Journal of Advances in Medicine and Medical Research <p style="text-align: justify;"><strong>Journal of Advances in Medicine and Medical Research (ISSN:&nbsp;2456-8899)</strong> aims to publish research papers, reviews and short communications in the areas of medicine and medical research.&nbsp; JAMMR will not only publish traditional full research reports, including short communications, but also this journal will publish reports/articles on all stages of the research process like study protocols, pilot studies and pre-protocols. JAMMR is novelty attracting, open minded, peer-reviewed medical periodical, designed to serve as a perfectly new platform for both mainstream and new ground shaking works as long as they are technically correct and scientifically motivated.&nbsp;The journal also encourages the submission of useful reports of negative results. This is a quality controlled,&nbsp;OPEN&nbsp;peer reviewed, open access INTERNATIONAL journal.</p> en-US (Journal of Advances in Medicine and Medical Research) (Journal of Advances in Medicine and Medical Research) Wed, 28 Apr 2021 09:17:23 +0000 OJS 60 Unusual Adult Bilateral Osteochondroma of the Talus with Severe Peroneal Tendinitis and Adult Bilateral Osteochondroma of Calcaneum with Haglund Syndrome – A Report of Two Cases and Review of Literature <p>We present two unusual cases of bilateral osteochondroma around the foot and ankle. The first case of a bilateral osteochondroma of the talus that presented with peroneal tendinitis and second of a case that presented as bilateral Haglund syndrome secondary to osteochondroma of the calcaneum. Both cases presented with an increase in size of the swelling in the sixth decade of life. This unusual presentation and bilaterality has not been reported in the literature.</p> A. Raviraj, Manish Samson, K. Abhishek Sugumar, Vidyasagar Maalepati ##submission.copyrightStatement## Tue, 04 May 2021 00:00:00 +0000 Techniques for Preservation of Post-extraction Alveolar Bone Loss: A Literature Review <p>Sequelae to too the extraction includes progressive loss in the vertical and horizontal dimension of alveolar ridge. These lead to changes in the alveolar process in a 3 dimensional fashion causing hard and soft tissue deficiency which may affect the ability to restore the site. Preservation of the alveolar crest after tooth extraction is essential to maintain the vertical and horizontal dimensions of the alveolar ridge. Several techniques and materials have been introduced to minimize crestal bone loss. There is a broad consensus that ridge preservation procedures are efficient in limiting the post extraction dimensional loss of the ridge. However, the key to successful outcome is proper treatment planning according to the case and prognosis.</p> <p><strong>Conclusion:</strong> The aim of this literature review is to discuss the several bone preservation techniques and materials to minimize post-extraction loss of hard and soft tissues.</p> Shejali Jana, Rucha Shah, Raison Thomas, A. B. Tarun Kumar, D. S. Mehta ##submission.copyrightStatement## Fri, 30 Apr 2021 00:00:00 +0000 The Malaria-Poverty Dilemma in Peri-Urban University Communities in Eastern Uganda <p><strong>Introduction:</strong> Malaria remains the world’s leading vector-born cause of mortality and morbidity, and Eastern Uganda contains some of the country’s highest prevalence rates. Though academic societies, such as universities, may be prone to high malaria transmission, the extent of the burden and risk factors in university communities of Eastern Uganda are poorly understood. The aim in this study was to examine malaria prevalence, preventive strategies, and risk factors, among University communities in Eastern Uganda; to inform targeted malaria eradication efforts in academic settings.</p> <p><strong>Methods:</strong> A mixed methods approach was applied. A case study of Islamic University in Uganda (IUIU), located in Eastern Uganda, was selected. A retrospective approach was used to determine malaria prevalence in IUIU from August to December 2019. Stratified random sampling was used to select IUIU community members; these were subjected to semi-structured questionnaires and Key informant Interviews (KII) to examine the preventive approaches and risk factors. An observational survey was also conducted to identify barriers to malaria prevention. Data was analyzed using descriptive statistics, graphs, Chi-square, and pictures; with STATA version-<strong>15.0</strong>.