Open Access Case Report

Are Osteoid Osteoma and Ankylosing Spondylitis in Some Way Linked? A Case Report

Riad Chiheub, Kamel Remita

Journal of Advances in Medicine and Medical Research, Page 99-104
DOI: 10.9734/jammr/2022/v34i231266

We present a 35-year-old male, who initially complained of progressive and persistent inflammatory back pain for 2 years, which was diagnosed as a T12 thoracic spine osteoid osteoma. The patient underwent intralesional resection of the tumor via a posterior approach, with immediate post-operative pain relief, and 2 years of pain-free spine interval. Recently, the patient presented with an inflammatory back pain. Visual Analogic Scale (V.A.S) was 7/10 and stiffness,The Back Pain Functional Scale (BPFS) was 30/60, suggesting a recurrence of the spinal Osteoid Osteoma (OO), diagnosis ruled out giving the negativity of the spine MRI and CT scan. Therefore, an ankylosing spondylitis was suspected, hence, sacroiliac joints MRI was performed, depicting an active bilateral sacroiliitis, confirming the diagnosis of AS according to ASAS criteria. The aim of this paper is to point out similarities between OO and AS and their clinical and probable therapeutic implications. Though few cases of their association have been reported in the literature, both of bone osteoblastic tumors and Ankylosing Spondylitis (AS) share a number of common features, which let us assuming a possible relationship and therefore, the necessity to assess for sacroiliitis in patients with osteoid osteoma. Differential diagnosis should be considered especially in patients with inflammatory back pain. Moreover, a purely pharmacological approach to the management of OO by the use of biological agents may be considered.

Open Access Case Study

Case Study on Tracheo - Bronchial Stenosis: Conservative vs Bronchoscopic Approach

Mahavir Modi, Kaumudi Devi

Journal of Advances in Medicine and Medical Research, Page 81-88
DOI: 10.9734/jammr/2022/v34i231264

Tracheo-bronchial stenosis can occur in infections like tuberculosis, malignancy and post- intubation, trauma to airway. Tracheal and airway stenosis remains a challenging area for pulmonologists and require interventions to cure the patients. The aim of this study is to differentiate treatment approach in the management of variety of tracheo-bronchial stenosis.   Patients with stenosis presents with breathlessness, stridor, hoarseness of voice, and are unable to expectorate. In some cases, patient will require emergency intubation and securing the airway before the treatment of stenosis. Intubation may cause mucosal damage and inflammation, granulation tissue formation, cartilage destruction, tracheomalacia and tracheal stenosis. Among these, post intubation tracheal stenosis has worst outcome and require interventions. Early diagnosis of this complication may change the natural history of the disease. If early diagnosis can be established, then bronchoscopy and balloon dilatation, stenting can be done, otherwise patient might have to undergo further resectional lung surgeries or tracheostomy depending on the site of the lesion. Each case of tracheo-bronchial stenosis needs different treatment approach and careful clinical and bronchoscopic evaluation.

Open Access Original Research Article

Vaginal Three-Dimensional Ultrasound and Chromohysteroscopy for Endometrial Evaluation in Cases of Failed Intracytoplasmic Sperm Injection

Mahmoud Mohammed Abdou, Hassan Tahseen Sheirf, Manal Mostafa Abdalla, Ashraf Al Mohammady Gharib

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/jammr/2022/v34i231255

Background: Implantation failure could be due to a variety of reasons, including embryo quality and uterine receptivity, but remains unexplained in many cases. The aim of the work was to evaluate vaginal three-dimensional ultrasound, chromohysteroscopy for endometrial evaluation in cases of previous failed intracytoplasmic sperm injection and histopathological examination of the suspected areas.

Methods: This study was carried on 50 patients who attended to the department of Gynecology in Tanta University Hospital and another private hospital. All patients was allocated in one group and examined between 30 and 120 days after the failed ICSI cycle. 3D vaginal ultrasound was done for all cases at the early luteal phase period then all the hysteroscopic operations was performed in the early follicular phase (3-4 days postmenstrual) as conventional hysteroscopy.

Results: Most common hysteroscopic finding was Polypoidal endometrium in 12% of cases, Arcuate uterus in 10% of cases, Arcuate uterus + T shaped cavity in 8% of cases and Niche, Polypectomy in 4% of cases and Biopsy of dark stained area was taken from all cases. Histopathology finding was normal Proliferative endometrium in 72% of cases and Early secretory endometrium in 4% of cases. Focal chronic nonspecific endometritis in 20% of cases and Polypoid endometrial hyperplasia in 4%.

