Open Access Original Research Article

Prevalence of Anti-HBcore Total and HBsAg among Health Care Workers in Public Hospitals, White Nile State, Sudan; 2013

Mawahib Ahmed Elawad Abu Elgasim, Taha Ahmed Elmukashfi, Asma Abdelaal Abdalla, Siham Ahmed Balla, Zeinab Swareldahab, Abdelgadir Ali Bashir

Journal of Advances in Medicine and Medical Research, Page 1-17
DOI: 10.9734/BJMMR/2016/18578

Background: HBV infection is an occupational disease where health care workers (HCW) are at high risk.

Aim: To measure the sero-prevalence of Anti-HBcore Total and HBsAg among HCWs in Public Hospitals, White Nile State, Sudan; 2013.

Methods: A cross-sectional, hospital- based study was conducted among health care workers in Public Hospitals in White Nile State, Sudan; 2013. A sample of 385 HCWs was selected using two stage cluster sampling. A pre-tested structured questionnaire was used. The HCWs signed the informed consent to fill the questionnaire and to draw 5 ml venous blood sample for HBV tests. Blood samples were investigated for Anti-HBcore Total. Positive blood specimens for Anti-HBcore Total were further investigated for HBsAg. Data was processed using statistical package for social sciences (SPSS), version 16. Descriptive statistics and non-parametric Z test for single proportion was used at 95% CL.

Results: Out of 385 HCWs, 230 (60%) were positive for Anti-HBcore Total. Out of 230 HCWs, 62 (27%) were positive for HBsAg. Prevalence for Anti-HBcore Total and HBsAg is significantly different from the expected values, P=0.001

Conclusion: Sero-prevalence of Anti-HBcore Total and HBsAg is high among HCWs in Public Hospitals in White Nile State, Sudan.

Open Access Original Research Article

Size of Maxillary Anterior Teeth in Relation to Selected Facial Anatomic Landmarks among a Group of Subjects in Port Harcourt

A. O. Arigbede, P. Igwedibia

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/24846

Aims: The study aims to correlate the intercanthal distance (ICD), interalar width (IAW), and intercommissural width (ICoW) to the intercanine width [ICW] and the width of the philtrum to the size of central incisors.

Study Design: It was a cross-sectional study conducted at the Department of Restorative Dentistry, University of Port Harcourt Teaching Hospital in the month of October, 2015.

Methodology: The study was conducted among dental students, dental surgery assistant trainees and patients attending the restorative clinic of our institution. A sample of 115 participants was employed. Measurements of ICD - distance between the inner angles of the palpebral fissure; IAW - distance between the ala of the nose at the widest point;  PW- width of the philtrum; and ICoW- the position of the corners of the mouth, at rest were done with the aid of a manual vernier caliper.  For accuracy, each parameter was measured three times following which the average was taken. ICW-intercanine width and width of central incisors were determined indirectly using dental floss stretching from the lateral surface of one tooth to the other along the greatest curvature of the arch. Descriptive statistics was performed and Pearson’s correlation coefficient was employed to determine the level of correlation between two parameters. Significance was set at P=0.05.

Results: The mean age of the participants was 28.52 years ±9.037. The intercommisural width has the greatest mean, 53.3±0.451. The mean of the philtrum was about the size of 1 central incisor. The mean for ICW was 47.4 mm (0.951), ICD was 31.7 mm ±0.376 and that of IAW was 38.1 mm ±0.421. The Pearson correlation coefficient varied from poor to weak.

Conclusion: The width of the philtrum was about the size of one central incisor. It appears the width of the philtrum could be used to estimate the size of central incisor No anatomic facial landmark provided significant predictive value for ICW. Level of correlation varied from poor to weak among the different anatomic facial landmarks investigated.

Open Access Original Research Article

Platelet-rich Fibrin Formation was delayed in Plastic Tubes

Budsara Jianpeampoolpol, Saranya Phuminart, Keskanya Subbalekha

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/25169

Introduction: Platelet-rich fibrin (PRF) is used in many regenerative treatments. Preparing PRF in glass tubes requires quick handling and generates biohazard concerns about silica contamination and glass breakage. Using plastic tubes may be an alternative to glass tubes.

Objectives: This study investigated the formation of PRF prepared in polypropylene (PP) and polystyrene (PS) tubes compared with glass tubes.

