Open Access Case Report

Peliosis Hepatis and Iron Deficiency – An Interesting Case Report

Anvita Anne, Bharath Suryadevara, Spoorthi Ramineni, Varun Kumar Bandi

Journal of Advances in Medicine and Medical Research, Page 41-44
DOI: 10.9734/jammr/2020/v32i1730640

Peliosis hepatis (PH) is a rare condition showing presence of multiple blood‑filled cystic cavities in the liver. It does not have any gender predilection, and is suspected to be idiopathic. However, in patients with predisposing diseases, its prevalence can range from 0.2 to 22%. The association between PH and anemia has not been completely established. PH has been reported in a patients with hematologic disease, and also in patient with spherocytic haemolytic anemia. It is also suggested that acute sequestration of blood can happen in these sinusoidal cavities, which can lead to development of anemia and thrombocytopenia. We present a case of 40-year female who presented with abdominal pain and recurrent iron deficiency anemia. On examination, she was severely pale, and had moderate hepatosplenomegaly. Ultrasonography showed hepatomegaly and splenomegaly, and her blood investigations revealed severe iron deficiency with bone marrow showing hypercellular marrow with depleted iron stores. Upper gastrointestinal endoscopy was normal. Liver biopsy showed changes suggestive of peliosis hepatis. She was treated with iron and multiple blood transfusions and is in good health 6 months post presentation. Also, the association between anemia and PH has not been established.

Open Access Case Study

Familial Adenomatous Polyposis Coli in East Africa: A Case Report and Review of the Literature

Richard Wismayer

Journal of Advances in Medicine and Medical Research, Page 74-80
DOI: 10.9734/jammr/2020/v32i1730647

Introduction: Familial adenomatous polyposis (FAP) is a rare diagnosis in East Africa. The author reports a case of a 21 year old gentleman presenting with occasional passage of blood stained stool, and found to have familial adenomatous polyposis coli. This is followed by a literature review on the pathogenesis, clinical features and treatment options of FAP in East Africa.

Presentation of Case: This patient presented with a strong family history of familial adenomatous polyposis, blood stained stool and a rectal mass. A total proctocolectomy and ileoanal anastomosis was carried out. The postoperative course of this patient was uneventful.

Discussion: The typical gross pathological and histological features of familial adenomatous polyposis and rectal adenocarcinoma were seen on the resected colorectal specimen. In addition this study reviews the literature regarding the clinical presentation, pathological characteristics and treatment options of familial adenomatous polyposis coli.

Conclusion: FAP should always be considered in a young patient presenting with a strong family history of CRC. Colonoscopy should be performed on these patients with early symptoms and those patients with a strong family history of FAP. In East Africa, the creation of a permanent stoma is unacceptable and therefore a proctocolectomy and Brooke ileostomy will not be a desirable option in a young patient in this part of the world.

Open Access Short Communication

Blunt Hohman-Lever Technique for Reduction of Intertrochanteric Fracture – A Surgical Technique

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

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/jammr/2020/v32i1730635

We present a 60 years old patient who presented to us with history of domestic fall and sustained injury to the right hip and was diagnosed with trochanteric fracture right side. As closed reduction was not acceptable and bone spike was not available in the set, we designed our own technique of using a bone lever introduced from the same incision from where reaming/nail insertion was done. To the best of our knowledge this technique has never been described before in english literature. Since our first case we have tried it in 6 other patients and without any issues.

Open Access Original Research Article

Comparing the Effect of Methods of Rat Euthanasia on the Brain of Wistar Rats: Cervical Dislocation, Chloroform Inhalation, Diethyl Ether Inhalation and Formalin Inhalation

U. S. Aguwa, C. E. Eze, B. N. Obinwa, S. N. Okeke, S. F. Onwuelingo, D. I. Okonkwo, D. K. Ogbuokiri, A. E. Agulanna, I. J. Obiesie, A. J. Umezulike

Journal of Advances in Medicine and Medical Research, Page 8-16
DOI: 10.9734/jammr/2020/v32i1730636