&nbsp;</p> <p><strong>Results:</strong> The study involved 255 respondents (204, 80% students, 51, 20% staff); 130, 51% were males, 125, 49% were females. Malaria prevalence was; 12.9%, 11.7% and 12.7% for students, staff, and the general study population respectively. Lowest prevalence was registered in November (8.3% for students, 0% for staff), and the highest in December (18.4% for students, 6.7% for staff). Overall malaria prevalence in IUIU was significantly greater than Uganda’s national prevalence (χ<sup>2</sup><strong>=</strong>182.009; p&lt;0.0001; 95%CI). The commonest intervention was, sleeping under insecticide-treated mosquito-nets (96%), and the rarest was usage of medicinal herbs (15%). Though 41 (17.5%) of respondents who used mosquito-nets never suffered malaria, usage of mosquito-nets was not significantly associated with absence of malaria infection (p = 0.83). The same applied for other interventions except timely testing and treatment (p = 0.02). Most frequently mentioned risk factors were; improper use of mosquito nets (214, 84%), inappropriate depositing of garbage (196, 77%), and “staying out late” (133, 52%). Key barriers to malaria prevention observed were; usage of damaged bed nets (38, 19% of 198), clogged trenches with liquid wastes, and perforated wire meshes in ventilators.</p> <p><strong>Conclusion: </strong>The overall prevalence of malaria in IUIU community was 12.7%; and was significantly higher than Uganda’s national prevalence (7%). Usage of insecticide-treated bed-nets was the commonest intervention, but showed no statistically significant association with malaria non-prevalence.Awareness programs should be enhanced to address inappropriate use of malaria control methods/tools, because the widespread adoption of these interventions alone did not effectively curb the burden.</p> Abdishakur E. Warsame, Jamilu E. Ssenku, Joseph L. Mpagi, Stanley J. Iramiot, Shaban A. Okurut, Ali Kudamba, Mujibu Nkambo, Aidah Namuli, Joweria Nakizito, George Gidudu, Hawa Nabuuma, Hussein M. Kafeero, Sarah Nachuha, Abdul Walusansa ##submission.copyrightStatement## Wed, 28 Apr 2021 09:19:31 +0000 Age at Menarche, Menstrual Characteristics and Associated Factors among Adolescent Girls in Indigenous Population in Niger Delta Region, Nigeria <p><strong>Aim:</strong>Age atmenarchevaries among different populations, and isdependent on interaction between genetic and environmental factors. The aim of this study was to determine the age at menarche, menstrual characteristics and associated factors among adolescent girls in indigenous population in Niger Delta region, Nigeria.</p> <p><strong>Study Design: </strong>A cross-sectional study on 903 adolescent school girls from 6 secondary schools in Rivers state selected by multi-staged random sampling technique.</p> <p><strong>Place and Duration of Study: </strong>Indigenous ethnic populations in urban and rural (coastal rural and upland rural) areas in Rivers state were surveyed between April and June 2019.</p> <p><strong>Methodology</strong><strong>:</strong> Data collected with questionnaire: menarcheal age, menstrual and demographic characteristics of participants.</p> <p><strong>Results: </strong>Age at menarche was12.10±1.37years, while urban area had11.62±0.13, coastal rural (11.69±0.04) and upland rural (13.24±0.10) years;with early menarche (10%) and delayed menarche (5%). Geographical area, ethnicity and fathers’ occupation significantly (P=0.001) influenced menarcheal age; with Ethnic groups: Ekpeye (12.96±1.36) &gt;Ogoni (12.89±0.71) &gt;Ikwerre (12.43±1.72) &gt;Kalabari (11.69±0.99); Fathers’ occupation: Professionals/public servants (11.82±1.14) and fishing (11.75±0.94) &lt; artisans/traders (12.02±1.36) and farming (12.69±1.45). Menstrual cycle length (days), was 28.04±1.57 (21-35), with majority (91.50%) having 26-30 days; and significantly different among geographical area (P=0.003), and ethnicity (P=0.001). Menstrual bleeding duration (days) was 4.55±1.03 (2-7), with majority (72.1%) having 4-5 days;and is statistically different according to geographical areas (P=0.001), ethnicity (P=0.001), and fathers’ occupation (P=0.14). Dysmenorrhoea was experienced by majority (56.6%) of subjects, and associated with increase in menarcheal age (P=0.01) and menstrual cycle length (P=0.001).