Open Access Case Study

Association of Type- 1 Diabetes Mellitus and Sickle Cell Disease in Children: Case Series from Saudi Arabia

Abdalla Mohamed Zayed, Sulaiman Al Muhaimeed, Turki Al Otaibi, Hossam Al Dossari, Hmoud Ghallab, Shangrila Joy Ancheta, Abdulrahman Al Ajami, Fahad Al Harbi, Asala Al Hazmi

Journal of Advances in Medicine and Medical Research, Page 20-25
DOI: 10.9734/jammr/2022/v34i1531395

This case series aims to highlight a unique coexistence of two important diseases in children, sickle cell anemia and diabetes mellitus, which are relatively common in Saudi Arabia. Co-existence of the two diseases in the same patient is very rare, with only few cases reported in the literature. This is the first time to report more than 2 patients with this combination from one center. The involved 4 children are originally from the Southern and Eastern regions of Saudi Arabia representing both the African and Arab-Indian sickle gene haplotypes. The coexistence of the two diseases is not related to the sickle cell disease severity. It also can affect homo- and heterozygous forms of sickle cell disease at any age during childhood from infancy through adolescence. In sickle cell disease patients, Type-1 Diabetes can first present insidiously or as Diabetic Ketoacidosis. No clear explanation to the rarity of this combination is known so far.  Diabetes mellitus should be considered in the differential diagnosis of cases with sickle cell disease experiencing abdominal pain, dehydration and acidosis. Further evaluation and comprehensive guidelines tailored for management of this condition are recommended.

Open Access Minireview Article

The Most Common Heart Diseases and Their Influence on Human Life: A Mini-review

Maad M. Mijwil, Ban Salman Shukur, Enas Sh. Mahmood

Journal of Advances in Medicine and Medical Research, Page 26-36
DOI: 10.9734/jammr/2022/v34i1531396

According to the World Health Organization, many people suffer from heart disease and blockage of blood vessels, which are the most common diseases of death worldwide. The heart is one of the human body organs located between the lungs in the middle of the chest behind the sternum muscle. In this article, the authors decided to highlight the types of heart disease that affect humans and the signs and causes. This article outlined that these diseases are dangerous, and care should be taken to review the specialists early and take the appropriate treatment in order not to cause sudden death.


Open Access Original Research Article

Relationships between Risky Driving and Psychopathy Traits

Liudas Vincentas Sinkevicius, Danielius Serapinas

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/jammr/2022/v34i1531392


Background: Despite all efforts to ensure road safety, road deaths rank eighth in the world. More than 3,500 people die on the world's roads every day, almost 1.3 million. avoided deaths and around 50 million injuries annually.

Aim  of  the  Study: The aim of the study was to investigate the links between risky driving and psychopathic traits.

Materials  and  Methods: 257 drivers participated, ranged from 18 to 66 years. A multivariate linear regression analysis was performed to determine if psychopathy predicts risky driving. Methods used in the study: the Driving Behavior Questionnaire to measure risky driving and the Triarchial Psychopathic Measures Questionnaire to measure psychopathic traits.

Results: Drivers with a higher degree of psychopathic disinhibition trait commit more driving errors, slips and lapses, aggressive and ordinary driving violations; Drivers with a higher degree of psychopathic meanness trait commit more aggressive and ordinary driving violations; Drivers with a higher degree of psychopathic boldness trait make fewer driving mistakes and have a lower overall risk of driving; Psychopathy traits can predict risky driving and the disinhibition trait of psychopathy has the highest prognostic value in predicting risky driving.

Conclusion: Psychopathy traits shows relationship with risky driving and psychopathy trait disinhibition can prognose risky driving.


Open Access Original Research Article

Quality of References Transcription of Theses at the Faculty of Medicine of Setif - Algeria

Djamila Adjiri, Slimane Laouamri

Journal of Advances in Medicine and Medical Research, Page 7-12
DOI: 10.9734/jammr/2022/v34i1531393

A fundamental principle of the scientific approach is to justify the main precise facts, stated during the writing of the thesis by scientific, professional and popularization documents. Aim is to contribute to the improvement of the quality of the scientific medical writing of the theses Faculty of Medicine of Setif, in particular the references transcription. Its a comparative study “before – after” a training session on the quality of the scientific medical writing of 120 theses at the faculty of medicine during the two academic years 2014 - 2015 et 2015 -2016. The references transcription was more correct for the pharmacy department. Transcription anomalies were significantly less frequent and the proportion of theses with a correct chapter title was significantly for times greater (OR = 4.0; 95% CI = 1.4–11.2). The same result for titer was observed for the second year (OR = 10.5; 95% CI = 3.4–32.1), but with no significant difference for the number of transcription abnormalities. The insufficient level of knowledge of techniques of scientific medical writing show that the usefulness of training sessions is indisputable for improving the quality of scientific texts and promoting publications.

