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) Tue, 23 Feb 2021 12:04:06 +0000 OJS 60 Outcome of Free Medial Sural Artery Perforator Flap (MSAP) for Head and Neck Reconstruction: A Systematic Review and Met Analysis <p><strong>Introduction:</strong> Since first described by Cadavas, A free medial sural artery perforator flap (MSAP) is getting popularity day by day. Specially, where the micro surgeons are desired to have thin, pliable flap with long pedicle and less donor site morbidities. For its above-mentioned characteristics and good outcome, it is now considered as one of the workhorse flaps for head and neck reconstruction.</p> <p><strong>Aims and Objectives: </strong>The aim was to find out the feasibilities and versatilities of this flap as workhorse in head and neck reconstruction. As well as taking into consideration of its low donor site morbidities.</p> <p><strong>Methods:</strong> A literature search has been performed in July 2020 in various data base including Pub Med, Trip database, Medline and Google Scholler to find out the outcome of head and neck reconstruction with free MSAP Flap. Data then were tabulated and analysed using Microsoft Excel datasheet.</p> <p><strong>Results:</strong> The results were promising. Overall, flap survival rate was 95%. Mean flap dimension was 9.3 cm x5.5 cm. Average pedicle length was 10.5 cm. Mean flap thickness was 6mm. Overall complication rate was 16% including 6% wound related and 2% donor site complication. Most of the cases donor site have closed directly (87%).</p> <p><strong>Conclusion:</strong> Free MSAP Flap is an ideal workhorse flap for head and neck reconstruction. However, as most of the literatures were case series or personal experiences of surgeons, a multicentre trial with large sample can give us more information.</p> M. M. Hosain ##submission.copyrightStatement## Tue, 23 Feb 2021 00:00:00 +0000 Evaluation of Local Corticosteroids Injection in Treatment of Carpal Tunnel Syndrome <p><strong>Background: </strong>Carpal tunnel syndrome is the most common type of peripheral nerve entrapment; it affects females more than males; it may be idiopathic or secondary to other disorders especially diabetes mellitus. Carpal tunnel syndrome mostly affects manual workers and may be bilateral or unilateral and mainly affects the dominant hand. Carpal tunnel syndrome has characteristic symptoms and signs including paresthesia and pain along median nerve distribution, these symptoms are usually accompanied by positive provocative tests. Electrodiagnostic studies remain the cornerstone in the diagnosis of CTS. Carpal tunnel syndrome can be treated conservatively by activities of daily living instructions, splints, medical treatments as neurotropic drugs and NSAIDs and local steroid injection. Also, it can be treated by surgical decompression in severe cases.</p> <p><strong>Aims: </strong>The aim of this study was to evaluate local steroid injection in the treatment of CTS. Twenty-one patients with mild and moderate CTS were included in this study.</p> <p><strong>Patients and Methods:</strong> This was a prospective study included 21 patients with symptoms and signs of mild to moderate CTS attending the outpatient clinic of orthopedic Department, Tanta University Hospitals in the period between February 2019- January 2020. 1 ml Triamcinolone was used with 2 ml lidocaine. Patient’ hand was rested on towel roll flexed about 30 to 45 degrees and injection was done according to landmarks. Night splint was described for 3 days after injection.</p> <p><strong>Results: </strong>In regards to clinical assessment; there was a significant clinical improvement after injection and follow-up period as compared to before injection. In regards to electrophysiological assessment; there was a significant improvement in NCS after injection.</p> <p><strong>Conclusion: </strong>Local steroid injection is an effective treatment and recommended as a therapeutic tool in the management of idiopathic mild to moderate CTS.</p> Mostafa Fersan Sallam, Nabil Omar Gharbo, Muhammed Abd Elmoneam Quolquela, Mohammed Osama Ramadan ##submission.copyrightStatement## Tue, 23 Feb 2021 00:00:00 +0000 An Up to Date Guideline for Management and Prevention of Dog and Cat Bite – A Literature Review <p><strong>Background: </strong>The prevalence of animal bites is high, of which the vast majority are from cats’ and dogs’. There is a wide variation in severity of such bites from mild to lethal. The evidence in the literature with respect to management does not provide a solid ground on which such cases could be managed. Dog and Cat bites are more common and can have dramatic consequences especially for children.</p> <p><strong>Objective: </strong>This project is to identify current evidence in the literature on epidemiology, management and prevention of dog and cat bites. This review is aimed at clinicians who deal with dog and cat bites. The basic principles of wound management and indications for use of antimicrobials, tetanus and rabies prophylaxis as well as preventive education are the primary focus of this article to help the clinicians. This aims at updating the management of patients who sustain a dog or a cat bite.