Conclusions: Chromohystroscopy is a safe and easy procedure which can help to improve the efficacy of hysteroscopy in diagnosing cases of endometritis and to increase the success rate of IVF and ICSI. It is highly recommended to be applied to cases of repeated ICSI or IVF failure.

Open Access Original Research Article

Prevalence and Antimicrobial Resistance Patterns of Escherichia coli O157:H7, Salmonella, and Shigella Species from Stool Samples of Patients with Diarrhea at Benjamin Mkapa Hospital

Alphonce B. Chandika, Reuben S. Mkala, Bushi Lugoba, Benjamin C. Kipilipili, Witness Saitot, Charles E. Kamkunguru, Susu J. Susu, Mkhoi L. Mkhoi, John B. Lindi, Japhet D. Chanzu, Catherine A. Masalu, Humphrey E. Kiwelu, Emmanuel J. Shansi, Lucas E. Matemba

Journal of Advances in Medicine and Medical Research, Page 11-19
DOI: 10.9734/jammr/2022/v34i231256

Background: Enterobacteriaceae is among the large group of gram-negative rod bacteria in which it comprises Escherichia coli, Salmonella, Shigella, and many other species whose natural habitat is the intestinal tract of humans and animals. Diarrheal diseases are a major problem worldwide caused by bacterial pathogens particularly in developing countries. A previous study reported a prevalence of 9.30% Extended Spectrum Beta Lactamases (ESBLs) producing Enterohemorrhagic Escherichia coli O157:H7 that revealed a high (100%) resistance to gentamicin, tetracycline, trimethoprim/sulphamethoxazole, and amoxicillin/ clavulanic acid.

Methods: A laboratory-based cross-sectional study was conducted at BMH. A convenient sampling method was used to enroll 308 patients with diarrhea in the study after consent for 12 months. Stool samples were collected into an acceptable clean sterile stool container and transported to Microbiology department for investigation. Analysis of data was performed using Statistical Package for Social Sciences (SPSS) version 17.0.

Results: Out of 308 participants, 61.0% (188) were female whereas 39.0% (120) were male. The age group of between 18 to 45 years had a larger number of participants recruited in study 257 (83.4%) and less number 4 (1.2%) in the age group above 60 years old. About 5.2 (16/308) percent of stool samples processed were positive with pathogenic bacteria whereas 94.8 (292/308) percent were negative (no pathogenic bacteria isolated) growth. The study presented two pathogenic bacteria species named E. coli strain O157:H7 and Salmonella typhi that were isolated from stool samples of patients with diarrhea and who attended the hospital for treatment. No any shigella species was isolated in the study. The prevalence of S. typhi was 3.2% (10/308) whereas E. coli strain O157:H7 was 1.9% (6/308) out of 308 stool samples processed. The in vitro drug resistance patterns of Ampicillin were observed to be high 9 (90%) followed by Amoxicillin/Clavulanate and tetracycline of which both had 6 (60%) resistance to S. typhi.

Conclusion: The study is currently insisting laboratory practitioners carry out an investigation of Escherichia coli strain O157:H7 as a routine test in parallel with other enteric pathogens.

Open Access Original Research Article

Knowledge and Practices of Primary Health Care Providers Regarding Childhood Immunization

Hind Ibrahim Gaber Alsemary, Nihal Salah Shihab, Heba Saied AlMahdy, Hanaa Abdelaziz Mohamed Zayed

Journal of Advances in Medicine and Medical Research, Page 20-30
DOI: 10.9734/jammr/2022/v34i231257

Background: Uptake of vaccination services isn’t only dependent on provision of these services, but also in knowledge and practice of health care providers (HCPs), so WHO indicated that training of HCPs is an essential component of all expanded programs on immunization (EPI) activities. The aim of this study is to lower primary vaccine failure, morbidities and mortalities among children.

Methods: This cross-sectional study included 150 HCPs and 16 primary healthcare units and one center in Shubra Khit District, Beheira Governorate, Egypt. Predesigned questionnaire and observational checklist were applied to collect data. The questionnaire assessed the knowledge of health care providers about storage, handling, administration, scheduling, doses, routes and contraindications of the different vaccines routinely. The checklist assessed the practice of health care providers regarding cold chain, room layout, preparation for vaccination session, general and specific practice related to each vaccine.

Results:  The majority of health care providers had adequate level of knowledge about all vaccines except for MMR vaccines & Hib vaccines. There were significant associations between knowledge levels and place of work with (p= <0.001), qualification (P = 0.015), site of task (P =<0.001) and training courses (P = <0.001) among studied health care providers.

