Open Access Case Report

Benign Late T Wave Inversion Post CABG: Case Report of Myocardial Reperfusion Sign Appearing Late on ECG

Muneera Al Taweel, Faisal AlAnazi, Sara Aldrees, Sarah AlMukhaylid, Zafar Iqbal

Journal of Advances in Medicine and Medical Research, Page 28-32
DOI: 10.9734/jammr/2022/v34i731324

Background: T wave inversion (TWI) has been described in a variety of clinical conditions, usually resolving in a timely manner after the index event. TWI has also been considered a robust sign of myocardial reperfusion appearing early after successful revascularization via fibrinolysis or percutaneous coronary intervention in ST-segment elevation myocardial infarction (STEMI) patients.

AIM: To report the late appearance of TWI after revascularization in a patient post-coronary artery bypass grafting (CABG), as a sign of successful myocardial perfusion.

Methods: A case report of a male patient presenting to King Abdulaziz hospital in the eastern region of Saudi Arabia with Non-ST-segment elevation myocardial infarction(NSTEMI) found to have triple vessel coronary artery disease, referred for CABG at King Abdulaziz medical city Riyadh Saudi Arabia with normal perioperative Electrocardiogram (ECG) and Echocardiogram, to revisit two months later with atypical chest pain and new non-ischemic persistent anterior TWI documented later on clinic visits.

Result and Conclusion: Extensive workup for a possible cause of new anterior TWI was conducted, therefore we concluded the new onset of anterior TWI late post CABG, was a benign sign of myocardial reperfusion.

Open Access Case Study

Melanosis Coli: A Rare Entity in Elderly Patients Presenting with Constipation

Sandeep Kumar, Raja Taha Yaseen Khan, Hina Ismail, Farina Hanif, Mahboob Jan, Ghazi Abrar, Muhammad Qaiser Panezai, Munir Tareen, Danish Kumar, Abbas Ali Tasneem, Syed Mudassir Laeeq, Nasir Hassan Luck

Journal of Advances in Medicine and Medical Research, Page 66-68
DOI: 10.9734/jammr/2022/v34i731328

Melanosis coli is a condition in which there is blackish to brown discoloration of colon and is commonly associated with chronic anthroquinolone laxative usage. It is frequently diagnosed as an incidental finding on colonoscopy or histopathological evaluation. Here, we present to you a case of a sixty-six years old man with history of constipation and laxative use.

Open Access Case Study

Unusual Aetiology of Vocal Process Granuloma in a Child

Oluwapelumi O. Olusoga-Peters, Moses Ayodele Akinola, John Ifeanyi Nwadiokwu, Tolulope .O Binuyo, Florence A. O, Oguntade

Journal of Advances in Medicine and Medical Research, Page 92-97
DOI: 10.9734/jammr/2022/v34i731332

Background: Vocal cord granuloma commonly arises following trauma or irritation from endotracheal intubation and reflux disease. Other uncommon causes are granuloma following voice abuse and foreign body in the larynx. Vocal process granuloma has however not been reported following blunt anterior neck trauma.

Case Presentation: We present a case of vocal cord granuloma following an anterior neck trauma. The patient is a seven year old boy who presented with persistent hoarseness and stridor post neck injury of three months duration. Systemic steroid has been used prior to presentation with temporary improvement. The direct laryngoscopy done under general anaesthesia revealed masses on both vocal processes, which were successfully excised surgically. There was total resolution of presenting complaints after surgery with no symptoms suggestive of recurrence six month post operation.

Conclusion: Post intubation and laryngopharyngeal reflux disease are common causes of vocal process granuloma. However, there is need to suspect granuloma formation following blunt anterior neck trauma for immediate conservative management avoiding the need for surgical intervention when patient present with upper airway obstruction.

Open Access Original Research Article

The Impact of Age on Malaria Prevalence among COVID-19 Patients and Healthy Volunteers with some Associated Symptoms in Rivers State, Nigeria

Onosakponome, Evelyn Orevaoghene, Nyenke, Clement Ugochukwu, Nwalozie, Rhoda, Hanson, Asikiya Huldah

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/jammr/2022/v34i731319

Background: The co-morbidity of malaria and COVID-19 is a growing public health concern since the outbreak of covid-19 especially in low and middle income countries due to poor healthcare facilities, system, personnel manpower and financial resources. It is generally known that age has a significant impact on malaria vulnerability, but with emerging concern on malaria and covid-19 co-infection, age based prevalence are among many studied characteristics of malaria prevalence in covid-19 patients especially in malaria endemic areas.

