hundred and two (37.4%),56.0% and 6.6% respondents had high, moderate and low social support respectively. The highest social support scores 5.9 + 1.7 was from family. Total perceived social support was higher among non-depressed diabetic respondents. There was a significant difference between the mean total support in the depressed and non-depressed group (4.88 ± 1.41 vs 4.50 ± 1.24, p = .03).

Conclusion: Type 2 DM patients who had high social support were less depressed, therefore, clinicians managing DM patients should explore the social support enjoyed by such patients to achieve good health outcome.

Open Access Original Research Article

Outcome of Micropulse Laser in Treatment of Open Angle Glaucoma in a Peripheral Hospital in Rivers State, Nigeria: Our Initial Experience

Elizabeth A. Awoyesuku, Bassey Fiebai

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/jammr/2019/v29i230061

Aims: To determine the Intraocular Pressure (IOP) and visual acuity changes before and after Micropulse laser treatment among patients with open angle glaucoma.

Study Design: A quasi-experimental study design.

Place and duration of Study: The Ophthalmic Specialists, a peripheral ophthalmologist group practice in Rivers State between February 2018 and December 2018.

Methodology: Twelve eligible patients with moderate and advanced open angle glaucoma on medical (topical) treatment were recruited after they gave informed consent. Baseline visual acuity (VA) and intra ocular pressure (IOP) were obtained prior to the use of the micropulse laser treatment. Following the laser treatment, VA and IOP were assessed at one day, one week, one month and 6 month post laser. p=.05 was regarded as statistically significant.

Results: A total of 12 patients were followed up for 6 months. Mean age was 37.42±7.00 years. Age range was 24-46 years with M: F ratio =1.4:1. Mean change in visual acuity across the time periods was statistically significant (p=0.0001). Mean IOP change over 6 months was 10.46mmHg (38.20%, p=0.0001). Median number of drugs used by participants dropped from 3 to 1. (P=0.002)

Conclusion: Micropulse Trans- scleral cyclophotocoagulation is a safe and effective way of managing glaucoma. It caused a mean drop in IOP of 10.46mmHg (38.20%) over 6 months in our study.

Open Access Original Research Article

Correlation of GSTP1 Polymorphism with Severity of Prostate Cancer in an Eastern Indian Population

Suparna Roy, Anindya Dasgupta, Subarnarekha Chatterji, Dilip Karmakar

Journal of Advances in Medicine and Medical Research, Page 1-10,
DOI: 10.9734/jammr/2019/v29i230062

Background: GSTP1 is one of the Glutathione-S-Transferases (GSTs) which suppress tumor genesis by detoxifying toxic carcinogens and reactive oxygen species (ROS). Prostate cancer is related to several mutations affecting the expression of GSTP1. A single nucleotide polymorphism (SNP: Ile105Val) in the GSTP1 gene results insignificant reduction in its anticancer activity. The current case control study was conducted to ascertain the risk of association of GSTP1polymorphism with risk of cancer prostate in an Eastern Indian population.

Materials and Methods: During a study period of 2 years, DNA was isolated using the phenol chloroform extraction method from the blood of 225 histopathologically diagnosed prostate cancer patients and 120 matched controls. The GSTP1 polymorphism was assessed by PCR amplification of the gene followed by restriction digestion with Alw261 (a restriction enzyme derived from Acinetobactro lwoffi RFL26). Histopathological grading in the case group was performed using Gleason’s scores and International Society of Urological Pathology (ISUP) grading.

Results: Comparison of the distribution of different GSTP1 alleles between the case and control groups was performed by chi square test and odds ratio analysis. A χ2 value of 18.56 suggested significantly higher number of G alleles in the case group. An odds ratio of 2.25 with a confidence interval of 1.52 to 3.34 for 95% CI showed that the G allele in GSTP1 gene were linked with greater risk of prostate cancer. Post hoc ANOVA and logistic regression suggested that cases having G alleles had more progressive form of diseases as evident from ISUP grades.

