Open Access Letter to the Editor

Ascending Urethrogram and Sonourethrogram in Evaluation of Male Anterior Urethra

V. N. S. Dola, S. Konduru, A. Ameeral, P. Maharaj, B. Sa, Ramesh Rao, Suresh Rao

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2017/33734

Aim: To determine the efficacy and accuracy of detection and characterization of anterior urethral strictures by sonourethrogram compared to retrograde urethrogram.

Materials and Methods: A total of 45 patients presented during the 4 months duration of the study. 31 patients qualified for the study; however 2 of these patients were excluded due to technical difficulties encountered during the sonourethrogram. The parameters studied were age, ethnicity, detection of strictures and characterization by length, location and diameter. In the RUG tapered segments on either side of the stricture were included. Age distribution, Paired t-test and correlation coefficient were examined.

Results: Age distribution of the study population was between 18-80 years. Among the study population, 58.6% were East Indian origin and 41.4% were African origin. 10 out of 29 patients showed normal anterior urethra by both RUG and SUG. Also, the two techniques correctly identified normal from abnormal study. The presence of a stricture and its location was correctly identified by both methods which were retrospectively confirmed with optical cystourethroscopy. The stricture length and diameter measured by SUG and RUG showed no statistically significant difference. The Pearson correlation coefficient(r) is 0.95 for length measurement (p<0.01) and correlation(r) is 0.837 for diameter measurement (p<0.01). Periurethral fibrosis and mucosal abnormalities were well shown by sonourethrogram. Among the strictures demonstrated by SUG, 52.6% showed periurethral fibrosis. The presence of periurethral fibrosis varied between the bulbar and penile areas, 77% in bulbar strictures compared to 24% in penile strictures.

Conclusion: Both RUG and SUG proved to be equally efficient in detecting the site of stricture and assessing the length and diameter of the stricture. We noticed that by including the tapered segments on either side of stricture in RUG, the length measurements were comparable to SUG. The periurethral fibrosis and mucosal abnormalities were well demonstrated by the SUG, which was not evident by the RUG.

Open Access Case Study

Endocrown-A Unique Way of Retention-Case Report

B. Sunil Rao, Siddhesh Bandekar, Shirin Kshirsagar, Shah Naman

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/JAMMR/2017/32747

All the teeth that have undergone root canal therapy require some form of restoration to enable them to function again. Endodontic treatment removes the vital contents of the canal, which subsequently leads to reduction in elasticity, desiccation and increases brittleness of remaining tooth structure.

The loss of structural integrity increases the incidence of crown fractures and microlekage at the margins of restoration in endodontically treated teeth compared with ‘vital’ teeth. Minimally invasive preparation to preserve maximum amount of tooth structure is considered to be the standard main goal for restoring teeth.

This is a case of endodontically treated right maxillary 1st molar requiring post endodontic management which was treated with EndoCrown.

Open Access Original Research Article

Concurrent Prediabetes and Prehypertension in a Rural Community in South East Nigeria

C. B. Nwatu, E. E. Young, C. C. Okwara, C. E. Okoli, P. C. Obi, O. B. Anyim, B. C. Ubani, C. I. Okafor, J. M. Oli

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/JAMMR/2017/34226

Aim: To determine the prevalence of concurrent prediabetes and prehypertension among apparently healthy adults in Ihuokpara, a rural community, South East Nigeria.

Study Design: The study was cross-sectional.

Place and Duration of Study: Ihuokpara, Nkanu East Local Government Area Enugu State Nigeria, May 2013.

Methodology: Eight hundred and twenty four (538 females and 286 males)consenting adult residents of Ihuokpara, a rural community in Enugu State of Nigeria, were recruited for the study through a cross-sectional, stratified, convenient sampling technique. A structured questionnaire assessed subject’s socio-demographic data, detailed anthropometric indices and blood pressure using standard protocols. Subject’s fasting plasma samples in addition to 2-hour post 75-gram-glucose-load plasma samples were assessed for glucose levels.

Results: The mean age of the participants was 51.1±16.2 years; females constituted 65.3% of the subjects and 46.3% of the study population had no formal education. Concurrent prediabetes and prehypertension was prevalent at 10.4% with no significant gender bias (P =.13). Older age, physical inactivity and impaired glucose tolerance were significant predictors of concurrent prediabetes and prehypertension (P =.007, .003 and .006 respectively) with older age and physical inactivity emerging as consistent significant predictors, after logistic regression models.

Conclusion: There was a high prevalence of concurrent prediabetes and prehypertension among adults in this rural Nigerian community.

Open Access Original Research Article

Treatment of Refractory Chronic Lateral Epicondylitis by Ultrasound Guided Injection of Autologus Stem Cells versus Autologus Whole Blood

Osama Abuel Naga, Ahmed Mohamad Othman, Islam Hassan Hegazy, Manal Ahmed El Telbany, Hazem Ibrahim Korashi

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/JAMMR/2017/33412

Background: Lateral epicondylitis, or tennis elbow, is a very common cause of elbow pain among the general population. It is a common presentation in orthopedic clinics.

Patients and Methods: Thirty patients with chronic lateral epicondylitis were included in this prospective study. The patients were divided into two treatments groups. The first group contains seventeen cases treated by local injection of autologous whole blood (group I) whereas the second group contains thirteen cases treated by local injection of autologous stem cells (group II).