</p> <p><strong>Conclusion:</strong> This study shows a low age at menarche, with earlier onset in urban and coastal rural areas than in upland rural areas. Ethnicity and geographical area, strongly influenced the menarcheal age and menstrual characteristics of subjects.</p> Ologhaguo M. Adienbo, Victoria T. Erigbali ##submission.copyrightStatement## Wed, 28 Apr 2021 00:00:00 +0000 Evaluation of Sarcopenia by Ultrasound of the Rectus Femoris Muscle as a Predictor of Outcomes of Surgical Intensive Care Unit Patients, A Prospective, Observational Study <p><strong>Background: </strong>Muscle wasting is a frequent finding in critically ill patients and is associated with worse short- and long term outcomes. Loss of mass and function of skeletal muscles starts early - in the first 24 hours after admission to Intensive Care Unit (ICU) - and may persist for years ‘Post-ICU syndrome’. Ultrasound of rectus femoris muscle is a valid and simple technique that could be used for longitudinal assessment of treatment success and facilitates the use of postoperative interventions that help in problems related to critical illness. The aim of this study is to evaluate sarcopenia by ultrasound of rectus femoris muscle as a predictor of outcomes of surgical intensive care unit.</p> <p><strong>Materials and Methods:</strong> This prospective observational study was performed on 40 patients admitted to the surgical ICU, Tanta University Hospitals, Egypt, after approval of the Institutional Ethical Committee, Tanta University. The study started from April 2019 till January 2020. An informed consent was taken from the nearest relatives of the patients. All data of the patients was confidential with secret codes and private files for each patient. All given data was used for the current medical research only. Any unexpected risks appeared during the course of the research were cleared to the participants and ethical committee at time.</p> <p><strong>Results</strong><strong>:</strong> Cross-sectional area of rectus femoris muscle decreased significantly at all-time measurements as compared to the baseline at day 0 (within 24 hours from SICU admission), 5, 10, 15, 20, 25 and 30. There were negative correlations between delta cross-sectional area of rectus femoris muscle and age, height, weight, Body Mass Index and baseline cross-sectional area of rectus femoris muscle. There was a positive correlation between delta cross-sectional area of rectus femoris muscle and duration of mechanical ventilation, ICU length of stay and mortality.</p> <p><strong>Conclusion</strong><strong>:</strong> Rectus femoris cross-sectional area measured by B-mode ultrasonography showed significant role in nutritional assessment as it decreases in critically ill patients with positive correlation with duration of mechanical ventilation and ICU stay.</p> Aya Hassan Hegazy, Mohammad Samir Abd El-Ghafar, Nagat Sayed El-shmaa, Sohair Moustafa Soliman ##submission.copyrightStatement## Fri, 30 Apr 2021 00:00:00 +0000 Pattern and Outcome Dermatological Admission at the University of Port Harcourt Teaching Hospital Rivers State <p><strong>Introduction:</strong> Dermatology is primarily an outpatient clinical and surgical subspecialty, but a substantial number of patients need in patient care for adequate management. In recent years, there is a rise in the number of inpatient dermatological admissions and an increase in spending. Rarely, skin diseases can be fatal.</p> <p><strong>Aims and Objectives: </strong>To analyze the disease patterns and clinical outcomes of dermatological patients admitted on the medical wards of a tertiary institution in southern &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Nigeria.</p> <p><strong>Materials and Methods: </strong>This study involves a retrospective analysis of the admission records of consecutive in <em>patients with a dermatological diagnosis admitted at the university of Port Harcourt</em> teaching hospital from January 2014 to July 2020. The data obtained were statistically analysed with emphasis on the patient’s demographic profile, clinical diagnosis, final outcome, and duration of admission.</p> <p><strong>Results: </strong>A total of 68 patients were admitted into our center during this time. Female outnumbered males with male female ratio of 1: 2.2. Infections (53 patients, 77.9%) were the most frequent reason for admission, followed by autoimmune disorders (5 patients, 7.4%), inflammatory causes, drug reactions and cutaneous manifestation of inter diseases had 3 patients each (4.4%). A patient was classed as idiopathic (1.5%).