Aim: The study was aimed at evaluating the impact of age in the prevalence of malaria and COVID-19 co-infection as well as some associated symptoms in Rivers State, Nigeria.

Methodology: The study was a cross-sectional study conducted among 600 covid-19 patients admitted in Rivers State Covid-19 Treatment Centre, Eleme. Consenting subjects were randomly selected and were classified into three groups based on age; 0-25yrs, 26-50yrs and >50yrs. Blood samples were collected using venipuncture technique and blood was collected in EDTA bottles. Thick film was prepared was stained using Giemsa for malaria microscopy. All data generated were analyzed statistically using analysis of variance (ANOVA) and chi-square test with a P<0.05 considered significant.

Result: Results showed that total malaria prevalence was 70.2 while on age group classifications, the prevalence was 100% in all age groups but healthy control group had less prevalence. This study has shown that prevalence of malaria among covid-19 subjects was significantly higher in all age groups (p<0.05). All symptoms were significantly associated with age at P<0.05; individuals >50years and 26 – 50years experienced more symptoms among COVID-19 patients and healthy volunteers respectively (P<0.05).

Conclusion: This study has shown that malarial prevalence is absolutely higher among covid-19 subjects and the level of prevalence does not discriminate among age groups. However, more research work is needed to fully understand the relationship between malaria and COVID-19 co-infection due to the novel nature of the disease globally and their shared clinical symptoms.

Open Access Original Research Article

Perception of HIV/AIDS among Tertiary Education Students in the Tamale Metropolis and Their Willingness to Take the HIV Test

Calvin Emmanuel Mensah, John Mbiyieba, Cletus Adiyaga Wezena

Journal of Advances in Medicine and Medical Research, Page 7-16
DOI: 10.9734/jammr/2022/v34i731322

Aim: The study assessed the perception of HIV/AIDS among students in tertiary education institutions in northern Ghana and their willingness to take the HIV test.

Study Design: Descriptive cross-sectional study.

Place and Duration of Study: Tamale Metropolis from September 2020 to June 2021.

Methodology: A convenience sampling technique was employed to select 374 students aged 15-30 years. Data from participants was collected using a standardized structure questionnaire and analyzed on Epi Info version 7. Cross tabulation was used to estimate the association between outcome variables and independent variables.

Results: Almost all participants (366; 93.61% [95% CI: 90.73 – 95. 63]) were aware of HIV/AIDS, having acquired information about the disease mostly from a health worker. A very high proportion of the respondents (346; 88.49% [95% CI: 84.95 – 91.29]) were also aware of the modes of transmission of HIV, with 64.41% of participants identifying unprotected sexual intercourse as a major mode of HIV transmission. Though aware of how HIV is transmitted, almost half (46.21%) of sexually active participants did not use a condom in their last sexual intercourse. More than half (221; 56.52% [95% CI: 51.57 – 61.35]) of respondents had never heard of any HIV/AIDS support groups in their schools or communities. Though a majority (58.57%) of respondents were aware of free HCT in the country, the majority (207; 52.94% [95% CI: 47.99 – 57.84]) of the respondents had never taken the HIV test. Close to half (167; 42.71% [95% CI: 37.90 – 47.66]) of respondents had no plans to take the HIV test in the future.

Conclusion: Our results revealed the need to intensify HIV/AIDS education, especially among the youth, emphasizing the increasing risk of HIV infection, importance of regular HIV tests for sexually active persons and the use of protection during casual sex. 

