Open Access Short Research Article

Age Estimation Using Digital IOPA- A Short Study

BR. Sathvikalakshmi, CH. Uma Reddy, R. Kirthika, L. Chandrashekar, R. Sudarshan

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/JAMMR/2017/36843

Aims and Objectives: The aim of the study is estimating the age of a person from his teeth particularly using the pulp to tooth area ratio. This ratio will be measured from the digital intraoral radiographic images taken for different patients with a sole purpose of estimation the age of the. Each patient’s maxillary central incisors will be evaluated and their pulp to tooth area ratio is taken.

Materials and Methods: The study comprises of 60 patients divided into two subsets of 10 test subjects and 50 study subjects. The RVG images of maxillary central incisors were collected and the pulp to tooth area ratio was measured using Image‑Pro Plus ІІ software (Media, Cybernetics, USA). Intraobserver variation was evaluated with paired t-test.

Results: The AR was a significant (p-value <0.001) predictor of age with a mean absolute error (MAE) of 4.908 years using the formula, Age = 89.778-379.020 (AR). This equation when applied on the test subset revealed no statistically significant difference (p = 0. 232) between estimated and chronological ages with no gender differences.

Conclusion: Considering the possible errors ±10 years were added to this method of age estimation provides a fairly accurate and reliable method.

Open Access Original Research Article

The Effects of Adding Intrathecal Midazolam to Bupivacaine in Spinal Anesthesia

Khatereh Isazadehfar, Masood Entezariasl, Zahra Aliakbari

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2017/36316

Aim: To study of intrathecal bupivacaine with and without midazolam to assess its effect on the onset, duration of sensory and motor block in lower limb surgery.

Place and Duration of Study: Fatemi Hospital, Ardebil University of Medical sciences, Iran. From March until September 2014.

Methodology: Eighty patients were randomly allocated to two groups: 40 patients in the control group received 3 ml of 0.5% bupivacaine plus 0.4 ml of 0.9% saline intrathecally; 40 patients in the midazolam group received 3 ml of 0.5% bupivacaine plus 0.4 ml (2 mg) midazolam. The onset, duration of sensory/motor block, side effects, sedation score and time for request for first rescue analgesia were noted in two groups. Data collected by questionnaires and the data were extracted and analyzed by SPSS software with Ch-square and T-tests.

Results: The deference in onset of sensory and motor block between groups was not significant (p>0.05). The duration of sensory and motor block was prolonged in the midazolam group significantly (p-value =0.005, p-value = 0.014 respectively). There were no episodes of hypotension, bradycardia, pruritus, vomiting and urinary retention in any patients. Incidence of nausea and sedation score was comparable in the two groups. Sedation score in the Midazolam group (3 patient had grade 1 sedation, 35 patients had grade 2 sedation and 2 patients had grade 3) was slightly higher than control group (1 patient had grade 1 sedation, 32 patients had grade 2 sedation and 7 patients had grade 3) (p=0.05). Request time for first rescue analgesia (Diclofenac) was longer in patients who received midazolam (147.38 versus 215.88, p-value<0.001).

Conclusion: Intrathecal midazolam increased the duration of sensory and motor block without increasing side effects.

Open Access Original Research Article

How Level of Education Relates to Knowledge, Attitude and Practices Regarding Breast Cancer and Its Screening Methods

Ayesha Rizwan, Zikria Saleem, Saleha Sadeeqa

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2017/37722

Context: Breast cancer is the most frequently diagnosed cancer among women worldwide. Breast cancer is a major contributor towards cancer related morbidity and mortality in Pakistani women.

Aims: The study aimed to examine how level of education relates to the knowledge, attitude and practices regarding breast cancer and its screening methods amongst women.

Settings and Design: A cross-sectional survey was conducted in Lahore, Pakistan.

Methods and Materials: 504 randomly selected women participated in study, data was collected using a structured self-administered and interview administered questionnaire.

Statistical Analysis Used: Descriptive statistics were applied for demographic data. For association of demographics with the mean scores of knowledge, attitude and practices, chi- square test was performed. P value < 0.05 was considered as significant.

