Open Access Case Study

Adenocarcinoma Comprising Sarcomatoid Carcinoma of the Lung Proliferating Rapidly in the Right Main Bronchus

Kotaro Mizuno, Motoki Hato, Hironori Tanaka

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2017/38450

An 82-year-old male was referred to hospital with cough. A chest computed tomography scan revealed atelectasis of right upper lobe and obstruction of the upper lobe bronchus. We conducted a transbronchial biopsy, but could not make a diagnosis. The mass proliferated rapidly, resulting in complete obstruction of the right main bronchus. Since the patient experienced severe respiratory failure, we performed right upper sleeve lobectomy in an emergency. The findings of histopathological examination revealed adenocarcinoma. However, several sarcomatoid carcinoma cells with a few adenocarcinoma cells were observed only in an intra-bronchial development part.

Open Access Original Research Article

Comparative Effectiveness of Chemical, Biological or Combination of Both Mosquito Larvicides for Dengue Control in George Town, Penang, Malaysia – A Field Trial

Wee Loon Chin, Surajudeen Abiola Abdulrahman, Abdul Rashid

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2017/38224

Background: Tackling the increasing trend of the dengue menace remains one of the most challenging tasks in public health medicine. Extensive literature search revealed no previous community intervention trial done in Penang and Malaysia to compare effectiveness of the use of various mosquito larvicides based on container indices as the definitive measurable outcomes. The study aim was to identify the most effective mosquito larvicidal measure for dengue control in dengue-sensitive areas in George Town, Penang.

Methods: A field trial was conducted in three localities randomly selected from a list of 33 dengue-sensitive areas. Area A was treated with both chemical and biological larvicide, Area B was treated with biological larvicide and Area C was treated with chemical larvicide as a standard preventive measure. Container indices (CI) were obtained weekly for eight consecutive weeks and data was analyzed using Repeated Measures ANOVA test in SPSS version 21.

Results: Comparative effectiveness of larvicidal measures between the three areas remained inconclusive as the p-value could not be computed between the three areas due to termination of iteration on ‘between-areas’ factor, although descriptively, better vector control was achieved through monotherapy with biological larvicide alone. Area A’s CI showed a drastic drop from 1.79 to 1.05 for the first two weeks, zero for weeks 3-5, 1.67 at week 6 and reducing to zero for the last two weeks. Area B’s CI showed an initial increase from 1.05 to 1.43 for the first two weeks and subsequently reduced to zero and remained zero until week 8. Area C’s CI showed zero reading for the first two weeks and by week 3, it went up to 1.00 before it reduced to and remained zero until week 8.

Conclusion: Monotherapy with biological larvicide alone seemed to offer better vector control, although statistical evidence of its superiority remained inconclusive. In view of this, integrated vector management should be enhanced by harnessing community participation to curtail dengue infections, irrespective of the choice of larvicide used for vector control.

Open Access Original Research Article

Inclination and Impediment towards Preventive Dentistry among Practising Dentists in Bangalore City- A Cross Sectional Study

N. Naveen, Swati Patnaik, N. Vanishree, Guru Suhas, Bharath Champasekan

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2017/24282

Objective: Despite the proven effectiveness of preventive dentistry, its acceptance and implementation is still far from being a success. The current study attempts to assess the inclination (attitudes) and impediment (perceived barriers) towards preventive dentistry of practising dentists attached to dental colleges, in Bangalore city.

Materials and Methods: A cross sectional study was conducted among clinicians attached to dental colleges in Bangalore city. A total of 176 practising dental faculty, completed a pretested and validated questionnaire. The questionnaire collected information regarding demographic details, characteristics, attitudes and perceived barriers towards preventive dental care. Data was analysed using SPSS version 19. Chi square test, ANOVA and Pearson’s correlation was used.

Results: The attitude and barrier towards preventive dental care was compared among age, gender, years of practice, designation and specialization respectively. A significant result was obtained for attitude among specialization (p=.001). Both attitude (p= 0.04) and barriers (p= 0.002) had a significant result when compared among designations. Attitude and perceived barriers towards preventive dental care were correlated with years of experience and it was seen that as the experience increases, attitude becomes positive and perceived barriers become low.

