Journal of Advances in Medicine and Medical Research

Background: In the 1970’s the introduction of Fine Need Aspiration Cytology (FNAC) proved to be the key method for examining the nature and malignant potential of many palpable lesions like thyroid, salivary glands and lymphadenopathies. Breast pathologies is one of the entity that can also be diagnosed with FNAC. Breast cancer is the most common malignancy of women with overall 100,000 cases being reported annually around the globe. The most frequent lesion encountered using FNAC in breast is fibro-adenoma followed by fibrocystic disease, breast abscess, chronic inflammatory conditions and suspicious malignant masses. In current cross sectional study we tried to find frequency of different breast lesions by FNAC.

Methodology and Results: 649 samples were recruited from the Vital Laboratory Larkana with different pathological lesions of breast during the year 2014 and 2015 by non-probability consecutive sampling. 613 (95%) were females and 32 (5%) were male with mean age of 30.8±12.8 years. Majority of case were of 20-39 years of age (55.8%). Most of the cases were diagnosed with benign lesions (329, 51%) followed by inflammatory lesions (132, 20.5%) and gynecomastia (15, 2.3%). Right breast was more affected (329, 51%). In present study we found a strong association of diagnosis with gender (p =0.000) and age (p =0.000).

Conclusion: So in this study it is concluded that large number of females with breast pathologies present with benign lesions like fibro-adenoma at the age of 20-39 years. It is also concluded that in this age group mastitis and abscesses are common due to different risk factors.

Objective: To assess physicians’ knowledge, attitude and practice of radiology.

Materials and Methods: Cross-sectional study utilizing an anonymous questionnaire responded to by physicians, divided into parts as follows: one with questions about the physicians’ knowledge of imaging modalities, availability of the modalities at the Jos University Teaching Hospital (JUTH), modalities with ionizing radiation, radiologist reports and way forward in improving services at radiology department.

Results: A total of 123 physicians participated in the study. Majority of the physicians (65.0%) were males. Male to female ratio was nearly 2:1. Concerning the impression about radiology, the study showed that 101(82.1%) like radiology as a specialty. There was however poor knowledge about the risks and hazards associated with radiological imaging modalities.

Conclusion: The non-radiologist physicians’ knowledge is heterogeneous and, in some aspects, needs to be improved. Multidisciplinary clinical meetings and teaching activities are important ways to disseminate information on the subject.

Aims: The objective of this work was to evaluate heart rate variability (HRV) in critically-ill neonates admitted to NICU, to detect the effect of different causes of critical illness on cardiac autonomic function and outcome of these neonates.

Study Design: Case-control study.

Place and Duration of Study: Neonatal Intensive Care Unit (NICU) of Pediatric Department, Tanta University Hospital, in the period from January 2018 to May 2019.

Methodology: We included 30 neonates who were critically-ill according to Score for Neonatal Acute Physiology with Perinatal Extension II (SNAPPE-II score) as cases Group. Fifteen healthy full term neonates, matched for age and sex, were enrolled as a control group. 24-hour Holter monitoring was performed with recording and interpretation of ECG data for every neonate in the study, including analysis of HRV.

Results: There was significant increase of mean HR in critically-ill neonates as compared to control group. There was significant decrease of all HRV parameters (SDNN, SDANN, SDNNI, RMSSD and PNN50) in critically-ill neonates as compared to control group (P< 0.05). Significant negative correlations between SNAPPE-II score and HRV parameters (SDNN, SDANN, SDNNI, RMSSD, PNN50) in critically-ill neonates were present, whereas there was non-significant positive correlation between SNAPPE-II score and mean heart rate.

Conclusion: HRV parameters decreased significantly in critically-ill neonates admitted to NICU, denoting severe cardiac autonomic dysfunction in these sick newborn infants. HRV strongly correlated to severity (SNAPPE-II score) and outcome, with strong relation to mortality of these critically-ill neonates.

Aim: The aim of this study was to determine the angular craniofacial soft tissue profile of adult southern Nigerian males of Igbo, Ijaw and Yoruba extractions.

Methodology: The study made use of a total number of one thousand two hundred (1200) subjects divided into four hundred (400) subjects each from the Igbo, Yoruba and Ijaw ethnic groups of southern Nigeria whose ages ranged between 21 to 40 years. Determination of minimum sample size was done using the Taro-Yamane’s formula. The study employed the use of photogrammetry. Standardized photographic record of the 1200 adults were taken in the natural head position. Photographs were analysed using a software tool (WinImager). Data generated were subjected to statistical analysis using SPSS version 25.0 and Microsoft Excel 2019.