Open Access Original Research Article

COVID-19 Vaccine Uptake and its Determinants among Adult Population in Somali Region of Ethiopia

Olusola Oladeji, Mowlid Aklil Aden, Alinoor Mohamed Farah, Ida Marie Ameda, Mohamed Diaaeldin Omer, Bukhari Shikh Aden, Asli Hassan Aden, Abdifatah Elmi Farah, Adawe Warsame

Journal of Advances in Medicine and Medical Research, Page 17-27
DOI: 10.9734/jammr/2022/v34i731323

Aims: To ensure effectiveness of COVID 19 vaccine in controlling the pandemic, high vaccination coverage rates are necessary to achieve herd immunity which will help reduce the transmission of the virus and ensure reduction in the risk of transmission of infection. The study assessed COVID-19 vaccine uptake and its determinants among the adult population in Somali region of Ethiopia.

Study Design: This was a cross-sectional analytical study

Place and Duration of Study: Somali Region of Ethiopia in October 2021

Methodology: A structured interviewer-administered questionnaire adapted from the World Health Organization (WHO) Strategic Advisory Group of Experts on Immunisation vaccine hesitancy survey question, administered to 433 adult population in eight selected sites. Bivariate analysis and multiple logistic regression were used to test association between vaccine uptake and some selected determinants. The level of significance was set at a p-value<5%.

Results: Only 29% of the respondents had received at least one dose of COVID 19 vaccine, 219(50.6%) reported no concern at all in getting infected and the perception of low risk of infection was significantly higher among those not vaccinated (χ2 =12.62, p<0.05). Only 101(23.3%) of the respondents reported that the vaccine was very important in the prevention of the disease and perceived no benefit was significantly higher among those not vaccinated (χ2 =32.30, p<0.05). Only 79(18.2%) of the respondents believed the vaccine was very safe and perceived lack of safety of the vaccine was significantly higher among those not vaccinated (χ2 =22.24, p<0.05). There was positive association between level of education and vaccine uptake (AOR = 1.90, 95% CI: 1.02–2.52; p<0.05 ) while 126(47.5%) of those who had desired to be vaccinated actually got vaccinated. Other factors associated with COVID-19 vaccination uptake were friends getting vaccinated and support by community and religious leaders.

Conclusion: The perceived low risk among the population to COVID19 infection which significantly affected the poor vaccine uptake is a major concern. With only half of the population who intended to be vaccinated and ended up being vaccinated shows the need for targeted socio behavioural change communication strategies with focus on benefit of the vaccine not only to individual but to the other members of their community.

Open Access Original Research Article

Immunohistochemical Expression of p53 Protein, in Relation to the Histological Type and Grade in Invasive Breast Carcinomas

O. A. Betiku, O. O. Odujoko, G. O. Omoniyi-Esan, B. J. Olasode

Journal of Advances in Medicine and Medical Research, Page 33-41
DOI: 10.9734/jammr/2022/v34i731325

Background: Breast cancer remains the commonest cause of cancer-related deaths in women. This study aims to determine the proportion of p53 expression in breast cancer cases in OAUTHC Ile-Ife and relate this to histological grades and types.

Methods:  Eighty-five histologically diagnosed breast cancer cases seen within a 2-year (2018-2019) period were retrieved. The tumours were graded using Nottingham grading system and the histological types were stated. Immunohistochemistry for p53 was performed on retrieved representative tissue blocks and its level of expression was scored as positive or negative. The association of p53 expression and the histological types and grades were sorted using the chi-square statistical test to compare variables and p-value < 0.05.

Results: The Invasive Ductal Carcinoma-Not Otherwise Specified (IDC-NOS) was the commonest histological type (92.9%). The histological grades 2 and 3 predominated accounting for 48.2% each. Of all the breast carcinoma cases analysed, grades 2 and 3 constituted 93.1%. The median age of 50.6 years was observed in p53 positive and 49.4 years in p53 negative. Even though most high-grade tumours were p53 positive, no significant association between p53 positivity and histological grades or histological types.

Conclusion: Conclusion: Many of our cases show expression of p53 and high grade tumours bare a high level of p53 expression. This finding though not statistically significant may suggest aggressive behaviour of tumours.

Open Access Original Research Article

Topical Intranasal Corticosteroids Compared with Systemic Steroids in the Treatment of Eustachian Tube Dysfunction in Children

Ahmed Farag Elkotb, Hossam Sayed Elsherif, Osama Amin Elbirmawy, Abo-Bakr Salah Behery

Journal of Advances in Medicine and Medical Research, Page 42-52
DOI: 10.9734/jammr/2022/v34i731326

Background: Using corticosteroids in treatment of ETD has been the focus of various studies in which many of them suggested that either topical intranasal corticosteroids or systemic oral steroids are helpful in the management of ETD. The aim of the work was for comparing the efficacy of topical intranasal corticosteroids with that of systemic oral steroids in the treatment of ETD.