Open Access Original Research Article

Incidence of Difficult Intubation in Tmj Ankylosis Patients in University Setting

P. Chithambara Shathviha, Rubin S. John

Journal of Advances in Medicine and Medical Research, Page 13-19
DOI: 10.9734/jammr/2022/v34i1531394

Introduction:  A fusion of the mandibular condyle with the base of the skull causes ankylosis of the temporomandibular joint (TMJ), which results in a lack of joint movement. The anesthesiologist is concerned about prolonged temporomandibular joint ankylosis because of the restricted airway, which makes intubation difficult. Despite the fact that TMJ ankylosis is a well-known risk factor for difficult airway management, the strategies used are based on the anesthesiologists' skill. It's never easy intubating a patient with temporomandibular joint ankylosis. The purpose of this study was to see how common problematic intubation was in TMJ ankylosis patients.

Aim of the Study: The aim of the present study was to evaluate the incidence of difficult intubation in TMJ ankylosis patients.

Materials and Methods: Among the overall data of patients attending Saveetha Dental College, a retrospective analysis of all the cases (patients who underwent TMJ ankylosis surgery) was extracted. Excel spreadsheets were used to enter the data. SPSS software version 19 was used to analyse the data collected. The data were statistically evaluated using the Chi square test.

Results: In this study, it was discovered that the incidence of difficult intubation in TMJ ankylosis surgery was higher in the age group of 5-18 years than in the other age groups. Intubation in children is tough. The chi square test resulted in statistically significant findings (p<0.005).

Conclusion: Nasal intubation and fiberoptic intubation were the most common modes of intubation used in TMJ ankylosis surgery, according to the results of this small sample retrospective analysis. The difficulty of intubation was increased in the paediatric age group (5-18 years).

Open Access Original Research Article

Pattern of Presentation of Liver Function Tests Parameters in a Tertiary Institution in Delta State, Nigeria

Voke Peter Orugbo, John Ohaju-Obodo

Journal of Advances in Medicine and Medical Research, Page 37-53
DOI: 10.9734/jammr/2022/v34i1531397


Aims: Liver function tests or "LFTs" are performed to measure liver function and identify the source of liver damage while examining the health state of the liver. The current study looked into the pattern of presentation of liver function tests values in a tertiary institution in Delta State, Nigeria.

Study Design: This was a cross-sectional study.

Place and Duration of Study: The study was carried out at the Delta state University Teaching Hospital (DELSUTH),Oghara, Delta State, Nigeria over a 24-month period.

Methodology: The study included 1436 recruited subjects who reported to the Chemical Pathology Laboratory for LFTs at the Delta State University Teaching Hospital (DELSUTH) in Oghara, Delta State, Nigeria. The participants' ages varied from infants to people in their 70s.

Results: There were no significant variations in total protein (TP) across the age groups. TP levels in neonates and infants varied from 4.73 g/dl (p>0.05). TP levels in adults varied from 6.43 to 7.75 g/dl. Total bilirubin (T.BIL) levels in adults were lower in general than in babies and neonates (p0.05). There were no gender differences in the LFTs parameters among the adult individuals. TP levels in the females (6.50 g/dl) were greater (p<0.05) than in the boys (8.84 g/dl) among the day-olds. However, after 2 weeks, the girls' TP levels (4.67 g/dl) were considerably lower (p0.05). All participants' TP levels were within reference intervals. More than 80% of subjects had substantially increased ALP levels. Infants have higher levels of bilirubin than adults.

Conclusion: At least 5% of the adult subjects developed hyperbilirubinemia. Gamma glutamyltransferase (GGT), Glutamate oxaloacetate transferase (GOT), and Glutamate pyruvate transferase (GPT) levels were significantly elevated in at least 50% of all subjects, regardless of age or gender. The immediate underlying reason is unknown.


Open Access Original Research Article

COVID-19 Vaccination: Early Estimates of a Relative Post Interventional Case Fatality Risk

Tareef Fadhil Raham

Journal of Advances in Medicine and Medical Research, Page 54-64
DOI: 10.9734/jammr/2022/v34i1531398


Background: Recent epidemiological studies have demonstrated the efficacy of vaccines in reducing COVID-19 absolute case-fatality risks (CFRs) on a real-world global scale. However, these studies used cumulative (add-on) deaths and case accounts as nominators and denominators respectively.

This study aims to shed light on the relative post-COVID-19 vaccination non– cumulative CFR as a tool in monitoring the effectiveness of this intervention.

Methodology: We used post-vaccination non- cumulative counts of deaths and cases as at April 3, 2021, for a comparison of pre-COVID-19 vaccination data.

Sixteen countries/territories, which ran the COVID-19 vaccination program for at least a hundred days, were included in the study.

A matched paired t-test and a receiver operating characteristic (ROC) test were used for statistical analyses.