</p> <p><strong>Materials and Methods: </strong>A literature review on the management of animal bites was performed. UK NICE guidelines, University of Texas bites management guidelines, WHO rabies prophylaxis protocol, UK Green Book and infectious diseases text books also reviewed.</p> <p><strong>Results: </strong>The available data in the literature suggest that appropriate wound management is the most important factor for prevention of infection in dog and cat bites. Antibiotic prophylaxis should only be given in high-risk wounds and primary closure should be performed in low-risk wounds.</p> <p><strong>Conclusions: </strong>Proper assessment and wound care are the prime consideration for dog and cat bites management.</p> M. M. Hosain, M. T. Mohamed, A. Siddiqui ##submission.copyrightStatement## Tue, 23 Feb 2021 00:00:00 +0000 Phytochemical Evaluation and Anti-Diabetic Effects of Ethanolic Leaf Extract of Petersianthus macrocarpus on Streptozotocin-Induced Diabetic Rats <p><strong>Aim:</strong> The purpose of this study was to evaluate the antidiabetic effect of ethanolic extracts of <em>Petersianthus macrocarpus</em> leaf and its phytochemical analysis using different solvents.</p> <p><strong>Place and Duration of Study:</strong> The study was carried out between March and September in 2018 in the Department of Anatomy, Madonna University, Elele. River State, Nigeria.</p> <p><strong>Materials and Methods:</strong> Twenty five Wistar rats, weighing between 200-225g were divided into five groups of five rats.&nbsp; Group A (Control) while Groups B, C, D and E were induced with diabetes using streptozotocin firstly 35mg/kg b.w; and 2 weeks later 25mg/kg b.w.&nbsp; Group B (Diabetic control), Group C received 0.5mg/kg b.w of Glibenclamide. Groups D and E received daily 50 and 100 mg/kg b.w of ethanolic leaf extract of <em>P. macrocarpus</em> orally for two weeks. The fasting blood glucose levels were determined weekly for two weeks. At the end of the experiment, the animals were sacrificed and the pancreas was removed for histological procedures.</p> <p><strong>Results:</strong> The body weights&nbsp;increased significantly (P&lt;0.05) in 100 mg/kg b.w group when compared to the diabetic control rats weight at the end of the experiment. Also there was a significantly decreased (P&lt;0.05) in blood glucose levels in <em>P. macrocarpus</em> (100mg/kg b.w). The histological section of the pancreas of diabetic control showed eosinophilic material in the islet, shrinkage of the islet of Langerhans while the group treated with 100 mg/kg of extract showed granulated and well prominent pancreatic islet of Langerhans. Phytochemical screening showed methanolic extract of <em>P. macrocarpus</em> leaf having alkaloid, saponin, tannin, phenol, flavonoid, cardiac glycoside, steroids, terpenoids, anthocyanin and anthraquinone. However, cardiac glycosides and steroids were absent in ethanolic extract. Cardiac glycoside and terpenoids were also absent in hexane and acetone extract, while phenol, cardiac glycosides, steroids and anthrocyanin were absent in the water extract.</p> <p><strong>Conclusion:</strong> Ethanolic leaf extract of <em>P. macrocarpus </em>ameliorate streptozotocin-induced diabetes in Wistar rats.</p> Aligwekwe A. Ugochukwu, Idaguko C. Anna ##submission.copyrightStatement## Wed, 24 Feb 2021 00:00:00 +0000 Fear, Psychosomatic Symptoms and Satisfaction of Primary Healthcare Workers during the First Wave of COVID-19 Pandemic in Rivers State Nigeria: A Descriptive Cross-sectional Study <p><strong>Introduction: </strong>Since the onset of COVID-19 pandemic there has been concerns about the imminent collapse of the health system if healthcare workers are physically, mentally, and socially affected to the point where service delivery is compromised. Therefore, this study investigated the fear, psychosomatic symptoms, and satisfaction of the Primary Healthcare Workers (PHCWs) during the first wave of the COVID-19 pandemic in Rivers State Nigeria.</p> <p><strong>Methods:</strong> A facility cross-sectional survey was conducted involving the primary healthcare workers. Descriptive analysis of mean with standard deviation were reported for continuous variables, frequency and percentage were used to report categorical variables.</p> <p><strong>Results:</strong> A total of 412 PHCWs participated in the study (mean age: 39.5±7.5). 