Results: In the first group, after a mean follow up of 21.2 months, the average VAS improved from 8.2 to 3.2, the average DASH score improved from 74 to 50 and the average Nirchl score improved from 5.9 to 2.7. In the second group, after a mean follow up of 18.7 months, the average VAS improved from 8.7 to 1.7, the average DASH score improved from 76 to 46 and the average Nirchl score improved from 5.8 to 1.7

Conclusion: Both stem cells and whole blood injections are safe and helpful for treating chronic lateral epicondylitis. Stem cell injection proved to be safer and more effective for treating tendinopathy. Ultrasonography plays an important role in diagnosing the condition, guiding the injection site as well as assessment of the response to treatment.

Open Access Original Research Article

Differentiation of Hemodynamics of Top Athletes Depending on Heart Rate Variability after Training

Oksana Guzii, Alexander Romanchuk

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/JAMMR/2017/33619

Aims: To predict the functional status of the cardiorespiratory system of athletes based on results of responses to exercise.

Study Design: Case-control study.

Place and Duration of Study: Palace of Sports "Dynamo" in Lviv, between January and February 2016.

Methodology: 32 qualified waterpolo male athletes aged 20.6±3.0 years were examined. The research included the study of physical parameters, HR and BP by using routine methods and changes of these parameters during the first 3 minutes after the Martinet Test (1 hour before training) and also the study of cardiorespiratory system using SACR before and during the first 5 minutes after training in state of relative relax in the sitting position. To assess the research results we have used the distribution-free method of statistical analysis, using which we can evaluate the Wilcoxon and Mann-Whitney criteria, and also percentile method analysis based on determining the individual assessments of each indicators that take into consideration falling in appropriate limits of percentile ranges.

Results: Hypokinetic type of hemodynamic is observed in 64% of athletes (EG2) and in 88.2% of athletes (EG1). According to the parameters of central hemodynamic, describing the size of the left ventricle in athletes from EG2, significantly greater (p<0.01) is the end-diastolic volume (EDV)-116.3(107.1;118.8) cm3 and end-systolic volume (ESV)-37.2 (33.9;39.2) cm3 comparing to EDV 92.5(87.0;107.6) cm3 and ESV 27.1(22.4;33.7) cm3 in EG1. Significantly larger (p<0.05) was a stroke volume 78.7(72.5;79.8) cm3 comparing to 64.9 (61.6;77.1) cm3 in EG1.The rate of α-factor that characterizes the BRS and predicts the effectiveness of the regulation of cardiac pump function was significantly higher (p<0.01) with EG2: BRSLF: 19.8(17.3;22.1) versus 10.7(8.7;17.5), BRSHF in EG2: 25.4(17.0;29.7) comparing to 12.8(8.9;24.9) in EG1.

Conclusion: The research revealed that the mentioned features of changes in heart rate variability in the high-frequency range after training have rather accurate determinants in hemodynamic securing an athlete, which in turn can be used to predict and adequately assess the state of the athlete in the recovery period after the competition.

Open Access Original Research Article

Prevalence of Chronic Kidney Disease in Relatives of Patients with Advanced Renal Disease in a Nigerian Tertiary Hospital

Monday O. Ogiator, EmmanueI I. Agaba, Oche O. Agbaji, Vivian N. Shaahu

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2017/33942

Genetic predisposition plays a key role in many forms of Chronic Kidney Disease (CKD). Family members of patients with advanced renal disease have been reported to have an increased prevalence of CKD. We sought to investigate the prevalence of CKD among first and second degree relatives of patients with CKD.

Methods: This was a hospital based descriptive cross sectional study. One hundred relatives of patients with advanced CKD as well as one hundred age and sex matched controls were recruited for the study. Glomerular filtration rate was estimated using the CKD-EPI formula. CKD was defined as eGFR < 60 mls/min/1.73m2.

Results: A significantly higher prevalence of CKD was detected among relatives of patients with CKD (11%) compared with controls (6%). P-value <0.05. There were higher rates of hypertension, diabetes, use of herbal medications and non-steroidal anti inflammatory drugs as well as alcohol use in relatives of patients with CKD compared with controls.

Conclusion: This study has shown that relatives of patients with advanced CKD are at increased risk of developing CKD.

Open Access Review Article

Lifestyle Modification and Adherence: An Inseparable Measure in Hypertension Control

Uwaegbulem, Mirian Nkeiruka

Journal of Advances in Medicine and Medical Research, Page 1-21
DOI: 10.9734/JAMMR/2017/33179

Hypertension is one of the major public health problems, prevalent all over the world. It is newly described as an iceberg disease, as the submerged portion of the iceberg represents the larger, hidden and undiagnosed portion of the disease. It is the leading risk factor for cardiovascular diseases and associated with cardiovascular morbidity and mortality globally. Non-adherence to recommended lifestyle is one of the several causes of uncontrolled hypertension. The possible modifiable risk factors include obesity, stress, physical inactivity, high salt diet, smoking, alcohol consumption and others. Lifestyle modification is non-pharmacological therapy that comprise dietary approaches to stop hypertension (DASH) diet, reduction of body weight among overweight, reduced alcoholic intake, smoking cessation, physical activity as recommended by WHO.

Adherence is a widespread problem in chronic conditions as hypertension, and is influenced by certain factors. These include; socioeconomic factors, health status of the individual, current therapy, cognitive factor, interpersonal relationship and personal factors. Adherence and lifestyle modification are inseparable measure and as such, public awareness has to be increased on lifestyle modification and importance of adherence emphasized. Understanding these factors can be useful in influencing the health behavior of the population. Motivational interview have shown positive results in improving adherence and participation of intended audience. This measure can be very effective when primary health care approach is applied.