Contentions still exist as to the most humane method of sacrificing experimental animals. Beyond humaneness, there is also the issue of appropriateness of a method of sacrifice with regards to organ safety. This study compared four common methods of rodent sacrifice used in Nigeria and their effects on the brain. Twenty male Wistar rats weighing 150 to 180g were randomly separated into four groups of five rats each. After a two week period of acclimatization, the animals were sacrificed; Group A by Cervical dislocation (CD) which also served as control, Group B by chloroform inhalation (CI), Group C by diethyl ether inhalation (DEI) and group D by Formalin inhalation (FI).  The time taken for the animals to pass out was documented and the brains were harvested. Four of the brains from rats in each group were homogenized in phosphate buffer solution and centrifuged at 10000rpm. The supernatant were used for antioxidant studies. The remaining one brain from each group were fixed in 10% formal saline and after 48 hours, the cerebellum (CB) and hippocampus (Hp) were used for histological studies using the H & E method. Our results show although CD was the quickest, it gave the least quantity of blood. Meanwhile CI was the most humane, gave the most blood and saved time compared to DEI and FI. None of the methods of sacrifice showed adverse effect on the antioxidant parameters of the rats. However, histological studies showed that while CD and CI showed no adverse effects on the hippocampus, only CD was completely safe for the CB. The other methods showed various levels of cell death. It is therefore expedient to consider these factors in making the choice of an appropriate method of sacrifice and to use the most humane and safest method with reference to the organ studied.

Open Access Original Research Article

Comparative Evaluation of Influence of Three Different Obturation Techniques on Removal of Filling Material during Retreatment: An in vitro Study

Deebah Choudhary

Journal of Advances in Medicine and Medical Research, Page 35-40
DOI: 10.9734/jammr/2020/v32i1730638

Aim: To evaluate the influence of various obturating techniques on retreatment teeth.

Place and Duration of Study: Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Jammu and Kashmir, India between December 2019 and February 2020.

Methodology: Sixty extracted mandibular premolars were randomly divided into three groups (n=20) based on the obturation technique adopted which endodontic treatment i.e., cold lateral compaction, thermoplasticized and GuttaFlow techniques. The samples were evaluated using micro-computed tomography for the volume before and after the retreatment to assess the remaining amount of filling material in the canals, and also the time taken for the removal of filling material during the retreatment. Data were analyzed using ANOVA followed by Post hoc test at P < 0.05.

Results: The percentage of remaining filling material was between 17%-27%. The highest percentage of remaining filling material was seen in samples obturated with GuttaFlow (P < 0.05). The time required for retreatment was highly significant in thermoplasticized technique (P < 0.05).

Conclusion: The type of obturating technique influenced the amount of filling material remained in the canal after retreatment and also the time taken during this removal.

Open Access Original Research Article

Coinfection of Hepatitis B and C with Human Immunodeficiency Virus in Hemophilia: A Cross Sectional Study

T. S. Espósito, T. M. M. Paz, L. O. W. Rodrigues, A. C. A. Santos, R. D. M. Almeida, O. F. Santos, R. L. Medeiros, J. A. S. Lopes, D. O. W. Rodrigues

Journal of Advances in Medicine and Medical Research, Page 45-52
DOI: 10.9734/jammr/2020/v32i1730641

Aims: To identify coinfection by Hepatitis B (HBV), Hepatitis C (HCV) and Human immunodeficiency virus (HIV) in Hemophiliacs.

Methodology: We included 107 hemophiliacs. For the current analysis, age, type, severity of Hemophilia and serum profile for Hepatitis B, C and HIV were included. The serological tests performed for Hepatitis and HIV were carried out using the enzyme-linked immunosorbent assay method (ELISA) and the confirmatory tests for HIV and HCV were done by the Western Blot and Polymerase Chain Reaction (PCR). The results of positive and negative serology were compared using the Mann-Whitney test using the Fundação Hemominas reproducibility map of serological reactions, through the CUT-off of each test.

Study Design: A cross-sectional study was carried out on hemophilics to asses the prevalence of infections diseases transmitted by transfusion.

Place and Duration of Study: Department of Hematology, public service on Coagulopathies at Fundação Hemominas Juiz de Fora Brazil, between January 2008 to December 2018.

Results: The average age was 32.77 years with standard deviation (SD)= 16.8 years. In regard to classification, 57.65% of patients with Hemophilia A were severe, and 57% of patients with Hemophilia B were moderate. Laboratory results demonstrated that 24.3% of the patients were HBV positive, and 40.2% were HCV positive, with 21.42% positive by PCR. The prevalence of HIV positive was 11.2%. In general analysis, 44.82% had at least one type of viral infection and 23.4% presented coinfections. HIV positive patients were all positive for HCV (11.2%) and 7.5% of patients were infected by HIV, HCV and HBV. The coexistence of hepatitis C and HIV was statistically relevant with (P = .001), considering the year of birth, most patients with HCV and HIV were born before 1980s (P = .001).

Conclusions: Infections by HBV, HCV and HIV are late complications in patients that received blood products before 1990s. Infection by a viral agent and the year of birth has a direct association, due to the standardization and implantation of tests for HIV and HCV in the 80s and 90s.

