Open Access Case Study

Multiple Hydatidosis with Rare Cardiac Localization

N. Zaghba, C. Farissi, M. Zerraa, K. Chaanoun, H. Benjelloun, N. Yassine

Journal of Advances in Medicine and Medical Research, Page 71-76
DOI: 10.9734/jammr/2022/v34i1631410

The present study highlights the Multiple pulmonary hydatidosis with cardiovascular localization. Cardiovascular localization remains exceptional with an estimated frequency between 0.5 and 2% of all hydatid localizations. Multislice CT with cardiac synchronization, as illustrated by our observation, allows an accurate morphological and extension assessment thanks to its very good spatial resolution and the possibilities of multiplanar reconstructions. Medical antiparasitic treatment is the treatment of choice for inoperable patients due to too many hydatid cysts, or debilitated terrain, or as a complementary treatment to surgery when there is a risk of dissemination.

Open Access Original Research Article

Prospective Observational Study: Risk Factors and Outcomes of Diabetic Foot Ulcer among Diabetes Mellitus Patients Admitted to Government Medical College, Nizamabad

Madhukar Sirasu, C. Ramchandraiah, C. Muralidhar

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/jammr/2022/v34i1631401

Background: Diabetes mellitus (DM), sometimes known as diabetes, is a collection of metabolic illnesses defined by a persistently high blood sugar level. Frequent urination, increased thirst, and increased appetite are common symptoms. In all nations, DM complications have become a serious public health issue.

Objectives: A hospital-based study, a prospective observational study was conducted among diabetic patients with diabetic foot ulcers at Government Medical College (GMC), Nizamabad. From September 2020 to October 2021

Materials and Methods: To calculate the sample size, a total population of 450 patients with type 2 DM diagnosed during the 6-month study period was considered. DFU patients were studied clinical characteristics of diabetic foot ulcer patients among diabetes mellitus patients, and risk factors and outcomes of diabetic foot ulcer.

Results: 100 Diabetic foot ulcers (DFU) patients were admitted to the GMC throughout the research period, with 61 (61%) of them being male. The age group between 18 to 78 years, with an average of 58.9 ± 9.56 years. The following groups had higher frequencies among participants: married 56 (56 %), schooling up to primary school 36 (36%). Type 2 diabetes mellitus affected 59 of them (59%). Amputations were performed on 35 (35%) of the patients, whereas 65 (65%) had no amputation. The most generally recommended antibiotic for the treatment of DFU was cloxacillin + metronidazole 39 (39%), followed by ceftriaxone. Furthermore, diabetic foot ulcer patients with neuropathy were more likely to require amputation (AOR = 1.6250; 95 % CI: 0.6479, 4.0756) than diabetic foot ulcer patients without neuropathy.

Conclusion: Blood glucose level, higher body mass index, inappropriate antibiotics use, neuropathy and advanced grade of diabetic foot ulcer were independent predictors of amputation. Thus, a focus on weight loss, treating hyperglycemia, and prescribing suitable antibiotics for patients with neuropathy and advanced diabetic foot ulcers might reduce the unfavorable consequences of diabetic foot ulcers.

Open Access Original Research Article

A Study to Compare and Adjust the Number of Occlusal Contacts in a Provisional Restoration in Centric Occlusion Using a Virtual Articulator and Functionally Generated Path Technique

Matety Ashwin, Amrit Tandan, Swapnil Pande, Manoj Upadhyay, Garima Agarwal, Arun Kumar Tiwari

Journal of Advances in Medicine and Medical Research, Page 11-21
DOI: 10.9734/jammr/2022/v34i1631402

Aim and Objective: The present study was done with the aim to compare and adjust the number of occlusal contacts of provisional restoration in centric occlusion using a virtual articulator and functionally generated path technique(FGP). objectives of this study were;1) To assess the number of occlusal contacts of a provisional restoration prepared on a virtual articulator and using FGP technique separately, 2)To compare the number of occlusal contacts of provisional crown fabricated by using virtual articulator and FGP technique. 3)To compare the number of adjustments required to equalise the contacts in provisional restoration made by using virtual articulator and FGP technique in centric occlusion.

Materials and Methods: The study involved Ten patients requiring complete veneers on lower first molars, were selected and given two provisional restorations one fabricated using functionally generated pathway and the other using a virtual articulator.

Results: The mean number of occlusal contacts in FGP at centric after the first four adjustments were 3.9, 5.4, 5.0, 6.6 respectively. The mean number of occlusal contacts in the prosthesis fabricated using virtual articulator at centric after the first four adjustments were 7.0, 9.7, 9.2, 10 respectively. The mean number of occlusal corrections made in FGP at centric was 6.4 and the mean value of occlusal corrections in virtual articulator at centric was 2.7. The mean value of number of occlusal contacts in prosthesis fabricated using FGP technique at eccentric after the first two adjustments were 4.6 and 4.7 respectively where as in the prosthesis fabricated using virtual articulator was 4.4 and 5.3 respectively. The number of occlusal contacts were marginally more in the prosthesis fabricated using virtual articulator than from the prosthesis fabricated using FGP. The mean value of occlusal corrections in FGP at eccentric was 2.7 whereas the mean value of number of occlusal corrections in a prosthesis using a virtual articulator was 1.9. The number of occlusal adjustments in virtual articulator was less in both centric and eccentric than that of FGP proposed by Meyers.

