Open Access Case Study

A Case Report of Peripheral –Type Ameloblastic Fibrodentinoma and a Review

Priyanka Agarwal, Nirupama Kothari, Minoti Girdhar

Journal of Advances in Medicine and Medical Research, Page 891-895
DOI: 10.9734/BJMMR/2015/17353

Ameloblastic fibrodentinoma (AFD) is a rare benign tumor usually interpreted as a neoplasm similar to ameloblastic fibroma (AF), characterized by formation of dysplastic dentin on histopathological diagnosis. Peripheral –type ameloblastic fibro-dentinoma (PAFD) is exceedingly rare, with all previously reported cases involving young patients. We here report a case of PAFD occurring in upper gingiva of an 11-year old male child, which was surgically incised.

Open Access Short Research Article

The Distribution of Matrix Metalloproteinase-2, Tissue Inhibitor of Metalloproteinase-2 and Tissue Inhibitor of Metalloproteinase-4 in Psoriatic Skin

Elga Sidhom, Mara Pilmane, Janis Kisis

Journal of Advances in Medicine and Medical Research, Page 883-890
DOI: 10.9734/BJMMR/2015/18206

Aims: To evaluate the appearance and distribution of matrix metalloproteinase-2 (MMP-2), tissue inhibitor of metalloproteinase-2 (TIMP-2) and tissue inhibitor of metalloproteinase-4 (TIMP-4) in lesional skin biopsies of psoriasis patients.
Study Design: Observational study.
Place and Duration of Study: Institute of Anatomy and Anthropology and Department of Infectology and Dermatology, RÄ«ga Stradiņš University, between September 2013 and June 2014.
Methodology: We included 40 patients (31 men, 9 women; age range 18-70 years) with Psoriasis vulgaris, with present characteristic psoriatic eruptions in typical localization sites and no treatment received. Skin samples were obtained using routine punch biopsy method. 10 clinically healthy skin samples obtained during nevus excision procedure were used as control material. All tissue specimens were stained with hematoxylin and eosin and by immunohistochemistry for MMP-2, TIMP-2 and TIMP-4. The intensity of staining was graded semiquantitatively. Spearman’s rank correlation coefficient was calculated.
Results: In psoriasis patients numerous MMP-2-containing keratinocytes were found in epidermis, MMP-2 positive dermal fibroblasts and inflammatory cells varied from few to abundant. Few epidermal cells and moderate to numerous dermal cells contained TIMP-2. Moderate to numerous epidermal and dermal cells contained TIMP-4. Statistically significant strong positive correlation was found between MMP-2 in epidermis and dermis (Spearman’s rank correlation coefficient = .878, P = .000). Statistically significant moderate positive correlation was found between TIMP-2 and TIMP-4 in dermis (Spearman’s rank correlation coefficient = .639, P = .000) and between TIMP-2 in epidermis and dermis (Spearman’s rank correlation coefficient = .564, P = .000).
Conclusion: TIMP-4 seems to be most important inhibitor of psoriatic skin degeneration, richly raised by MMP-2. Its moderate correlation with TIMP-2 proves involvement of other tissue inhibitors in the degeneration inhibition and gives evidence about possible patterning between the tissue inhibitors of metalloproteinases.

Open Access Original Research Article

A Further Step in the Relationship between Uric Acid and Vascular Risk: Tubular Handling of Uric Acid in Hypertension Study

Consolación Rosado, Carmen Felipe, Rosario Manzanedo, Begoña Alaguero, Amelia Fidalgo, Carlos Chacón, Jesús Martín

Journal of Advances in Medicine and Medical Research, Page 829-835
DOI: 10.9734/BJMMR/2015/15607