223 (54.4%) were sure of going to work, while 260 (63.4%) were afraid of contracting the COVID-19 virus. However, 294 (71.7%) were not stigmatized and 256 (62.4%) were satisfied with their capacity for work. Also, 333 (81.2%), 357(87.3%), and 271(66.6%) were not satisfied with, transportation, money to meet their daily needs, and work environment, respectively. Perceived psychosomatic symptoms by respondents were chest pain (50.0%), stomach upset (38.0%), lump in the throat (40.0%), no feeling of hunger (52.0%), and shortness of breath (32.0%). Anxiety and stress symptoms experienced were inability to concentrate (38.2%), got angry easily (24.9%), worried (48.5%), low mood, anxiety, or depression (24.1%) and afraid of encountering security personnel on their way to work (67.6%).</p> <p><strong>Conclusions</strong><strong>:</strong> We observed perceived fears, psychosomatic, anxiety, and stress symptoms, as well as low satisfaction among the primary healthcare workers. We suggest that the government and health care agencies should put in place measures that will improve the psychological well-being and mental health of the PHCWs during the pandemic.</p> Clement Kevin Edet, Agiriye M. Harry, Anthony Ike Wegbom, Benjamin O. Osaro ##submission.copyrightStatement## Thu, 25 Feb 2021 00:00:00 +0000 Immature Platelet Fraction as a Non-Invasive Marker for Esophageal Varices <p><strong>Background: </strong>All cirrhotic patients should be screened for oesophageal varices (OV) at the time of diagnosis. The development of a non-invasive method for the detection of OV is a vital issue in subjects with cirrhosis to decrease the need for invasive endoscopic procedures that can be costly. This work aimed to evaluate immature platelet fraction (IPF) as a non-invasive marker and predictor of OV.</p> <p><strong>Methods: </strong>This cross-sectional study was carried out on 80 cirrhotic patients with esophageal varices diagnosed by upper endoscopy. They were divided into Group (1): 40 patients with cirrhosis with esophageal varices and Group (2): 40 patients with cirrhosis and without esophageal varices. All patients were subjected to the complete history taking, physical examination, routine laboratory investigations (Complete blood count, IPF, C-reactive protein, Liver and kidney function tests, Bone marrow aspiration for some cases, Ascetic sample analysis when applicable), Pelvic-Abdominal ultrasonography, Child Pugh score assessment, Upper GIT endoscopy.</p> <p><strong>Results: </strong>There was a significant difference between the studied groups regarding IPF (p&lt;0.001). At cutoff &gt;12 IPF had (AUC= 0.993) with sensitivity of 97.5% and specificity of 97.5% for detection of esophageal varices. There was a significant negative correlation between IPF and platelets count (p- value &lt; 0.001). There was a significant positive correlation between IPF and Child Pugh score (p- value &lt;0.001). There was a highly significant positive correlation between IPF and CRP (p value &lt;0.001). There was significant difference between the two groups as regards splenic longitudinal diameter (p&lt;0.001). As regards platelet count, there was a significant difference between the two groups (p&lt;0.001). It was significantly lower in Group 1.</p> <p><strong>Conclusions: </strong>IPF is elevated in cirrhotic patients with naive esophageal varices than in cirrhotic patients without varices. IPF could be used as a noninvasive, easy to measure method for detection of the presence of esophageal varices at a cutoff level of &gt;12.</p> Alyaa Marzouk Soliman, Sherief Mohamed Abd-Elsalam, Amal Saeid ALBendary, Osama El. Sayed Negm ##submission.copyrightStatement## Thu, 25 Feb 2021 00:00:00 +0000 Pharmacotherapy for Patients with Chronic Kidney Disease during the COVID-19: A Narrative Review <p><strong>Background: </strong>COVID-19 is considered the most challenging global pandemic. Patients with COVID-19 are more vulnerable to renal impairment especially those admitted to the Intensive Care Units (ICUs).</p> <p><strong>Objective: </strong>In this review we discuss the epidemiology, the pathophysiology, the clinical implications and specific COVID-19 therapy in CKD patients.</p> <p><strong>Results: </strong>The prevalence of CKD patients with COVID-19 varies between 0.7 to 47.6%. Patients with CKD ought to be encouraged to take extra precautions (isolation, distancing, wearing Personal Protective Equipment (PPE)) to limit the risk of exposure to the virus. Renin-Angiotensin System (RAS) and SARS-CoV-2 interactions, through the binding of the virus to ACE-2, have&nbsp; produced speculations of both likely damage and advantage of RAS inhibitor use during the pandemic. Remidisivir should be avoided in CKD patients (Cr Cl&lt;30ml/min) with COVID-19. In addition, the doses of nephrotoxic medications (chloroquine phosphate and dexamethasone) that are recommended to be used in the management of COVID-19 should be adjusted according to creatinine clearance and dialysis.</p> <p><strong>Conclusion: </strong>COVID-19 may worsen the impaired kidney function and increase mortality. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Care givers should pay especial attention to medications dosing in COVID-19 patient with CKD history.</p> Mansour Adam Mahmoud ##submission.copyrightStatement## Tue, 23 Feb 2021 00:00:00 +0000