Open Access Case Study

Colon Obstruction and Gradual Regression of Giant Pseudopolyps in Inflammatory Bowel Disease

Rebeca Higuera Álvarez, Fidencio Bao Pérez

Journal of Advances in Medicine and Medical Research, Page 509-513
DOI: 10.9734/BJMMR/2015/15229

Inflammatory pseudopolyps associated with inflammatory bowel disease occur on inflamed colon mucosa due to the regeneration and healing of ulcerated epithelium. They are classified as giant when they are over 1.5-cm in diameter. These are a rare, benign complication, but can be similar in appearance to colorectal cancer. It has been reported that they do not usually regress after medical treatment, requiring endoscopic resection or even surgery. In this paper, we report an unusual case with gradual regression of giant pseudopolyps with medical treatment, in a patient with inflammatory bowel disease, and another very uncommon case of a giant pseudopolyp in indeterminate colitis, with obstruction requiring surgery, as it was not possible to rule out carcinoma. A multidisciplinary team is very important.

Open Access Short Research Article

Occurrence of Burkitt’s Lymphoma among All Childhood Tumors Seen in Abia State University Teaching Hospital ABA, South East Nigeria (11 Years Retrospective Study)

H. N. Chineke, P. O. U. Adogu, K. C. Diwe, C. O. Emerole, M. U. Ewuzie

Journal of Advances in Medicine and Medical Research, Page 533-537
DOI: 10.9734/BJMMR/2015/13724

Background: Burkitt’s lymphoma (BL) is the commonest tumour in Africa. It is a rapidly growing tumour. Its multi-organ involvement and complexity of signs and symptoms, call for an urgent diagnosis and treatment to achieve a better prognosis.
Objective: To determine the occurrence of BL, a childhood tumour, in Abia State University Teaching Hospital in the years 2000 to 2010.
Methodology: It was a descriptive cross sectional survey in which the case files of all the patients who presented at the paediatric clinic, children emergency room, ward and cancer registry for BL cases between January 2000 and December 2011 were evaluated. The BL occurrence was manually worked out as the percentage of confirmed BL cases in relation to the total number of childhood tumours seen within that period.
Results: The occurrence of BL (among the 40 pediatric cancer cases) was 65%, meaning that it was more common than the other childhood tumours seen within the same period. It was also commoner in males than in females, and also more in the lower socio-economic class than in the middle and upper socio-economic classes as assessed by the occupation of the parents of the patients.
Conclusion: BL is a common childhood tumour in the tropics more commonly seen among the lower socio-economic group. Efforts should be made by caregivers to identify the disease in time for early treatment and follow-up because BL responds well to aggressive chemotherapy when started early.

Open Access Original Research Article

Quality of Life among Female Breast Cancer Patients in a University Hospital in Malaysia

Zobaida Edib, Verasingam Kumarasamy

Journal of Advances in Medicine and Medical Research, Page 453-462
DOI: 10.9734/BJMMR/2015/15065

Aims: To assess the Quality of Life (QOL) among female breast cancer patients in a university hospital in Malaysia.
Study Design: The study was designed as a cross-sectional study.
Place and Duration of Study: The study was conducted at the Surgery and Oncology Clinic in University Kebangsaan Malaysia Medical Centre (UKMMC) between 22nd May 2014 and 27th June 2014.
Methodology: A total of 133 female breast cancer patients were selected by universal sampling, out of which 117 patients responded. The QOL was measured both by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) and breast cancer specific supplementary module (QLQ-BR23).
Results: The global health status/QOL mean score was 67.81 (SD±18.92). Mean age of the respondent was 54 years (SD±18.39). Nearly half of the Malay breast cancer patients (45.6%) diagnosed at the stage of III & IV. In the functional scales, the highest mean score was observed for cognitive functioning 83.19 (SD±22.26); whereas emotional functioning had the lowest mean score 62.96 (SD±26.39). The respondents were satisfied with their body image with a mean score of 81.34 (SD±24.26) but greatly affected by sexual functioning with a mean score of 31.48 (SD±26.96). Most prevalent general symptoms reported in this study were fatigue, insomnia, pain, appetite loss and financial difficulties; and most prevalent breast cancer specific symptom was found upset by hair loss.
Conclusion: Specific measures should be taken for the routine breast cancer screening, awareness and education programmes to promote early detection and diagnosis of the breast cancer. The planned rehabilitation protocol should be addressed by health care professionals to further improve the QOL among breast cancer patients.