Conclusions: As regards knowledge levels among studied health care providers, nearly two third had a good knowledge; the same for practice, it was very good in about two thirds of the studied units/center.

Open Access Original Research Article

Sonographic Evaluation of Renal Dimensions and Volume in Normal Pregnancy in Bayelsa State, South-South, Nigeria

E. K. Kiridi, P. C. Oriji, I. J. Abasi

Journal of Advances in Medicine and Medical Research, Page 31-39
DOI: 10.9734/jammr/2022/v34i231258

Background: Physiological changes in the renal system lead to important modifications in electrolyte, acid-base balance and renal function. Some of these changes occur in the renal dimensions and volume, and to adequately interpret these changes, physiological changes in pregnancy should be well understood.

Objective: To evaluate the renal dimensions and volume, and correlate them with age, parity and trimesters in normal pregnancy in Bayelsa State, Nigeria.

Study Design: Prospective, descriptive, cross-sectional study.

Place and Duration of Study: Departments of Obstetrics and Gynaecology, and Radiology of the two tertiary hospitals in Bayelsa State, Nigeria, from July to December, 2021.

Materials and Methods: Sonographic assessments of the renal dimensions and volume in 400 randomly selected normal pregnant women in both tertiary health institutions were done, after obtaining written informed consent from them. Data were entered into a pre-designed proforma, and analysed using Statistical Product and Service Solutions for windows® version 25, SPSS Inc.; Chicago, USA). Results were presented in frequencies and percentages for categorical variables; mean and standard deviation for continuous variables. Student’s t-test was used to compare sample means; and Chi-square for associations.

Results: A total of 400 pregnant women were scanned. The mean renal bipolar length, mean antero-posterior diameter and mean renal width were 10.9 ± 1.0 cm, 4.7 ± 0.6 cm and 6.4 ± 0.7 cm respectively. Mean renal volume was 174.2 ± 44.8 cm. Renal volume was highest in the left kidney of women > 35 years (186.8 ± 47.3 cm3), and was lowest (162.8 ± 33.6 cm3) in the right kidney of women < 20 years. The mean values of the renal dimensions and volume increased with parity of the women and trimester of pregnancy.

Conclusion: This study produced a mean renal volume in pregnancy for our locality. It was revealed that the renal volume and dimensions were lowest in younger women and highest in older women. The renal volume increased as pregnancy advanced; and with increasing parity.

Open Access Original Research Article

Evaluation of Nutritional Status of Haemodialysis Patients Using Malnutrition Inflammation Score

Mona M. Elgamasy, Ahmed A. Abo Omar, Hossam A. Hodeib, Mostafa T. Gabr

Journal of Advances in Medicine and Medical Research, Page 40-52
DOI: 10.9734/jammr/2022/v34i231259

Background: One of the common problems of maintenance dialysis patients is malnutrition especially Protein-Energy Malnutrition (PEM) and several studies have revealed that PEM is associated with increased morbidity, mortality, and impaired quality of life. The aim of this work was to evaluate the nutritional status in hemodialysis patients using malnutrition inflammation score (MIS).

Methods: This cross-sectional study was carried out on 100 patients on regular hemodialysis. Patients were classified in to two groups according to MIS status; group A which were well nourished and group B which were malnourished. Patients included were subjected to; through history taking, laboratory investigations [CBC, Blood glucose level, Kidney function, Livre function tests, Lipid profile (cholesterol- triglycerides-HDL-LDL), Sodium-Potassium- phosphorus, C-reactive protein, ESR, Iron study (serum iron-serum ferritin-total iron binding capacity)], malnutrition-inflammation questionnaire and malnutrition-inflammation score.

Results: There was a statistically significant difference regarding blood hemoglobin, TIBC, creatinine, sodium, HDL, ESR, and CRP between two groups as they all decreased in group B more than group A, except CRP and ESR, creatinine and HDL they increased in group B more than group A (P value <0.05).

Conclusions: It is important to incorporate MIS in the care of hemodialysis patients for early detection of malnutrition and for medical nutrition therapy to optimize patients' nutritional status for better outcomes.

Open Access Original Research Article

Evaluation of Efficacy of Percutaneous Nephrolithotomy in Prone Versus Supine Positions

Abdallah Atef Homouda, Abdelhamid Mahmoud Elbahnasy, Mohammed Adel Ahmed Omar

Journal of Advances in Medicine and Medical Research, Page 53-61
DOI: 10.9734/jammr/2022/v34i231260

Aims: To compare between supine and prone percutaneous nephrolithotomy (PCNL) in the management of renal stones regarding stone free rate, operative time and fluoroscopy time.

