Open Access Case Study

Stabilization of Chronic Lymphatic Leukemia with Amanita phalloides: Effect of Additional Chelidonium majus. Case Report

Isolde Riede

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/21897

Objectives: Amanita phalloides contains amanitin, inhibiting RNA polymerase II. Partial inhibition with amanitin influences tumor cell - but not normal cell - activity. A patient with diagnosed B-cell chronic lymphatic leukemia was treated successfully for eight years with Amanita phalloides. However, the necessary dose for stabilization of the disease increased during this time. In addition thrombocyte levels decreased, indicating bone marrow affection. Therefore additional regimen was necessary.

Methods: Chelidonium majus contains alkaloids with cytostatic and cytotoxic potential. In addition to Amanita, Chelidonium was applied.

Results: During treatment with Amanita and Chelidonium, leukocyte levels and lactate-dehydrogenase levels were roughly unaffected, meaning there is no strong effect on tumor growth of cells, and no observable cell destruction. Anyhow, thrombocyte levels increased after the Chelidonium treatment, indicating an effect in the bone marrow.

Conclusion: Chelidonium majus can be useful during Amanita therapy as a pulse to regenerate bone marrow affection.

Open Access Case Study

Supernumerary Molars: A Rare Finding

Ayesha Bashir, Sohail Abbas Khan, Muhammad Kashif, Noreen Sarwar, Shazia Naaz

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/BJMMR/2016/21951

Panoramic radiographs of a female patients aged twenty one years without any associated syndromic or systemic medical history, revealed the presence of the two supernumerary molars, right upper and left lower fourth molars. Both the teeth were disto-molars. The right upper fourth molar had normal tooth morphology with regard to its crown and root but was slightly smaller than the existing third molars. The left lower disto-molar had somewhat different morphology as compared to adjacent third molar and smaller in size as compared to the fourth right upper disto-molar. Their crowns were tuberculated and both had single root (2D radiographic morphology).

Open Access Short Research Article

Transabdominal and Transrectal Sonographic Variation of the Prostate Volume and Dimensions: In Evaluation of Benign Prostatic Hyperplasia

Siva Krishna Prasad Konduru, Anthony Ameeral, Paramanand Maharaj, Santoshi Muppala, Bidyadhar Sa, T. Ramesh Rao, Suresh R. Rao

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/22255

Benign prostatic hyperplasia (BPH) is the non-malignant enlargement of the prostate. Estimation of Prostate volume and dimensions contribute significantly to the management of BPH. Correlations between the trans-abdominal and trans-rectal ultrasound methods in estimating prostate volume and dimensions were studied with variable results. Ninety-one consecutive patients of 50 years or older with were scanned by Trans abdominal and transrectal sonographs (TA&TRUS) at the same session after obtaining the consent. All the scans were performed on a single ultrasound machine. The volume and dimensions of the prostate obtained by both methods were compared and correlated using Pearson correlation coefficient. The data was analysed further in groups based on volumes and ethnicity. Twenty-four patients were also scanned by other consultant radiologist and the data was analysed to compare the interobserver variations.

Results: The mean age of the patients was 66.03±10.41 years. The mean prostate volume for ninety one patients by TA & TRUS was 44.4±35.1 ml and 46.2±34.7 ml, respectively (r = 0.965, p<0.001). Among the total patients 42 were of East Indian (EI) origin, 45 were of Caribbean African (CA) origin and 4 were of mixed race. The mean prostate volume of EI race by TA & TRUS was 35.3±23.3 and 38.9±25.9 ml respectively(r = 0.950, p<0.001). The mean prostate volume of CA race by TA & TRUS was 50.8±39.4 and 51.0±38.5 ml, respectively (r = 0.967, p<0.001). The mean prostate volume of observer A and observer B by TA & TRUS was 43.5±28.8 and 45.8±25.9 ml                (r = 0.953, P<0.001) and 46.6±39 and 46.9±27.4 ml (r = 0.877, p<0.001) respectively.

Conclusion: Strong correlation between TA & TRUS estimation of prostate volume and dimensions for volumes up to 100ml found in our study offers TAUS as a cost effective, less invasive, quick and well tolerable alternative to TRUS. TRUS however may be a reasonable choice for accurate measurements in larger (>100 millilitres) prostates, this needs to be further investigated by a larger sample size.