Conclusion: The present study shows that virtual articulator has been deemed better in terms of both patient compliance as well as operator’s ease in delivering of the prosthesis.

Open Access Original Research Article

Urinary CD80 and Serum Soluble Urokinase Plasminogen Activator Receptor (SuPAR) as Novel Diagnostic Biomarkers in Pediatric Patients with Nephrotic Syndrome

Sara Mabrouk Elghoul, Amal Said El-Bendary Saad, Maher Ahmed Abdel-Hafez, Nagi Mohammed Abu El-Hana

Journal of Advances in Medicine and Medical Research, Page 22-30
DOI: 10.9734/jammr/2022/v34i1631403

Background: This study aimed to evaluate urinary CD80 and serum SuPAR in patients with primary nephrotic syndrome as a non-invasive diagnostic biomarker to predict steroid responsiveness in those patients.

Methods: This prospective cohort study was carried out on total 60 children and adolescents with idiopathic nephrotic syndrome (INS) at initial presentation and 30 healthy matched controls. Urinary CD80 and serum SuPAR were measured for all subjects. Patients were divided on follow up into two groups: group A: patients proved to be steroid sensitive nephrotic syndrome (n=30), group B: patients proved to be steroid resistant nephrotic syndrome or proved by biopsy to be focal segmental glomerulosclerosis (n=30).

Results: Urinary CD80 levels were significantly higher in group A than group B and C (P <0.001). SuPAR was significantly higher in group B than group A and C (P <0.001). Both urinary CD80 and serum SuPAR were positively correlated to 24h urinary protein, protein/ creatinine ratio and serum cholesterol (P = 0.001, 0.003, <0.001, <0.001 and <0.001 respectively). Also both urinary CD80 and SuPAR were negatively correlated to albumin (P <0.001 and <0.001 respectively). By ROC curve, urinary CD80 can predict steroid sensitivity with 80% sensitivity, 96.67% specificity and accuracy 95% and serum SuPAR can predict steroid resistance with 76.67% sensitivity, 88.33% specificity and accuracy 86%.

Conclusions: Urinary CD80 and serum SuPAR can be useful in predicting renal pathology or steroid responsiveness in patients with idiopathic nephrotic syndrome especially if renal biopsy is contraindicated.

Open Access Original Research Article

Comparative Study on Hair Transplantation with or without Platelets Rich Plasma Effect in Treatment of Cicatricial Alopecia

Ahmed Youssef Abo Eleneen, Tarek Gamal Shoukr, Ahmed Hassan Nofal, El Sayed Mohamed Abd Elrazik

Journal of Advances in Medicine and Medical Research, Page 31-39
DOI: 10.9734/jammr/2022/v34i1631404

Background and Aim: Scarring is an important clinical problem that occurs because of skin damage. Each year, around 100 million individuals in the Western world develop new scars, some of which pose substantial issues for those who are affected. The purpose of this work was to compare the effect of platelets rich plasma (PRP) on hair transplantation in treatment of cicatricial alopecia

Methods: This randomized control study was performed on 45 cases with 2ry cicatricial alopecia. The alopecic area of each patient was divided into two halves: 1st half (A) [hair transplantation without PRP injection] and 2nd half (B) [hair transplantation after intradermal injection of autologous PRP in recipient site intra-operative and two weeks postoperative]. Each patient was submitted to general examination, local examination of the donor and recipient sites, and laboratory investigations.

Results: Our study suggests that it after hair transplantation is an effective treatment for cicatricial alopecia (CA).

Conclusion: PRP has a high concentration of growth factors such as platelet-derived growth factor, vascular endothelial growth factor, and epidermal growth factor. Our study suggests that PRP is an effective treatment for CA.

Open Access Original Research Article

Assessment of the Woundy Healing Activity of the Aqueous Extract of Leaves of Diospyros hoyleana (F.) White (Ebenaceae)

Simone Veronique Fannang, Antoine Vayaraï Manaoda, François Eya’ane Meva, Gisele Etame Loe, Benoit Deschamps Mbida Mvomo, Jacques Yinyang, Jean pierre Ngene

Journal of Advances in Medicine and Medical Research, Page 40-51
DOI: 10.9734/jammr/2022/v34i1631406

Wounds are an extremely common reason for consultation in emergency departments. They mostly result from traffic accidents but also of different traumatisms. Their healing is possible thanks to a natural, spontaneous and coordinated process set up by the body. This process can be accelerated by the use of synthetic, biosynthetic or natural healing agents. Indeed, many medicinal plants are endowed with healing properties such as Diospyros hoyleana F. White, whose leaves help in the management of wounds. The present study consists in carrying out a phytochemical screening, evaluating the acute toxicity (oral and cutaneous) and determining the healing activity of the aqueous extract of Diospyros hoyleana leaves in comparison with that of BIAFINE®.