</p> D. Altraide Dasetima, Otike-Odibi Bolaji ##submission.copyrightStatement## Fri, 30 Apr 2021 00:00:00 +0000 Frequency and Determinants of Tongue Lesions among Patients Reported in a Teaching Institute: A Cross-Sectional Study <p><strong>Aims: </strong>The purpose of the study is to evaluate the frequency, distribution and determinants of tongue lesions in our teaching institute. Also to find an association of common tongue lesions with various study variables.</p> <p><strong>Study Design:</strong> Cross-sectional study design.</p> <p><strong>Place and Duration of Study:</strong> The study was conducted at Fatima Jinnah Dental College &amp; Hospital, Karachi, Pakistan. All the lesions presented on the tongue were included reported from January 2017 to December 2020.</p> <p><strong>Methodology: </strong>There were 670 oral lesions documented in the Department of Oral Pathology and Oral Medicine out of which 93 (13.8%) represented tongue lesions. We included 93 patients with tongue lesions (45 men, 48 women; age range 18-80 years). These lesions include the atrophic tongue, geographic tongue, candidiasis, keratotic lesion, ulceration, oral pigmentation, fibroma, black hairy tongue, traumatic neuroma, herpes infection, oral submucous fibrosis, and oral squamous cell carcinoma.</p> <p><strong>Results:</strong> In the study, common clinical presentations on the tongue were ulceration (29%), erythematous/depapillated tongue (22.6%), white keratotic and plaque-like lesions (21.6%), and black discoloration (8.6%). The clinical presentation was statistically associated with gender (p=0.03), age (p=0.04) and site of lesion (p&lt;.001). Atrophic glossitis (19.4%), traumatic ulcer (12.9%), pseudomembranous candidiasis (12.9%), oral pigmentation (8.6%), oral squamous cell carcinoma (7.5%), geographic tongue (6.5%), recurrent aphthous stomatitis (6.5%), and frictional keratosis (6.5%) were most commonly reported tongue lesions. There was a relationship of tongue lesions with causes and site of the lesion (P&lt;0.001).</p> <p><strong>Conclusion:</strong> Initial tongue lesions may reflect underlying massive abnormal changes and this could be an early diagnostic parameter.&nbsp; Through vigilant screening of the oral mucosa, we may be able to detect such mucosal alterations and search out the possible cause in order to provide effective treatment to the patient. In this way, we may also prevent the malignant transformation of any susceptible oral lesions.</p> Mehwish Feroz Ali, Gulrukh Askary, Shahrukh Saran, Adnan Zaidi, Farwa Sajjad, Hussain Askary ##submission.copyrightStatement## Fri, 30 Apr 2021 00:00:00 +0000 Assessment of Sub-endometrial Blood Flow Parameters Following Oral Dydrogesterone versus Micronized Vaginal Progesterone in Women with Idiopathic Recurrent Miscarriage <p><strong>Background:</strong> Recurrent pregnancy loss is an important reproductive health issue, affecting 2%–5% of couples. An unsupportive endometrium, leading to abnormal implantation, is considered to be one of the key factors contributing to idiopathic recurrent spontaneous miscarriage (IRSM). The aim of this work was to evaluate differences in uteroplacental blood flow and pregnancy outcome in women with idiopathic recurrent spontaneous miscarriage (IRSM) following administration of micronized vaginal progesterone versus oral dydrogesteron.</p> <p><strong>Materials and Methods: </strong>This prospective, randomized-controlled study comprised 90 pregnant women who came to outpatient clinic of obstetrics&nbsp; .All women had a singleton pregnancy with active cardiac pulsations at gestational age between 5-8 weeks Pregnant women in the study group were randomly distributed into: Group {A}: 30 pregnant women received 10 mg of oral dydrogesterone (Duphaston; Abbott Company) twice daily.Group {B}: 30 pregnant women received 200 mg micronized vaginal progesterone (Prontogest) twice-daily. Control group:30 pregnant women without history of recurrent miscarriage served as controls and they received folic acid as placebo.</p> <p><strong>Results:</strong> comparing the Doppler indices before progesterone supplementation, the mean resistance index (RI) was statistically significant less in the control group compared with both study groups (A&amp;B) (P=0.012, P=0.005 respectively) .Moreover, pulsatility index (PI) was statistically significant less in the control group compared with both study groups (A&amp;B) (P=0.026, P=0.05 respectively) .Paralleled to that, the S/D ratio was statistically significant less in control group compared with both group A &amp;B (P=0.43, &amp; P=0.019respectively) .In addition, the mean PSV was significantly higher in control group&nbsp; compared to group B (P=0.047) and was higher in control group than group A with nearly significant P value.