Open Access Original Research Article

Serum Periostin Level in Asthmatic Children with Exercise Induced Bronchospasm

Reem M. Soliman, Mohamed B. Hamza, Rasha M. El-Shafiey, Hesham A. Elserogy, Nabil M El-Esawy

Journal of Advances in Medicine and Medical Research, Page 53-67
DOI: 10.9734/jammr/2020/v32i1730642

Background: There are few biomarkers that can be easily accessed in clinical settings and may reflect refractory Th2-eosinophlic inflammation and remodeling of the asthmatic airways. Serum periostin may be one such biomarker to aid our understanding of the patho-bio-physiology of asthma and exercise induced asthma. The aim of the study is to explore the relationship between serum periostin level and exercise induced bronchoconstriction in asthmatic children.

Materials and Methods: This cross-sectional study was carried out on (90) children both sexes aged from 6 to 15 years including, (60) children with bronchial asthma and (30) children were enrolled as control group in the period from January 2018 to January 2019. Patients were randomly classified into two groups: I) Patient group: divided into 2 groups according to standardized treadmill exercise challenge test: Group A: (30) asthmatic children with positive test. Group B: (30) asthmatic children with negative test. II-Control group: (30) children apparently healthy with no personal or family history of asthma. All children were subjected to the following Investigations: Chest x-ray, pulmonary functions tests (FEV1 & PEFR) except controls, Laboratory investigations as CBC and Serum periostin level.

Results: The mean values of both the percentage of PEFR and FEV1 after exercise in group A were significantly lower than those in group B and the percentage of PEFR and FEV1 after exercise in each group were significantly lower than the percentage before exercise in the same group. The mean value of eosinophilic count in group A was significantly higher than (group B and control group) and the mean value of eosinophilic count in group B was significantly higher than control group. The mean value of serum level of periostin in group A was significantly higher than (group B and control group), however, there was no significant difference between group B and control group as regard to serum level of periostin.

Chest tightness, cough and wheezes after exercise and eosinophilic count in patients with high serum periostin level were significantly higher than patients with low serum periostin level, and both PEFR and FEV1 after exercise in patients with high serum periostin level were significantly lower than patients with low serum periostin level. Also the normal serum periostin levels vary among different age groups.

Conclusion: Serum periostin level can be considered as a useful biomarker for diagnosis of Exercise induced bronchospasm (EIB) in asthmatic children especially when lung function test cannot be done However, cautious is required in evaluating serum periostin levels in children because it varies with age.

Open Access Original Research Article

The Sub – Acute Effects of Raw Honey on Prothrombin Time, Activated Partial Thromboplastin Time and Platelet Values in Albino Wistar Rats

Akudo Chidinma Ohale, Emmanuel Ifeanyi Obeagu, Happiness Alaribe Mark, Chidindu C. Mmadu- Okoli, Chukwuebuka Brian Ugoh-Ezepue, Chibuike Ernest Ohanu, Uzoma Chinyere Okongwu, Chidinma Ijeoma Nlemadim, Ifeoma Blessing Ekeigwe, Ogochukwu Adamaka Okeke

Journal of Advances in Medicine and Medical Research, Page 68-73
DOI: 10.9734/jammr/2020/v32i1730643

For centuries honey has been regarded as wonderful gift of nature in which the properties of an excellent food, beneficial alike to adults and children, are combined with medicinal properties. Surprisingly, its sub-acute effect on coagulation is unknown. Hence; this present study aims at evaluating the effects of raw honey on coagulation in albino wistar rats. Thirty (30), 3-4 months old albino wistar rats both males and females were used for the study. The experimental animals were divided into five (A, B, C, D, E) groups with six rats per group. The test groups (B-E) were gavaged with graded doses (625, 1250, 2500, 5000 mg/kg body weight) respectively of the raw honey once daily for nine days. Group A served as control. Two (2) animals were bled from each group after 3, 6 and 9 days through the ocular plexus. Four (4) ml of venous blood was collected. Two (2) ml was delivered into 0.25ml trisodium citrate anticoagulant bottle for determination of Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT). The remaining two (2) ml was delivered into K3EDTA anticoagulant bottle for platelet value determination. There was no statistical significant difference (P > 0.05) recorded in all the parameters investigated among the test groups when compared with the control group on Day 3. However, group B revealed a statistical significant decrease (P < 0.05) in PT when compared with the control group on Day 6. In addition, no statistical significant difference (P>0.05) was recorded on Day 9 when all the parameters investigated among the test groups were compared with the control group. Furthermore, there was no exposure related statistical significant difference (P>0.05) in the test groups in PT and APTT in the ANOVA.  However, there was a time related significant difference (P<0.05) in platelet value of group C when Days 3, 6 and 9 were compared. It can be concluded that raw honey possesses a sub-acute coagulation stimulatory potentials which is likely to be dose and duration related.