Background: Uric acid poses a major risk to cardiovascular function which, in turn, increases the chances of kidney disease. This is not only an indication of renal damage, but also precipitates its development. We analyzed the kidney metabolism in hypertensive patients in order to establish any disparities compared to those of healthy individuals, and to ascertain if there were any changes in cases such as hypertension with chronic renal failure, including the use of diuretics in cases of obesity.
Methods: We performed a descriptive, cross-sectional and retrospective study of 95 hypertensive patients to determine the parameters of renal excretion of uric acid. We compared the results of the hypertensive patients with the existing data of healthy individuals; examining the effects of chronic kidney disease - the administration of diuretics including cases of obesity - in the renal metabolism of uric acid.
Results: The clearance of uric acid (5,56 ml/min) and its fractional excretion (6,65%) are lower in hypertensive people than in healthy individuals (UACl: 8-12 ml/min and UAEF: 8-10%). This clearance decreases significantly in hypertensive patients with chronic kidney disease compared to hypertensive patients with normal renal function (3.38 vs. 6.16 ml / min) including patients treated with diuretics (6.1 vs. 6.4 ml/min). Obesity also contributes to the reduction of renal excretion of uric acid.
Conclusion: Renal excretion of uric acid is reduced in cases of hypertension with normal renal function and no diuretic therapy, in cases of chronic kidney disease and in treatment with diuretics. So, the question here is whether this could be the pathogenic basis for many forms of essential hypertension, or whether it is caused by the negative impact of hypertension in the kidney.

Open Access Original Research Article

Eight Months vs Six Months Anti-TB Regimen in the Treatment of Newly Diagnosed Pulmonary Tuberculosis Patients in Nigeria

Olusoji James Daniel, Olusola Adedeji Adejumo, Hussein Abdulrrazzaq, Mustapha Gidado, Olajumoke Onazi, Gabriel Akang

Journal of Advances in Medicine and Medical Research, Page 836-841
DOI: 10.9734/BJMMR/2015/17320

Background: The eight month’s treatment regimen (2RHZE/6EH) was used by the Nigerian National TB and Leprosy Control Programme for the management of tuberculosis cases since 2003 when they commenced operation until October 2010 when the six month’s treatment regimen (2RHZE/4RH) was introduced. This study compared the treatment outcomes of patients managed with eight and six month’s treatment regimen between October 2009 and December 2011.
Methods: A desk review was carried out on the programme data of the Lagos State Tuberculosis and Leprosy Control Programme (LSTBLCP). The treatment outcomes of new smear positive TB patients managed between October 2009 and September 2010 (the eight month’s treatment regimen period) and January to December 2011 (six month’s treatment regimen period) were compared using Epi Info 2007 statistical software.
Results: A total of 4249 and 4167 smear positive TB patients were registered during the eight and six month’s treatment regimen period respectively. The prevalence of HIV among TB patients was significantly higher (14.4%) during the eight month’s treatment regime period compared with the six month’s (12.1%) treatment regime period (P = .02). The cure rate of patients managed during the eight month’s treatment regimen period was significantly lower (67.2%) and defaulter rate significantly higher (16.7%) compared with the cure (73.9%) and defaulter rates (12.2%) of patients managed during the six month’s treatment regimen period (P<.001). However the failure and death rates of patients managed during the eight and six month’s treatment regimen periods were comparable (P>.05). Among TB/HIV co-infected patients, the death rate was significantly higher among patients managed during the six month’s regimen period and the default rate was significantly higher in patients managed during the eight month’s treatment regimen period (p<.05).
Conclusion: Patients had better treatment outcomes during the six month’s treatment regimen period in Lagos State. Sustaining these gains will be essential in reaching the national and global targets.

Open Access Original Research Article

Increasing Number of Comorbidities is Related to Delay to Surgical Management of a Perforated Peptic Ulcer in Patients who Died

Arkadiusz Peter Wysocki, Peita M. Webb, Jennifer Allen, Therese Rey-Conde, John B. North

Journal of Advances in Medicine and Medical Research, Page 842-847
DOI: 10.9734/BJMMR/2015/18198