Patients and Methods: prospective trial on 100 consecutive patients in the age group of 6- 12 years with an intact TM as to be documented on otoscopic examination and with an ETD as to be documented with a tympanogram type C. Subjects were allocated equally into two groups group 1: had intranasal corticosteroids and group 2:  had systemic oral steroids. Data such as ear complaint, patient history, general investigation, otorhinolaryngological clinical check, tympanometry, pure tone audiometry and treatment, if taken were collected from all the patients.

Results: The decrease in tympanograms type C after treatment was correlated with the increase in type A tympanograms which indicate complete resolution of the condition in both tested groups of both treatment arms. Difference between the two study groups regarding tympanogram type C normalization shows no statistically significant difference between each treatment arm. Pure tone audiometry results indicate an improvement in the subjects HL after management in both examined groups, but results weren’t statistically significant.

Conclusions: Using corticosteroids, whether oral or intranasal, in the management of ETD is effective in resolving the condition, but there is no significant difference between the two in the outcome results and so oral steroid complications could be avoided by using local steroid spray.

Open Access Original Research Article

Roles of NK Cells in Sepsis

Ayriana Safari Baesmat

Journal of Advances in Medicine and Medical Research, Page 53-65
DOI: 10.9734/jammr/2022/v34i731327

Purpose: The body's severe reaction to an infection is known as sepsis. It's a medical emergency that might put your life in jeopardy. Sepsis occurs when an existing infection sets off a chain reaction throughout your body. Sepsis is caused by infect ions that begin in the lungs, urinary tract, skin, or gastrointestinal system. During prolonged sepsis, apoptosis and diminished immunological activities of natural killer (NK) cells contribute to patients' vulnerability to secondary/nosocomial infections and viral reactivation, resulting in worse life quality and long-term death.

Methods: The gene expression data were retrieved from Gene Expression Omnibus (GEO) (GSE60424). Fold change and p value analysis, hierarchical clustering, and pathway analysis were performed.

Results: In this study, we identified altered genes involved in sepsis in NK cells. Ten genes corresponding 11 probe sets were differentially expressed following the sepsis. We identified a network between these genes and pathways they belong to. Pathway analysis showed that these genes are mostly associated with autoimmune response.

Conclusion: DLL1, SERPINA1, IFI44L, XCL1, CD3G, IGHM, PAX8-AS1, PACSIN1, PDE4B and SCML1 genes were found to be associated with sepsis. Almost all these genes are effective in the autoimmune response, especially during the sepsis. Therefore, it is hypothesized that downregulation or upregulation of these genes may affect immune response. And it is predicted that NK cells may be an important factor for autoimmune disease.

Open Access Original Research Article

Burnout Syndrome among Lebanese Pediatric Dentists: An Epidemiological Study

Carole Sabbagh, Nahla Nassif Debs

Journal of Advances in Medicine and Medical Research, Page 69-77
DOI: 10.9734/jammr/2022/v34i731329

Background: Burnout is the result of unsuccessful management of chronic work related stress. The syndrome is characterized by three dimensions: emotional exhaustion, depersonalization and reduced personal accomplishment. It is considered a risk to dentists where they face various types of stressors including constant time pressure and low patient appreciation. Additional sources of pressure are present in pediatric dentistry such as uncooperative and fearful patients.

Aim of the Study: The aim of the study was to determine the prevalence of burnout among Lebanese pediatric dentists and to analyze various factors that may influence the appearance of the syndrome.

Materials and Methods: An observational cross-sectional study was performed among 117 Lebanese pediatric dentists who answered a two-part questionnaire. The first part consisted of demographic data and personal information. The second is the Maslach Burnout Inventory Human Services Survey for Medical Personnel used for the detection of the syndrome. Statistical analysis was performed to determine burnout’s prevalence and to analyze its correlation with various variables.