</p> <p><strong>Conclusion: </strong>Considerable improvement in uteroplacental blood flow parameters of pregnant women with IRSM is evident with progesterone supplementation.</p> Magda I. Nasr, Mona K. Omar, Walid M. Ataallah, Amal E. Mahfouz ##submission.copyrightStatement## Tue, 04 May 2021 00:00:00 +0000 Glycemic Parameters in Relation to Pulse Pressure in Patients with Type 2 Diabetes Mellitus <p><strong>Aims:</strong> Pulse pressure (PP) is determined by the complex relationship between stroke volume of the heart, aortic elasticity and peripheral vascular resistance. PP has been considered an independent risk factor for cardiovascular mortality of normotensive and hypertensive individuals. The aim of this study was to determine the prevalence of hypertension (HT) in patients with Type 2 diabetes mellitus (DM) and to evaluate the relationship between glycemic parameters and PP.</p> <p><strong>Methodology</strong><strong>:</strong> A total of 422 patients with type 2 DM, mean age 58.0±13.2 years, were included in the study. Data on patient demographics, blood pressure and PP readings ​​were recorded in each patient as were the glycemic parameters including fasting blood glucose (FBG), postprandial blood glucose (PPBG) and HbA1c. Glycemic parameters were also evaluated with respect to PP groups. The patients were divided into 4 groups according to the PP readings including group 1 (PP ≤45 mmHg), group 2 (PP:46-54 mmHg), group 3 (PP:55-64 mmHg) and group 4 (PP ≥65 mmHg).</p> <p><strong>Results:</strong> Hypertension was evident in 79.6% of patients. Mean PP was 55.3±12.5mmHg. While group 1 and 2 were similar in terms of glycemic parameters, FBG (p=0.026), PPBG (<em>p</em>=0.019) and HbA1c (%) (<em>p</em>=0.004) were significantly lower than group 3 and group 4 (<em>p</em>&lt; .05).</p> <p><strong>Conclusions:</strong> Our findings revealed HT at a high frequency of 79.6% in patients with Type 2 DM. Significant highest values were found for FBG, PPBG and HbA1c in high PP patients. These results may be associated with increased cardiovascular risk in patients with poor glycemic control with Type 2 DM and high PP. In order to reduce the pulse pressure in diabetic patients, it will be appropriate to keep blood pressure at target values besides strict blood glycemic control.</p> Seydahmet Akin, Zeki Aydin, Ozlem Cakir Acikgoz, Necmi Eren, Engin Ersin Simsek ##submission.copyrightStatement## Wed, 05 May 2021 00:00:00 +0000 Syphilis Seroprevalence among Blood Donors at the Chad National Blood Transfusion Center in N’Djamena <p>This involves evaluating the risk of syphilis transfusion in blood donors having a reaction to the group antigen and confirming positive or negative by the treponemal test.</p> <p>From August 2019 to August 2020, an observational study of syphilitic markers was conducted with blood donors (replacement families and volunteers non-remunerated) at the Center National de Transfusion Sanguine de N’Djamena. The donors included were also tested negative for the markers (HBsAg, Ab anti HCV, Ag /Ab HIV) according to standard methods of clinical microbiology.</p> <p>During one year, 24587 donors were identified of which 654 (2.65%) were confirmed positive by the treponemal test. Different positive rates of syphilis were determined in family replacement donors (94%), voluntary non-remunerated donors (6.12%), male (86%) and female (13%) respectively.</p> <p>This study determined a level of specific antigen for syphilis in a study population that reacted positively to the non-treponemal test.</p> <p>In view of this result, we recommend screening with the treponemal test in any blood donor having a reaction with a non-treponemal test in order to minimize the residual risk of transmission of syphilis among blood donors in Chad.