Conclusion: From our study we can conclude that GSTP1 polymorphism is not only significantly associated with risk of prostate cancer but also with its severity in our Eastern Indian population. GSTP1 polymorphism should be considered as a prognostic indicator for prostate cancer patients along with planning for more aggressive management of the disease.

Open Access Original Research Article

Effectiveness of Kinesio Taping in the Management of Knee Osteoarthritis

Aung Aung Nwe, Myo Tint Tun, Si Thu Aung, La Min Tun, Khin Thuzar Myaing

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/jammr/2019/v29i230063

Background: Knee osteoarthritis (OA) is one of the commonest chronic joint problems presenting with pain and stiffness. As a consequence, activities of daily living are limited and decline the quality of life. Kinesio tape (KT) has been popular in worldwide by its positive effects including reducing pain, relieving stiffness and improving function. However, the therapeutic application tension, direction and technique have not been identified yet and still weak evidence in OA knee.

Aims: To find out the effectiveness of Kinesio taping in the management of OA knee.

Study Design: Hospital based randomized control trial.

Place and duration of Study: This study was conducted in the Outpatient Department of Physical Medicine and Rehabilitation in both Mandalay Orthopedics Hospital and 300 Bedded Teaching Hospital, Mandalay. It was started from May, 2017 to August, 2018.

Methodology: A total of 60 patients were randomly assigned into group A and group B. Group A (intervention group) received KT plus conventional exercise and group B (control group) received conventional exercise alone. Both groups were assessed in week 0 (before study), week 2 (during study) and week 3 (end of study). Assessments measures were VAS, WOMAC index and TUG test. The amount of analgesic consumptions was recorded in week 2 and week 3 assessments.

Results: There were no significant differences in baseline characteristics of patients between the two groups. The intragroup analysis showed significant difference in VAS, WOMAC index and TUG test (p<0.05) in both groups. However, intergroup analysis showed more significant improvements of VAS, WOMAC index and TUG test in intervention group than control group in week 2 and week 3 (p<0.05).

Conclusion: KT plus conventional exercise is more effective than conventional exercise alone in terms of relieving pain, reducing stiffness and improving function in patients with OA knee.

Open Access Original Research Article

The Prognostic Implication of CD49d Expression by Flow Cytometry and Trisomy 12 Detection by Fluorescent in situ Hybridization in Chronic Lymphocytic Leukemia

Eman Mosaad Zaki, Sahar Abd Allah El-Gammal, Noha Gaber Sayed, Mayada Fawzy Sediek, Asmaa Ahmed Mohamed

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/jammr/2019/v29i230064

Chronic lymphocytic leukemia (CLL) is the most common chronic lympho‑proliferative disorder. This study done to detect the level of  cluster of differentiation (CD)49d in CLL patients by flow cytometry and its correlation with the prognosis (survival) and with (trisomy12) detected by fluorescent in situ hybridization (FISH).

Methods: Clinico - hematological profiles done to fourty CLL patients. CD49d tested by flow cytometry and trisomy12 was detected by FISH.

Results: CLL patients classified according to modified Rai staging system into: low risk 12.5%, intermediate risk 22.5% and high risk 65%. CD49d and trisomy12 positivity were detected in 29 patients (72.5%) and 22 patients (55%), respectively. There was a significant positive correlation between the percentage of trisomy12 and of CD49d cells in CLL patients (P =0.034). And also, between CD49d and CD38 (P =0.034). On the other hand, there was no significant relation between both CD49d and trisomy12 expression and modified Rai staging system.

As regard to overall survival (O.S) and disease free survival (DFS), both CD49d, trisomy12 positive cases were associated with shorter disease free, and overall survivals compared to the negative cases.

Regarding to the relation between the use of combination of fludarabine, cyclophosphamide, and rituximab (FCR) as a standard treatment in CLL and OS and DFS of patients in our study, we found that FCR account for the better outcome associated with its use.

Conclusion: CLL B-cell membrane expression of CD49d as measured by flow cytometry is a powerful prognostic parameter in patients with CLL. Its positive correlation with the trisomy12 and CD38 and the association of both CD49d and trisomy12 with short survival times indicate that they may have roles in the prognosis of CLL.

