Journal of Advances in Medicine and Medical Research

Autism spectrum disorder (ASD) is a complex, heterogenous group of neurodevelopmental disorders that result due to interaction of genes and environmental factors. ASD is associated with behavioural alterations and deficits in social communication. Current research on pathophysiology has proposed a link between severity of symptoms of ASD and gastrointestinal disturbances. Intestinal inflammation, dysregulation of gut microbiome may affect intestinal permeability, mucosal immune function and subsequently cause GI symptoms. Studies have also proposed the role of metabolic activity of the gut microbiome and dietary components (food allergens/toxins) to be associated with behavioral alterations in neurodevelopmental conditions including ASD. The present review aims to highlight the potential role of nutrients and dietary changes on gastrointestinal pathology and symptoms of ASD.

Background and Purpose: Cellular component and clotting factors are involved in thrombotic events such as stroke, but the type and nature of alteration of those haemostatic parameters remain unclear. Our objective was to identify possible abnormal changes in some haemostatic parameters in established stroke patients.

Materials and Methods: This was a prospective case-control study conducted at Braithwaite Memorial Specialist Hospital, Port Harcourt, Nigeria. Standard operating procedures were adopted to assay fibrinogen, antithrombin, tissue plasminogen activator, prothrombin time and activated partial thromboplastin time as well as the determination of platelet count and platelet indices. The data were analyzed using Statistical Package for Social Science (SPSS) version 17.0 software.

Results: A total of 108 individuals comprised of 54 stroke patients aged between 45 and 73 years (mean, 59± 13.04 years), 20 (37.04%) men and 34 (62.96%) women and another 54 age- and sex-matched healthy control subjects were studied. Significantly (p<0.05) higher mean values of mean platelet volume (MPPV), platelet distribution width (PDW), Platelet larger cell ratio (PLCR), antithrombin, tissue plasminogen activator and fibrinogen were observed in the stroke patients when compared to those of the control subjects. Whereas, significantly lower (p<0.05) mean values of platelet count, prothrombin time and activated partial thromboplastin time were observed in the stroke patients than in those of the control subjects.

Conclusion: Several haemostatic parameters were found to be altered in stroke patients and have the potential to be risk factors but have not been demonstrated as being causative. Further work is needed to establish where they begin to contribute to stroke prognosis.

Aims: To measure the waist circumference of Sudanese adults in Khartoum Locality and its relationship to blood pressure and lifestyle  during celebration of international day of hypertension in May 2016 .

Study Design: It was a descriptive cross-sectional study.

Place of the Celebration: Khartoum Locality at Alsahaa Alkhadraa (The Green Park).

Methodology: A total of 364 adult participants, 196 men and 168 women were interviewed using structured questionnaire. Blood pressure (BP) was measured considering hypertension as ≥ 140 mmHg and ≥ 90 mmHg for systole and diastole BP respectively. Waist circumference was measured using an anthropometric measuring tape at cut-off point of 94 cm and 80 cm for men and women respectively. Data was managed by SPSS version 20 and Chi-square test at 95% CL was used to test the association between waist circumference, blood pressure and life style characteristics.

Results: Age distribution of the study population showed 48.2% females and 45.4% males in the middle age group (38-57 years). Two thirds of the study population were hypertensive, 62.8% of males and 64.3% of females. The mean waist circumference of men was 97.82 cm + 16.7, mean Systolic BP was 127 + 22 and mean Diastolic BP was 85 + 15. The mean waist circumference of women was 99.31 + 16.2, mean Systolic was 128 + 24 and mean Diastolic BP was 84 +17.

Abnormal waist circumference was found in 61.2% of males and 86.9% of females. Fifty nine (30.1%) of the males and 86 (51.2%) of the females with abnormal waist circumference were hypertensive. The association between abnormal waist circumference and high blood pressure was significant among both sexes, P value = 0.001.

Physical exercise and fat and salt foods were not significantly associated waist circumference in both men and women.

Conclusion: Two thirds of women and men in the celebrating areas were hypertensive.  Half of women and one third of men were significantly hypertensive and having abnormal waist circumference. Doing physical exercise, avoiding fat and salt foods was insignificantly associated with normal waist circumference. Large survey with representative sample is needed to estimate the real Sudanese waist circumference.  

