Open Access Case Study

Late Sudden Deafness in Unoperated Ear of Patients with Otospongiosis: Case Studies

Alexandre Caixeta Guimaraes, Thiago Messias Zago, Guilherme Machado de Carvalho, Fernando Laffitte Fernandes, Jorge Rizzato Paschoal

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2015/17420

Background: It is not known whether there is etiological relationship between otospongiosis and sudden deafness. The most common etiologies that explain sudden deafness are viral infections, vascular and autoimmune process. 

Methods: Two cases of patients with otospongiosis that have developed sudden deafness are presented.

Results-Case report: We report two cases of late sudden deafness in the unoperated ear of patients with otospongiosis. Both patients underwent previous surgical treatment in the contralateral ear with a a short period of hearing improvement  and poor  hearing outcome some days  after. In both reported cases the patients with bilateral otospongiosis had sudden deafness affecting both ears. The first episodes had the onsets postoperatively at the operated ears. The second episodes were at the contralateral ears in the late follow-up, especially considering that in both cases the patients showed satisfactory results regarding hearing improvement postoperatively although temporarily we therefore question the existence of the association between otospongiosis and sudden deafness.

Discussion: Sudden deafness in patients with otospongiosis is a rare occurrence and because of the few cases reported, it is not possible to establish any relationship. Maybe there is a possible immunological cause for the association of otosclerosis and sudden deafness.

Conclusion: The association between sudden deafness and otosclerosis can be considered.

Open Access Minireview Article

Arguments in Support and Against Euthanasia

Visnja Strinic

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/BJMMR/2015/19151

The aim of this article is to present and confront the arguments in support of euthanasia and physician assisted suicide, and the arguments against. The arguments for and against euthanasia are listed and discussed to literature cited.

Euthanasia is an act of mercy, and, basically means to take a deliberate action with the express intention of ending a life to relieve intractable, persistent, unstoppable suffering.

The phenomenon about both the morality and legality of euthanasia and physician assisted death have been a significant debates of the last decades of the twentieth century and they will remain further a source of controversies.

This paper explores and analyze the arguments in support and against euthanasia and physician assisted suicide. For the purpose of this article has been viewed over the Internet and Google total of 247 journal articles, book chapters and websites, and, in writing of this article we used 74 references cited in the manuscript.

The ‘end of life’ issue in relation to euthanasia and physician assisted suicide is a most widely discussed phenomenon not only in academic and official literature, but also in daily life.

Euthanasia should be legally permissible if certain conditions are present: the patient is terminally ill, death is imminent, and, treatment was appropriate and well. If a patient autonomously chooses to end his life or have someone else assist him in doing so, then it is morally permissible. Patient must be fully informed of the diagnosis and prognosis of an incurable, fatal disease, and competent to make the decision.

This article is a contribution to the debate on the important topic of euthanasia.

We conclude that euthanasia should be used only in cases of last resort and not as an alternative to palliative care.

Open Access Original Research Article

The Effect of Smoking on Fertility Hormones in Male Adult Smokers in South-South Nigeria

Bassey, Iya Eze, Essien, Okon Ekwere, Gali, Rebecca Mtaku, Isong, Idongesit Koko-Abasi Paul, Udoh, Alphonsus Ekpe, Akpan, Uwem Okon

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2015/19287

Aims: To investigate the relationship between tobacco smoking and serum concentrations of male reproductive hormones-luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone and prolactin.

Study Design:  The design of the study was cross sectional.

Place and Duration of Study: the Department of Chemical Pathology, University of Calabar Teaching Hospital between October 2012 and October 2013.

Methodology: 140 male tobacco smokers and 61 male non-smokers aged between 19 and 45 years were recruited for this study. Serum testosterone, prolactin, FSH and LH was determined using Enzyme linked immunosorbent assay. Body mass index was measured and smoking pack years calculated.

Results: The mean values for testosterone, prolactin, FSH and LH was 8.5±3.43 ng/ml; 8.9±4.65 ng/ml; 7.97±9.06 mIU/ml and 17.2±9.35 ng/ml respectively for the smokers and 12.3±4.01 ng/ml; 9.2±5.97 ng/ml; 4.3±2.57 mIU/ml and 10.8±5.18 ng/ml respectively for the non-smokers. The mean testosterone level was significantly lower (P<.0001) in the smokers compared to the controls while LH and FSH values were significantly higher (P<.0001) in the smokers compared to controls. There was however no significant difference (P = .699) in the mean levels of prolactin.

