Open Access Case Report

Cornual Twin Ectopic Pregnancy: A Case Report

Oriji Vaduneme Kingsley, Nyeche Solomon, Ibe Vitalis

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/JAMMR/2017/34186

A 22 years old female, G1P0E(ectopic) 1, who presented with ten hours history of sudden onset of lower abdominal pains, which later became generalized and progressive, abdominal distension, dizziness and weakness after thirteen weeks amenorrhea. She had a previous history of left partial salpingectomy for ruptured ectopic gestation. She was treated with a repeat laparotomy and right-sided wedge resection for the index ruptured cornual pregnancy. Two fetuses and the placenta were removed from the peritoneal cavity. She was discharged from the hospital 5 days later in stable clinical condition.

Open Access Original Research Article

Subclinical Oral Bisphosphonate-related Osteonecrosis of the Jaw: Systematic Review of the Literature and an Additional Case

S. P. Vasconcelos, A. L. P. Lemos, F. Bandeira

Journal of Advances in Medicine and Medical Research, Page 1-19
DOI: 10.9734/JAMMR/2017/34007

Introduction: Bisphosphonate-related osteonecrosis of the jaw (BRONJ), which has few studies despite the increase in the number of cases published in the literature in the last decade, is a rare complication related to the use of oral bisphosphonates. The objectives of this study are to perform a systematic review of the literature on cases of osteonecrosis of jaw associated with the use of oral bisphosphonates in the treatment of osteoporosis and to identify the main clinical characteristics and risk factors related to the cases described in the literature. In addition, a case of subclinical osteonecrosis of jaw associated with the use of oral bisphosphonate for a short period of time was reported.

Methods: A systematic review was conducted to identify cases of BRONJ among individuals using oral bisphosphonate. The survey included articles published in English from the period January 1950 to October 2016 in the PubMed and Cochraine databases.

Results: 49 published articles were selected, totalling 284 patients diagnosed with BRONJ. The mean age of the patients was 72.68 years and 96% were female. Alendronate was the most prescribed bisphosphonate, being used by 88.08% of the patients and osteoporosis/osteopenia was the indication of the treatment in 95% of the cases. The median duration of therapy until diagnosis of osteonecrosis of jaw was 5.23 years; 12.38% were on corticosteroids use at diagnosis and 82% of the patients performed some dental procedure preceding the onset of lesions. The mandible was the site most affected (74.64% of the cases) and 57,81% of the cases were in stage 2 at diagnosis. The most frequent associated conditions were: hypertension, corticosteroid use rheumatoid arthritis and diabetes mellitus, and 28% of cases occurred during the first 3 years of therapy.

Conclusion: Bisphosphonate-related osteonecrosis of the jaw is a rare disease which is associated with dental procedures and systemic conditions, and may occur at any time during therapy.

Open Access Original Research Article

Spirometric Values in Healthy Nigerian School Children Aged 6-11 Years

H. O. Akhiwu, I. Aliyu

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2017/34804

Background: Respiratory disorders are among the leading cause of morbidity and mortality in children and the use of spirometry in measuring lung function, diagnosing and monitoring of variety of paediatric respiratory diseases is becoming relevant.

Aims: To determine the standard Forced vital capacity (FVC), Forced Expiratory Volume in 1 second (FEV1) and Peak Expiratory Flow Rate (PEFR) values for children in this environment.

Methods: The study was descriptive cross sectional study of 710 primary school pupils aged 6-11 years in Kano metropolis.

Results: There was no significant difference in the mean anthropometry and lung function parameter between the males and females studied. The result of this study showed that on the average the FEV1, FVC and PEFR was slightly higher in boys for most ages and the mean Lung function parameters increased with height. When compared to studies in Caucasians, this study had higher mean PEFR for height while the mean FEV1 and FVC values were lower than that in those studies. The predictive regression equation for the major lung function parameters for both gender were also obtained. FEV1 – Male: 0.018H+-1.099, Female: 0.019H + - 1.142. FVC- Male: 0.018H + - 1.057 while Female was 0.019H+ -1.181 and PEFR - Male was 0.069H + -5.344 while Female was 0.052H + -3.153.

Conclusions: It is necessary for African countries especially Nigeria, to have validated Spirometric reference values for children.

Open Access Original Research Article

The Evaluation of Osteosarcoma and Ewing Sarcoma by Bone Markers in Children and Adult after Chemotherapy

Kabouche Samy, Martin Coheen Solal, N. Roustila, Asma Benhamdi, Linda Chakmak, Agnes Ostertag, Corrin Colet, Maza Rabeh, Abdelkader Rouabah, Leila Rouabah

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2017/33972

Background: In the east of Algeria, the rate of bone tumors is very high, unfortunately the Pathological Anatomy and radiology are not sufficient for evaluation and confirmation of the diagnosis. Bone alkaline phosphatase (BAP) and tartrate-resistant acid phosphatase (TRAP5b) were commonly elevated in Ostéosarcoma and Ewing sarcoma patients. The Ostéosarcoma is the most striking tumor in childhood and adolescence and Ewing sarcoma is the second bone tumor after the Ostéosarcoma. Evaluation and failure of the treatment is a major problem in the clinical practice of the bone sarcomas in Algeria.

The objective of this study was to assess the serum BAP and TRAP5b levels and establish the relation between age and serum level of those markers in control population   and to study the bone tumors after chemotherapy with the correlation between the serum levels of BAP and TRAP5b before and after chemotherapy in children and adult.

