Open Access Case Report

Os Acromiale-unusual Manifestation as Superior Spur and Bursitis-A Case Report

A. Raviraj, Vidyasagar Maalepati, K. Abhishek Sugumar, Vivek Kumar N. Savsani, Ajith K. Prabhu, Ashish Anand

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/jammr/2019/v31i230284

An Os acromiale is a condition that results from the failure of fusion of the anterior acromial apophysis. It can be asymptomatic. It can also result in subacromial impingement and rotator cuff tear. In this case report of a 39 year-old lady we would like to present the management of the painful bursitis and spur formation on the superior surface of a meso-type of os acromiale. Conservative management in the form of rest, anti-inflammatory drugs and physiotherapy did not provide symptomatic relief. Patient then underwent surgical excision of the superior spur. Open reduction and internal fixation was not carried out. Patient had resolution of pain and no recurrence of symptoms or features of impingement at 6 months follow up. To the best of our knowledge there are limited reports in English literature about this rare subset of patients with symptomatic os acromiale with superior spur formation and with no features of impingement or cuff pathology.

Open Access Original Research Article

Relation between DMFT and Socioeconomic Status in Females Attending Taibah University Clinics

Ebtehal Alhusaini, Sara Alraddadi, Abrar Almatrfi, Shrouq Alrwitai, Roa'a Alrefai, May Gamar Elanbya

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/jammr/2019/v31i230281

Aim: To assess the decayed, missing and filled tooth (DMFT) index of adult female patients attending dental clinics in the College of Dentistry Taibah University. And to link the socioeconomic factors that may influence the DMFT.

Study Design: A Cross-sectional analytical study.

Place and Duration of Study: Conducted in Taibah University Dental Clinics, Female campus between January 2016 and May 2016.

Methodology: The sample included 110 newly registered adult female patients (>18 years) attended dental clinics for screening. Dental examination for the patient using an explorer and dental mirror was done. Decayed, missing and filled tooth (DMFT) index used by the World Health Organization for the evaluation of dental caries was used. The SPSS software was used for data analysis.

Results: Low DMFT presented in 49.0% of educated and 50.0% of not educated subjects. The highest percent of subjects with moderate-income ranging from 4000 to 5999 S.R/month have moderate DMFT (58.8%). The highest percent (47.4%-61.5%) of the other groups have low DMFT. Statistically, the difference is not significant.

Conclusion: The study demonstrates that DMFT is independent of socioeconomic status.

Open Access Original Research Article

Socio-demographic Factors Associated with Treatment Initiation Delays among Tuberculosis Patients in Namibia

Francis F. Chikuse, Loveness N. Dzikiti, Auxilia Chideme-Munodawafa, Talkmore Maruta, Greanious A. Mavondo, Munyaradzi Mukesi, Mathew Maisiri, Patricia T. Gundidza, Munyaradzi M. Soko

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/jammr/2019/v31i230282

Background: Delayed tuberculosis (TB) treatment increases the rate of spread of the bacilli in the community and mortality rates. Rapid diagnosis and early TB treatment initiation are crucial to successful outcomes and delays affect TB control programs. In Namibia, there is a paucity of data on the demographic factors affecting TB treatment initiation since GeneXpert MTB/RIF (Xpert) assay was introduced in 2017.

Methods: This was a descriptive cross-sectional retrospective study conducted at Katutura Hospital TB clinic from 1st July 2018 to 31st March 2019. A total of seventy-two (72) participants comprising twenty-five (25) rifampicin resistant-TB (RR-TB) and forty-seven (47) non- RR-TB adult patients were enrolled using consecutive sampling. Patients’ medical records, Xpert results and a questionnaire were used to collect data. The data were analyzed using Stata statistical software version 12. Association between socio-demographic factors and treatment initiation delays were established using logistic regression analysis.

Results: Staying with a TB patient (AOR=17.22, 95% CI: 2.29-129.773), employment status (AOR=1.23, 95% CI, 002-129), previous TB treatment (AOR=2.19, 95% CI: 0.076-0.86) and being HIV positive (AOR= 1.23, 95% CI: 0.0034-057) were the socio-demographic factors that were significantly associated with treatment initiation delays. Treatment initiation delay median time at Katutura Intermediate Hospital TB Clinic was 10 days (IQR: 1-32) and 3 days (IQR: 0-12) for RR-TB and non- RR-TB respectively.