Open Access Original Research Article

Insulin Resistance in Egyptian Nonalcoholic Fatty Liver Disease patients

Amal Ahmed Mohamed, Wafaa Gh. Shousha, Olfat Shaker, Mohamed El-Sayed Mahdy, Eman M. A. Ibrahim, Hala Abd AL Aal, Ahmed Abdel Hamid, Marwa Azzat, Amal El Shimy

Journal of Advances in Medicine and Medical Research, Page 463-473
DOI: 10.9734/BJMMR/2015/11380

Background: The liver has been recognized as a major target of injury in patients with insulin resistance or the metabolic syndrome. Insulin resistance is associated with fat accumulation in the liver, a condition called nonalcoholic fatty liver disease (NAFLD). NAFLD is a clinicopathologic entity that includes a spectrum of liver damage ranging from simple steatosis to nonalcoholic steatohepatitis (NASH), advanced fibrosis, and rarely, progression to cirrhosis. Recent studies emphasize the role of insulin resistance, oxidative stress and subsequent lipid peroxidation, proinflammatory cytokines, adipokines and mitochondrial dysfunction in the development and progression of NAFLD. About 20% all adults have NAFLD and 2% to 3% of adults have NASH. A strong correlation exists between overweight, in particular visceral fat accumulation, and prevalence of NASH.
Aim: "This study aimed at assessing the effect of insulin resistance in a sample of Egyptian patients with non-Alcoholic fatty liver".
Methods: This study was conducted on 2 groups 104 NAFLD as diagnosed by ultrasound examination and 21 healthy participants as control group. All the participants were subjected to an abdominal ultrasonography, liver enzymes, lipid profile (triglycerides, HDL, LDL cholesterol), glucose and fasting insulin.
Results: The blood sugar and fasting insulin levels were significantly higher in NAFLD patients than control group (172.81±35.47 mg/ml vs 101.33±11.95 mg/ml and11.72±4.7 U/ml vs 5.93±4.68) respectively. 88.5% of NAFLD patients were obese (BMI ≥ 30) and 11.5% were over weight (BMI < 30) while 23.8% were obese and 76.2% were overweight for control group. HOMA-IR was significantly higher in NAFLD patients than in healthy controls (5.02±2.39 vs. 1.41±1.20; P<0.001). We found 81.7% of the studied patients fulfilled the metabolic syndrome criteria while 9.5% for controls. HOMA-IR ROC curve showed 94.23% sensitivity and 85.71 specificity in NAFLD group. Fasting Insulin ROC curve showed 91.35% sensitivity and 80.95% specificity in NAFLD group.
Conclusion: Patients with NAFLD have higher insulin resistance and have higher lipid profile, ALT & AST levels compared with their control group. Also the Ratio of the metabolic syndrome was higher in the NAFLD patients (81.7%).

Open Access Original Research Article

A Qualitative Content Analysis of Breast Cancer Narratives Hosted Through the Medium of Social Media

Niamh M. Foley, Máirín O’Mahony, Elaine A. Lehane, Tulin Cil, Mark A. Corrigan

Journal of Advances in Medicine and Medical Research, Page 474-483
DOI: 10.9734/BJMMR/2015/15309

Aims: Social media and networking host a significant amount of breast cancer related information. Breast cancer accounts for the largest number of new internet postings amongst the top four cancers. The objective of this study was to apply qualitative content analysis to the most highly rated breast cancer narratives hosted on youtube and identify the common themes.
Study Design: Qualitative content analysis of youtube video blogs.
Methodology: Data for analysis were extracted from youtube. The search terms used were “breast cancer survivor” and “breast cancer stories”. All clips were transcribed in their entirety. Data were analysed subsequently.
Results: The overarching theme apparent from transcript analysis was that of ‘the experience of fighting cancer’. Five categories, namely, (1) ‘first finding out’, (2) coping strategies, (3) ‘living with uncertainty’, (4) ‘reaching out and giving back’ and (5) ‘learning lessons’ were identified as key issues for participants in fighting cancer.
Conclusion: Participating in blogs generates important peer and social support. Many patients wanted to ‘reach out and give back’, an endeavour contributing to satisfaction among breast cancer survivors in peer support programmes and an enormous resource to potential survivorship programmes.

Open Access Original Research Article

Anti-Sickling and Membrane Stabilizing Effects of Carica papaya Leaf Extract

A. O. Naiho, B. C. Okonkwor, C. Okoukwu

Journal of Advances in Medicine and Medical Research, Page 484-492
DOI: 10.9734/BJMMR/2015/14608