</p> Mbanga Djimadoum, Bessimbaye Nadlaou, Ali Mahamat Moussa, Abba Alifa Mahamat, Soureya Zakaria, Brahim Boy Otchom ##submission.copyrightStatement## Fri, 07 May 2021 00:00:00 +0000 Assessment of in Obsessive Compulsive Disorder <p><strong>Background: </strong>Obsessive compulsive disorder (OCD) is a common and potentially debilitating disorder. Neuropsychological assessment provides unique complementary information that is critical for evaluating higher cortical abilities. This study aimed to assess the neuropsychological functions in OCD patients which can then point to the brain structures or pathways and to study the correlation between these assessments and different clinical variables.</p> <p><strong>Methods: </strong>This cross-sectional case control study had included sixty patients who were divided into two groups, Group I: thirty OCD patients diagnosed by DSM-IV and Group II: thirty healthy controls who were recruited from the community, matched with patients’ age, gender, and education.</p> <p><strong>Results: </strong>The age of onset in our study was 19.13 ± 0.35 years, the mean duration was 7.44 ± 3.88 years, 40% of the studied cases had severe OCD symptoms and 33.3% of them were compulsive cleaners. There was a high significant difference between the two groups regarding WCST in favor of the control group. There was a high significant difference between the two groups regarding ROCF where the control group showed better results than the OCD patients.</p> <p><strong>Conclusions: </strong>Neuropsychological test performance remains an informative and objective means of investigation, especially when applied to psychiatric disorders. The executive functions in OCD patients were impaired in comparison to the normal study subjects.</p> Sarah Alaa Mohsen, Fatma Ahmed El Deeb, Ehab Sayed Ramadan, Mai Abd El-Raouf Eissa ##submission.copyrightStatement## Sat, 08 May 2021 00:00:00 +0000 Health Complications in Patients Recovering from COVID-19: A Narrative Review of Post-COVID Syndrome <p><strong>Introduction:</strong> Due to the unprecedented health and economic complications resulting from COVID-19, the coronavirus pandemic is currently a leading global health concern. COVID-19 poses significant health risks, life-threatening clinical conditions, and even mortality in affected individuals. Several associated complications have also arisen as a result of COVID-19, including mass hospitalization, the need for invasive ventilation and intensive care unit (ICU) support, delayed recovery from infection, and post-recovery health issues. Furthermore, the pandemic itself has created enormous panic, which in turn affects the mental health of COVID-19 patients, individuals who have recovered from the disease, and the general population.</p> <p>Just over a year has now passed since the beginning of the global COVID-19 pandemic and in this time, over 110 million individuals have been infected worldwide. Post-infection recovery times and long-term complications are now becoming more apparent. Especially physical and mental health complications arising from post-COVID-19-infection, which prevent a return to a healthy lifestyle and everyday routine remain a critical issue.</p> <p><strong>Objective:</strong> The primary objective of this narrative review is to address this clinically relevant issue and overview the health complications commonly observed in individuals who have recovered from COVID-19.</p> <p><strong>Methods: </strong>An investigation was performed on online databases for relevant articles from 2020 until January 2021. Key index words used in search were post-covid, myalgia, fatigue, pain.</p> <p><strong>Results:</strong> Fatigue, myalgia (i.e., muscle pain), sleep disruptions, and mental health issues (e.g., anxiety and depression) are among the most reported post-recovery symptoms in patients recovering from the disease. The etiology and potential management of these health complications are discussed, considering recently published findings from COVID-19 patients as well as previous studies focusing on complications arising from other related pandemics.</p> <p><strong>Conclusion:</strong> Patients who have recovered from COVID-19 should be evaluated for signs of fatigue, muscle pain, mental health difficulties, and sleeping difficulties regardless of disease severity. Based on this review of the literature, complete clinical and psychiatric evaluation, and the use of validated indicators of the severity of COVID-19 disease, symptoms are recommended to develop efficient health management approaches that meet patients' needs.</p> Marcus Yu Bin Pai, Andrew Seung Ho Park, Bruno Fu Lon Chen, Juliana Takiguti Toma, Hong Jin Pai ##submission.copyrightStatement## Sat, 08 May 2021 00:00:00 +0000