Results: Results showed ethnic variations across the different ethnic groups. Age related changes were also observed. On comparison with other racial populations, marked differences were observed.

Conclusion: These anthropometric values define the facial soft tissue norm of southern Nigeria and could be useful in anthropometric studies, orofacial, orthodontic and maxillofacial surgeries, and forensics.

Background:  The prevalence of childhood obesity (COB) in the developing world is currently high and is rising rapidly. Unlike developed countries, studies evaluating the association between parental socio-economic status (SES) and risk of COB in developing countries are limited. Besides, the association varies across country and race/ethnicity and changes overtime. The aim of this study was to assess the association between parental SES and life style habits (LSHs) and risk of COB in Uyo, Southern Nigeria.

Methods: Five hundred pupils and the corresponding number of parents were examined between April and September 2018 using socio-demographic/LSHs assessment questionnaire and body mass index (BMI) evaluation. Data analysis was performed and frequencies and percentages were computed.  Associations between SES and LSHs of parents and risk of COW/COB were evaluated using multiple logistic regression analysis. Odds ratios and corresponding 95% confidence intervals were estimated.

Results: The prevalence of COW and COB was 3.4% and 16% respectively. The risk of COW/COB was higher among children whose parents had high level of education (OR=1.81, C.I=1.985-3.327,P=0.046), high level of income(OR=16.07, C.I=3.773-68.455,P=0.0001), employed(OR=1.138,C.I=0.157-12.057) and poor dietary habits. High level of physical activity of fathers and high income level of mothers decreased the risk of COW/COB.

Conclusion:  High SES and poor LSHs of parents are associated with increased risk of COW/COB. Interventions necessary to reduce high prevalence of COW/COB in our cities and other developing countries should include among other risk factors parental SES and LSHs.

Aims: The etiological spectrum and clinical profile of admitted patients presenting with pancytopenia were studied.

Study Design: This was a prospective study conducted on 200 patients presenting to the Department of Medicine, Department of Oncology and the Allied Specialities of Medicine, Dayan and Medical College and Hospital, Ludhiana and were found to have pancytopenia during hospital stay.

Results: Mean age of the patients was 45.69 ± 17.05 years with maximum number of patients (23%) in the age group of 51-60 years and 119 patients were males and 81 patients were females. Most common physical finding was pallor (95%), followed by splenomegaly (22%) and hepatomegaly (17%). Total of 107 patients were vegetarians (53.5%) and 93 patients (46.5%) were non-vegetarians. Mean hemoglobin was 7.16 ± 2.04 g/dl, mean total leucocyte count was 2.51 ± 1.02 x 10³/cu. mm, mean platelet count was 54885.37 x 10³/ul ± 40320.96 and mean the absolute neutrophil count was 1.59 x 10³ /cu.mm ± 0.84. Ten patients of pancytopenia were because of tropical fever which included 4 cases of dengue, 3 cases of malaria, 2 cases of enteric fever and 1case of mixed infection (malaria + scrub typhus). Viral markers were positive in 14 out of the 63 patients tested. Out of these 14 patients, 4 were HBsAg reactive, 7 were HCV +ve and 3 were HIV +ve. Most common red blood cell picture on peripheral blood film was normocytic normochromic (34.5%), followed by mixed morphology (33.5%). Macrocytic and microcytic morphology was seen in 19.5% and 12.5% of the patients respectively. Hypercellular marrow was seen in 82 patients (42.9%), normocellular marrow was seen in 58 patients (30.3%) and hypocellular marrow was seen in 51 patients (26.7%). The most common cause of pancytopenia in this study was megaloblastic anemia in 59 patients (29.5%), the 2nd common cause was leukemias in 28 patients (14%) and the 3^rd cause was aplastic anemia in 22 patients (11%). Drug induced pancytopenia was seen in 21 patients (10.5%) and hypersplenism in 9 cases (4.5%).

Conclusion: This study has helped us in knowing the various etiologies of pancytopeniain this hospital. Megaloblastic anemia was the most common etiology in this study followed by leukemiasand aplastic anemia. The study helped us in understanding of the age and gender distribution, the hematological parameters, the peripheral blood film in pancytopenia and the bone marrow picture in these patients.

