Open Access Case Report

Early Infection of Bilateral Total Knee Arthroplasty with Salmonella typhi: Case Report and Review of Literature

A. Raviraj, Maalepati Vidya Sagar, Azhar Amin, Sanjay Pai, Venkatdeep Mohan, Ashish Anand

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/jammr/2019/v29i430084

Acute Salmonella typhi prosthetic joint infection (PJI) is a rare event. In Endemic areas one needs to be cautious if the patient is immunocompromised. We report a case of bilateral simultaneous PJI of the knee in a 60-year-old lady who was not immunocompromised. The patient presented on Post op Day 5 with Fever and local signs suggestive of infection. As this was an Early PJI she was successfully treated with Debridement, Poly exchange and Intravenous and oral antibiotics for 6 weeks. This case highlights the fact that in patients living in these areas and in seasons where incidence of enteric fever is high, patients should be screened preoperatively for Salmonella infection by history and stool cultures. To our knowledge this is the first case report of Early Bilateral Simultaneous infection with Salmonella typhi.

Open Access Original Research Article

Low Prevalence of Asymptomatic Malaria in Pregnancy among Subjects Attending Antenatal Clinic at a Tertiary Hospital in Bauchi, Nigeria: A Preliminary Report

A. S. Kadas, K. O. Okon, M. Alkali, Y. B. Jibrin, S. T. Balogun, M. A. Baffa, L. M. Dattijo, A. Shehu, C. Chama

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/jammr/2019/v29i430077

Background: Asymptomatic malaria in pregnancy still posed clinical challenge and diagnostic problem. The preventive measures are often advocated during antenatal visits. This study assessed the prevalence of asymptomatic malaria in pregnancy among subjects attending ante-natal clinics.

Methodology: The cross-sectional study was conducted among 140 volunteer asymptomatic pregnant women attending antenatal clinics at Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) between July and September 2017. A structured questionnaire was used to obtain data on sociodemography, obstetric history and malaria control practices from the subjects following an informed consent. They were subjected to malaria screening by rapid diagnostic test (RDT) and Giemsa-stained blood smears were prepared for RDT-positive subjects. The malaria positive subjects were treated according to national treatment guidelines on malaria in pregnancy.

Results: The overall mean (standard deviation) age of the 140 subjects was 24.2 (±10.3) years with majority within the age group of 27-32 years (41.4%, 58/140; p<0.05). Only three of the 140 subjects had malaria parasitaemia giving a prevalence of 2.1% (3/140). Among all the variables analyzed, malaria in pregnancy was associated with only older age (p<0.05) in the present study. 

Conclusion: The study revealed low prevalence of asymptomatic malaria among pregnant women attending ATBUTH, Nigeria and could be attributed to the satisfactory ante-natal and malaria prevention practices. However, elaborate epidemiological studies are required to ascertain the finding.

Open Access Original Research Article

Factors Related to Deaths of under 5 Years Old Children in Dar Alsalam Area-Khartoum-Sudan

Asma Abdelaal Abdalla, Christina Nagi Milad, Siham Ahmed Balla, Haieder Abuahmed Mohamed, Mohamed Ali Awad Elkarim

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/jammr/2019/v29i430078

Aims: This study is done to identify factors affecting under five mortality in Dar Alsalam area, Khartoum.

Study Design: This is a community based cross-sectional study.

Place and Duration of Study: The study was carried out in block 25 in Dar Alsalam area in Khartoum State during March- April 2012.

Methodology: A total of 240 women in reproductive age who had an experience of child death were interviewed. The data was collected by semi-final medical students using structured questionnaire.  Two stage cluster sampling was used to select the households. Data was summarized using descriptive statistics and logistic regression analysis was carried out to identify factors associated with under-five mortality.

Results: Age of 156 (65%) of the deceased children was less than one year, while the age of 84 (35%) was between one and five years. The age of (25%) of the mother at the time of their child birth was below 18 years.  The majority of the mothers (70.8%) were illiterate, 74.2% were working and 80% were married.  Of the children 51.7 were males and for 74.2% of them the birth interval was less than 2 years.  Only 16.7% were breast fed for more than two years while the rest (83.3%) were breast fed up to 2years. Only 34.2% of the deceased children had completed their vaccination, and 68.3% had been admitted to hospital more than once before death.

Half of the families have piped water in their houses, in 75.8% of the houses there are pit latrines and in 68.3% there is electricity supply.

Logistic regression analysis identified incomplete vaccination, not employed mothers and having no latrines in the house as the factors related to the death of children between 1-5 years than those below one year.

Conclusion: Under-five mortality in low socioeconomic areas is associated with Low family income, mother’s illiteracy, early marriage and absence of latrines in the houses.

Open Access Original Research Article

Zinc Supplementation as Adjunctive Therapy in Adults with Tuberculosis in Calabar, Nigeria: A Randomized Controlled Trial

Regina I. Ejemot-Nwadiaro, Edisua H. Itam, Emmanuel N. Ezedinachi

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/jammr/2019/v29i430079

Introduction: Tuberculosis (TB) still remains a leading killer from a single infectious agent worldwide, especially in Asia and Africa. Achieving the Sustainable Development Goal (SDG) 3 will be contingent on addressing ways of reducing the impact of TB to the health, socio-economic and health system of populations most at risk. Micronutrients supplementation is increasingly being recognized as having great potentials to that effect.