Methodology: PRF was prepared from human blood (n=20) in PP, PS, and glass tubes. The time required for PRF clot formation and retraction from the tube wall were observed. The PDGF-AB, TGF-β1 levels, and the gross/SEM appearance of the PRF clots were also evaluated.  

Results: The PRF clots in PP and PS tubes formed and retracted significantly slower compared with those in glass tubes. The PDGF-AB levels in the PRF from PP, PS, and glass tubes were not significantly different. Although the TGF-β1 levels in the PRF from PP and glass tubes were not different, that from the PRF from PS tubes was significantly higher. The gross structure and SEM appearance of PRF from the three tube types were similar.

Conclusion: The slow clot formation in PP and PS tubes can extend PRF handling time while retaining PDGF-AB level and fibrin appearance. Owing to this delay in clot formation, we could obtain the plasma without adding any anticoagulant chemical agents. The plasma can be used for accelerating bone regeneration as platelet-rich plasma.

Open Access Original Research Article

A Comparison of Rheumatoid Arthritis Patients in Kuwait with Other Populations: Results from the KRRD Registry

Adeeba Al-Herz, Adel Al-Awadhi, Khulood Saleh, Waleed Al-Kandari, Eman Hasan, Aqeel Ghanem, Fatemah Abutiban, Ahmad Alenizi, Mohammed Hussain, Yaser Ali, Ahmad Khadrawy, Ammad Fazal, Khaled Mokaddem, Beena Aftab, Najaf Haider, Ajaz Zaman, Ghada Mazloum, Youssef Bartella, Sally Hamed, Ahmed Al-Saber

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/BJMMR/2016/24673

Objective: Data on rheumatoid arthritis (RA) in Kuwait and The Middle East is scarce. Available data from Western countries may not be representative of the region. We describe RA patients in Kuwait and compare them with other RA populations and with Kuwaiti general population.

Methods: Adult RA patients from Kuwait Registry for Rheumatic Diseases (KRRD), the first RA registry in The Middle East, were studied from February 2013 through February 2015. Demographic, clinical and serologic data were compared with other RA populations and with Kuwaiti general population.

Results: 835 patients were enrolled, 62.3% female. Mean age 50.6±12 years and disease duration 6.1±6 years. RA was diagnosed at a mean age of 44.9±12 years. 17.1% had family history of autoimmune rheumatic diseases. 3.1% had rheumatoid nodules. Rheumatoid factor (RF) and anti-citrullinated peptide (ACPA) were detected in 75.6% and 57.8%, respectively. Both were positive in 49% (r=0.287, p=0.001). ANA was positive in 19.1%. Both ACPA and a combination of positive RF and ACPA were more in males (p=0.017, 0.004 respectively), whereas ANA was more in females (p=0.01). One third of male patients were smokers versus 1.9% of females. Smoking was correlated to RF (p=0.009) and ACPA (p=0,002). Difference in ACPA between genders was statistically explained by the predominance of smoking in males. Comorbidities included diabetes mellitus (DM) (20.8%), hypertension (20.2%), hyperlipidemia (10.5%) and coronary artery disease (CAD) (3.1%). 4 cases of cancer were reported.

Conclusion: RA population in Kuwait includes less women than other RA populations but more than Kuwaiti general population. Family history is more common. A higher positive ACPA in males was explained by smoking difference. Hypertension and hyperlipidemia were less reported than in both Kuwaiti general population and other RA populations. CAD was similar to other RA populations. DM was more reported, reflecting its high background prevalence in Kuwait.

Open Access Original Research Article

Relationship of Parental Knowledge and Attitude with Oral Health Status of Children in Karachi East

Anum Sami, Kulsoom Fatima, Hira Moin, Raima Bashir, Jehanzaib Ahmed

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/24767

Objective: This study aims to determine the relationship of parental knowledge and attitude towards their child’s oral habits and health status, and evaluate whether educational status of parents plays a significant role and the level of motivation of parents for child’s regular dental checkup.
Design: Descriptive, cross-sectional study.

Place and Duration of Study: Dental OPD of Dow International Dental College and Fazaia Degree College, April 2014, Karachi East, Pakistan.

Methodology: Parents of preschool and primary school going children. A self-designed closed ended type questionnaire was provided in both English and Urdu language. Statistical analysis was done using SPSS version 16. The relationship between variables was done by frequency distribution and Chi-square test.