Conclusion: The risk of infertility associated with smoking may be attributed to lower levels of testosterone rather than hyperprolactinaemia. This decrease in testosterone levels may translate to a decrease in fertility as testosterone is the principal reproductive hormone in males.

Open Access Original Research Article

Lipid Profile Status in Chronic Obstructive Pulmonary Disease and Association with Interleukin 8

Ritabrata Mitra, Subinay Datta, Mrinal Pal, Kaushik Ghosh, Debajoity Paul, Keya Pal

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2015/18703

Background: There are several conflicting pictures found about blood lipid profile parameters in Chronic Obstructive Pulmonary Disease.

Aim: The present study was conducted to evaluate the exact profile of lipid status in COPD and as inflammation has been implicated in the pathogenesis of COPD, is there any association between inflammatory chemokines and lipid profile.

Methods: From February 2011 to May 2013 five hundred fifty two patients with COPD presented to Burdwan Medical College and Hospital and 521 subjects having no COPD as age and sex-matched control entered to the study. Diagnosis of COPD was confirmed according to clinical findings and pulmonary function test. Lipid parameters and IL8 in serum were measured in all subjects.

Results: The mean level of TG was 148.32±12.18 mg/dl and 134.54±11.78 mg/dl in COPD patients and healthy control, respectively. (p<0.001). The mean level of TC was 186.46±22.91 mg/dl and 173.77±15.21 in COPD patients and healthy control respectively (p<0.001). LDL level mean value was 118.91±12.92 mg/dl and 118.91±12.92 mg/dl in COPD patients and control respectively (p<0.001). The mean value of HDL showed 33.46±4.69 mg/dl in COPD patients and 38.38±5.22 mg/dl in control (p = 0.034). Regression analysis was showed IL8 was statistically significantly correlated with TC (r = 0.785, p <0.001), TG (r = 0.871, p<0.001), LDL (r = 0.882, p<0.001), VLDL (r = 0.679, p=0.016) and HDL (r = -0.681, p=0.012),

Conclusion: COPD patients showed significantly higher serum levels of TC, TG, LDL, IL8 and serum concentrations of HDL were also decreased significantly compared to controls. Moreover, lipid profile parameters were well correlated with serum IL8.

Open Access Original Research Article

Effect of Resistive and Aerobic Exercise on Reducing Insulin Sensitivity during Pregnancy

Heba M. Embaby, Engy M. El Nahas, Hesham M. Kamal

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2015/16269

Aims: The purpose of this study was to evaluate whether a combined resistive and aerobic training program would improve insulin sensitivity compared with aerobic training alone in pregnant women.

Place and Duration of Study: Department of Obstetrics and Gynecology, Out Patient Clinic at El Mataria Teaching Hospital, between January and July 2014.

Methodology: This study was carried out upon forty primipara pregnant women, who had insulin resistance, their age ranged from 25 to 35 years and their gestational age ranged from 20 to 24 weeks. They were divided into two groups equal in number, group (A) who performed resistance exercise and aerobic exercise (RE and AE) and group (B) who performed who aerobic exercise only(AE only).

Assessment of all subjects in both groups (A&B) was carried out at the beginning of the study and at 37 weeks of gestation using HOMA test.

Results: There was a highly statistically significance decrease in insulin resistance in both groups where the p value was (0.0001) favoring group (A). 

Conclusion: Adding resistance exercise to aerobic exercise had a greater effect on improving insulin sensitivity than aerobic exercise only.

Open Access Original Research Article

Relationship between Blood Pressure, Blood Glucose and Body Mass Index and Coexisting Prehypertension and Prediabetes among Rural Adults in Niger Delta Region, Nigeria