For this, a total of 73 patients: 40 Ostéosarcoma and 33 Ewing sarcoma aged 5-20 years, admitted in the hospital of Constantine named BENBADIS, between January 19, 2013 and January 03, 2015 and 100 patients aged 5- 20 years, as control population were reviewed in a prospective study. Bone alkaline phosphatase (BAP), was measured by using Ysis and tartrate-resistant acid phosphatase (TRAP5b), by Elisa kit.

Results show that elevated serum levels of these markers are a very good prognostic factor of primary bone tumors as well as monitoring and evaluation tools, and the Difference of rate of markers before and after chemotherapy is good factor for the evaluation of bone sarcoma. 

Bone markers BAP and TRAP5b can be used in the evaluation of bone tumors and to assess remodeling during chemotherapy for primary tumors in the children and the adults.

Open Access Original Research Article

The Role of Family Setting in the Prevalence of Diarrhea Diseases in Under-five Children in Imo State University Teaching Hospital, Nigeria

H. N. Chineke, R. U. Oluoha, E. P. Uwha, B. C. Azudialu, E. Nwaigbo

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2017/34639

Background: Among children under five years of age, diarrhea remains one of the leading cause of death globally. Diarrhea kills an estimated 2.5 million people annually with 60 – 70% of them being children under five years of age. Most of the deaths occur in low income countries where an estimated 25% of under-five mortality is directly attributed to diarrhea diseases.

Materials and Methods: The study examined the role of family setting in the prevalence of diarrhea diseases among under-five children admitted into paediatrics department of Imo State University Teaching Hospital (IMSUTH), Orlu between January 1st 2006 and December 31st 2015. Information was collected from the admission records of the children using a proforma and data generated was analysed using SPSS version 20.

Results: A total of 6230 under-five children were admitted in the 10 year period under review with 245 presenting with diarrhea giving a diarrhea prevalence of 3.93%. There were 152 (62.0%) males and 93 (32.0%) females with diarrhea. Majority of the children (72.3%) were infants and the mean age was 5.93 ± 5.58 months. Most of the admitted children (80.4%) were from monogamous family setting and majority (74.7%) presented during the dry season. Variables significantly associated with diarrhea episodes were gender, family size, maternal education, fathers’ occupation and sewage disposal methods. Predictors of diarrhea diseases include gender, family size, fathers’ occupation and sewage disposal methods.

Conclusion: Our study demonstrated important relationship between socioeconomic status of families and diarrhea morbidity. Improving families’ disposable income and proper family planning are viable measures that can help curb diarrhea diseases in under-five children.

Open Access Original Research Article

Predictors of Factors Sustaining HIV/STI Protective Behaviours among Adolescent Girls and Young Women in Mukuru Slums, Nairobi: A Retrospective Cohort Study

Julius N. Nguku, Fiona N. Mbai, Elizabeth W. Mwaniki

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/JAMMR/2017/34552

Aims: To identify factors which contribute to sustained human immunodeficiency virus protective behaviours for out-of-school slum-dwelling young women aged 15-24 years by assessing consistent condom use and having one sexual partner of a group of young women who previously benefited from three different Behaviour Change Communication program models at least one year before.

Study Design: The design for this study is retrospective cohort.

Place and Duration of the Study: Mukuru Slums in Nairobi, Kenya between November 2015 and April 2017.

Methodology: Using probability proportionate to size sampling, 446 adolescent girls and young women (227 previously exposed, 219 unexposed to three different programs) were identified from four villages in the Mukuru Slums and enrolled in the study. Odds ratios with p-values and Pearson’s correlation coefficients were used to determine relationships of select independent variables and dependent variables. One-way ANOVA test was performed to show the differences in the impact of the different programmes.

Results: Bivariate and multivariate analyses; and one-way ANOVA test showed statistically significant (P<.05) differences between program models in sustaining protective behaviours. Other predictors of sustained consistent condom use were: a minimum of secondary school level of education (P=.0004) and an income of at least KES 1,000 per month (P=.002); and for one sexual partner: a minimum of secondary school level education (P=.0003) and living with parents (P=.019).

Conclusion: The findings show that a Behaviour Change Communication program model integrating Evidence-based Behavioural Interventions, gender and economic empowerment was more efficacious for sustaining protective behaviours than program models that do not.  Developers of programmes for slum-dwelling adolescent girls and young women should consider employing strategies to encourage adolescent girls to live with their parents; married women with more than one sexual partners to use condoms during sex; opportunities availed for those eligible and willing to return to school.

Open Access Review Article

Recurring Epidemics of Meningococcal Meningitis in African Meningitis Belt: A Review of Challenges and Prospects

D. J. Omeh, B. A. Ojo, C. K. Omeh

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/JAMMR/2017/34151

The African meningitis belt (AMB) is made up of 26 contiguous countries from Senegal in the West to Ethiopia in the East. Recurring epidemics of meningococcal meningitis have afflicted this region for more than a century. Epidemics are seasonal, occurring during the dry hot season and they can cause many deaths, and residual disability.
This review presents a quick overview of the past and current trends of epidemic meningococcal meningitis in African meningitis belt, together with some recommendations aimed at ensuring “epidemic meningitis - free Africa”. Data was collected through the analysis of peer-reviewed studies and surveillance data on national, sub-national, and regional levels. This was performed using various search engines such as Pub Med, Google scholar, regional WHO homepages, and department of health websites.
Despite much progress in surveillance and biological research, the pattern of epidemic meningitis in the African meningitis belt is still poorly understood, making it difficult to model and predict the epidemics. Other major challenges in controlling the menace of epidemic meningococcal meningitis in this area include inadequate surveillance during epidemics, and non availability of effective vaccines. For an effective control of meningococcal meningitis in the African meningitis belt, there is a need for an effective surveillance system and accelerated development of a polyvalent conjugate vaccine that will be affordable to Sub-Saharan African countries.