Conclusion: Dentists’ have a positive attitude towards preventive dental care but their perception towards the barriers might have an impact on its implementation.

Open Access Original Research Article

Knowledge of Cervical Cancer and Its Screening among Female Nurses Working in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, South-Eastern Nigeria

Ifeanyichukwu U. Ezebialu, Cyril C. Ezenyeaku, Joseph C. Umeobika, Lawrence C. Ikeako, Geoffrey I. Ubboe, Chukwuemeka E. Ojiyi

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2017/38013

Background: Cancer of the cervix, although a preventable disease, continues to be one of the commonest cancers among women in developing countries. Unlike the developed nations, developing countries still experience late presentations of cervical cancer, probably due to poor knowledge and poor uptake of the preventive measures. Adequate knowledge of this condition among nurses will be beneficial to women as nurses constitute a significant proportion of care givers to women.

Methodology: A cross sectional survey of consenting female nurses working in a teaching hospital using pretested self administered questionnaires was done. Data analysis was with SPSS (IBM SPSS statistics 20). Chi square test was used to test for association between variables and level of significance was set at P ≤ 0.05.

Results: The mean age of the respondents was 37.1 years ± 9.8. One hundred and fifty three (92.7%) had heard of cervical cancer. Only 20% identified HPV as the cause of cervical cancer. Younger age, junior rank and having nursed a cervical cancer patient significantly influenced the knowledge of the correct cause of cervical cancer. More than 90% knew about Pap test but only 16% have actually had a Pap test.

Conclusion: There was a fairly good level of awareness of cervical cancer among this group of nurses but the knowledge of the aetiology was very poor. Awareness of the screening procedure was also high but this did not translate into practice as only few of the women have actually had a Pap smear test.

Open Access Original Research Article

Assessing Management and Leadership Quality Styles of Sub-district Leaders in Relation to Staff Performance in the Sub-districts: The Pursuit of Health System Strengthening, Fanteakwa District

James Atampiiga Avoka, Issah Seidu

Journal of Advances in Medicine and Medical Research, Page 1-14
DOI: 10.9734/JAMMR/2017/38238

Background: Sub-district leaders/managers are health care professionals appointed to lead or manage the sub-districts. A series of survey and monitoring reports have unearthed weak leadership and management at the sub-districts which has the potential of weakening the sub-district health systems and which contributes to the overall effect on resilient health systems. The objectives of the study were to: determine the leadership styles exhibited by sub-district leaders, analyze the association between the leadership/management styles of Sub-district leaders and performance of their subordinates, and analyze the relationship between Leadership Styles and performance of Sub-district leaders.

Methods: A cross-sectional survey design was employed. The average performance of the leaders was calculated based on the Ghana Health Service performance appraisals criteria. Principal Component and Exploratory Factor Analyses were used to determine the leadership styles exhibited whilst correlation and regression analyses were used to determine the association between: leadership styles and subordinates performance, and leadership styles and leaders performance.

Results: The results showed that transformational and supportive are the leadership styles exhibited by the leaders and both are positively related to the performance of their subordinates. However, transformational leadership style tends to add more to the subordinates performance than the supportive style leaders. Both leadership styles are each significantly associated to the performance of the leaders. Additionally, a higher overall leader’s performance is associated with a higher subordinate’s performance. Also a higher leadership ability rating is associated with higher leaders’ performance.

Conclusion: Sub-district leaders or managers` leadership styles have a tremendous influence on the performance of their subordinates and the leaders themselves. The transformational and supportive leadership styles are positively related to the performance of the subordinates. A qualitative research is needed to obtain in-depth information about the leadership quality styles of sub-district leaders.