Methodology: A retrospective analysis was performed in the period between January 2019 and January 2021 for patients underwent PCNL for renal stones 2 cm or more. They were 77 patients divided into two groups, group (A) prone 38 patients and group (B) supine 39 patients.

Results: the study demonstrated a significant difference in operation time which was (92.5 ± 24.85 min.) in prone group & (68.3 ± 22.90 min.) in supine group with p-value (<0.001), also significant difference in fluoroscopy time which was (258.0 ± 57.19 sec.) in prone group & (166.9 ± 46.60 sec.) in supine group with p-value (<0.001) with shorter operation and fluoroscopy time in the supine than the prone. The study has also demonstrated that there is no statistically significant difference between the two groups as regarding to stone free rate.

Conclusion: in patients with renal stones, 2 cm or more, supine PCNL has proved to be superior to prone PCNL as regarding operative and fluoroscopy time but no difference as regards stone free rate. However, Urologists should be familiar with the differences in the positions and be able to use the method appropriate for each patient.

Open Access Original Research Article

A Study to Determine the Prevalence of Traumatic Head Injuries in Zanzibar: Case Study of Mnazi Mmoja Hospital

Said A. Yusuf, Chukwuma J. Okafor, Said A. Said, Isack J. Chussi, Suhaila A. Masoud, Salamuu R. Ali, Shemsa S. Bakar, Mohammed S. Juma, Adam R. Suleiman

Journal of Advances in Medicine and Medical Research, Page 62-67
DOI: 10.9734/jammr/2022/v34i231261

Introduction: Worldwide, traumatic head injuries account for a high degree of morbidity and mortality. Road accidents appear to be the commonest cause of these injuries. This study is aimed at assessing the prevalence and predictive factors of Traumatic head injury at a tertiary institution health facility in Zanzibar.

Method: A retrospective observational study of  head injury patients that are attended  at Mnazi Mmoja Hospital, Zanzibar from May 2019 to May 2020

Results: A total number of 81 patients were included in the study and distributed as follows; 63 males (77.8%) and 18 females (22.2%) participants. The majority of patients were between the age group of 16-30 years and 40 (49.4%) in total. Road Traffic Accident was the leading cause of injuries (67.9%). Others include assault (13.6%), falling (13.6%), and being struck by an object (4.9%). The study also recorded a higher prevalence of traumatic brain injury TBI (57.9%), including, concussion (9.8%), contusion (18.5%), epidural hematoma (8.6%), skull fracture (14.8%), and subarachnoid hemorrhage (6.2%). This was compared with other causes of head injuries (42.1%) such as cut wounds (9.8%) and soft tissue injuries (32.1%). 64.2% of the patients were treated as outpatients, with 33.3% as inpatients. About 2.5% of the patients died. The west district recorded the highest prevalence of patients with injury rates compared to other districts.

Conclusion: Public awareness campaigns and health promotions concerning road safety rules are needed to help reduce the high burden of road traffic accidents.  Government should also pay attention to the improvement of roads as a way to curb this menace.

Open Access Original Research Article

The Possible Role of Nanocurcumin in Rat Model of Statin Induced Myopathy: Histological and Immune Histochemical Study

Doha S. Mohamed, Nesreen G. Abdelhaleem, Ebtsam A. Shaaban, Ahmed M. Abu-Dief

Journal of Advances in Medicine and Medical Research, Page 68-80
DOI: 10.9734/jammr/2022/v34i231263

Background: Statins are the most commonly used drugs for reducing hypercholesterolemia. Unfortunately, statins induced myopathy is a common side effect of statins. Usually represented by fatigue, muscle pain, muscle tenderness, muscle weakness and nocturnal cramping. Curcumin has been proved as anti –inflammatory agent in the inflammatory conditions.

Aim: This research aimed to study the protective effect of nanocurcumin on the histological changes produced by atorvastatin in the skeletal muscles.

Material and Methods: A thirty albino rats (2-3 months old) were used in the present study.

The rats were randomly divided into four groups.

Group I: (five rats) and was used as a control group (control) , they were given 2 ml carboxy methyl cellulous (0.5%)orally through orogastric tube daily for 4 weeks.

Group II: (five rats) They were given nanocurcumin in a dose of 15ml \kg b.w orally through orogastric tube daily for 4weeks.

Group III: (ten rats) They were be given atorvastatin in a dose of 40 ml \kg b.w orally through orogastric tube daily for 4 weeks and divided into two subgroups.