The antisickling and membrane stabilizing effect of aqueous extract of Carica papaya leaf was investigated. Fifty confirmed HbSS patients on routine clinical checkup were involved in this experiment after their consent has been obtained. 50 samples of HbSS blood were collected. The samples were divided into five groups, with ten (10) samples in each group. The samples in the different groups were treated with different concentration of the extract ranging from 2mg/ml to 10mg/ml. In group 1 the samples were treated with 2mg/ml concentration of Carica papaya leaf extract. In group 2 the samples were treated with 4mg/ml concentration of Carica papaya leaf extract. In group 3 the samples were treated with 6mg/ml concentration of Carica papaya leaf extract. Group 4 samples were treated with 8mg/ml concentration of Carica papaya leaf extract. While group 5 samples were treated with 10mg/ml concentration of Carica papaya leaf extract. For each sample three different tests were carried out (osmotic fragility, sickling test and reversal sickling test). For each test, two test tubes were set up; control without Carica papaya leaf extract and Experiment with Carica papaya leaf extract. Data obtained was analysed using Student’s T-test on SPSS software computer package. Results showed a dose dependent significant reduction (p<0.05) in sickling of Reb Blood Cell treated with different doses of the extract, also the extract show ability to reverse already sickled Red Blood Cells as there was significant reduction (p<0.05) in sickling of Red Blood Cells after treatment. There was also significant reduction (p<0.05) in osmotic fragility of Red Blood Cells treated with the extract. We therefore conclude that aqueous extract of Carica papaya leaf has anti-sickling effect which may be related to its direct action on HaemoglobinS and also its membrane stabilizing ability. This extract therefore may be a good candidate in Sickle Cell Disease therapy.

Open Access Original Research Article

Effects of Three Different Modes of Exercise Training on Plasma Lipoprotein Profile in Healthy Men

Sardar Mohammadi, Slahadin Ahmadi, Mozafar Yektayar, Keivan Ahmadi Dehrashid

Journal of Advances in Medicine and Medical Research, Page 493-499
DOI: 10.9734/BJMMR/2015/14898

Objective: The present study was designed to compare the effects of resistance, endurance, and combined endurance / resistance exercises on plasma lipid and lipoprotein profile in healthy untrained middle-aged men.
Methods: Healthy middle-aged staff of Islamic Azad University of Sanandaj were randomly assigned to eight weeks of three-times weekly endurance training groups (ET, 30.67±1.1 years, n = 10), resistance training (RT, 31.75±1.1 years, n = 10), combined endurance resistance training (ERT, 30.38±1.1 years, n = 10) and control (c, 30.38±1.1 years, n = 10). Subjects of ET, RT and ER groups underwent endurance (E), resistance (R) and combined endurance / resistance (ER) training respectively. Control group subjects remained sedentary during the period of the study. Plasma lipids and lipoproteins were measured at baseline and at the end of the study.
Results: Apolipoprotein B (apo B) decreased significantly (p =0.05) in ERT group. Triglyceride (TG) and LDL-cholesterol (LDL-C) decreased significantly (p =0.05) in both ERT and ET groups. High-density lipoprotein (HDL) increased significantly in RT group (p =0.05). Lipoprotein lipase, total cholesterol and apo A levels did not change significantly in none of the trained groups.
Conclusion: Based on the results of the current study, ERT is the mode of choice for correcting plasma TG, LDL and apo B abnormalities, while RT works better for boosting HDL.

Open Access Original Research Article

Pattern of Abnormal Serum Lipids and Lipoprotein Ratios in Nigerian Hypertensive Patients Seen in Clinical Practice

Ebenezer Adekunle Ajayi, Akande Oladimeji Ajayi, Victor Oladeji Adeyeye

Journal of Advances in Medicine and Medical Research, Page 500-508
DOI: 10.9734/BJMMR/2015/15021

Background: Hypertension is a major health problem worldwide. Its role, and other well-known coronary risk factors, especially dyslipidemia, in atherogenesis have informed estimation of cardiovascular risk. Hitherto, low density lipoprotein (LDL-C) and high density lipoprotein (HDL-C) are prominent in guidelines but attempts are being made to include the use of lipoprotein ratios to optimize the predictive capacity of lipid profile in risk evaluation. This study aimed to describe pattern of lipids abnormalities, including the common lipid ratios used in clinical practice and to understand if they differ more with abdominal obesity which compared with peripheral obesity in subjects with systemic hypertension.
Materials and Methods: Two hundred and eleven new adult hypertensive patients were studied in a hospital-based cross-sectional study. Serum lipids were measured and lipoprotein ratios calculated. SPSS IBM 20 was used to analyze data.
Results: Mean age was 57.35±12.66 years. The prevalence of abnormal serum lipids in this study population was: elevated LDL-C (58.0%); elevated total cholesterol (38.9%); low HDL-C (31.4%); and elevated triglyceride (22.0%). For ratios of lipid profile, Castelli risk index-I (CRI-I) and Castelli risk index- II (CRI-II) were abnormal in 31.2% and 27.9%, respectively. Coronary disease risk ratio and atherogenic index of plasma were abnormal in 12.6% and 12.1%, respectively. Seven subjects (3.5%) had atherogenic lipid triad of low HDL-C, elevated LDL-C and high triglyceride with all the 7 subjects having abdominal obesity. Irrespective of the measure of obesity employed, LDL-C had the highest sensitivity.
Conclusion: Lipids abnormalities were common in our hypertensive subjects, the commonest being high LDL-C. CRI-I and CRI-II demonstrated higher prevalence than the CDR and AIP as well as higher sensitivities, though their use may under-estimate the burden of dyslipidemia in our patients. Finally, irrespective of the measure of adiposity, lipids profiles in our study population were comparable.