Open Access Original Research Article

Prevalence and Determinants of Common Fears in Children and Their Socio-Demographic Characteristic

Abdulbari Bener, Elnour E. Dafeeah, Suhaila Ghuloum

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/22552

Objective: Most children experience some degree of fear during their development. Excessive fears can create serious obstacles to children. The aim of this study was to identify the most common fears in a sample of children and adolescents and examine the socio-demographic correlates of fears.

Materials and Methods: This cross-sectional study was conducted during the period from July 2010 to February 2012 at Public and Private Schools of the Ministry of Education and Higher Education, State of Qatar. Out of 2188 students approached, 1703 students agreed to participate in this study, with a response rate of 77.8%. The questionnaire includes socio-demographic information, academic performance, behaviour at home and various fears. 

Results: More than half of the children experienced fears (56.7%). Most of them were in the intermediate level, 12 – 15 years old (46.1%). Overall, reported fears were significantly more frequent in girls (62.6%) than boys (37.4%) (p<0.001). A significant difference was observed between girls and boys who experienced fears in their age group (p<0.001), education of mother (p=0.04), household income (p=0.008) and academic performance (p<0.001). The most frequent reported fears were fear of someone dying in the family (85.2%), parents getting divorced (84.5%), breaking religious law (82%), being kidnapped (78.2%), family members ill (78%) and dying (76.7%). 

Conclusions: The study findings revealed that fears were highly prevalent in Arab children and adolescents in Qatar. Girls reported more fears than boys. There was a significant difference observed between girls and boys in their age group and academic performance for the reported fears.

Open Access Original Research Article

Evaluation of Preventive Self-care Behaviors and Its Related Factors in Patients with Heart Failure

Parvin Mangolian Shahrbabaki, Esmat Nouhi, Majid Kazemi, Fazlollah Ahmadi

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/21499

Background: Self-care behaviors are the most important way to prevent frequent hospitalization, improve the quality of life, and reduce mortality in patients suffering from heart failure.

Aims: To assess the preventive self-care behaviors and its associated factors in heart failure patients in Kerman teaching hospitals.     

Place and Duration of Study: South-East of Iran, Cardiology Clinics of Kerman teaching hospitals from August 2014 to January 2015.

Methodology: This cross-sectional study evaluated preventive self-care behaviors in 150 patients suffering from heart failure by a valid and reliable questionnaire and checklist. Subjects were selected by simple random sampling among patients with heart failure from Cardiology Clinics of Kerman teaching hospitals. The Data was analyzed by using of SPSS, version 20.                                                                  

Results: Most (68.5%) of the subjects were moderate at complying with medication regimen (mean=54.41±8.41) and 78.3% were poor at non-medication regimen (mean=61.04±7.21). Control pulse was poor in the majority of them (91.5%). There was a significant relationship between total mean self-care score and age (p=0.05), marital status (p= 0.03), education (p=0.009), the number of hospitalization (p= 0.02), NYHA functional class (p= 0.002) and monthly income (p= 0.003).                                                                                                        

Conclusion: Due to poor self-care in patients suffering from heart failure and its relationship with some personal factors, it is better to plan for training these patients based on their needs.

Open Access Original Research Article

Cardiovascular and Respiratory Responses of Apparently Healthy Participants to Cervical Traction in Sitting Position Using Different Weights

Afamefuna Victor Egwuonwu, Cynthia Okonkwo, Emmanuel Chiebuka Okoye, Antoninus Obinna Ezeukwu, Charles Ikechukwu Ezema

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/21885

Background and Aim: Cervical Traction (CT) is a vital physiotherapeutic modality in the management of cervical musculoskeletal disorders. This study determined the cardio-respiratory responses to CT using different percentage body weights on Apparently Healthy Individuals (AHI).

Materials and Methods: 163 consecutively recruited AHI that met the inclusion criteria were randomly assigned into three groups (A, B and C) that were subjected to CT weights of 7.5%, 10% and 15% of their total body weights respectively. Participants’ systolic (SBP) and diastolic (DBP) blood pressure, Pulse Rate (PR), Respiratory Rate (RR) and Inspiratory Capacity (IC) was recorded before and after traction. The side-effects reported by participants during and after traction were also recorded using a previously validated 8- item self-administered questionnaire.