Objective: This study thus assessed the potential benefits or otherwise of zinc supplementation on tuberculosis treatment outcomes in Calabar, Nigeria.

Methods: Eligible patients (81) out of the 182 assessed were randomized to receive anti-TB drug regimen plus oral administration of individual zinc, 25 mg daily for 60 days (intervention group), while the control group received anti-tuberculosis drug regimen only for 60 days. Both qualitative and quantitative data were collected. Clinical examination, Karnofsky performance scale index, direct sputum examination, anthropometric measurements and blood collection for haematological and zinc assessment were carried out before and 2 months after anti-TB treatment began.  Difference in treatment effects between and within groups for continuous variables was tested using t-test. Mantel-Haenszel summary estimate of the relative risk (RR) was used to test the clinical effectiveness of the intervention. The Pearson test was applied to determine the correlation between variables.

Main Results: The mean serum zinc levels at 2 months of TB treatment were significantly higher in the intervention group (14.4 ± 0.37µmol/L) in comparison with the control (12.9 ± 0.37 µmol/L); (p = 0.004). A significant difference (p = 0.010) in the serum concentrations of zinc was observed between the two groups when adjustments were made for TB-HIV co-infection. Risk reduction of about 41% for acid fast bacilli (AFB) positivity (RR: 0.59; 95% CI 0.23 to 1.46) was observed after 2 months of anti-TB treatment in favour of the intervention group. Similarly, intervention group had significantly (p = 0.005) lower proportion of patients with serum zinc levels < 10.7 µmol/L (intervention: 5; Control 10) and (p = 0.030) BMI < 18.5 kg /m2 below the lower ranges ((intervention: 9; Control 16). There was a significant improvement in the haematological parameters as evidenced by significant higher proportion of patients in the intervention group than the control group with values above the lower ranges for these parameters with risk reductions in favour of the intervention group for lower ranges as 34%, 12%, 73% and 58% respectively for haemoglobin, albumin, serum total protein and globulins.

Conclusion: Irrespective of HIV status in individuals with tuberculosis, zinc micronutrient supplementation significantly increases clinical outcomes, haematological parameters, improves nutritional status as proxied by anthropometric indices and leads to faster sputum smear conversion. The study adds to the growing body of evidence in support of the beneficial role of zinc in TB control.

Open Access Original Research Article

The Effectiveness of Social Cognitive Theory-based Educational Intervention on School Children’s Breakfast Consumption

Amin Mirzaei, Fazlollah Ghofranipour, Zeinab Ghazanfari

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/jammr/2019/v29i430080

Introduction: Breakfast consumption has a lot of beneficial effects on nutritional status and cognitive activities of school-aged children's. This study aimed to examine the efficacy of social cognitive theory–based education on schoolchildren breakfast eating behaviors.

Methods: Two schools with similar socio-demographic characteristics were selected from 20 public primary schools of Ilam city (west of Iran) and randomly assigned as intervention or control school. Fifty school children from 3rd, 4th and 5th grades of each school participated in this study. Educational intervention was performed during 6-weeks and was focused on enhancing the self-efficacy, social support and self-regulation mediators to promote the school children’s breakfast consumption. Data were collected at baseline and 8-weeks after intervention using a 57-item questionnaire and a breakfast food diary and analyzed using Nutritionist IV food processor software and IBM SPSS statistics data editor.

Results: The findings showed that mean scores of all Social Cognitive Theory (SCT) constructs as well as breakfast eating behaviors in intervention group significantly increased at 8-weeks after intervention (p < 0.05). Also, there was a significant increase in mean score of knowledge in control group at 8 weeks follow-up (p < 0.05). Moreover, the results showed that mean scores of energy and all measured macro and micronutrients intakes significantly increased at follow-up in intervention group (p < 0.05). Also, there were significant increases in mean scores of energy, zinc, calcium and vitamin D intakes in control group at 8-weeks follow-up (p < 0.05).  

Conclusions: The findings of the present study showed that social cognitive theory is an effective framework to planning and implementation of the educational intervention to promotion of male school children’s breakfast consumption.

Open Access Original Research Article

Some Effects of Crude Aqueous Extracts of Hibiscus sabdariffa Leaves on the Testes and Sperm Parameters of Adult Male Wistar Rats (Rattus norelegicus)

A. Ashamu Ebenezer, A. Oyeniran David, T. Awora Koyinsola, O. T. Olayemi, O. Oyewo Olutoyi

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/jammr/2019/v29i430082

Hibiscus sabdariffa is a common garden plant native to warm-temperate, subtropical and tropical regions throughout the world, used in traditional medicine. It is mostly cultivated for its flowers. The calyces are used as a refrigerant in form of tea (especially in making the sorrel drink popularly known as ‘zobo’ in Nigeria), jellies and jam.

