Open Access Minireview Article

Raynaud’s Disease and Clinical Challenges: A Minireview of Literature with a Spotlight on Acupuncture

Naseem Akhtar Qureshi, Sheelaj Sharma, Rahul Guru, Andrea Kahlenberg, Mohammed Khulaif Alharbi

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/jammr/2019/v29i730104

Background: Primary Raynaud’s disease preferentially afflicts women with 5% prevalence rate reported in general population, manifests triphasic color phenomenon along with paresthesia involving distal digits and toes and triggered by severe cold and stress.

Objective: This review critically describes several perspectives of Raynaud’s diseases with a focus on medical acupuncture.

Methods: Electronic searches of relevant data prior to 2019 published in PubMed, MEDLINE, Google Scholar, and ScienceDirect databases were made using the Boolean operators and keywords. Finally, 32 articles that addressed specifically Raynaud’s disease and acupuncture were retained for this minireview.

Results: Raynaud’s disease classified into primary and secondary is poorly understood phenomenon, lacks standard care and, hence, needs patient-centered holistic approach. Evidently, medical acupuncture with safe clinical profile has been effectively used as an alternative therapy in Raynaud’s disease. Outcome results with the use of conservative approaches, modern therapies, behavioral interventions and medical acupuncture vary considerably across the board and primary RD carries better prognosis than secondary RD.

Conclusion: Both Raynaud's disease phenomena are complex conditions; need individualized treatment approach including surgical in refractory cases and further rigor studies to unravel their pathophysiology pathways and standardized interventions.

Open Access Original Research Article

Prevalence of Streptococcus agalactiae Serotypes Associated with Anogenital Colonization among Pregnant Women in Jos

Dahal A. Samuel, Daniel Z. Egah, Kandakai-Olukemi T. Yvonne

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/jammr/2019/v29i730098

Aim: The aim of this study was to determine the prevalence of GBS serotype distribution in Jos University Teaching Hospital.

Materials and Methodology: This was a hospital based descriptive cross-sectional study of 300 women receiving health care at the Jos University Teaching Hospital between July 2017 and November 2017. Systematic sampling technique was employed in recruiting consenting subjects for this study. High vaginal and anorectal swabs were collected from each subject after obtaining their consent by signing a structured consent form. The identified Streptococcus agalactiae (GBS) isolates were serotyped using immuLex strep-B antisera from SSI Diagnostica, 2 Herredysvejen, DK-3400 Hillerod Demnark to identify the different serotypes. The results obtained were computed using SPSS version 21.

Results: A total of 300 women obtaining health care in Jos University Teaching Hospital (JUTH) were enrolled in this study between the months of July, 2017 and November, 2017. In all, vaginal and anorectal swabs were taken from 200 pregnant women and 100 non-pregnant women. The age range of the study population was between 16 years to 48 years with a mean age of 31.9 year (SD ± 6.6). The prevalence rate among the study population was 6.3%. The colonization rate among pregnant and non-pregnant women was 6.5% and 6.0% respectively with no significant statistical difference. Serotype Ia was the commonest isolate responsible for 42.1% of the GBS isolates. Serotype III accounted for 31.6% of the isolates, followed by serotype V (15.8%). Serotype II was less common, responsible for only 10.5%.

Conclusion: This study showed that GBS colonization rate among the study population was 6.3%. Approximately, 6.5% and 6.0% prevalence rate were found among pregnant and non-pregnant women respectively. Of all the GBS isolates, serotypes Ia, II, III, and serotype V were isolated with serotype Ia being the most prevalent serotype. This knowledge of serotype distribution will help in instituting serotype specific GBS vaccines for the prevention of GBS diseases in Jos.

Open Access Original Research Article

Insecticide Susceptibility Profile of Malaria Vector Populations from the Coastal and Mainland Areas of Akwa Ibom State, Nigeria

