Open Access Case Study

Self-knotting of Nasogastric Tube: Case Report and Review of Literature

Obukowho Lucky Onotai, Ndubuisi Sunny Uyanwanne

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/BJMMR/2015/19071

Naso-Gastric (NG) tube use is very common in patients’ care at all levels of healthcare service delivery Worldwide. However, it is not without its complications. Naso-Gastric tube self-knotting is an unusual complication associated with its insertion and removal. A review of literature shows that no such case has been documented in our environment. Therefore, we thought it necessary to report this first case of self-knotting of NG tube encountered in the management of a 60 year old male post laryngectomy patient in the University of Port-Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria. We want colleagues and other healthcare providers to be conversant with this unusual complication.

Open Access Short Research Article

Computational DIO2 rSNP Analysis, Transcriptional Factor Binding Sites and Disease

Norman E. Buroker

Journal of Advances in Medicine and Medical Research, Page 1-24
DOI: 10.9734/BJMMR/2015/18535

Purpose: The DIO2 gene transcribes the deiodinase type 2 enzyme that changes the thyroid prohormone, thyroxine (T4), to the biologically active triiodothyronine (T3) hormone. T3 plays a vital part in the regulation of energy balance and glucose metabolism. DIO2 single-nucleotide polymorphisms (SNPs) were computationally examined with respect to changes in punitive transcriptional factor binding sites (TFBS) and these changes were discussed in relation to human disease.

Methods: The JASPAR CORE and ConSite databases were instrumental in identifying the TFBS.  The Vector NTI Advance 11.5 computer program was employed in locating all the TFBS in the DIO2 gene from 2.4 kb upstream of the transcriptional start site to 508 bp past the 3’UTR.  The JASPAR CORE database was also involved in computing each nucleotide occurrence (%) within the TFBS.

Results: Regulatory SNPs (rSNPs) in the promoter region novel SNP (-2035bp), 5’UTR (rs12885300), intron one (rs225010, 225011 and rs225012), exon two [rs225014 (Thr92Ala)] and 3’ UTR (rs6574549, rs225015 and rs225017) of the DIO2 gene are in linkage disequilibrium.  These rSNP alleles were found to alter the DNA landscape for potential transcriptional factors (TFs) to attach resulting in changes in TFBS.

Conclusion: The alleles of each rSNP were found to generate unique TFBS resulting in potential changes in TF DIO2 regulation. These regulatory changes were discussed with respect to changes in human health resulting in disease or sickness.

Open Access Minireview Article

Anti-restenotic Therapies for Peripheral Arterial Disease

Vincent Varghese, Jon C. George

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2015/18492

Defining the ideal treatment for peripheral arterial disease remains an ongoing endeavor. The initial treatment standard of balloon angioplasty and stenting has produced suboptimal long-term outcomes due to in-stent restenosis and the subsequent need for revascularization. Yet, the field of endovascular medicine has seen an explosion of new technologies, which have yielded promising early and mid-term results. Anti-restenotic drug therapies have the potential to reduce neointimal hyperplasia, in-stent restenosis, and improve vessel patency in femoro-popliteal arteries. We discuss herein current and future drug eluting technologies across various delivery methods and platforms.

Open Access Original Research Article

Retrospective Analysis of Site and Pathological Characteristics of Recurrence in Patients with Adenomatous Colonic Polyps

Elie J. Chahla, Antonio R. Cheesman, Muhammad B. Hammami, Kara Christopher, Christine Hachem

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2015/17521

Aim: The benefits of colonoscopy surveillance in reducing the incidence and mortality of colorectal cancer are known. However, benefit may be driven by early detection of left side colon lesions to a greater extent than right side counterparts. The correlation between initial (“index”) adenoma(s) location, recurrent polyp(s) and their respective pathologic grade is not well understood. The purpose of this study was to determine if index colonic adenoma polypectomy location (right vs. left) correlated with recurrent adenoma location and polyp pathology.
Methodology: Retrospective review of patient medical records including all cases of completely resected adenomatous polyp(s) without evidence of dysplasia at initial colonoscopy with repeat follow-up study between November 1998 and August 2009 was performed at a tertiary level academic hospital. The splenic flexure was used to discriminate right vs. left side colon polyps.
Results: Records of 112 patients (53.6% males) with index adenomatous colonic polyps who had follow-up complete colonoscopy with polypectomy were reviewed. Mean (SD) time of follow-up colonoscopy was 43.3 (22.6) months. The mean age at presentation was 59.5 years. Initial polyp site was found on the right in 46 patients (41.1%), left in 38 (33.9%), and both right and left in 28 patients (25.0%). Patients with right side index adenomas were significantly older compared to those with left side lesions, with a mean (SD) age of 61.2 (9.9) vs. 55.6 (7.3) years respectively (p=0.008). Polyp pathology on follow-up colonoscopy revealed 16 (14.3%) hyperplastic, 84 (75.0%) adenomatous, 6 (5.4%) tubulovillous, 5 (4.5%) high grade dysplasia (HGD), and 1 (0.9%) cancer case. 28 of 39 right side index adenomas (71.8%), and 24 of 33 left side index adenomas (72.7%) had same side adenomatous or higher grade pathologic recurrence. Ipsilateral recurrence proved to be statistically significant (p<0.001). In addition, right side index adenomatous polyps had higher rates of adenomatous polyp recurrence (44/46, 95.7%) compared to left side index ones (26/38, 68.4%), independent of recurrence site (p<0.001).
Conclusion: Initial adenomatous polyp side may predict recurrent adenomatous location and polyp pathologic grade. Follow-up endoscopic surveillance methods and intervals should consider side of previous adenomatous polyp location.