Aim: This study evaluates the effects of aqueous leaves extract of Hibiscus sabdariffa on the body, testis weight, histology of the testes and sperm parameter of adult male Wistar rats.

Methodology: Twenty-five adult male wistar rats of 10-12 weeks and weighing about 120-140g were divided into four groups (A, B, C and D) (five rats / group), Group A was kept as control and B, C, D were administered 250 mg, 500 mg, 1000 mg  of Hibiscus sabdarfia leaf extract per Kg body weight for 8 weeks. The rats in each group were fed with rat feed and water ad libitum. Administration was by means of an oral cannula. At the end of each experimental period, the rats were sacrificed by cervical dislocation, the testes were harvested and immediately fixed in Bouin’s fluid for histological procedure. However, as soon as the animals were sacrificed, the cauda epididymis was removed and semen analysis was carried out immediately.

Results: There was a significant decrease in body weight of all the test groups at (P <0.05) and a significant decrease in the testes of the rats in group D when compared with the control group. Statistical analysis revealed decrease in sperm count, motility and viability with a significance decrease (P <0.05) in group D only as compared to control group. The histoarchitecture revealed significant degenerative changes characterized by vacuolization in the intestitium and seminiferous epithelium when compared with the control group.

Conclusion: The aqueous leaves extract of Hibiscus sabdariffa appears to have adverse effects on the fertility of male rats especially when taken over a long period of time.

Open Access Original Research Article

Antiplasmodial, Antipyretic, Haematological and Histological Effects of the Leaf Extracts of Moringa oleifera in Plasmodium berghei berghei Infected Mice

O. Olaniran, F. C. Adetuyi, F. O. Omoya, S. A. Odediran, R. E. Hassan-olajokun, E. A. Awoyeni, B. W. Odetoyin, A. Adesina, A. Awe, R. A. Bejide, Odujoko O, L. O. Akinyemi, O. O. Oyetoke, D. O. Afolayan

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/jammr/2019/v29i430083

The aqueous and ethanolic extracts of Moringa oleifera leaf were evaluated for safety, antimalarial and antipyretic activities because it is commonly used for various types of ailments especially malaria and fever. The various concentration of these extracts (0-800mg/kg) were tested against Plasmodium berghei berghei infected albino mice of either sex, in a Peters’ four day antiplasmodial test while antipyretic activities were evaluated in malaria- induced mice. Their possible effects on haematological parameters of PCV, WBC, neutrophil, lymphocytes count and liver enzymes were also determined as well as on the liver and kidney architecture. All the tested doses of the aqueous extract were comparable in antiplasmodial activity (p>0.05) to each of the tested doses of the ethanolic extract which were significantly different (p<0.05) from the negative control.  Only the highest doses of both extracts gave significantly higher (p<0.05) antiplasmodial activity than the standard drug. For the ethanolic extract, a significant antipyretic activity was not observed until at 800mg/kg in time T3 while the aqueous extract exerted no significant antipyretic activity at all doses and at all times. The ethanolic extract gave significantly higher PCV values than that of the aqueous. The administration of the aqueous extract gave significantly lower WBC than the ethanolic extract while comparable increase in lymphocyte count was noticeable at each of the doses of both extracts when compared to the negative control. Only 100mg/kg and 800mg/kg of the aqueous extract maintained a relatively high neutrophils count in this study. Also, the aqueous extract elicited higher concentration of ALT (greater than fourfold of normal) but the ethanolic extract produced the highest level of AST at the highest dose of 800mg/kg when compared to the ethanolic extract. Histological examination of the kidney showed progressive degeneration while that of the liver showed recovery when compared to negative control as a result of progressive increase in dosage of the extracts in malarial treatment.

In conclusion, though both aqueous and ethanolic extracts of M. oleifera leaves exert chemosuppressive antiplasmodial activities in Plasmodium berghei berghei infected mice and exhibited antipyretic activity with some improved haematological parameters, caution should be taken in its indiscriminate use because of probable toxic effects on the kidney and the liver.

Open Access Review Article

Hepatitis D Virus: An Overview for Dentists

Nima Mahboobi, Stephen R. Porter, Mario Rizzetto, Seyed Moayed Alavian

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/jammr/2019/v29i430081

Hepatitis D is considered to be the most severe form of viral hepatitis. This virus requires hepatitis B for its life cycle and it is estimated that at least 5% of hepatitis B virus infected patients are also infected with hepatitis D, counting for 15 million infections worldwide most optimistically. Hepatitis D has a similar transmission pattern to hepatitis B and hepatitis C viruses. However, there is less information about the virus of hepatitis D than about the other agents of viral hepatitis. In particular, there is total lack of information on hepatitis D in the setting of dental diseases and management. To our knowledge, there are only few reports on hepatitis D of dental health care workers (DHCW), the association of hepatitis D with oral conditions and on the role of oral fluid in transmission of hepatitis D. The present report reviews current knowledge of hepatitis D for dentists and dental personnel. Therefore, epidemiology, transmission modes, sign and symptoms, diagnostic methods and treatment options of hepatitis D are discussed under relevant subheadings.