Results: A total of 200 completed questionnaires were considered for final analysis. 61% of the parents had children of preschool age and 38.5% were primary school going. 56.5% of the subjects had education up to Graduation or higher level. Majority of the parents belonged to Middle class 63%. 82-96% of parents were aware of preventive role of tooth brushing and fluoride. 95.5% considered regular dental checkup important.74-95% of parents showed positive attitude towards factors important for maintenance of oral health. But 64.5% of parents still did not take their child for regular visit to dentist.

Conclusions: The study shows that parents have relatively higher knowledge and positive attitude regardless of educational and socioeconomic status, however children still seemed to practice habits which affected their oral health therefore preventive dental programmes should not only focus on educating but developing personal skills in both the parents and young children and improve parents’ attitude on importance of early preventive dental visit.

Open Access Original Research Article

Occupational Risk Factors for Musculoskeletal Disorders among Operation Room Nurses at Cairo University Hospitals

Gehad Abo El Ata, Eman Khalifa, Soha El Desouky, Dina Sabry, Marie Manawil

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/BJMMR/2016/24634

Aims: To assess the occupational risk factors that contribute to the occurrence of work- related musculoskeletal disorders among Operation Room (OR) nurses and MSDs relation to biomarker c-telopeptide of type II collagen (CTX-II).

Study Design: A cross sectional study.

Place and Duration of Study: Cairo University hospitals from January to April 2014.

Methodology: The study was conducted upon 184 OR nurses from different specialties. They include 155 females and 29 males with age ranged 20-50 years and work duration ranged 2-35 years. They represent 52.6% of the OR nurses work power all over Cairo University hospitals. The individuals were subjected to questionnaires including Standardized Nordic Questionnaire (SNQ), Job Content Questionnaire (JCQ) and Quick Exposure Check (QEC) for ergonomic risk assessment. Urinary CTX-II was measured.

Results: Out of 184 OR nurses, 180 have musculoskeletal symptoms with a prevalence of 97.8%. CTX-II in females was non-statistically significant higher than in males. Higher non-statistically significant levels of CTX-II were found in those aged ≥ 40 years than in those < 40. Non- statistically significant differences were in correlation between CTX-II and various occupational risk factors as BMI, age, duration of employment, physical risk factors except for outreached arm (r= 0.16, p=0.03) and psychosocial factors except for deficient rest break (r=-0.15, p=0.038) which showed statistically significant differences. No statistically significant correlation was found between CTX-II and any of musculoskeletal symptoms during the past twelve months by applying SNQ. A statistically significant difference (Z=2.26, p=0.02) was found in OR nurses group with knee crepitus in comparison with nurses group without knee crepitus among those with high level of urinary CTX-II. Other MSDs showed no statistically significant differences between symptomatizing and non-symptomatizing groups.

Conclusion: Operating room nurses are exposed to multiple occupational risk factors leading to MSDs. CTX-II may be a valuable biomarker in early osteoarthritis.

Open Access Original Research Article

Parental Influence on Sickle Cell Crisis among Patients Attending Secondary Facilities in Abeokuta South Local Government Area, Ogun State

Olorunfemi Emmanuel Amoran, Ahmed Babatunde Jimoh, A. D. Alabi

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/24656

Introduction: Sickle Cell Disease (SCD), the most common genetic disorder amongst Black people and one of the major chronic non-communicable diseases (NCD) affecting children, poses a significant psychosocial burden, not only on the sufferers but also on the parents. This study therefore sets out to assess the influence of these parents’ knowledge and practices towards reducing the frequency and seeking appropriate treatment of Sickle Cell Crisis in their children.

Methodology: This study is a descriptive cross-sectional study conducted in Abeokuta South Local Government Area. A Total Sampling of all the sickle cell patients that attend the selected facilities were recruited into the study. Data were collected with the use of questionnaires which were interviewer administered. Statistical analyses were conducted using SPSS for Windows version 20.0.

Results: A total of 415 patients were recruited into the study. Only 39.0% had adequate knowledge of SCD, 75.2% on prevention of crisis and 62.0% on predisposing factors to sickle cell crisis. About two-third [68.0%] of participants’ source of information is by hospital staffs. Majority 81.4% have only one child with SCD. The frequency of sickle cell crisis was statistically significantly associated with the Marital status of the parents [x2 = 24.029, p = 0.0001], Parents level of education x2 = 18.538, p = 0.0001, and the source of parents information about SCD x2 = 18.194 and P = 0.001. On logistic regression analysis, predictors of low frequency of crisis were individuals who had parents with tertiary education [OR=2.37, CI=1.45-3.87], information from health workers [OR=0.58, C.I=0.43-0.79], and family income above minimum wage [OR=0.147, C.I=0.06-0.34].