I. A. Atting, N. D. Ekpo, M. E. Akpan, B. E. Bassey, M. J. Asuquo, L. P. E. Usip, P. U. Inyama, L. M. Samdi

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/jammr/2019/v29i730099

Development of resistance by different malaria vector populations to insecticides has become a big threat to malaria vector elimination. This study evaluated the susceptibility of Anopheles mosquito populations in Akwa Ibom State, Nigeria to permethrin (0.75%), deltamethrin (0.5%), lambdacyhalothrin (0.5%), alphacypermethrin (0.75%), Dichlorodiphenyltrichloethane (DDT), propoxur, bendiocarb and pirimiphosmethylin in World Health Organization (WHO) test tubes following standard protocols. The mosquitoes were obtained as aquatic forms and reared under laboratory conditions to adults. The adults were subjected to WHO susceptibility bioassays following standard procedures. Malaria vectors across the study sites were resistant to permethrin, deltamethrin, lambdacyhalothrin and alphacypermethrin insecticides. Full susceptibility to propoxur and bendiocarb was recorded across the sites. Full susceptibility to pirimiphosmethyl was recorded in populations from three sites. Nevertheless, population of the malaria vectors collected from Oron was resistant to pirimiphosmethyl. KDT50 and KDT95 estimated for each insecticide using a log-time probit model revealed that knockdown was more rapid for deltamethrin, lambdacyhalothrin, alphacypermethrin, propoxur, bendiocarb and pirimiphosmethyl than for DDT and permethrin  across the study sites. Morphological identification of all the mosquito samples used revealed that they were female Anopheles gambiae s.l. Sustained susceptibility of malaria vectors to pyrethriod is necessary for successful malaria control with insecticide treated nets and Indoor Residual Spraying (IRS). Emergence of focal points with insecticide resistance gives serious concern especially with the scale-up in distribution of pyrethriod treated nets to these areas. This may increase selection pressures due to overexposure. Further study to identify the exact resistance mechanism(s) of malaria vectors from these sites is recommended.

Open Access Original Research Article

Evaluation of Awareness of Susceptibility to Human Papilloma Virus and Cervical Cancer Screening among Nurses at University of Benin Teaching Hospital, Benin City, Nigeria

Ndie Elkenah Chubike, Elusoji Christiana Irolo, Ejidokun Adeolu

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/jammr/2019/v29i730100

Aim of the Study: The study aimed at evaluation of awareness of Susceptibility to Human Papilloma Virus and Cervical Cancer Screening among Nurses at University of Benin Teaching Hospital.

Research Design: Cross sectional descriptive survey design was used for the study.

Study Place: The place of study is University of Benin Teaching Hospital, Benin City, Nigeria.

Duration of Study: Data was collected within four weeks in December 2016.

Method of Data Collection: A validated self-structured questionnaire was utilised for data collection. A total of 281 nurses who worked in UBTH were recruited for the study. The study setting was purposively selected due the cervical cancer mortality observed among nurses in recent time. The level of significance was put at 0.05.

Findings: The results showed that 62 (24.2%) and 153 (59.8%) of the nurses are aware of susceptibility to Human papilloma Virus and cervical cancer and its prevention, respectively. However, 116 (45.3%) exhibited a negative attitude towards the proven screening modality. Those who demonstrated negative attitude towards pap smears utilisation were less likely to utilise it. This was found to be statistically significant (chi-square = 14.899, df = 1, p value = 0.000.

Conclusion: Besides, nurses with university education exhibited positive attitude towards pap smear test more than their counterparts who had diploma education in nursing/midwifery. Similarly, older nurses exhibited a positive attitude more than the younger counterparts.

Recommendation: Intervention programmes that would focus on change of attitude of the nurses towards utilisation of cervical cancer screening were recommended. Further study on the utilisation of cervical cancer screening by these nurses were also was also recommended.

Open Access Original Research Article

Fournier's Gangrene: From Diagnosis to Reconstruction

Amine Rafik, Samira Taqafi, Mounia Diouri, Naima Bahechar, Abdessamad Chlihi, Ayoub Halfya, Khalid Elmourtaji, Redouane Rabii, Fethi Meziane

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/jammr/2019/v29i730101

Fournier gangrene (FG) is an acute and potentially fatal infection of the scrotum, perineum, and abdominal wall. It is characterized by necrotizing fasciitis with loss of subcutaneous tissue and skin. Although originally thought to be an idiopathic process, FG has been shown to have a predilection for patients with diabetes as well as long-term alcohol misuse; however, it can also affect patients with non‐obvious immune compromise. Twenty patients were admitted to our hospital with the diagnosis of Fournier gangrene, between 1 January 2011 to January 2013.

The epidemiological characteristics, evolution and treatment modalities were reviewed. Early surgical debridement of necrotic tissues and antibiotics are fundamental in the treatment of FG. Scrotal reconstruction with skin grafts or flaps is fundamental to improve the quality of life and provides social reinsertion.

Open Access Original Research Article

Biochemical Assessment of the Liver in SCD in a Tertiary Hospital in South-South, Nigeria

Kingsley Akaba, Ofem Enang, Bassey Okon Bassey, Oluwakorede Babatope, Omolabake Riman

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/jammr/2019/v29i730103

Background: Sickle cell disease (SCD) is often associated with liver disease. The constant state of haemolysis, multiple blood transfusion, viral hepatitis, hepatic sinusoidal congestion, haemosiderosis and cholestasis, are all conditions which may eventually evolve into liver disease. Sickle cell disease is a heterogeneous group of disorders that is usually associated with an autosomal recessive structural haemoglobin disorder. Biochemical abnormalities have been associated with SCD and it is usually more pronounced in vaso occlusive crises; an acute bone crisis and common painful complication of SCD, than in steady state.