Background: Safety and health management are some of the vital constituents of oil and gas industry activities, because most of the operational conditions, chemicals and end products associated with oil and gas production are well-known to pose serious safety and health threats to the workers. However, these hazards can be prevented and controlled with good safety practices. This study aims to investigate the knowledge, attitude and practices of workers in the downstream petroleum companies about occupational hazards and safety processes.

Materials and Methods: The study was a descriptive cross-sectional study which involved a quantitative approach to collect data from 379 technical workers engaged in operations in the selected downstream petroleum companies, sampled via multi-stage sampling technique. A semi-structured interviewer-administered questionnaire was used to collect relevant information. Data was analysed via Statistical Package for Social Science (SPSS) version 20 software.

Results: Almost one-third 120 (32.0%) of the respondents were between the ages of 38-43 years old. Majority 343 (91.0%) were males, while most 277 (73.0%) were single. Majority 363 (95.8%) had good Level of knowledge on occupational Hazard, while 359 (94.7%) of the respondents had good Level of knowledge on safety measure on occupational hazard. More than one-third 139 (36.70%) had positive behaviour towards preventive measures for occupational hazard, while 167(44%) had good practice towards Safety measures for occupational hazard. Level of knowledge on occupational hazard was significantly associated age, sex and religion (p<0.05).

Conclusion: Though most of the respondents were knowledgeable about occupational hazard and safety measures, positive behaviour towards safety measure and its practice was low among workers in the downstream petroleum companies. Hence the need for behavioural interventional programmes directed at ensuring positive occupational safety related behaviour among workers generally and those in industrial settings particularly.

Background: Health and mental related illnesses has emerged as a new challenge in the rural and undeveloped areas in Ogoniland where petroleum exploration activities have devastated the entire ecosystem. Many of the school children are no longer zealous about their academic activities, as their performances in school are always very poor. It has been reported that the children’s poor performance in school is closely linked with several health and mental challenges suffered by these children in the highly polluted areas.

Methods: The study comprises of 383 primary school teachers selected from 8 rural communities in the four (4) Ogoni Local Government Areas (Gokana, Tai, Eleme and Khana) in Rivers State where massive environmental pollution has been reported. Structured questionnaires were used to collect the data from the teachers on the children’s exposure to oil pollution; self-rated mental illnesses and behavioural symptoms among the school children, perception to petroleum pollution and mental illnesses.

Results: The results revealed that the signs of mental illnesses like anxiety disorder, attention-deficit disorder, autism spectrum disorder, mood disorder, schizophrenia and eating disorder were noticeable among the school children. The children also exhibited behavioural challenges such as extreme fear, difficulty in concentrating, self-imposed injuries, aggressive behaviour, avoiding other classmates and poor academic performances. The field survey further revealed that mental illnesses and behavioural challenges were common in areas of massive petroleum pollution of the environment. Other causes of these illnesses were revealed to be poverty and psychoactive substance use.

Conclusion: It was concluded that constant exposures of the children to environmental pollution is associated with decreasing neuroplasticity of the brain.

Aims: Dexmedetomidine, which has been increasingly used as an anesthetic adjuvant, is more lipophilic and more active than another α₂-adrenergic agonist clonidine and enantiomeric levomedetomidine. Lipophilicity and stereostructure affect the clinical effects of α₂-adrenergic agonists. We aimed to compare the membrane interactivity of dexmedetomidine with clonidine and levomedetomidine from a point of view different from the mode of action on α₂-adrenergic receptors.

Methodology: Unilamellar vesicles were prepared with phospholipids and cholesterol to mimic the lipid compositions of peripheral nerve cell, central nerve cell and cardiomyocyte membranes, and lipid rafts. They were subjected to the reactions with dexmedetomidine, clonidine and levomedetomidine at 10-200 μM, followed by measuring fluorescence polarization to determine the membrane interactivity to change membrane fluidity and specify the membrane region for the stereostructure-specific interaction.

Results: Dexmedetomidine and clonidine acted on lipid bilayers to increase the membrane fluidity with potencies varying by a compositional difference of membrane lipids. Dexmedetomidine showed greater interactivity with neuro-mimetic and cardiomyocyte-mimetic membranes than clonidine, being consistent with their comparative lipophilicity and activity. The effects of α₂-adrenergic agonists on lipid raft model membranes were much weaker than those on other membranes, indicating that lipid rafts are not mechanistically relevant to them. Higher interactive dexmedetomidine was discriminated from lower interactive levomedetomidine in the presence of chiral cholesterol in membranes. An interactivity difference between two enantiomers was largest in the superficial region of lipid bilayers and the rank order of their membrane-interacting potency was reversed by replacing cholesterol with epicholesterol, suggesting that cholesterol’s 3β-hydroxyl groups positioned close to the membrane surface are responsible for the enantioselective interaction.