Data was analyzed using Paired t-test, Independent t-test, Chi square test and One-way ANOVA.

Results: IC and PR significantly changed across the three groups post-traction. RR significantly changed in groups B and C post-traction but not in group A. SBP and DBP showed no significant differences in any of the group post-traction. The participant’s side effects of pain in the neck or arm, dizziness and shortness of breath were found to be significantly associated with cervical traction across the three groups, (p < 0.05; CI=0.00-0.00).

Conclusion: CT alters the cardiovascular and respiratory system leading to side effects that increase with increased traction weight. Use of a minimum weight for CT is recommended.

Open Access Original Research Article

Correlation between Anthropometric Variables, Social Class, Age and Hematological Profile among Children with Sickle Cell Anemia in ENUGU South-East Nigeria

Josephat Maduabuchi Chinawa, Odutola Isreal Odetunde, Kingsely Ihedioha Achigbu, Eberechukwu Achigbu, Elias Aniwada, Awoere Tamunosiki Chinawa

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/21621

Background: Sickle cell anaemia (SCA), a common haematological genetic disorder, could affect both the growth and haematological profile of the sufferer.

Objectives: This study aims at determining any correlation between anthropometric variables and haematological parameters among children with sickle cell anaemia (SCA).

It also determines the association between social class and haematological parameters of children with SCA.

Methods: A total of 80 subjects were recruited into the study, comprising 40 HbSS patients. This is cross sectional study of haematological indices and anthropometric measurement of children with sickle cell anaemia aged 6-20 years.

All data were coded, entered, and then analyzed using the Statistical Package for Social Sciences program (SPSS), version 20.

Results: There was statistical significant correlation between BSA and total white blood cell count (TWBC) (p=0.028) but not with Haemoglobin concentration (Hb) and Erythrocyte sedimentation rate (ESR). Hb: r=0.073, p=0.654 ESR: r=0.224, p=0.164 TWBC: r=0.348, p=0.028. The Haemoglobin concentration, TWBC and ESR values are 7.77 g/dl, 11.96×109, and 15.4 mm/hr There is also no statistical significant correlation between BMI and haematological variables:  TWBC r= 0.100 p=0.51, Hb: r=0.118, p= 0.469  ESR: r= 0.033, p=0.841.

There is also no statistical significant correlation between chest circumference and haematological indices. TWBC r= 0.216 p=0.181, Hb: r=0.043, p= 0.793 ESR: r= 0.143, p=0.378.

There were no statistical differences in mean for all the variables studied among the social classes. Hb; p=0.373 ESR p=0.633. TWBC p= 0.451.

Conclusion: Infection is not the only cause of elevation in TWBCs. it is important to also consider the impact of surface area on white blood cell count of children with SCD before using antimicrobials for such infections.

Open Access Original Research Article

Malarial Acute Kidney Injury: 25 Years Experience from a Center in an Endemic Region

Rubina Naqvi, Fazal Akhtar, Ejaz Ahmed, Rashid Sheikh, Sajid Bhatti, Abbas Haider, Anwar Naqvi, Adib Rizvi

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/21471

Background: While malaria rarely occurs in many parts of the world, it still causes serious complications like acute kidney injury (AKI) in endemic areas and needs to be reported.

Methods: This study was carried out at Sindh Institute of Urology and Transplantation, Karachi, Pakistan. From January 1990 – December 2014, 5623 patients with acute kidney injury (AKI) were registered at this institution. AKI was defined as sudden rise in creatinine or decline in urine output or both. All patients had normal sized non obstructed kidneys on ultrasonography, with no previous co morbidity. Malaria parasite was seen on blood peripheral film in all patients.

Results: Among total patients with AKI, 671 (11.93%) developed AKI in association with malarial infection. Average age of patients was 33.70±16.426 (range 4-98 years) with M: F ratio of 3:1. The causes were plasmodium falciparum in 59%, vivax in 15.2%, dual infection in 3.57% and undefined species in the rest. Oligo-anuria and vomiting were the most common associated symptoms along with fever. Renal replacement therapy was required in 76.6% of patients. Complete recovery was seen in 64.82%, while 21.2% died during the acute phase of illness. Jaundice, old age, altered level of consciousness, raised total leukocyte count, oliguria, hyperkalemia and falciparum malaria were the independent risk factors associated with high mortality.