Conclusion: The prolonged treatment initiation delays among HIV positive RR-TB patients might be due to low adherence to HIV care interventions. Staying with a household TB patient and those who were previously treated for TB were also associated with treatment initiation delays. Poor health systems infrastructure and stigma could be the determinants of this delay in these groups. An integrated family-based approach to TB and HIV care involving health care workers can mitigate TB treatment delays post-diagnosis. Further studies should explore the factors associated with late initiation to second-line treatment from a community perspective. Lastly, there is a need to assess the cost-utility of bedaquiline and delamanid drugs roll-out in Namibian health care in comparison with the standard treatment.

Open Access Original Research Article

Comparative Effects of Single Agent Rectal Diclofenac versus a Combination of Rectal Diclofenac and Intramuscular Pentazocine, on Post Caesarean Section Pain Relief in a Tertiary Institution in Southern Nigeria

N. J. Kwosah, P. A. Awoyesuku, D. A. MacPepple, D. H. John

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/jammr/2019/v31i230283

Background: Caesarean section commonly causes moderate to severe pain in the first 24 hours after surgery with associated discomfort, delayed ambulation, difficulty initiating breastfeeding and prolonged hospital stay. Receiving adequate analgesia after caesarean section is very important for the patient’s comfort, overall wellbeing and recovery.

Objective: To compare the efficacy, time to rescue-analgesia and side effects of single agent rectal diclofenac versus its combination with intramuscular pentazocine for pain management after caesarean section in Rivers State University Teaching Hospital (RSUTH).

Methodology: A randomized double-blind clinical trial was carried out at the RSUTH. A total of 120 patients scheduled for either elective or emergency caesarean section were recruited. Group ‘A’ received rectal diclofenac 100 mg and intramuscular placebo (unimodal group) while group ‘B’ received rectal diclofenac 100mg and intramuscular pentazocine 30 mg (multimodal group). Socio-demographic information was collected via structured proforma, while Visual Analog Scale (VAS) was used to assess the level of pain. Data were analyzed using SPSS version 20 and statistical significance was set at p < 0.05.

Results: The mean ages of respondents in unimodal and multimodal groups were 31.7 ± 4.3 years and 31.3 ± 5.2 years respectively. The difference in the median pain score and range was significant only at 8 hours between the groups, there was no significant difference before and after 8 hours. Although the mean time (in minutes) to first rescue-analgesia was shorter in the unimodal (147.5 ± 60.1) as compared to the multimodal group (170.0), this difference was not statistically significant. There was no side effect noticed in either of the two groups.

Conclusion: The combined agents (diclofenac and pentazocine) had a superior analgesic effect to the single agent (diclofenac alone) when given as used in the study.

Open Access Original Research Article

Relationship of Calories Intake and Physical Activity in Adolescents in Colima, Mexico: A Cross-sectional Study

María de los Ángeles Castro-Cornejo, Xiomara Arteaga-Herrera, Nicolás Padilla-Raygoza

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/jammr/2019/v31i230285

Aims: To identify the relationship between calories intake, physical activity and body mass index in adolescents in Colima Mexico.

Study Design: A cross-sectional study analytic, observational.

Place and Duration of the Study:  Colima and Tecoman, Mexico.

Methodology: It was designed in adolescents, of both genders, with a BMI in 85th percentile or greater, where the average daily calorie intake was quantified with the SNUT survey and the level of physical activity with the International Physical Activity Questionnaire. Anthropometry to obtain the BMI. The stage of change of the trans-theoretical model was identified. Statistical analysis was Pearson's r between calories and BMI and between physical activity and BMI, systolic and diastolic blood pressure with BMI, and the stages of change.

Results and Discussion: Poor correlation (r = 0.13) but significant linear relationship between calorie intake with BMI (t = 2.01 P = .05) and moderate correlation (r = - 0.41) and significant linear relationship (t =- 6.76, P = .0001) between activities physical and BMI. Between systolic and diastolic blood pressure and BMI, r= 0.28 and 0.34, respectively, with a strong linear trend in both (P = .0001) Of the adolescents, 39.32% were in the action stage (they plan to take actions to improve their overweight / obesity status) and 34% in the pre-contemplation phase (where the adolescent does not plan to do anything about his overweight / obesity).

Conclusion: There is a relationship between daily calorie intake and BMI and a strong negative relationship between physical activity and BMI, and a third of adolescents do not see overweight / obesity as a problem and have not thought of doing anything about modifying their lifestyle to improve their BMI.