Conclusion: Dexmedetomidine structure-specifically interacts with biomimetic membranes depending on their lipid compositions more potently than clonidine and levomedetomidine. Such membrane interactivity associated with higher lipophilicity and stereostructure characterizes dexmedetomidine in addition to higher affinity for α₂-adrenergic receptors.

Aim: To analyze the optic discs and vertical cup disc ratio in a black population.

Method: This is a retrospective study of glaucoma suspects who presented to the clinic. Medical history was recorded and comprehensive ocular examination done on each of the subjects. Ocular examination included visual acuity, visual field, tonometry and ophthalmoscopy. Instruments used during the research were Pen torch for examination of the external structures of the eyes, Keeler ophthalmoscopes for fundus examination, Snellen’s charts both literate and illiterate charts for visual acuity assessment, Reichert AT 555 Auto non-contact tonometer for measurementof the intra-ocular pressure.

The optic discs were analyzed using Optical Coherence Tomography machine. Data was analyzed using the statistical package EPI info version 6.04d, a software package designed by the Centers for Disease Control and Prevention (CDC), USA in 2001.

Results: This study included total of 240 optic discs of 120 participants comprising 60 males and 60 females were examined with a mean age of 42.8±13.79; the age range was 19 to 75 years. Very Small discs (<1.0mm) 3 accounted for1.3%, Small discs (1.0-1.3mm) 4 accounted for 1.7%, Medium (1.4-1.7mm) 67 accounted for 27.9%, Large (1.8-2.0mm) 58 accounted for 24.2% while Very Large (>2.0mm) 108 accounted for 45.0% in this study.

VCDR was noticed to have increased with increasing disc diameter. Optic disc diameter increased with increasing RNFL thickness as well (p < 0.05; r = 0.18).

All the very small as well as the small discs were cupped 3% (n = 7/240), 14.6% (n = 35/240) of the medium to very large are also cupped while the remaining 82.5% ( n = 198/240) are normal.

Conclusion: There was no significant correlation between disc diameter and VCDR. There was also a weak positive correlation between the optic disc diameter and the retinal nerve fiber layer thickness of the subjects, such a correlation may be the result of either an increased number of nerve fibers in eyes with larger discs or a smaller distance between the circular scan and the true optic disc margin.

Background: Adipocytokines have been recently implicated in the pathogenesis of preeclampsia. Visfatin is one of such adipokines.

Objective: To determine the association between serum visfatin levels and preeclampsia.

Methods: A prospective, case-control study was carried out in 160 pregnant women consisting of 80 pre-eclamptics and 80 normotensive controls, matched for age and parity during the third trimester. Maternal serum visfatin levels were determined in both groups using a visfatin (Human) enzyme- linked immunosorbent assay. Serum Visfatin levels were compared between the groups and correlated to the blood pressure, proteinuria, fetal birth weight and Apgar scores.

Results: The mean serum visfatin level was significantly higher (10.3±6.9 ng/ml) in preeclampsia than (7.4±4.4 ng/ml) in the control group (p=0.001). The mean serum visfatin level was higher in severe pre-eclamptics (10.8±8.9 ng/ml) compared to (9.6±5.8ng/ml) in mild preeclamptics and this was statistically significant (p=0.021). Visfatin levels showed a negative and non-significant correlation with both systolic (r= -0.011 and p=0.924), diastolic blood pressure (r= -0.012, p=0.913) and body mass index (r= -0.142, p=0.209) in both study and control groups. Mean birth weight was significantly lower in the preeclampsia (2.8±0.25 kg) compared to the control group (3.2±0.31 kg) P=0.000. the mean birth weight was lower in severe preeclampsia (2.7±0.25 kg compared to 2.9±0.39 in mild preeclamsia. There was no significant correlation between the visfatin levels and Apgar score at 5minutes and birth weights in both groups (P=>0.05).

Conclusion: This study showed a significant increase in the level of visfatin in preeclampsia compared to their normo-tensive controls. However, this increased level was not consistent with the severity of the disease.