Aim: The aim of the study was to investigate the circumferential anthropometric body characteristics of adult male Ijaws of southern Nigeria.

Methodology: The research design was a non-experimental, cross-sectional design. It made use of a total number of four hundred (400) subjects whose ages ranged between 21 to 40 years with BMI of 18.50 to <30.00. Individuals whose BMI fell within the category of overweight according to conventional BMI classification were included in the study because they looked apparently healthier than those with BMI classified as normal. Minimum sample size was determined using the Taro Yamane’s formula. Circumferential body anthropometric measurements and BMI were taken using stadiometer, digital calipers, calibrated flexible meter tape and weighting scale. Statistical analysis was done using statistical package for the social science (SPSS version 25.0) and Microsoft Excel 2019. Continuous variables were presented as mean±SD; minimum and maximum. Age was categorized into two groups (21 – 30 and 31 – 40) years while Body Mass Index (BMI) was also categorized into two; normal weight (18.5 – 24.9) and slightly overweight (25.0 – 30.7). Independent sample t-test was therefore carried out to determine significant difference in the measured anthropometric parameters according to age. The confidence interval was set at 95%, therefore p< 0.05 was considered significant.

Results: Results were presented in tables. Age and BMI were had no impact on the studied anthropometric parameters as there were no statistically significant difference seen when compared across age and BMI groups. On comparison with other racial populations, racial variation was observed.

Conclusion: Circumferential anthropometric studies are mainly used to demonstrate health status, growth rate and other population demography. This study catalogued anthropometric description of body circumference of the Ijaw ethnic group. These anthropometric values will be useful in medical studies and forensics.

Background: Humanitarian emergencies upset and wreck existing healthcare services and systems. Pregnant women and infant are incredibly defenseless, as these infants are exposed to the risk of preventable childhood disease which includes HIV that is transmitted from their HIV positive mother. In the absence of any intervention, the risk of HIV transmission increases to about 40% among infant born to HIV positive mothers.

Objectives: To examine the prevalence and uptake of HIV services among pregnant women and to assess the level of Early Infant Diagnosis (EID) by PCR uptake for children under 2 months born to HIV positive mothers.

Methods: A sentinel case study approach conducted in 3 internally displaced people (IDP) camps in 3 LGAs (Banki, Dikwa and Ngala) of Borno state Nigeria, from January 2018 to May 2019. Data collected using standard tools and DHIS 2.0 used for data extraction and MS Excel used for analysis.

Results: Prevalence of HIV among pregnant women (1st ANC Visits) in the 3 IDP camps were 1.22% (Ngala), 0.44% (Banki) and 0.16% (Dikwa) with an average of 0.61% compared to the 2018 National zonal average for the North East of1.1%. Uptake of HIV testing service among pregnant women in the 3 IDP camps were 90.65% (Ngala), 100% (Banki) and 100% (Dikwa), with an average uptake of 96.9%; while EID uptake for HIV exposed children within 2 months of age were: 50.0% (Dikwa), 12.5% (Banki) and 0% (Ngala).

Conclusions: The study also shows that none of the 3 IDP camps were able to optimize Early Infant Diagnosis at 2 months of birth. It is hereby recommended that Care-giver Focused Approach should be prioritized in preventing mother-to-child transmission (PMTCT) service delivery.

Aim: The aim of the study was to investigate and compare the linear anthropometric body features of the Igbo, Ijaw and Yoruba, the three major ethnic groups in Southern Nigeria. The research design was a cross-sectional design.

Methodology: The study made use of a total number of one thousand two hundred (1200) subjects divided into four hundred (400) subjects randomly selected from each of the Igbo, Yoruba and Ijaw ethnic groups of southern Nigeria whose ages ranged between 21 to 40 years with BMI of 18.50 to 30.00. Due to bone density, subjects whose BMI fell within the category of overweight according to conventional BMI classification, looked apparently healthy and were included in the study. Determination of minimum sample size was done using the Taro Yamane’s formula. BMI and linear body anthropometric measurements were taken using stadiometer, calibrated flexible meter tape, meter rule and weighing scale. Statistical analysis was done using statistical package for the social science (SPSS version 25.0) and Microsoft Excel 2019. Continuous variables were presented as mean±SD; minimum and maximum. Age was grouped into two categories (21 – 30 and 31 – 40) years. Body Mass Index (BMI) was also grouped into two; normal weight and slightly overweight. Independent sample t-test was thus carried out to determine significant difference in the measured anthropometric variables across age and BMI groups. Confidence interval was set at 95%, therefore p< 0.05 was considered significant.