Open Access Original Research Article

Awareness and Knowledge of Breast Cancer Screening Methods among Women in Al-Qunfudah, Saudi Arabia

Khaled A. Yaghmour, Safa J. Alamri, Rehab H. Alfaqeh, Layla M. Alnashri, Basma J. Alamri, Manar A. Makin

Journal of Advances in Medicine and Medical Research, Page 81-95
DOI: 10.9734/jammr/2020/v32i1730648

Objectives: Breast cancer is the most common malignancy affecting women in Saudi Arabia. Screening helps in early detection and prompt treatment of breast cancer, leading to a better prognosis. Lack of knowledge and awareness of its screening methods can lead to bad outcomes. So far, little is known of women’s knowledge of breast cancer screening. This study was conducted to assess the knowledge, attitudes, and practice of breast cancer screening among Saudi women in Al-Qunfudah.

Methods: This is a cross-sectional study including 203 adult Saudi women aged 18 years and above. Data were collected through a self-administered questionnaire from Saudi women in Al-Qunfudah, Saudi Arabia in 2019. The data were entered and statistically analyzed using SPSS software.

Results: Findings revealed that all the participants in this study heard of breast cancer, and their awareness of breast self-examination was high (93.6%). Awareness levels were lower concerning clinical breast examination (63.1%) and mammography (65.5%). However, only 43.3% correctly practiced breast self-examination, and 5.9% had ever heard of a mammogram. Knowledge of breast cancer screening with mammography screening was significantly related to participant age (P=0.04), marital status (P=0.008), and occupation (P=0.04). Furthermore, the relation between participants who underwent mammography and age was significant (P=0.001).

Conclusion: Our data indicate that the knowledge, awareness, and practices were insufficient, and educational interventions are required in Al-Qunfudah to encourage young women to practice screening for early detection. 

Open Access Review Article

COVID-19 Diagnosis, Treatments and Prevention: A Review

Soumik Chatterjee, Sabyasachi Chatterjee

Journal of Advances in Medicine and Medical Research, Page 17-34
DOI: 10.9734/jammr/2020/v32i1730637

Novel Coronavirus are very harmful virus. This viruses have positive single stranded RNA genome and enveloped which is called nucleocapsid. The family of this virus is Coronaviridae. This virus originated from species of avian and mammalian. This virus effect on upper respiratory tract in humans. Many species of these novel coronaviruses (HCoVs) are named as HCoV-HKU1, HCoV-NL63. Predominant species of this virus is Middle East respiratory syndrome (MERS-CoV) across the world.  In both adults and childrens HCoV-HKU1 sp. is causes for chronic pulmonary disease and HCoV-NL63 species causes for upper and lower respiratory tract disease. Most recent species of this virus is MERS-CoV. This species caused for acute pneumonia and occasional renal failure. The new strain of novel Coronavirus is SARS-CoV-2. This strain causes for the Coronavirus Disease 2019 (COVID-19). This disease named by the World Health Organization. Now world fighting against COVID-19 and according to the recent statistics report of world about the COVID-19 cases approx 22.6M confirmed cases and 792K death cases appeared and recovered 14.5M. COVID-19 disease starts to spread from December 2019 from china. Covid-19 disease is emerged in Wuhan seafood market at Wuhan of South China and then rapidly spread throughout the world. The corona virus outbreak has been declared a public health emergency of International concern by World Health Organization (WHO). In this article we summarize the current clinical characteristics of coronavirus and diagnosis, treatments and prevention of COVID-19 disease. In this review article, we analyze data from various Research Reports like WHO guidelines and other articles. It is very important to the readers that new data of COVID-19 updating nearly every hour of day regarding clinical characteristics, diagnosis, treatment strategies, and outcomes COVID-19 disease. The degree of COVID-19 disease varying throughout the world. COVID-19 affected patient shows various symptoms like fever, cough, sore throat, breathlessness, fatigue, and malaise among others. The COVID-19 disease is being treated through general treatment like symptomatic treatment, by using antiviral drugs, oxygen therapy and by the immune system. There is no vaccine or therapeutic strategies for deal with this disease yet. In this critical situation preventive measures must be require.  A very important issue in preventing viral infection is hand hygiene. There are other entities that people can boosting the immune system and help in infection prevention.