Open Access Original Research Article

Cone Beam Computed Tomography for Exploring Morphology of Mandibular First Molar

Muhammad Sohail Zafar, Mothanna Alrahabi

Journal of Advances in Medicine and Medical Research, Page 514-521
DOI: 10.9734/BJMMR/2015/15189

Aims: The root canals have complex morphology and vary widely among individuals variations. The objective of this research was to analyse the morphology of root canals and existence of extra canals in mandibular first molar in subpopulation of Al-Medina Al-Munawarah.
Study Design: Experimental/Analytical.
Place and Duration of Study: College of dentistry, Taibah University, Madinah Munawwarrah, Saudi Arabia, 2014.
Methodology: This study was conducted using freshly extracted mandibular first molars (n=100). All teeth were examined for morphology of roots, root canals and apical foramen by Cone Beam Computed Tomography (CBCT). The root canals configuration was classified using Vertucci's classification.
Results: All mandibular first molars (100%) had two distinct and clearly separated roots. There was a high probability of two canals (92.5%) in mesial root compared to the distal root that contain two canals only in 20% of teeth. There was no occurrence of more than two roots or more than two canals in any of the roots in the selected teeth. The majority of distal roots (80%) had single canal with type I canal configuration followed by type III (10%), type V (7.5%) and type II (2.5%). The mesial roots presented comparatively complex canals configuration. Type I canal configuration was observed in only 7.5% teeth. The incidence of C shaped canals was very low (2.5%).
Conclusion: The occurrence of single rooted mandibular first molars as well as supernumerary roots is very unlikely. The incidence of two distinct canals in mesial root is high (>92%), however distal roots mainly represented one canal (80%).

Open Access Original Research Article

Hepatotoxicity and Nephrotoxicity of Automobile Gas Oil (Diesel Oil) and Its Biochemical Effect on Hematological and Oxidative Stress Parameters in Wistar Male Albino Rats

Momoh Johnson, Longe Adeteju Olufunmilayo, Damazio Olanrewaju Anthony, Ogundare Cecilia Oyinlade

Journal of Advances in Medicine and Medical Research, Page 522-532
DOI: 10.9734/BJMMR/2015/13719

Aims: The study was designed to investigate the hepatotoxicity and nephrotoxicity of automobile gas oil (Diesel oil) and its biochemical effect on hematological and oxidative stress parameters in Wistar male albino rats.
Methodology: Preliminary toxicity study to determine the volume of diesel oil that could cause toxicity was carried out using 56 healthy albino rats. Another set of 20 albino rats were grouped into two groups and used for the biochemical analysis. Group I animals were the control group and Group II animals were administered with 1 ml of diesel oil per kg body weight. The hematological parameters were determined using BC-3200 Auto Hematology Analyzer. Liver injuries were measured in the plasma using AST, ALT, ALP, GGT, TP and TB Randox kits respectively. Liver histopathological examination was also determined. The oxidative stress parameters assayed in the liver homogenate were TBARS, SOD, CAT and GSH. Kidney injuries were assayed using urea and creatinine Randox kits.
Results: Preliminary toxicity study shows that group II albino rats exhibited changes in behavioural pattern such as salivation, respiratory distress, coma, sedation and death. The LD50 was calculated to be 2.5ml/Kg body weight of diesel oil. The results of this study show that WBC, lymphocyte and granulocyte values were significantly increased (P<0.05) in group II animals compared to group I animals. HGB, RBC and HCT values were significantly reduced (P<0.05) in the group administered with diesel oil compared to the healthy group. All the liver biomarker enzymes: AST, ALT, ALP and GGT were significantly increased (P<0.05) in group II rats compared to group I rats. The plasma TB values increased in group II animals while their plasma TP values significantly reduced (P<0.05) when compared to group I animals. Liver histopathological examination also confirmed that administration of diesel oil caused liver lesions in group II animals. Administration of diesel oil to group II rats caused significant reduction (P<0.05) in the activities of the enzymic antioxidants (SOD and CAT) and non enzymic antioxidant (GSH) values of the liver homogenate. The TBARS values were significantly high in group II rats compared to group I rats. These biochemical parameters (SOD, CAT, GSH and TBARS) indicate oxidative stress in animals administered with diesel oil.
Conclusion: The results of this study show that administration of diesel oil is hematotoxic, its affects the liver, kidney and oxidative stress parameters.