Aim: The aim of the study was to assess some biochemical parameters in relation to SCD patients in our environment with a view to improving the monitoring and management of these patients. 

Methodology: The study was a comparative hospital based research carried out at the University of Calabar Teaching Hospital (UCTH), Calabar, South-South Nigeria. Liver function tests were carried out on 60 SCA both in steady state and in crisis and also on 50 apparently healthy adults.  The data collected were analyzed using statistical data for social sciences (SPSS) Version 22 for windows. Pearson linear correlation and simple inferential statistical methods were employed for data analysis, a P ≤ 0.05 was considered to be statistically significant.

Result: The serum concentrations of AST, ALT, ALP, LDH, Total and conjugated bilirubin were seen to be elevated in VOC compared to in steady state and with the apparently healthy control group. The AST/ALT ratio was also observed to be elevated in VOC as compared with the steady state and the control. Significant product moment correlation was observed in the biochemical parameters both in steady state and in VOC.

Conclusion: The findings of this study revealed marked changes in the biochemical parameters of the liver in VOC than in steady state. It will be recommended that routine evaluation and proper interpretation of liver enzymes is paramount in early detection of liver pathology in SCD.

Open Access Original Research Article

Organ Dose Distribution and Estimated Cancer Risk to Paediatric Patients Undergoing Computed Tomography in a Nigerian Tertiary Hospital

C. A. Aborisade, O. C. Famurewa, F. I. Ibitoye, F. A. Balogun

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/jammr/2019/v29i730105

Aims: The aim of this research work is to estimate the organ dose distribution and the associated radiation induced cancer risk for some commonly performed Computerized Tomography (CT) examinations in a tertiary medical facility in South Nigeria.

Study Design:  The study was designed to estimate the radiological implications of radiation dose that the paediatric patients were exposed to during routine CT examinations.

Place and Duration of Study: Department of Radiology, Obafemi Awolowo University Teaching Hospital Complex, (OAUTHC), Ile-Ife, Nigeria, between August 16,  2011 to August 15 2012.

Methodology: Well calibrated thermoluminescent dosimeters (LiF-100) were attached to the skin of paediatric patients such as skull, chest, abdomen, and pelvic in the path of the primary X-ray beam to determine radiation exposure during CT examination. The effective dose was calculated from the equivalent dose obtained from OAUTHC, and the cancer risk associated was estimated by multiply age-dependent lifetime cancer mortality risk (per unit dose) with estimated age-dependent doses produced by various CT examinations.

Results: Out of 258 paediatric patients scanned the equivalent dose measured for abdominal CT scan ranged from 23.49 - 55. 26 mSv; skull CT scan ranged from 10.07 – 69.94 mSv and chest CT scan ranged from 8.60 – 31.94 mSv. The peak tube voltage (kVp) used range from 80 – 140 while the exposure current-time product (mA) range from 30 – 300.  The abdominal CT scan had the highest cancer risk ranging from digestive 37.5% to lung cancer risk of 0.4%. The risks estimated in this work were higher than the ICRP recommended value. Reducing the millampere-second setting of the equipment for paediatric without significant loss of radiological information will reduce this risk.

Conclusion: In this study the estimated cancer risk to paediatric patients undergoing CT is high.  This is in keeping with findings in a previous study thus emphasizing the need to standardize and optimize radiation dose in paediatric patients undergoing CT in Nigeria so as to keep cancer risk at the minimum.

Open Access Review Article

Sexual Assault of Nigerian Female Adolescents: A Review of the Trend and Effects

E. M. Eyong, C. I. Emechebe

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/jammr/2019/v29i730102

Introduction: Adolescent sexual assault is a huge public health problem with physical, reproductive health and psycho-social consequences.

Methods: A literature review was carried out on its prevalence, forms, risk factors and effects using multiple databases, namely MEDLINE, Web of Science Core Collection, and Google Scholar Google search. Additional information was from medical textbooks and journals.

Results: The estimated prevalence of sexual aggression among adolescents varied widely in different studies in Nigeria, ranging from 6 to 74%. Broad variation may be due to different incident reporting rates at multiple locations.

Conclusion: The solution to this problem involves the mobilization and active co-operation of all stakeholders in the society such as parents, guardians, teachers, non-governmental organizations, religious leaders, political leaders and government. Sex education should be given at home, school and other settings to both males and from other formal sources.