Open Access Original Research Article

Acute Promyelocytic Leukemia Patients Receiving ATRA with and without Voriconazole Prophylaxis: Effect on Incidence and Outcomes of Differentiation Syndrome

Jason N. Barreto, John C. Kuth, Candy S. Peskey, Ross A. Dierkhising, Naseema Gangat, Mrinal M. Patnaik

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2015/17743

Background: The combination of all trans-retinoic acid (ATRA) and voriconazole may lead to increased ATRA exposure resulting in a higher incidence of differentiation syndrome (DS).

Patients and Methods: This single center analysis evaluated the incidence and outcomes of ATRA-induced DS in 46 adult patients with acute promyelocytic leukemia (APL) undergoing induction chemotherapy.
Results: Thirty-one patients (69% by day 60) received a chemotherapy regimen including ATRA coinciding with voriconazole administration and 15 patients underwent treatment without voriconazole. The overall incidence of DS was 36% (n=16) by day 60, with patients receiving voriconazole showing a trend towards a higher incidence (HR 2.31, CI 0.78-6.847, p=0.1308). This trend persisted after adjusting for BMI (HR 1.96, CI 0.65-5.94, p=0.23); however, a small number of DS events precluded statistical significance.
Conclusion: A trend towards an increased incidence and severity of ATRA-mediated DS was seen in adult APL patients receiving voriconazole prophylaxis during induction chemotherapy. This important finding warrants validation in larger studies.

Open Access Original Research Article

Barriers to Implementation of Facility-based Kangaroo Mother Care for Pre-term and Low Birth Weight Infants in River Nile State, Sudan; 2014

Asma Abdelaal Abdalla, Eman Aljaali Hamid Muhammed Ali

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2015/18741

Background: Prematurity and low birth weight (LBW) currently account for approximately 40% of neonatal deaths in developing countries.
Objectives: To identify major factors that limit the introduction of kangaroo mother care (KMC) services in River Nile State, Sudan.
Methods: A facility based qualitative cross-sectional study conducted in two hospitals (Atbara and Al-Damar hospital). A total of seven pediatricians working in these two hospitals were interviewed using semi – structured interview.
Analysis: Analysis of the data was done manually. The interviewers' responses were entered into a data collection template. The data were reviewed and common themes were identified.
Results: Prematurity and low birth weight were a major health problem. Respiratory distress syndrome, hypothermia and sepsis were the leading causes of death. Problems facing pediatricians when caring for the preterm were; lack of incubators, non-functioning incubators, insufficient and untrained staff especially nurses beside rapid turnover. Only two of our pediatricians had heard about KMC but all of them were willing to adopt it in their units. Lack of awareness among mothers, health staff and the community, and the community health culture were the main two obstacles to KMC implementation. Financial support, staff training and isolated wards were needed for mothers' privacy. Knowledgeable practitioners to develop evidence-based policies were important for KMC implementation. Raising awareness among mothers, health cadre especially nurses caring for mothers and their babies and the community about KMC.
Conclusion: Lack of knowledge among health cadre, mother, families and community were obstacles to KMC. Awareness need to be raised.

Open Access Original Research Article

Peak Expiratory Flow (PEF) in Relation to Selected Anthropometric Parameters in Healthy Adult Males of Kumaun Region of India: A Comparative Study

Kumari Poonam, Mehar Bano, Kamlesh Jha, Parveen Bhardwaj

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2015/12460

Background: PEF is a reasonably good measure of ventilatory function. It varies with various anthropometric parameters, geographical location of the subjects as well as various disease processes.
Objective: To assess the relationship between PEF and certain selected anthropometric parameters and to devise prediction equation based upon these parameters.
Materials and Methods: Three hundred healthy male adults in the age group of 18-60 years have been assessed for PEF using Wright Peak Flow Meter.
Results: In the age group ≤ 40 years, PEF was on the average greater than in the age group > 40 years. Prediction equations were derived for PEF dependent on age and height in <40 age group and age and weight in >40 years age group.
Conclusion: PEF appears to decline with advancing age, and to increase with height in younger subjects and weight in older subjects.