Results: Results were presented in charts and tables. Variations were observed across the different ethnic groups. Age related changes and variations in BMI were also observed in the anthropometric parameters studied. On comparison with other racial populations, certain parameters were close while most showed marked variation which underscores racial variation. Though certain degree of variation was observed across the three negroid ethnic groups, it is not adequate to subcategorise these Southern Nigerian ethnic groups.

Conclusion: These anthropometric values not only provide a description of the standard linear anthropometric body features of southern Nigeria but could find use in anthropological and medical studies, standardization of anatomical models as well as in the design of products to fit this negroid population.

Background: Bleeding from the nose is one of the commonest emergencies that could present in a typical ear, nose and throat clinic. It is often a frightful experience for both the patient and relations, especially in severe cases.

Aim: To determine the aetiological profile, the management and outcome in patients that presented with epistaxis in University of Port Harcourt teaching hospital. 

Patients and Methods: This was a retrospective study of patients with complaints of epistaxis that were managed within the period of January 2006 to January 2018 in the Ear, Nose and Throat (ENT) department, including referrals from the accident & emergency department and children emergency ward. Data on demographics, aetiology, associated clinical features, treatment modalities and outcome of such treatments were all collated. These were analyzed using IBM statistical package for social sciences SPSSversion 20and results presented in simple descriptive tables.

Results: There were altogether 196 patients studied, 95 males and 101 females, giving a male to female ratio of 1:1.06.  The age range was from 1 to 81 years. Age group 30-39 was the most affected with 22.29% Aetiological factors were; hypertension in 9.2% trauma in 11.2%, idiopathic in most; 58.2%, chronic rhinosinusitis in 18.4%. Conservative medical therapy was the commonest treatment modality; 68.38%. Anterior nasal packing in 26.5% while 4.1% had posterior packing. Anterior aspect of the nose was the commonest site of bleed recorded in 160 cases.

All the patients had a favourable outcome.

Conclusion: Epistaxis in this environment still presents as a common emergency and in the majority of the case, the cause is not known, however, trauma appears to be one of the commonest cause implicated in our setting. The young adults appear to be the ones mainly affected.

Introduction: Pain is one of the most recurrent complaints obtainable in paediatric settings especially while carrying out procedures. The emergency section is a very tasking place for children. Hence it is important for health care workers to follow a child focussed or individual methods in their assessment and management of pain and painful procedures.

Aim: To determine health workers’ approach towards non-pharmacological management of procedural pain in children at the University of Port Harcourt Teaching Hospital (UPTH). 

Methods: This descriptive cross-sectional study was carried out between November 2019 and January 2020. A semi-structured questionnaire was used to retrieve information on biodata, knowledge and practice of non -pharmacological management of procedural pain in children. Data was entered into Microsoft Excel spread sheet and analysed using Statistical Package for Social Sciences version 21.

Results: Respondents in this study included 25(24.8%) physicians and 61(60.4%) nurses. Forty-four respondents (43.5%) had more than 10 years’ work experience. Self-development 59 (58.4%) was the most common source of knowledge of paediatric pain management. Fourteen (13.9%) respondents knew the appropriate time of applying non-pharmacological measures of which distraction was the most common strategy mentioned (n=85, 84.2%) and used (36%). Nurses were significantly more knowledgeable about non-pharmacological methods of pain management in children (p= .000).

Conclusion: There are gaps in knowledge and practice of clinicians concerning use of non-pharmacological interventions in the management of procedural pain in children. Development of a standard protocol would be an asset. There is need for necessary tools, and institutional commitment to adequate pain relief for children in our institution.

Aims and Objectives: To evaluate wound healing and patient’s comfort after oral soft tissue surgical procedures performed by diode laser in comparison with diathermy.

Methods: This study includes 20 patients requiring oral soft tissue surgical procedures are randomly categorized into group A and group B of 10 patients each. Group A patients will undergo diathermy and group B patients will undergo laser therapy. Clinical assessment and photographs of patients will be done preoperatively and postoperatively on 1st day, 3rd day, 7th day, 2nd    week and 4th week. Evaluation of postoperative bleeding, pain, infection and healing will be carried out.