A. Nwafor, F. C. Mmom, O. Obia, C. Obiandu, V. O. Hart, B. C. Chinko

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/BJMMR/2015/14777

The incidence of hypertension, diabetes and overweight-obese are emerging health problems, which are increasingly prevalent globally. The objective of the study was to evaluate the prevalence and the relationship between blood pressure, blood glucose and body mass index, and the tendency of developing prehypertension and pre-diabetes in rural adults in the Niger Delta region. A cross-sectional, population-based descriptive design was used. A total sample of 250 subjects aged 20 years and older, that had resided continually in the order of 10 years and above, in the oil and gas extraction environments, were recruited. While body mass index was calculated using internationally accepted standard methods, blood pressure and fasting blood glucose level were recorded also by standard methods, classified and correlated. One-way ANOVA and Pearson’s correlation analyses were used for comparisons between groups.  Result showed that although blood pressure and blood glucose measurements increase with age, males had higher prevalence of high blood pressure and raised blood glucose compared with females (p<0.05). Both sexes had almost similar distribution of high body mass index which was not statistically significantly different (p>0.05). In total, overweight coexisted among 14% of participants with normal blood glucose, 19.6% pre-diabetes, 7.6% diabetes, 24% normotensive, 15.4% pre-hypertensive and 1.8% hypertensive. Pre-diabetes coexisted among 9.8% normotensive and pre-hypertensive respectively, while 0.2% normotensive, 5.6% pre-hypertensive, and 18.2% hypertensive had combined diabetes. About 16.4% had both combined diabetes and obesity, and hypertension and obesity. Overall, 19.5% had combined hypertension, obesity and diabetes. In total, the prevalence of obesity was 16.4%, hypertension 18.2%, and diabetes 24.0%. The prevalence of coexisting prehypertension and pre-diabetes, pre-non-communicable and main non-communicable diseases was 17.5%, 21.3%, and 23.7% respectively. Data analysis revealed positive and linear correlation and statistically significantly different (p<0.001) in the varying degree of complex association of blood pressure and blood glucose as well as body mass index.  In conclusion, notwithstanding, this study provides baseline population based data establishing that the populations in the oil bearing communities are at high risk of developing hypertension, diabetes, and overweight-obese together with high prevalence of combination of pre-hypertension and pre-diabetes. The coexisting of significantly high prevalence of prehypertension and pre-diabetes with raised body mass index, in particular, have a more adverse effect by progression to full hypertension and diabetes. There is the need for national programme for prevention, control or delay the burden of the risk factors for non-communicable diseases for oil and gas bearing communities.

Open Access Original Research Article

Contraception Usage: Knowledge, Attitude and Associated Factors among Women of Reproductive Age Attending a Health Facility in Benin City, Nigeria

Obi Andrew Ifeanyichukwu, Labiran Adetunji

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/BJMMR/2015/16282

Background: Contraceptive usage remains a challenge in developing countries. Despite high contraceptive awareness and knowledge, studies have shown disappointingly very low contraceptive usage. The 2013 Nigeria Demographic and Health Survey (NDHS) report places modern contraceptive usage in Nigeria at 10%, amounting commutatively as a 6% increase over a 24 year period. This study was conducted to assess knowledge, attitude, contraceptive usage and associated factors among women of reproductive age attending a health facility in Benin City, with the goal of developing programs and interventions to improve contraceptive usage.

Methods: A health facility based descriptive cross sectional study design was utilized for this study, involving researcher administration of semi-structured questionnaires to 161 consenting women (15-49 years) attending immunization clinics in a health facility in Benin City. The data collected were analyzed using IBM SPSS version 21.0 statistical software with statistical significance set at p< 0.05 and 95% Confidence Interval.

Results: One hundred and thirty eight (85.7%) women studied were aware of contraception with 128 (92.8%) having correct knowledge of contraception. One hundred and fourteen (82.6%) women had positive attitudes towards contraception use while (17.4%) had negative attitudes. Furthermore, the per cent of contraceptive users was calculated to be 64.5% (n=89) among women studied. Multivariate analysis following bivariate analysis identified being single (OR=0.136; 95% CI = 0.026 - 0.719; p=0.019) and having negative attitude (OR=0.367; 95% CI = 0.147 - 0.917; p=0.032) towards contraception to be negatively associated with contraception usage when compared to being married and having positive attitude towards contraception.

Conclusion: The level of awareness and knowledge on contraception among women studied was high, with gaps identified to exist between knowledge, attitude and contraceptive usage. There is need to develop interventions to sustain and improve contraception  usage among women in Benin City, Edo State.