Conclusion: The study reveals that the level of care and support given to SCD children may reflect in their parent’s level of education, depth of knowledge about the disease and financial capability, therefore attention to the psychosocial problems of parents and/or caregivers of these children is of utmost importance.

Open Access Original Research Article

Effect of Acute Placenta Inflammatory Changes on Fetal Outcome among Paturients in Nigeria

B. P. Athanasius, T. K. Nyengidiki

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/25208

Introduction: The placenta unit is significant for the survival of the fetus. Infections from the mother can cause histologically identifiable inflammatory changes in the placenta, which may adversely affect the fetus.

Aim: To identify the inflammatory changes in the placenta and its effect on fetal outcome.

Study Design: Cross sectional study.

Place and Duration of Study: Department of Obstetrics and Gynaecology and Department of Anatomical pathology of the University of Port Harcourt Teaching hospital, between 1st September – 31st of December, 2015.

Methods: Histological analysis of 189 placenta tissues of singleton birth paturients was carried out. The sociodemographic characteristics of patients and the fetal outcome was collated and analyzed. The information obtained was processed using the SPSS version 20 software and Epi info software version 7. Results were presented in tables; test of association was done using student’s t-test with P value < 0.05 set as significant.

Results: The mean age of patients was 30.9±4.6 years with age range of 19-48years. Acute placental inflammatory changes of varying grades were noted in 64.6%(122) of placenta with severe inflammatory changes constituting 8.5%(16) of all examined placentae. Severely inflamed placenta was associated with birth asphyxia (P=0.0000033) and fetal demise (P=0.0352).

Conclusion: Acute inflammatory changes are common among paturients in Port Harcourt Nigeria. These changes in placenta are associated with birth asphyxia and fetal demise especially when they are severe.

Open Access Review Article

The Hsp90 Chaperone Machinery: An Important Hub in Protein Interaction Networks

Jürgen Radons

Journal of Advances in Medicine and Medical Research, Page 1-32
DOI: 10.9734/BJMMR/2016/24631

Heat shock protein 90 (Hsp90) represents one of the most conserved proteins in living organisms and is present in all kingdoms of life except for Archaea. HSP90 proteins define a widespread family of molecular chaperones that play a fundamental role in protein homoeostasis and viability. HSP90s mediate folding and maturation of a broad spectrum of client proteins including steroid hormone receptors, transcription factors, and protein kinases. HSP90s primarily exist as homodimers whose activity is regulated by ATP. Hsp90 can adopt different ATP-triggered conformations, ranging from an open V-shaped unliganded to a closed ATP-bound state. HSP90 chaperones can be found not only in the cytosol, ER, chloroplasts, mitochondria, and the nucleus but also in the extracellular milieu where they act as potent stimulators of immune responses. The activity of Hsp90 is regulated by post-translational modifications and its association with numerous co-chaperones and client proteins involved in signal transduction and transcriptional regulation. Elevated levels of HSP90s can be found in a broad spectrum of cancers where they enhance cell growth, suppress senescence, and confer resistance to stress-induced apoptosis, including protection against cytostatic drugs and radiation therapy. Since numerous oncoproteins are clients of Hsp90, targeting Hsp90 represents a useful anti-cancer approach. In this review, the current knowledge on the Hsp90 chaperone machinery and its role in disease and therapy is compiled.

Open Access Review Article

Fanconi Anemia Genes and Reactive Oxygen Species in Cancer Development

Igor Afanas’ev

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/24279

Fanconi Anemia (FA) is an autosomal recessive disease of childhood. However, the FA pathway is responsible for the development of leukemia and the other cancers. It has been also demonstrated that FA, an only human genomic instability syndrome is very sensitive to oxidative stress and ROS overproduction. In the present work, we consider major mechanisms of antioxidant protection in FA cells. We showed that there are two types of such mechanisms: the suppression of ROS overproduction by FA genes through the activation of basic FA anemia proteins under the conditions of oxidative stress and the application of free radical scavengers able to react with iron-dependent ROS such as flavonoids rutin and quercetin. The last nontoxic compounds of vitamin P group might be recommended for the treatment of FA anemia patients. Then, we discussed the role of FA anemia proteins in cancer development.