Results: At the end of the study the assessment of parameters such as bleeding, swelling, wound healing, presence of infection were approximately similar in both the treatment methods to be insignificant, 70% of the patients included in this study under the laser group were very satisfied with the procedure & the pain experience by the patients in the same group was comparatively less, when compared to the diathermy group.

Conclusion: The observations suggest that both the treatment options were effective although laser proves better in terms of minimal bleeding, pain, reduced swelling, faster healing and patient’s comfort. Further research and a longer follow up period is desirable for a definitive conclusion.

The biological processes of a human body occur in liquid medium. The human body contains around 55-60% of water in young people. At birth the percentage is around 75%, and in elderly people it is - 50-55% (by weight). The state of water in the body of athletes is an indicator for their status during physical exertion and recovery. Dehydration is a natural process developing during the period of training and football match, which influences the functioning of the locomotor, nervous, respiratory and cardio-vascular systems.

The research of Ivaylo Yakimov for the period 2014-2019 from Bulgarian football players confirmed the importance of the requirement for the footballers to start physical workload optimally hydrated, in order to slow down and decrease the influence of the negative effects from the inevitable dehydration during a football match. Yakimov is а medical doctor in the football team Ludogorets.

One of the co-authors considers the possibility for hydration and recovery to be done using water with hydrogen index pH over 8.5, and a negative oxidation reduction potential (ORP). The results show that footballers, who drink Catholyte water have better heart indicators compared to the ones they would have if they drink table water. Analyses are conducted of processes in ATP and mitochondria in the cell for faster achieving of maximum sports performance and recovery.

Background: Diabetes population in Sudan is around one million 90% have type 2 diabetes. In Sudan diabetes is as increasing problem, being responsible for 10% of hospital admission and mortality.

Measurement of zinc and copper is an important in decrease development of complication of DM, any disturbance in level of both zinc and copper have role in pathogenesis, prognosis of type 2 DM. This study aimed to assess the relationship between DM type 2 and trace elements by measured serum zinc and serum copper levels among Sudanese DM type 2 in Khartoum state.

Materials and Methods: This is a descriptive, case control study, was conducted in Khartoum state, Sudan. During the period from April to July 2018. Forty Sudanese patients with DM (20 controlled patients with DM and 20 uncontrolled patients with DM) Diabetes patients were divided into controlled and uncontrolled groups by measuring HbA1C. (Female 25% and male 15%), with different age. were selected as case and 30 apparently healthy individuals were selected as control group. Serum zinc and copper levels were analysis using Atomic Absorption Spectroscopy and ichroma for HbA1c, the obtained results were analyzed using social science software package.

Results: This study showed significant lower of serum zinc in diabetes type 2 patients comparison with control group and on another hand showed significant increase of serum copper in diabetes type 2 patients.

We concluded serum zinc significant lower in both diabetes group than healthy group, copper significant high in both diabetes group than healthy group, gender have significant effect in serum zinc and copper, weak positive correlation between zinc and HbA1C and weak negative correlation between copper and HbA1C.

Conclusion: This study concluded that the serum levels of Zinc significant lower in type 2 diabetes than healthy individuals. Serum levels of Copper significant increase in type 2 diabetes than healthy individuals as have been found in present study. Gender have significant effect in serum Zn and Cu in diabetic patients.

Weak Positive correlation between serum Zinc with HbA1c and weak negative correlation between copper with HbA1c.

Many details of the emergence of 2019 novel coronavirus infection such as its origin, spread, epidemiology, full spectrum of clinical illness, treatment and mortality rate has not been clearly defined. This review focuses the epidemiological evidences, clinical manifestations, investigations and treatment provided to the admitted cases of the 2019 novel coronavirus pneumonia in various hospitals of Wuhan city and other regions in China. Information have been gathered mainly from relevant researches and papers that were published recently. Clinical manifestations included fever, non-productive cough, dyspnoea, myalgia, fatigue, radiographic manifestations of pneumonia and detection of the novel virus by RT-PCR method. Some patients rapidly developed acute respiratory distress syndrome, acute respiratory failure, and other serious complications with fatal outcomes. There are neither vaccines nor effective treatments for the disease caused by the virus, but efforts are typically confined to symptomatic and supportive management. Antivirals and corticosteroids were used in severe illness but had no effective outcome.