Open Access Case Report

An Unusual Presentation of a Primaryeosinophilic Gastrointestinal Disorder (Case Report)

M. C. Fadous Khalife, P. Noun, F. Semaan, R. Dagher, M. Karam, W. Ghaname, R. Ghiye, R. Chaabane, M. Samarani, M. Al-Ojaimi

Journal of Advances in Medicine and Medical Research, Page 1-4
DOI: 10.9734/JAMMR/2017/35609

Primary Eosinophilic gastroenteritis is an uncommon inflammatory gastrointestinal disease affecting children first described in 1937.Its incidence is 1/100000. The eosinophilic infiltration can occur in one or more segments of the gastrointestinal tract especially stomach and duodenum in the absence of known etiology. One or more layers are infiltrated by eosinophils. The clinical manifestations are heterogeneous. Its pathogenesis is not fully understood but food hypersensitivity is considered a major factor. Treatments are mostly unsatisfactory, and prognosis is uncertain. No guidelines up to this date have been published regarding the management of these patients.

We report the case of a premature twin boy who was admitted to the –Neonatal Intensive Care Unit-NICU for suspected sepsis.

Our purpose is to highlight the importance of multidisciplinary team approach for management of unusual neonatal cases where sub-specialized workup and skills are a must for early diagnosis and clinical success. Our case is peculiar because of the young age of presentation and the scarce gastrointestinal symptoms at presentation that swayed us towards a hematologic or infectious disorder which are the likely diagnoses at this age.

Open Access Short Research Article

Benefits of Incremental Pace Walking in Chronic Obstructive Pulmonary Disease Patients

Manjush Karthika, Sammita Jadhav, Lalitha V. Pillai, Chris Sara Mathew, Abdullah Al Dhaish

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2017/32546

Background: Exercise training in chronic obstructive pulmonary diseases (COPD) patients can be challenging due to exertional dyspnea. It has been suggested that gradual exercise training may result in improved exercise capacity and decreased dyspnea levels in stable COPD patients.

Objective: The objective of this study was to assess the response of COPD patients to incremental pace walking and breathing retraining exercises.

Methods: 40 subjects who were clinically diagnosed to have Global initiative for chronic Obstructive Lung Disease (GOLD) classification- Stage 3, Severe COPD, and referring to our centre were divided equally into a control and an experimental group. The mean age of control group was 60.4±5.6 and experimental group was 59.5±6.1. Male population comprised of 65% and 70% of the subjects in control and experimental groups respectively. The control arm received breathing retraining exercises and level surface walking for six weeks, whereas experimental group received incremental pace walking for six weeks in addition to what control group has received. Exercise tolerance was assessed by distance covered in six minute walk test (6 MWT) and dyspnea levels by visual analogue scale (VAS).

Results: The average increase in six minute walk distance (6 MWD) was 25.85±10.79 and 75.84 ± 16.80 meters, respectively for the control and the experimental group. The average reduction in dyspnea after the 6 MWT was 11.0 ± 5.21 and 19.28 ± 3.89 mm, respectively for the control and the experimental group. Both these changes in outcome measurement were found to be statistically significant (p< 0.05).

Conclusion: We conclude that incremental pace walking with breathing retraining exercises are beneficial in improving exercise tolerance and dyspnea levels of elderly patients with COPD.

Open Access Original Research Article

Cognitive Functioning, Health Screening Behaviors and Desire to Improve One’s Health in Diabetic versus Healthy Older Women

Luciana Laganá, Kimberly Arellano, David Alpizar

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/JAMMR/2017/34173

Aims: To attempt to fill a gap in the literature on diabetic versus healthy older women on desire to improve one’s health, health screening behaviors, and cognitive health.

Study Design:  Between-subjects design.

Place and Duration of Study: Department of Psychology, California State University Northridge, between July 2013 and June 2015.

Methodology: In this preliminary study, we compared 30 diabetic older women to 42 healthy older women (i.e., respondents who reported having no physical illnesses and not taking any medications) on: desire to improve their health (hypothesized as being higher in the diabetes group), receiving mammograms and regular health screenings (analyzed without any hypotheses, due to the lack of evidence on this topic), as well as cognitive functioning (hypothesized as lower in the diabetes group, based on prior research findings). Participants (N=72, mean age=69.29, SD=6.579, age range=50-90) were multiethnic, non-institutionalized women over the age of 50 residing in Los Angeles County who completed our research packet. The latter contained the first author’s demographics list and her original structured interview protocol on older women’s health, as well as the well-known Mini-Cog.

Results: The results of an Analysis of Variance (ANOVA) showed that, as hypothesized, diabetic women desired to improve their health more than the women in the control group [F (1,70)=11.87, p<.05, η2=.15]. Additionally, upon implementing Chi-square analyses, we discovered that diabetic respondents were significantly more likely to receive mammograms [X2(1)=5.87, p<.05] and general health screenings [X2(1)=4.51, p<.05] than healthy women. Moreover, in contrast with prior literature’s findings, cognitive health in the diabetic group obtained marginal significance in an ANOVA as being better than the cognitive health of the control group [F(1,68)=3.30, p=.06, η2=.05].