Open Access Original Research Article

Serum and Salivary Cortisol Levels in Diabetics Attending University of Calabar Teaching Hospital, Calabar, Nigeria

Bassey, Iya Eze, Gali, Rebecca Mtaku, Ogbolu, Ifechukwude Augustina, Essien, Okon Ekwere, Usoro, Chinyere Adanna Opara, Emeribe, Anthony Uchenna

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2015/19286

Aims: To investigate if salivary cortisol can be used as an alternative to serum cortisol in the management of diabetes mellitus.

Study design:  The design of the study was cross sectional.

Place and Duration of Study: Diabetic Clinic of the Department of Internal Medicine and the Department of Chemical Pathology, University of Calabar Teaching Hospital between June 2009 and July 2010.

Methodology: Fifty five (55) type II diabetic patients and thirty three (33) non-diabetic controls (45 men, 43 women; age range 30 - 69 years) were recruited for this study. The levels of salivary cortisol, serum cortisol, fasting plasma glucose and glycated haemoglobin were determined. Serum and salivary cortisol was determined using enzyme immunoassay; fasting plasma glucose using colorimetric method and glycated haemoglobin using cation-exchange resin separation method.

Results: The mean serum and salivary cortisol levels were significantly higher (p=0.000)  in diabetics as compared to the controls. The salivary cortisol was about 70% lower than the serum cortisol in each group. There was no significant difference between the percentage difference between the serum and salivary cortisol levels in both the diabetics and controls. There was a significant positive correlation between serum cortisol and salivary cortisol in both the diabetic subjects (r = 0.362, p=0.007) and controls (r =0.406, p= 0.019).

Conclusion: Cortisol levels in saliva reflected those in serum in both diabetics and controls therefore salivary cortisol may be used in place of serum cortisol in the management of diabetes.

Open Access Review Article

Sleep Pattern: Preventing Factors for Alzheimer Disease

Zhoobin Khorgami, Kiminobu Sugaya

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/BJMMR/2015/19333

Alzheimer’s disease is investigated by scientists broadly. Although there is no definitive treatment, a better medical intervention can be assumed as a preventive medicine which postpones the onset of disease and delays its progression. Understanding that the sleep changes affect the brain which it will be stabilized later as a cardinal manifestation of disease leads us to review recent studies and theories. In this review, we show that the interruption of circadian rhythm along with disruption of immune and endocrine systems can cause neuronal physiology changes. These changes can enhance neuro inflammation pathology by the time through Aβ deposition forming plaques in the brain tissue. Besides higher level of Aβ in CSF, immune system dysfunction occurred by aging will change solubility of Aβ. Furthermore, the defect in insulin and subsequently decreases in insulin receptor impair glucose metabolism. The dysregulation of glucose metabolism expedites the degenerative pathway and contributes to other oxidative stresses in neurons. The cortex of brain gradually will be damaged extremely and the brain size will shrink intensely and atrophy. In summary, we found that improving of sleep quality can reduce the disease progression and delay its symptoms by having effects in neuropathology.

Open Access Review Article

Applications and Efficacy of Photodynamic Therapy in Periodontics: A Review Study

Mohammadreza Talebi, Rojin Taliee

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2015/18517

Aims: Periodontitis is a common cause of tooth loss in adults and is an anaerobic bacterial infection. Enzymes, endotoxins and other cytotoxic bacterial products result in tissue destruction and initiation of chronic inflammation. Mechanical debridement by scaling and root planing (SRP) is the most effective treatment for this condition. Local delivery of antibiotics is an effective alternative treatment with less systemic side effects. Photodynamic therapy (PDT) is a technique of local delivery of antimicrobial agents. This study reviews the applications and efficacy of PDT for treatment of chronic and aggressive periodontitis.

Place and Duration of Study: Sample: Department of periodontics, Shahid Beheshti University of Medical Sciences, Dental School, between June 2015 and April 2015.

Methodology: A search was carried out in PubMed and Google Scholar using the keywords “photodynamic therapy” AND “chronic periodontitis” (MeSH), “photodynamic therapy” AND “aggressive periodontitis” and “photodynamic therapy” AND “periodontal treatment” (MeSH). English articles published from 2000 to 2015 were searched and a total of 32 papers including 8 articles on aggressive periodontitis and 24 on chronic periodontitis were found.

Conclusion: PDT is a minimally invasive treatment for periodontal disease. Methodological limitations of studies in this regard prevent a conclusion being drawn regarding the optimal efficacy of PDT as an adjunct for treatment of periodontitis.