Open Access Original Research Article

Seroprevalence of Helicobacter pylori Infection among Asymptomatic Children in Lagos, Nigeria

Quadri Remi, F. O. Olufemi, O. O. Odedara, S. A. Bamiro

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2015/15985

Aim: Helicobacter pylori infection is mainly acquired during childhood and is strongly linked with peptic ulcer disease. This study determines the seroprevalence of Helicobacter pylori infection among school children in Lagos, Nigeria.

Place of Study: Alimosho and Ajeromi Local Government Areas of Lagos state, Nigeria between months March to September 2014.

Methodology: 195 asymptomatic children of aged 2-16 attending public health facility in selected Local Government in Lagos, Nigeria were recruited for the study with descriptive questionnaire. Blood samples of 5 ml were collected into plain bottle and sera obtained were analysed for Helicobacter pylori Immunoglobulin G using DiaSpot H. pylori kit.

Results: Of the 195 children examined for H. pylori IgG, 72.3% were seropositive while highest rate of 72.7% seroprevalence was recorded among children aged 5-7 years. Of seropositive observed among children aged 5-7 years, 37.5% and 62.5% were male and female respectively, while seropositive rate among children age 8-10 years, 51.3%  were female and 48.7% male (p=0.055). Seroprevalence rate of 70.1% was observed among the children living in a house with population of 6 -7 people (p=0.076) while significant value of 69.1% and 76.6% were recorded among the children whose parents are traders and middle class employees respectively (p<0.05). Households with no regular potable water supply (never) have higher rate of 70.3% seroprevalence and 73.2% rate was observed among those that sometimes have water for their drinking and domestic use. Seropositive children of 72.5% sometimes buy food from elsewhere while only 73.2% seropositive always buy food from street vendors or other sources outside their home

Conclusion: It could be deduced that while H. pylori is acquired early in life, infection can be asymptomatic and poor standards of living and socioeconomic status can contribute to early infections.

Open Access Original Research Article

Microbial Agents and Associated Factors of Persistent Diarrhoea in Children Less Than 5 Years of Age in Edo State, Nigeria

Paul Erhunmwunse Imade, Nosakhare Odeh Eghafona

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2015/18754

Background: Persistent diarrhoea is a major health problem for children in developing countries.

Aims: This study was carried out to assess the microbial agents of persistent diarrhoea as well as other associated factors of infection.

Methodology: Faecal and blood samples were collected from children less than 5 years of age with persistent diarrhoea in Edo State, Nigeria. The faecal specimens were processed using standard microbiological methods while the blood specimens were processed for malaria parasites using staining technique.

Results: The overall results showed a prevalence of 42(25.1%). Single infection was 37(22.2%) while mixed infection had 5(3.0%). Rotavirus was the most prevalent microbial agent (23.4%), followed by cryptosporidium species (14.9%). Sex and age did not show statistical significance (P>0.05). The effects of associated factors of infection on diarrhoeal patients was not statistically significant (P>0.05), although, undernourished, low socioeconomic status and not breastfeeding children had higher rates of infection than their counterparts.

Conclusion: Persistent diarrhoea is not uncommon in this locality since the prevalence rate was 25.1% Thus, preventive measures should be put in place to address the associated factors of persistent diarrhoea in order to minimize the reoccurrence of the infection.

Open Access Review Article

Role of Free Radicals and Common Antioxidants in Oral Health, an Update

Anil Kumar Nagarajappa, Divya Pandya, Sreedevi ., K. S. Ravi

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/BJMMR/2015/18796

Free radicals have been implicated in the etiology of large number of major diseases. They can adversely alter many crucial biological molecules leading to loss of form and function. Such undesirable changes in the body can lead to diseased conditions. Antioxidants are compounds which destroy the free radicals in the body, thereby preventing against harmful oxidation- reduction reactions. Antioxidants are critical for maintaining optimum health and wellbeing. The best sources are fruits and vegetables which provide a variety of antioxidants like Vitamins A, C, E & carotenoids. As in every medical field, the usage of antioxidants is becoming more frequent in dentistry also. It can help adjunct treating the progress of oral problems such as periodontitis or gingivitis or progression of potentially malignant disorders to malignancy. Thus, a greater consumption of fruits and vegetables should be encouraged as they are the natural sources of these chemopreventive antioxidant along with other protective factors packaged by nature. This review focuses on commonly used effective antioxidants in different oral and dental pathologies as a new generation adjunctive remedy.