Results: Results showed a direct relation between the level of education and the knowledge of women. Mean knowledge score was 34.5% in the group having no formal education. The groups having primary, matriculation, college level and university level education had mean knowledge scores of 43.7%, 51.6%, 65.8% and 66.6% respectively. Attitudes and practices were independent of the level of education. However, participants from class 1 (no formal education) had better attitude towards Breast Self Exam than any other class. All the groups had almost equal practice scores relating to BSE, although, the overall practices score was low (36.5%).

Conclusion: It was concluded that overall knowledge about breast cancer was relatively weak in all participants, being lowest in people with less education.

Open Access Original Research Article

Prevalence and Distribution of Wolff-Parkinson-White Pattern or Syndrome among Young Adult Population in Nigeria

Oluwadare Ogunlade, Muritala Abiola Asafa

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2017/37173

Aims: This study aimed to determine the pattern and distribution of Wolff-Parkinson-White (WPW) pattern or syndrome among young adults.

Study Design: This is a cross-sectional descriptive study.

Place and Duration of Study: Department of Physiological Sciences and ECG Unit, Health Centre, Obafemi Awolowo University, Ile-Ife, between March 2014 and December 2016.

Methodology: Young adult population in the University Community was screened with ECG as part of medical screening procedure. Screening lasted over a period of 3 years.

The participants had their resting standard 12-lead ECG recorded according to internationally approved protocol. The ECG strips were screened for WPW pattern or syndrome.

Results: Nine thousand eight hundred and twenty six (9826) young adults (48% males, 52% females) within the age range of 15 - 40 years were screened. Eleven (11) cases (7 males and 4 females) of WPW pattern were diagnosed. No case of WPW syndrome was detected. The prevalence of WPW pattern in the study population was 0.11%. Out of the 11 cases, 7 (6 males and 1 female) had stable WPW pattern while 4 (1 male and 3 females) had intermittent WPW pattern. More than half (57.14%) of the cases with stable WPW pattern presented with sinus bradycardia while others present with normal heart rate. Intermittent WPW pattern mimicked premature ventricular ectopic beats. The dominant type of WPW pattern in the study was type B.

Conclusion: This study concluded that the prevalence of WPW pattern was 0.11% and that the pre-excited ECG was more frequent in males. The dominant form of WPW pattern is type B which asymptomatically presented with bradyarrhythmia.

Open Access Original Research Article

Evaluation of the Efficacy of Topical Timolol Therapy on Oral Lichen Planus: Clinical and Immunohistochemical Study

Hamdy Abdel Motagaly Metwaly, Mohamed Abdel-Moniem Ebrahem, Fatma Fathi Hussein

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/JAMMR/2017/37603

Aims: To evaluate the efficacies of Timolol topical therapy in patients with atrophic- erosive Oral Lichen Planus (OLP).

Study Design: This study was conducted in outpatient clinic of Department of Oral Medicine, Oral Diagnosis and Periodontology, Faculty of Dentistry, Minia University and Department of Oral Pathology, Faculty of Dentistry, Tanta University.

Methodology: This study included 20 patients with symptomatic OLP of 4-7 years duration. They were classified into two groups; Group A: treated by 0.1% topical triamcinolone acetonide paste and Group B: treated by 10 drops of 0.5% Timolol. Each patient was monitored 4 times every 2 weeks for 2 months. The objective and subjective clinical progress was assessed using the clinical score (CS) and a Visual Analog Scale (VAS). Biopsies were taken at baseline and after treatment, stained with H&E and immunohistochemically for VEGF, Ki-67 and CD34.

Results: All patients showed significant improvement in all outcomes within the follow up periods when compared with the baseline (P < 0.05). Both drugs resulted in reduction of pain and lesion size. No significant difference was found between both studied groups at the end of week 8 in terms of VAS and CS scores (P > 0.05). In Timolol group, VEGF expression was reduced and Ki-67 labeling index was decreased from 19% to 11%. The mean number of MVD was (44.50±6.03) at baseline became (25.56±6.44) after treatment. The degree of inflammation was also decreased.