Results: High emotional exhaustion was noted in 34.5% of participants, 15.5% had high depersonalization and 47.4% had reduced personal accomplishment. Lebanese pediatric dentists with little professional experience had high emotional exhaustion scores (P= .01). Depersonalization was lower in exclusive pediatric dentists (P= .04). Furthermore, personal accomplishment was higher when respondents exercised moderately (P= .04). The prevalence of overall burnout was found 3.4% with male pediatric dentists experiencing more burnout than females (P= .03).

Conclusion: Burnout in its three dimensions’ model was experienced by few pediatric dentists in Lebanon with gender predominance towards males.

Open Access Original Research Article

Delayed Mental Health Impacts of COVID-19 and Confinement Strategy: Distillates of a Prospective Study from North Kashmir

Charanjit Singh, Suhail Rashid, Syed Masood Shah

Journal of Advances in Medicine and Medical Research, Page 78-84
DOI: 10.9734/jammr/2022/v34i731330

Background: Since December 2019, the Covid-19 pandemic has pushed mankind into a whirlpool of fear, anxiety, and uncertainty. There has been a ‘Covidization’of medical literature. Despite abundant studies on immediate mental health impacts, there is a dearth of literature on work related to delayed impacts of Covid-19 on mental health. This facet of delayed   mental health impacts needs characterization and quantification, for, putting in place a framework of working guidelines to tackle such mental health issues in case of any future  health catastrophes

Aim: To gauge the delayed mental health impacts on the inmates who were discharged from a confinement facility in Kashmir. The interactions were conducted on mobile phones.

Methods: A primary care physician and his associates, who were actively involved in the care of inmates  at  the  confinement  facility,  followed  up  the  consenting  inmates  at 6-8 weeks after discharge by way of mobile call interactions. Questionnaire-based thematic queries were put to the participants and responses were recorded. This confinement facility was an isolation–quarantine ‘Covid Care’ Centre of Associated Hospital, Government Medical College, Baramulla in North Kashmir for most months of the year 2020.

Results:  The data was collected, collated and analyzed. Various qualitative and quantitative inferences were generated. Certain suggestions/ recommendations were also presented.

Open Access Original Research Article

Impact of COVID-19 on Admission into the Department of Paediatric Bingham University Teaching Hospital (BHUTH) Jos

Maryam Shehu, Marcia Ihekaike, Adenike O. Jimoh, Hassan Shehu, Yakubu Mava, Edwin E. Eseigbe, Alhassan M. Yakubu

Journal of Advances in Medicine and Medical Research, Page 85-91
DOI: 10.9734/jammr/2022/v34i731331

Introduction: The Coronavirus disease 2019 (COVID 19) pandemic has a significant impact on global health systems, not only in terms of the number of people infected with the disease, but also in terms of patients with other diseases. The COVID-19 pandemic, as well as the measures taken to combat it, such as complete lockdown, has a significant impact on health seeking behaviour and the health care-delivery system. Studies have shown that while COVID-19 confirmed cases have gradually increased, visits to hospitals for non-COVID infections have steadily decreased. Concerns are arising about the potential harmful impact of COVID-19 response strategies on the management of other medical disorders.

Objective: To assess the effect of COVID-19 pandemic on admissions into the Department of Paediatrics Bingham University Teaching Hospital, Jos, Plateau State.

Methodology: We retrospectively analyzed the hospital out-patients and admission records into the Paediatrics department of Bingham University Teaching Hospital from April 2019 to March 2021. The records from one year pre-COVID and one year COVID period were compared. The data was analyzed using SPSS version 22.

Results: The total number of pediatric patients seen at the Paediatrics department (POPD/EPU/SCBU/PMW) decreased by 28 percent, from 5657 in 2019/2020 to 4079 in 2020/2021 (P <0.001). The number of patients hospitalized in the Paediatrics medical ward (PMW) declined by 19 percent, while the number of admissions in the Special Care Baby Unit (SCBU) declined by 10 percent. The overall number of consultations in the emergency department unit (EPU) decreased by 23 percent. The total number of patients seen and admitted in the various units of the paediatric department decreased during the lockdown period by 60 percent compared to the pre-lockdown period.

 Conclusion: The pandemic and the precautions taken in response to COVID-19 have resulted in a significant reduction in pediatric admissions for diseases other than COVID-19.