Introduction: The incidence of peptic ulcer disease has declined since the introduction of medical therapy, but the rate of perforated peptic ulcer and associated mortality has remained relatively constant. Delay to definitive treatment is known to adversely affect survival.
Methods: The Australian and New Zealand Audit of Surgical Mortality (ANZASM) retrospectively collects data on patients who died following surgery. To determine which patient characteristics are associated with delayed (not on the day of admission) surgical treatment of a perforated peptic ulcer, all patients who died in Queensland were identified from the ANZASM database.
Results: There were 39 deaths between 2007 and 2013 with a median age was 76 years. The median number of comorbidities was three and American Society of Anaesthesiologists (ASA) class was 4. Twenty nine patients had operative intervention on the day of admission and 10 underwent surgery later. Those with delayed surgery had a greater number of comorbidities (4 vs. 3; p = 0.016) but did not differ with respect to other demographics compared to those who underwent repair on the day of admission. The reviewing surgeon found no management issues in two thirds of patients.
Conclusion: Queensland patients with an increasing number of comorbidities were more likely to have delayed surgical intervention for a perforated peptic ulcer. Surgical delay is a known determinant of survival in patients with a perforated peptic ulcer and surgeons must be especially vigilant in multiply comorbid patients in making the diagnosis and expediting repair.

Open Access Original Research Article

Prevalence of Smoking among Patients Attending Cardiac Clinic in Gaza Strip

H. A. Abu Tawila, A. A. Thabet

Journal of Advances in Medicine and Medical Research, Page 848-854
DOI: 10.9734/BJMMR/2015/16770

The aims of the study were to determine the prevalence of tobacco smoking among patients attending private clinic and to examine the socio-demographic correlates of smoking in Gaza City. A retrospective study was carried out. The case records of all patients attending private chest clinic Abu Tawelia in Gaza City from 2006-2014 were included. A total number of 1034 records of patients was included. The sample consisted of 514 males (49.85%) and 518 females (50.15%). The patients age ranged from 18 to 90 years with mean age of 54.7 years. Overall, the smoking prevalence was of 19.2%. Males smoked more than females (16.3% vs. 2.9% of total sample). Most current smokers smoked cigarettes (82.5%), but the use of Shisha was also common (17.5%). Mean smoking years was 26.16. Smoking prevailed in patients with age ranging from 28 to 58 years (48.5%). A bit less than 40% of smokers has started before 20 years of age.
Health-promotion activities should be established to decrease the prevalence of smoking and prevent future adverse health outcomes.

Open Access Original Research Article

The Effects of Self-care Training on Self-perception in Diabetic Adolescents

Fatemeh Bahramnezhad, Arezoo Fathi, Mahmoud Shiri, Parvaneh Asgari

Journal of Advances in Medicine and Medical Research, Page 855-862
DOI: 10.9734/BJMMR/2015/16245

Introduction: Some of the problems that diabetic adolescents face are disturbances in mental image, difficulty in communicating with peers, and fear of dependence and lack of self-sufficiency, which cause changes in self-perception.
Methods: This study was a clinical trial with a sample size of 80 patients in two groups, including a control group (n=40) and an experimental group (n=40) of adolescents between 11–19 years of age referred to the Iran Diabetes Association (Aboozar). The training content was similar in both groups. In the control group, the educational contents were presented in three sessions of four hours; in the experimental group, they were trained by a CD. Their self-perception scores were then measured by using an 80-item Piers-Harris questionnaire, before and after intervention. SPSS software version16 was used for the data analysis.
Results: There were no significant differences in the self-perception of the two groups before the intervention, but there was a significant difference between the self-perception scores obtained from the Piers-Harris test in the control and experimental groups after the intervention (P=0. 000).
Conclusion: The self-perception of diabetic adolescents can be increased by the use of e-learning, and subsequently their blood glucose levels can be reduced, thus reducing various complications from diabetes.