A phytochemical screening was carried out in order to highlight the presence of secondary metabolites responsible for the healing activity. Acute oral and cutaneous toxicity tests were carried out on different batches of rats. Subsequently, the evaluation of the healing activity by induction of traumatic lesions on batches of rats was made. The evolution of wounds of the different batches was compared on the one hand by calibrated photography and on the other hand by histological analysis.

At the end of this study, the results show that the aqueous extract of Diospyros hoyleana leaves has a healing activity with a healing profile at doses of 100 and 200 mg/kg similar to that of BIAFINE.

The aqueous extract of Diospyros hoyleana leaves has healing activity with a healing profile similar to that of trolamine at doses of 100 mg/kg and 200 mg/kg. Flavonoids or tannins could be responsible for this activity.

Open Access Original Research Article

Study of Some Hematological Markers of Systemic Inflammatory Response in Preeclampsia

Ayman M. Abd-Elaziz, Heba R. Elbasyuony, Maaly M. Mabrouk, Magdy H. Balaha

Journal of Advances in Medicine and Medical Research, Page 52-62
DOI: 10.9734/jammr/2022/v34i1631407

Background: Preeclampsia is one of the major health problems during pregnancy, which is characterized by hypertension, proteinuria, and features of multi-organ disease, and it complicates about 2 to 8% of pregnancies with increased maternal and neonatal morbidity and mortality, aim of this study was to evaluate the following blood markers in preeclampsia; neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, red cell distribution width, mean platelet volume and platelet value.

Subjects and Methods: This was diagnostic research, observational method and cross-sectional design that was conducted at Obstetrics and Gynecology Department, Tanta University Hospitals, from 1-7-2020 to 1-11-2021. After fulfilling the Research and Ethics Committee guidelines, pregnant women were counseled to be enrolled in this study.

Results: There was significant decrease in PLR in severe preeclampsia group compared to control group (P<0.001) as well as mild preeclampsia group (P<0.001); while there was no statistically significant difference between control group and mild preeclampsia group (P>0.05). There was significant elevation in RDW in severe preeclampsia group compared to control group (P=0.005) as well as mild preeclampsia group (P<0.001); There was significant reduction in MPV in severe preeclampsia group compared to mild preeclampsia group (P<0.001) as well as control group (P<0.001); while there was no statistically significant difference between mild preeclampsia group and control group (P>0.05). There was significant decrease in PCT in severe preeclampsia group compared to control group (P=0.034) as well as mild preeclampsia group (P=0.009); while there was no statistically significant difference between control group and mild preeclampsia group (P>0.05).

Conclusion: In differentiation of preeclampsia, the highest sensitivity was achieved with MPV, while the highest specificity was achieved with PLR. In the differentiation of severe preeclamptic cases, the highest sensitivity was achieved with lymphocytes and MPV, while the highest specificity was achieved with PLR.

Open Access Original Research Article

Indications and Clinical Utility of Cardiac Biomarkers in the Emergency Room of a Nigerian Tertiary Hospital

Adeola O. Ajibare, Oluseye O. Oladimeji, Phillip A. Adebola, Akinola O. Dada, Sunday O. Ogundele, Folasade A. Daniel, Olatunde P. Olabode, Adeyemi O. Dada, Ehimen Okogun, Adebowale O. Adekoya, Ramon A. Moronkola, Oluwaseun O Okunuga

Journal of Advances in Medicine and Medical Research, Page 63-70
DOI: 10.9734/jammr/2022/v34i1631408

Background: The prevalence of acute coronary syndrome (ACS) in Nigeria is on the rise with dire morbidity and mortality risks. Cardiac biomarkers are rapid and sensitive tools used as adjunct in the diagnosis of ACS. The clinical utility of cardiac biomarkers is yet to be well explored in Nigerian setting.

Objectives: To determine the indications and clinical utility of cardiac biomarkers as well as their electrocardiographic (ECG) changes.

Methods: This study is a retrospective review of all patients who had point-of-care serum Troponin-I, Creatine kinase MB isoenzyme and myoglobin done at the medical emergency department of LASUTH over a three year period (January 2017 to December 2019). Their records were retrieved; demographics, indications for testing and ECG findings were recorded. Data was analyzed using SPSS version 20.0 software.

Results: 593 tests were done in the 3 years period of study. Only 397 patients had complete records. 48.6% were male. The mean age of the study population was 55.02 + 16.64 years (range 13-94 years). Chest pain was the commonest indication for test (91%). Other indications are loss of consciousness, palpitations, seizures and unexplained dyspnea.  Mean duration of chest pain prior to presentation was 9 days. 16.1% (64 patients) of patients tested had elevated cardiac biomarkers and 87.5% of those with elevated cardiac biomarkers had abnormal ECG suggestive of ACS.

Conclusion: This study showed that cardiac biomarker is an important point-of-care test in the evaluation of chest pain. Cardiac biomarkers should therefore be a routine test in the emergency room.