Group III a (animal model): scarified 24h after the last dose.

Group III b (recovery group): scarified 2weeks after the last dose.

Group IV: (ten rats) they were given atorvastatin in a dose of 40 ml \kg b.w orally through orogastric for 4 weeks followed by nanocurcumin in a dose of 15mg \kg b.w orally daily for 4weeks.

Results: Degenerative and apoptotic changes were observed in the skeletal muscles in the atorvastatin treated groups, these changes could be attenuated by administration of nanocurcumin.

Conclusion: Apoptosis is a mechanism of atorvastatin induced myopathy. Nanocurcumin particles could attenuate this process and attenuated the toxicity of the drug. After stoppage of atorvastatin some of histopathological changes could be recovered.

Open Access Original Research Article

Influence of Calcium Hydroxide as an Intracanal Medicament on Apical Seal

Pooja Balani, Hina Ahmed

Journal of Advances in Medicine and Medical Research, Page 89-98
DOI: 10.9734/jammr/2022/v34i231265

Aim of the Study: Aim of endodontic therapy is to restore the natural tooth functionally as well as esthetically. The success of the treatment depends predominantly on the reduction or complete eradication of pathogens and their byproducts (mechanically and chemically) along with adequate seal. Studies have concluded that chemo mechanical instrumentation alone will only render 50-70% of infected canals free of microorganisms therefore, an effective antimicrobial agent as intracanal medication should be used to improve treatment outcome. Moreover Improper apical seal has been reported as most common cause of endodontic treatment failure in different studies Therefore it is essential to know the effect of most commonly used intracanal medicament Ca (OH) 2 on apical seal, in order to reduce the chances of endodontic failure. The aim of this study is to evaluate the effect of intracanal medicament on apical seal.

Study Design: Quasi Experimental study.

Place of the Study: The samples were prepared at Ziauddin University and was analyzed at Karachi University.

Methodology: Mandibular premolars were prepared using step back technique and were divided into two groups.  In Group A, no intracanal medicament was placed and in Group B intracanal medicament was placed. Samples were placed in Indian ink dye for 7 days and were then cleaned in running water before sectioning up to 5 mm (1 mm each) using Microtome and analyzed under stereomicroscope. Shapiro-Wilks test and Mann Whitney U test was used for data analysis.

Results: Group with intracanal medicament showed least amount of dye penetration with mean value 2.30±1.832 as compared to non-medicated group mean value (2.96 ±1.69) but the results were not statically significant p value 0.072.

Conclusion: The results of this study concluded that there is no statistically significant difference in leakage between group A and group B (non-medicated and medicated group).

Open Access Original Research Article

Prevalence of Self Medication and Knowledge of its Associated Risks among Undergraduate Students of a State University in Southwest Nigeria

K. A. Adesina, M. Adeeyo Ayoka, A. Olamide Afolalu, E. E. Anyebe

Journal of Advances in Medicine and Medical Research, Page 105-115
DOI: 10.9734/jammr/2022/v34i231301

Introduction: Self-medication, as one element of self-care, is the selection and use of medicines by individuals to treat self-recognized illnesses or symptoms. It is the use of non-prescribed medicines by people on the basis of their own initiative.

Aim and Purpose: This study assessed the prevalence of self-medication and knowledge of its associated risks among undergraduate students of Osun State University, Osogbo campus. The study determined reasons and factors influencing self-medication among the students.

Methodology: A descriptive cross-sectional design was adopted for the study. A researcher-developed questionnaire was used to collect data a convenient sample of 407 respondents. Data were analysed using Statistical Package for the Social Sciences (SPSS) version 25. Results were presented using tables, pie chart, frequency and percentages.

Results: This study shows a very young population of students (average age of 17±5.6 years; range – 16 to 27 years), with male making up over two-thirds (slightly over 64%). Prevalence is relatively high; 55.3% of students had used drugs without medical advice, with more than half of the respondents preferring to buy drugs from chemist or pharmacy shops rather than going to school clinic. Antibiotics are the most commonly self-medicated drug on the campus, with headache as the most frequent reported symptom. Factors such as high cost of consultation, urgency and degree of health problem, pressure of time explained why students self-medicate. Male gender appears absolute determinant (p=0.000) of self-medication; other socio-demographic variables were not significantly related to prevalence to self-medication.

Conclusion: Prevalence of self-medication is relatively high with good knowledge of its associated risks among students of Osun State University, Osogbo Campus. It is recommended that health promotion by health workers and university clinic has become paramount.