Results: The relative post-COVID-19 vaccination CFRs are less than absolute (cumulative) CFRs and less than pre-vaccination CFRs. The matched paired t-test for testing mean differences between pre-COVID-19 vaccination and relative post-COVID-19 vaccination CFRs show a p-value level of (0.126).

The ROC test shows that the area under the curve was 0.391 for relative post-COVID-19 CFRs with an asymptotic significance of 0.291. The best COVID-19 cut-off CFR point was 1.6% which is an observed discriminator level between pre-vaccinated high CFRs and relative post-vaccinated CFRs lower level.

Conclusions: The relative post-COVID-19-vaccination CFR is more sensitive than absolute CFR and can be used as a tool for measuring the effectiveness of COVID-19 vaccination coverage in reducing CFR in addition to standered parameters.

Recommendations: The real world relative post-interventional CFR can be used as new indicator to replace absolute (cumulative) post-interventional CFR) as an early pos- interventional assessment.


Open Access Original Research Article

The Determinants of Child Survival in South-west Nigeria

Bamisaye, Bukola Olanike, Adepoju, Thomas Oladejo

Journal of Advances in Medicine and Medical Research, Page 65-74
DOI: 10.9734/jammr/2022/v34i1531399

Introduction: Child survival is an essential component of public health concerned with reducing child morbidity and mortality. Despite the gains attained during the Millennium Development Goals era, globally 14,000 children less than five years of age still die daily. Therefore, this study sought to evaluate the determinants of child survival in South-west Nigeria.

Methods: A A four-stage random sampling technique four-stage random sampling was used to sample 1308 mothers of under-five children in southwest Nigeria. Information on demographic and socio-economic characteristics, child-related, maternal, paternal, and environmental factors were collected using a pre-tested, interviewer-administered semi-structured questionnaire. Data were analysed using SPSS version 20, descriptive statistics, and logistic regression was performed at a 5% level of significance.

Results: Mean age of respondents was 30.7±6.1years. Factors that significantly (p<0.05) influenced the survival of the under-five children were; mothers' literacy level, residence, low parity, mothers’ educational qualification, type of flooring materials, and mothers' age at first birth. The odds of child survival is twice as higher in literate than non-literate mothers (OR:1.9; CI:1.2-2.8), urban than rural dwellers (OR:2.2; CI:1.1-4.8), mothers with at least a secondary education than uneducated (OR:2.1; CI:1.3-3.5), type of flooring materials (OR:4.3; CI:2.3-8.2) and respondents age at first birth (OR:1.1; CI:1.0-1.1). Also, women with low parity had less likelihood of under-five death than mothers with higher parity (OR:0.5; CI:0.3-0.9).

Conclusion: The study identified literacy level, residence, low parity, mothers’ educational qualification, and type of flooring materials as determinants of child survival in southwest Nigeria. Therefore, all stakeholders should develop a more effective response to these determinants to ensure sustainable, realistic, and practical measures that will increase the survival of under-five children in the area.

Open Access Original Research Article

Patterns and Determinants of Utilization of Antenatal Care Services in Tanta, Egypt

Eman Abdulhamid Hamza, Shimaa M. Saied, Asmaa Abd Elrheem Ataallah, Samir Abdelmageed Atlam

Journal of Advances in Medicine and Medical Research, Page 75-85
DOI: 10.9734/jammr/2022/v34i1531405

Background: Antenatal care (ANC) is the health care given to pregnant women, to monitor the pregnancy and reduce the risks for the mother and baby during pregnancy and at delivery. To be most effective, it is recommended that all pregnant women should have at least four antenatal checkups during pregnancy, started as early as possible in the first trimester.

Aim: The study aimed to determine the utilization pattern of antenatal care facilities and to identify the determinants of utilization of the antenatal care services in family health centers in Tanta District.

Methods: This cross-sectional study was conducted on 400 women attending four family health care facilities in Tanta city. The tools of the study were a predesigned, pretested structured questionnaire that inquire about socio-demographic data, obstetric history, medical history, the content of antenatal care program and utilization pattern, the attitude of the studied pregnant women towards ANC. Informed consent was obtained from each participant and data confidentiality was guaranteed. The data were collected through interviewing the selected women.

Results: More than half of participants (51.3%) started the first visit of ANC in their first trimester. Most of them (62.3%) received adequate ANC. Mothers in rural areas utilized ANC more than urban ones. The age of pregnant women was significantly lower among those who received adequate ANC than those with inadequate ANC. A higher percentage of adequate ANC recipients were more educated however the difference was not statistically significant. There was a statistically significant difference between adequacy of ANC and family income. Gravidity, parity, and children’s numbers did not significantly differ according to the adequacy of ANC.

Conclusion: Age of the women, residence, obstetric complication, the way to the health facility transportation cost, transportation comfortability, the number of work hours of health care providers were the significant predictors for the determination of utilization pattern of ANC services by the studied pregnant women.