Open Access Original Research Article

Determinants of Maternal Mortality in North Eastern Nigeria: A Population Based Study

Mustapha A. Kolo, Yusuf M. Adamu, Muhammad Chutiyami, Abdulkarim G. Mairiga, Buba S. Mshelia

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/JAMMR/2017/38070

Aims: The aim of this study is to explore the determinants of maternal mortality across urban and rural areas of Borno State, North Eastern Nigeria.

Method: A cross-sectional study design was used. Data were sourced from in-depth interview of women of reproductive age sampled across the state. 300 women of reproductive age were interviewed in urban areas, 100 each from the three senatorial districts of the state. Whereas 123 women were selected from three villages in each of the three senatorial districts. SPSS v16 was used for data analysis.

Results: It was identified that early marriage is prevalent in both urban and rural areas of the state as more than 60% of the respondents in each area were married between 13 to 19 years of age. Similarly, about half of the respondents had their first pregnancy before 20 years of age, but no statistical significant difference was found between age at first pregnancy and pregnancy complications (ᵡ2= 19.4, df18, P>.05 in Urban Borno, ᵡ2= 11.2, df10, P>.05 in Rural Borno, α=0.05). Although, utilization of antenatal care (ANC) services were relatively high, but 17% (urban) and 29% (rural) of the women were found not to be attending ANC. Home delivery was also a common feature constituting 39% for urban Borno and 49% for rural Borno. A statistically significant relationship was found between level of education and maternal health/mortality in both urban and rural areas (P<.05). Accordingly, ethnicity is significantly associated with maternal health seeking behavior in Urban Borno (P<.05), as high parity was found to increase pregnancy complications in rural Borno state (P<.05).

Conclusion: Major determinants of maternal deaths in urban/rural Borno state were poor access to basic obstetric care services, financial difficulty and illiteracy. The study thus recommends increase in awareness as well as a sustainable free maternal health services in the state.

Open Access Original Research Article

Variety of the Structures of Staphylococcus Cassette Chromosome Mec in Coagulase- negative Staphylococci and Their Effects on Drug Resistance

Alia Essa Shams Aldeen, Kareem Thamer Meshkoor

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/JAMMR/2017/38128

Background: In the past coagulase negative staphylococcus were often seen as contaminants, but were later considered one of the most common photogenic bacteria in the hospital over the last decade Identification of beta-lactam and particularly methicillin in hospitals is of concern. The fundamental principle for the treatment of CoNS is the rapid identification of resistance mechanisms particularly their resistance to methicillin. The objective of this study is to determine the antibiotic resistance, the frequency of the mecA gene, and to determine the types of SCCmec in the CoNS isolates of from clinical isolates and control.

Study Design: Point prevalence case-control study.

Place and Duration of Study: Breast milk samples were collected from (200) patients suffering from mastitis and 106 lactational women as control whom visit center of breast examination in hospital Al- Sadder –in Najaf- Iraq, during the period from July/ 2015 to Jun/ 2016.

The standard biochemical tests were used for all isolates are coagulase, catalase, oxidase, and modified oxidase the CoNS isolates, then diagnosed by vitek -2 technique and the antibiotic sensitivity testing was carried out also by vitek-2 system. Then genomic isolate were extracted and mecA gene was detected by PCR technique, the types of SCCmec were performed by RFLP-PCR.

Results: Among the 62 breast milk isolates (50 mastitis, 12 control), identification of CoNS at the species level indicated that Staphylococcus epidermidis was the most common species, with 40 isolates, followed by Staphylococcus haemolyticus (10), Staphylococcus hominis (12).All isolates appeared had mecA gene , no one harbored SCCmec type I, 8 (12.9%) harbored SCCmec type II, 12 (19.3%) harbored SCCmec type III, 30 (48.3%) harbored SCCmec type IV and 8 (12.9%) remained non-typable. Staphylococcus epidermidis was the most isolates that harbored SCCmec type IV.

Conclusion: The results showed that CoNS revealed high percentage of resistance to methicillin, and the type III, SCCmec type was the most prevalence type of which encodes the largest number of resistance genes. The study give the information could be used in epidemiological study for preventing of infectious control in hospital and health centers.