Open Access Original Research Article

Pattern of Maternal Group B Streptococcus (GBS) Colonization in Relation to CD4 Count among HIV Positive Women in Jos

Dahal A. Samuel, Sabitu M. Zainu, Hosea S. Hamafyelto, Ille Mamman, Daniel Z. Egah, Kandakai-Olukemi T. Yvonne

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/jammr/2019/v29i230065

Aim: The aim of this study was to determine the prevalence of GBS colonization among HIV positive and HIV negative pregnant women in relation to CD4 cell counts.

Materials and Methodology: This was a hospital based descriptive cross-sectional study of 200 pregnant women (100 HIV positive and 100 HIV negative) and 100 non-pregnant women (50 HIV positive and 50 HIV negative) obtaining health care at the Jos University Teaching Hospital between July 2017 and November 2017. Systematic sampling technique and written informed consent were used in recruiting subjects for this study. High vaginal and anorectal swabs were collected from each subject after filling a structured questionnaire. CD4 cell count was also done for all the HIV positive patients at Aids Prevention Initiative in Nigeria (APIN) of Jos University Teaching Hospital (JUTH). The results from the laboratory analysis of the specimens were computed using SPSS version 21.

Results: A colonization rate of 7.3% was observed in HIV positive patients compare to 5.3% in HIV negative. The different in colonization rate between the two groups was not statistically significant (X2 = 0.507; P = 0.477) (Table 1). In pregnant women living with HIV, colonization rate was 8.0% compare to 5.0% observed in non-pregnant women living with HIV. This however, was not statistically significant (Table 2) (χ2 = 0.013; P = 0.908). HIV positive subjects with low CD4 counts (<200 cells/μl) were observed to have high colonization rate (20.0%) than patients with high CD4 counts (≥500 cells/μl). Those with CD4 counts between 200-499 cells/μl had 8.1% colonization rate. These findings, though not statistically significant (Table 4) (χ2 = 1.3814; P = 0.2399), the increased colonization rate in low CD4 cell counts may be due to inability of the patient to mount immune response against the organism.

Conclusion: There was no statistically significant difference in GBS colonization among HIV positive patients. A higher colonization rate was observed in HIV patients among the age group 21-25 years; ager was not significantly risk factor for GBS colonization in HIV patients. CD4 cell counts seem not to play any significant role in GBS colonization rate. Although, it was observed to be higher in patients with low CD4 cell counts; the different was not statistically significant.

Open Access Original Research Article

Quality of Life of Diabetic Children in Public Diabetes Specialized Clinics, Khartoum State, Sudan

Hiba Ali Elzaki, Kamil Merghani Ali, Osama Ahmed Elkhidir, Sarra Mohamed Kheir

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/jammr/2019/v29i230068

Background: Quality of life assessment can be a good baseline measures to determine the efficacy of health policies that are designed to reduce or eradicate the detrimental disease effect.

Aim: This study aimed at assessing the different dimensions of quality of life in children with diabetes including physical, social, emotional and school function.

Methods: The study was conducted in Khartoum state - Sudan using a cross sectional design. Data was obtained in 2018 at three outpatient diabetes clinics, using systematic random sampling with sample size of 138 diabetic children aged between 2-18 years, via structured interviews. Descriptive and inferential statistics were used to analyze the data and test the relationship between quality of life and other independent variables: demography ( age, gender, parents’ education, age, residency and occupation), type of diabetes, type of treatment, duration of illness, control of diabetes and insurance status.

Results:  The mean age of children was 11.1±3.64 years. Most of them were females 63%. More than half of participants were not covered by any insurance scheme. Those with diabetes reported personal and adverse social effects, poor control; HA1C more than 6.5% in 90% of participants. Mean generic quality of life was 80.03 ± 27 and 80.84 ± 28 p-value =0.73 for parents and children respectively.

Conclusion: Diabetes adversely affects the quality of life of diabetic children which is influenced by history of hospitalization. Further studies on Diabetes quality of life are recommended.