Conclusion:  Topical Timolol has similar therapeutic effects of triamcinolone acetonide paste on atrophic-erosive OLP that could be used a second alternative therapy. Further studies on a larger sample for longer period is required to evaluate the efficacy, safety and the molecular mechanism behind Timolol therapeutic effects on OLP.

Open Access Original Research Article

Alterations of Aqueous Persea americana Seed Extract on Renal Functions Associated with Diabetes Mellitus in Wistar Rats

M. Egwaoje, A. A. Aigbiremolen, R. N. Ativie, P. E. Ohwin, I. K. Aromose, M. O. Odigie, J. C. Igweh

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2017/37956

Kidney, paired organ whose functions include removing waste products from the blood and regulating the amount of fluid (electrolytes and water) in the body. Life-threatening illnesses occur when too many of these waste products accumulate in the bloodstream. Fortunately, a healthy kidney can easily function by ridding the body of these substances. This study was undertaken to determine the effect that aqueous extract of Persea americana seed has on renal (kidney) functions in alloxan-induced, diabetic (hyperglycemic) wistar rats. Thirty-Five (35) Wistar rats (140 – 200 g) were assigned into seven groups of 5 rats each with group A serving as normal control. While Groups B and C were respectively treated with 250 mg/kg and 500 mg/kg of Persea seed extract (Non-diabetic rats), groups D and E received Alloxan (diabetic control), and Alloxan (diabetic, then treated with 50 mg/kg of metformin). Groups F and G were diabetic rats which respectively received 250 mg/kg and 500 mg/kg of Persea seed extract. After 28 days of administration, rats were sacrificed with blood samples collected via cardiac puncture for electrolytes, urea and creatinine evaluation. Result shows in diabetic untreated rats, an elevation in the concentrations of Na+, K+, Cl-, Mg2+, Urea and Creatinine. Somehow, these levels significantly decreased at P<0.05 in rats that were treated with Persea americana seed extracts. No significant change was seen in HCo3- concentrations of diabetic control as against normal control. Apparently, Persea americana is a potent hypoglycemic agent, capable of ameliorating altered renal function associated with diabetes mellitus.

Open Access Original Research Article

Study of Myocardial Dysfunction in Patients with Cirrhosis of Liver

Lily Devi, Pradeep Kumar Malik, Jyoti Ranjan Mallick, Lalit Kumar Meher

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2017/37987

Aim: To evaluate the myocardial dysfunction in patients with liver cirrhosis and its relationship with the aetiology and severity.

Study Design: Cross sectional study.

Methodology: A study was carried out in the Department of General Medicine in MKCG Medical college, Odisha between 2014-2016. After explaining the nature of study and obtaining proper consent 60 patients in the age group of 21-65 years fulfilling the inclusion criteria were included in the study. Out of 60 cases of liver cirrhosis 46 were alcoholic and 14 non-alcoholic. A thorough cardiac evaluation was done with recording of ECG and echocardiography findings.

Results: 1) Diastolic dysfunction was found in 19 (32%) cases of cirrhosis of liver out of which 15 were alcoholic and 4 were non alcoholic. 2) Systolic dysfunction was present in 6 (10%) cases and all of them were alcoholic. 3) Prolonged QTc interval was found in 27 (45%) cases of liver cirrhosis. The difference of mean QTc interval between patients of Child Pugh stage A, B, C was statistically significant.(p-value ˂0.05). 4) The difference of E/A ratio and that of decelearion time between alcoholic and non-alcoholic group is not statistically significant. (p value >0.05) 5) the difference of E/A ratio and that of deceleration time between patients of Child pugh A, B and C is not statistically significant. (p value>0.05).                                                                 

Conclusion: Diastolic dysfunction was present in 32% cases which is not related of severity and etiology of cirrhosis of liver. Systolic dysfunction was present in 10% cases which could be related to etiology of alcohol consumption. Prolongation of QTc interval is related to disease severity. However echocardiographic parameters of diastolic dysfunction have no relation to aetiology and severity of disease.