Open Access Original Research Article

Therapeutic Implication of Terfezia claveryi Extract on Corneal Ulcer of Rabbit’s Eye

Yousef H. Aldebasi, Manzoor A. Qureshi, Amjad A. Khan, Salah M. Aly, Muhammad I. Ahmad

Journal of Advances in Medicine and Medical Research, Page 863-873
DOI: 10.9734/BJMMR/2015/17229

Aims: The aim of this study was to investigate the antimicrobial activity of Terfezia claveryi crude extract on induced corneal ulcer in rabbit’s eye.
Study Design: Study was carried out in Rabbits eye.
Place and Duration of the Study: This study was conducted in the experimental laboratories at College of Applied Medical Sciences of Qassim University during the period from March to June 2013.
Methodology: Crude aqueous extract of this truffle, in different concentrations, was introduced through intraperitoneal injection to rabbits for their safety dose.
Corneal epithelial wound was induced in different groups of rabbit’s eye with sodium hydroxide and later this wound was contaminated with some selected bacteria like Staphylococcus aureus and Escherchia coli to produce iatrogenic infection. The healing power of different concentrations of T. claveryi crude extract was observed by different clinical findings.
Results: We observed that 1.5% crude extract of this desert truffle significantly healed the corneal ulcer almost within 9 days. Delayed response in healing was observed with 3% T. claveryi, while 5% extract developed some extra corneal complications. The healing response of corneal ulcer to topical application of different concentrations of T. claveryi extract was compared with a synthetic antibiotic (Vigamox 0.5%) as a reference standard drug.
Conclusion: It was concluded that aqueous extract of T. claveryi has no significant toxic effects against liver and kidney function parameters. The antibacterial activity of this desert truffle recommends as an alternative medicine for some corneal infections. However, the therapeutic role of some specific ingredients present in this truffle needs further investigations.

Open Access Original Research Article

Prevalence, Awareness and Factors Associated with Hypertension among Adult Residents in Lagos: A Population Based Study

Olusoji James Daniel, Olusola Adedeji Adejumo, Esther Ngozi Adejumo, Rotimi Samuel Owolabi, Rotimi Williams Braimoh, Albert Adekunle Salako

Journal of Advances in Medicine and Medical Research, Page 874-882
DOI: 10.9734/BJMMR/2015/17421

Background: Hypertension is a global public health problem in both developed and developing countries. It is estimated that 75% of the world hypertensive patients in 2025 will be in developing countries including Nigeria. There is need to understand the nature of the epidemic and institute control measures to reverse the increasing tide of the disease in developing countries.
Methodology: A descriptive cross-sectional survey carried out among Lagos residents between May and June 2012 in four Local Government Areas namely Alimosho, Mushin, Ajegunle/Ifelodun and Kosofe. The study variables were age, sex, occupation, education, marital status, religion and BMI while the outcome variable were frequency of hypertension and mean blood pressure. Statistical analysis included the use of proportions, percentages, chi-square, ‘t’ test and logistic regression using SPSS version 21
Results: A total of 4088 adults aged between 20-81 years (male = 1465 and females= 2623) were included in this study. The overall prevalence of hypertension was 40.9%. Hypertension increased with age in both males and females. Of the 1673 respondents identified as having hypertension, only 316 (18.9%) respondents were previously aware of their diagnosis. Of the 316 known hypertensive patients, only 20 (6.3%) had their blood pressure within the normal range. Age, gender, marital status and BMI were socio-demographic factors associated with hypertension.
Conclusion: The prevalence of hypertension and obesity were found to be high in Lagos state. The need for public health actions to avert the consequences of the high prevalence of hypertension.cannot be over-emphasized.

Open Access Review Article

Alternatives to Hormone Replacement Therapy in Postmenopausal Women

M. Najimudeen, K. Sachchithanantham, B. Sameera

Journal of Advances in Medicine and Medical Research, Page 816-828
DOI: 10.9734/BJMMR/2015/18412

Substantial number of postmenopausal women suffers in silence. They experience vasomotor symptoms, sleep disturbances, atrophic changes in the genital and urinary systems and lack of sexual desire. The fear, side effects and contra indications of oestrogen discourage hormone replacement therapy.
Life style modification with change in dietary habit, regular exercise, cessation of alcohol and smoking can help them immensely. Tibolone, Selective oestrogen receptor modulators (SERMs), Antidepressants like Venlafaxine, th Alpha 2 agonists like clonidine, carbapentine and various supplements are frequently prescribed. Available alternatives and their merits are discussed.