Conclusion: Malaria still causes significant morbidity and mortality in our part of the world. Vivax malaria which was thought to be ‘benign’ can present with hemolysis, thrombocytopenia and kidney failure, though risk of death is 2.36 fold higher with falciparum malaria.

Open Access Original Research Article

Indices of Cardiovascular Diseases and Malaria Parisitemia amongst Solid Waste Disposal Workers in Port Harcourt Nigeria

Eleanya Evangeline Ukachi, C. K. Wachukwu, A. O. Ollor, F. U. Amuh

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/BJMMR/2016/19514

The aim of this study was to evaluate the health risks of solid waste disposal workers and scavengers, involved in the handling and disposal of municipal wastes, especially their cardiovascular health. The study was carried out in Port Harcourt, Nigeria from 2011 to 2013. Male solid waste disposal workers and scavengers (n=100) aged between 19 and 53years who have worked from six months to 15 years in waste disposal industry, were used in this study. Twenty six percent were aged 40 years and above while 74% were aged between 19 to 39 years. These were compared with 100 male subjects of same age group (21 to 50) who were not solid waste disposal workers; they served as the control group. Their blood pressures (systolic and diastolic) were measured using a standard mercury sphygmomanometer, weight was measured using calibrated electronic scale and height was measured using a Stadiometer. Body Mass Index (BMI) was calculated by the formula (weight/height2). These were used as indices of cardiovascular disease in the volunteers. The level of malaria parasitemia was evaluated. A well-structured questionnaire was given to each volunteer in this study as a behavioral determinant. Mean systolic pressure of the solid waste disposal workers and the control group were 136±13.58 mmHg (Mean ± SD) and 117±12-04 mmHg respectively. The diastolic pressures were 88±12.73 mmHg and 71±10.71 mmHg respectively. This was significant (p<0.01) despite the fact that the solid waste disposal workers had a lower BMI value (24.25±3.19 Kg/M2) than the controls (29.46±3.75 Kg/M2). The increase in blood pressure cuts across duration of exposure, 55.84% of the solid waste disposal workers reported regular alcohol intake, while 43.27% reported current tobacco use against 20% and 7% of the control group. There was no significant difference (p>0.01) when  the blood pressures of solid waste disposal workers aged 40 and above was compared with that of 19 to 39 age group. Prevalence of malaria parasitaemia was higher in the solid waste disposal workers in comparison to the controls 92% and 69% respectively.

Open Access Review Article

Efficacy of Tacrolimus in Treating Nephrotic Syndrome Children

Sijan Thapa, Hongzhu Lu

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/21806

Nephrotic Syndrome (NS) is primarily a pediatric disorder, common in pre-schooler and school aged children. Immunosuppresive drugs like prednisolone, cyclophosphamide, cyclosporine A (CsA) has been the main treatment regimen in the management of Nephrotic syndrome. This has remain still the same therapy which is not satisfactory in the management of nephrotic syndrome children. The management of children with idiopathic Steroid-Resistant Nephrotic Syndrome (SRNS) and Steroid-Dependent Nephrotic Syndrome (SDNS) are difficult to treat but there is no consensus on the most appropriate treatment therapy. Pneumonia and urinary tract infection are also a challenge in the management of NS. The main goal of treatment is complete or partial remission of proteinuria, which is the most important marker of long term outcome. Calcineurin inhibitors (CNIs) are used to avoid steroid toxicity in children with NS. There are limited data on the relative efficacy and safety of calcineurin inhibitors and alkylating agents for NS in children. There are different immunosuppressant drugs but tacrolimus can be used in the treatment of childhood NS which is less expensive, have less cosmetic side effects and easy to administered. In this review we discuss the safety and efficacy of tacrolimus, a new drug which can be administered orally as a twice daily dose in the management of childhood NS. Some study suggests that application of tacrolimus can be a new turning point for the treatment of nephrotic syndrome.