Conclusion: We have established a significant relationship between diabetes and a) desire to improve one’s health and b) health screening behaviors, as well as c) cognitive impairment (at a marginally significant level) among diabetic versus healthy women. This has important clinical and public health implications. Although the findings of prior research suggest that diabetic older women often experience impaired cognitive performance compared to healthy older women, our marginally significant results showed that the opposite is true, at least in our ethnically diverse sample of modest size. Moreover, we found that diabetic older women desired to improve their health significantly more than healthy women and pursued cancer screenings and general health screenings more than their healthy counterpart. The limited size of our sample does not allow for generalizations of our findings. Additional research with larger samples is definitely needed to investigate these topics further.

Open Access Original Research Article

Knowledge, Attitudes and Perception of the Hospital Staff towards Smoking at Sahloul Hospital - Sousse- Tunisia

Hela Ghali, Salwa Khéfacha Aissa, Latifa Merzougui, Sihem Ben Frej, Rabeb Ben Ouanes, Mohamed Ben Rejeb, Houyem Said Latiri

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/JAMMR/2017/35566

Background: In Tunisia, smoking remains prevalent among the health professionals. In order to combat this epidemic, it is necessary to start a tobacco control strategy.

Objectives: Our work aims to study the knowledge and the attitude of the hospital staff toward smoking, and the perception of their role in tobacco control.

Methods: It is a cross-sectional descriptive study conducted during 15 months. Data were collected using a self-administered and anonymous questionnaire. A pre-study was made in April 2013 in three departments of the hospital of Sahloul in order to test the questionnaire. The statistical analysis was performed using the SPSS software.

Results: 768 questionnaires were retained. Our population was mainly female (51%) and the average age was 37.8 (±11.3) years. 21% were smokers. The majority of respondents was for the regulatory measures against tobacco. Almost ¾ of the respondents were aware of the existence of a Tunisian law prohibiting smoking in workplace. Non-smokers thought they had more influence on the smokers to make them quit (p < 10-3). Health professionals have recognized the role of tobacco in the genesis of cardiovascular disease, lung disease and lung cancer. In addition, 27% of the respondents were unaware of the existence of the anti tobacco consultation in the hospital. 

Conclusion: Smoking remains a public health problem among health professionals. A holistic approach, including a strengthening of laws against smoking, and provision of resources of tobacco cessation, is necessary to promote smoking cessation among the hospital staff.

Open Access Original Research Article

Development of a Theoretical Model for the Appreciation of the Perception of Quality of Work Life and Occupational Stress, and Its Validation through Statistical Analyses

Sabrine Battal, Taoufiq Fechtali, Saida Toufik

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/JAMMR/2017/35959

The present study describes the development of a theoretical model and a questionnaire measuring the perception of Quality of Worklife (QWL) and Occupational Stress (OS), as well as their validation through statistical analyses.

The model and questionnaire are simulated on the field, in an aircraft manufacturing company in Morocco. Validity of the construct, internal coherence and stability in time are measured.

The results of this study show satisfactory psychometric properties and demonstrate the validity of the questionnaire and the developed model.

Open Access Original Research Article

The Glutathione S-Transferase Activities in the Evaluation Acute Viral Hepatitis B and Chronic Alcoholic Liver Disease

S. D. Sawant, M. R. Mogarekar

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2017/35540

Glutathione S-Transferase is an important hepatic detoxifying enzyme. Half-life of GST alpha in plasma is about1hr; its concentration follows the changes in the hepatocellular damage more rapidly than aspartate amino transferase (AST) or alanine amino transferase (ALT).

Aim and Objectives: To validate chronic alcoholic liver disease and acute viral hepatitis B could produce any significant changes in serum glutathione S-transferase activities.

Materials and Methods: A total of 120 samples were used in the present research. 20 hepatitis B patient 40 chronic alcoholic hepatitis patients and 60 age and sex matched control subjects. Serum GST activity and standard LFT (Liver Function Test) parameters done.

Results: GST activity showed a significantly increase (p value< 0.001) in chronic alcoholic liver disease patients (22.293±4.159 IU/L vs 20.127±4.789 IU/L) and in acute viral hepatitis (23.685±6.751 IU/L vs 20.127±4.789 IU/L). In multiple logistic regression analysis when GST measurement was added to a LFT, the diagnostic significance increased from R2=0.792 to 0.884 in acute viral hepatitis B and from R2= 0.843 to 0.849 in chronic alcoholic cirrhosis. Standard LFT parameters are significantly different in both groups. Area under ROC (Receiver Operative Characteristic Curve) is 0.952 for model having albumin+ ALT which is increased to 0.992 after addition of GST in previous model in acute viral Hepatitis B. While in alcoholic Hepatitis Area under ROC is 0.966 for model having albumin+ ALT which is increased to 0.974 after addition of GST in previous model.

Conclusion: GST activity may provide additional LFT measurement to the current battery of tests to differentiate acute hepatitis B and alcoholic liver disease from normal population and may improve the evaluation of Hepatitis B virus and alcoholic cirrhosis when added to routine LFT parameters.

Open Access Original Research Article

Determining Sources of Motivation for Nurses of Different Generations in Turkey

E. Sarioglu, D. Ozmen

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2017/35010

The aim of the study is to determine the motivation sources of nurses from different generations. 396 nurses were recruited for our study. The data were collected by “Socio-demographic Questionnaire” and “Motivation Sources Inventory-MSI”. The nurses were divided into 3 groups: Baby Boomer-BB (14), generationX (266), generation Y (116). Motivation levels weren’t statistically significant amoung the groups. In the dual- comparisons, motivation levels of generation Y were significantly higher than those of generation X. The MSI averages of the nurses were found to be different from each other. The managers are advised to consider the generation differences to increase the motivation.