Open Access Original Research Article

The Development of the Short-form of “25-Question Geriatric Locomotive Function Scale”

Yu Tanabe, Yoshiyuki Suehara, Yongji Kim, Shuko Nojiri, Taketo Okubo, Midori Ishii, Takayuki Kawasaki, Kiyoshi Matsuoka, Keisuke Akaike, Kenta Mukaihara, Naoko Okubo, Tsuyoshi Saito, Kazuo Kaneko

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/JAMMR/2018/40196

Objectives: In 2007, the Japanese Orthopaedic Association (JOA) proposed the term “locomotive syndrome” (LS) to describe a condition in high-risk musculoskeletal disease patients who are highly likely to require nursing care. The JOA developed a screening tool, the 25-question Geriatric Locomotive Function Scale “GLFS-25” and the 5-question Geriatric Locomotive Function Scale “GLFS-5” in 2012.

However, there are some issues about these screening tools. GLFS-25 has 25 questions, and complete response is needed to diagnose LS, but our previous studies revealed that the complete response rates were extremely low (50-70%). GLFS-5 which has only 5 questions and it can only screen Normal and LS, but it can’t classify Grade 1 LS and Grade 2 LS. We thought we need short-form of GLFS-25 which is easier than GLFS-25 and more accurate than GLFS-5.

Methods: We developed a short-form of GLFS-25 by performing an exploratory/explanatory factor analysis (EFA) of approximately 1000 orthopaedic outpatients. We also performed confirmation studies in an additional cohort using an item response theory (IRT) analysis, a principal component analysis (PCA) and a receiver operating characteristic (ROC) analysis.

Results: We used an EFA to develop a short-form of GLFS-25 (GLFS-9), which consisted of 9 questions that were included in the GLFS-25. These 9 items were graded on the 5-point scale; the total score (0–36) was used to diagnose patients with Grade 1 LS (3–5 points) or Grade 2 LS (≥6 points) LS; while No-LS (normal) was defined by a score of ≤2 points. The ability of GLFS-9 to predict LS was confirmed by an IRT analysis, a PCA, and an ROC analysis.

Conclusion: We developed the GLFS-9 which can classify Grade 1 LS and Grade 2 LS, a short-form of the GLFS-25. We believe that the GLFS-9 may allow for the more accessible screening and prevention of LS.

Open Access Original Research Article

Birth Injuries, Risk Factors and Predictors of Outcome in Maiduguri North-eastern Nigeria

Simon Pius, Bisumang Joel Dada, Yenti Machoko, Hauwa Yusuf Musa, Mustapha Bello

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2018/40276

Introduction: Birth injuries are impairment of neonatal body function sustained by the baby at birth which can be avoidable and unavoidable. Despite advances in prenatal care, birth injuries occurs especially in prolonged and difficult labour /deliveries.

Objectives: The study aimed to determine the risk factors and predictors of outcome at Special Care Baby Unit of the University of Maiduguri Teaching Hospital Maiduguri, North-Eastern Nigeria.

Patients and Methods: This was a prospective cross-sectional studies conducted over 12 months from 1st January to 31st December 2016. Patients who met the inclusion criteria after obtaining ethical clearance were evaluated after consenting to participate in the study.

Results: Sixty one (5.7%) out of 1078 neonates admitted to Special Care Baby Unit (SCBU) with birth injuries were recruited into the study. The common risk factors identified were primiparity 25/61 (40.7%) p=0.017, mode of delivery spontaneous vaginal delivery 36/61 (58.8%). Deliver at tertiary centre was high 38/61 (62.3%), though not statistically significant. When compared neonates with one- two birth injuries  compared to those greater than 2 birth injuries delivery by non-obstetrician was associated with higher risk of birth injury p=0.001. Facial nerve palsy, Erb’s palsy was the common central nervous system injury; perinatal asphyxia was higher 24/61 (39.1%). Soft tissue injury constituted the majority; Facial and skin bruises 37/61 (60.7%), sub-conjunctival haemorrhage 25/61 (40.1%) cephalhaematoma and subgaleal haemorrhage was 10/61 (16.4%) and 8/61 (13.1%) respectively. Clavicular fracture was the commonest 5/61 (8.2%), followed by humerus 4/61 (6.6%). Two patients with liver and splenic rupture died within 2 days of admission.

Conclusion: The risk factors and predictors of birth injuries are intertwined; largely birth injury is avoidable with good antenatal care and prompt management of labour processes by trained personnel.

Open Access Original Research Article

Epidemiology of Tracheostomy Patients in Intensive Care Unit of King Abdulaziz Medical City

Farhan Alenezi, Sreekanth Mohan, Nourah Mohammad Aldekhayel, Arwa Hussain Alruwaili, Hind Mohammed Alshabanat, Winnie Philip, Shoeb Qureshi

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/JAMMR/2018/40321

Introduction: Tracheostomy is one of the common procedures that are performed in the intensive care unit (ICU) for airway management. The primary aim of this study was to review the role of tracheostomy, its benefits and risks in ICUs of King Abdul-Aziz Medical City (KAMC), Riyadh, Saudi Arabia with a view to realize factors affecting the patient’s outcome.

Materials and Methods: A retrospective study reviewed the charts of various adult ICUs of KAMC from the patients’ medical records. Patients who aged 18 years and above and underwent tracheostomy in the ICU were evaluated for the incidence and hospital outcome. Analysis of data was done by SPSS (Version 22). Data was analyzed statistically by using frequencies, percentages mean, standard deviation. Mann-Whitney U test and chi-square tests were done to study the influence and difference between of various variables.

Results: Total number of 128 patients was tracheostomized with predominance of males with mean age of 61.30 ± 20.05 years. The majority were diagnosed with Stroke/Traumatic Brain Injury (28.1%) followed by Carcinoma (13.3%). The predominant reason for tracheostomy was prolonged intubation 54.7% while the main complication was fever and infection (30.8%). The mean duration of the ICU stay was 37.01 ± 38.603 days. The outcome of this study showed low mortalities for tracheostomy patients.

Conclusion: Tracheostomy performed in the ICUs of KAMC was dominantly done in males mainly with indication of prolonged intubation. It was associated with fever and infection as complication and with low mortality rate.

Open Access Original Research Article

Screening and Association between Diabetes Mellitus and Abo Blood Grouping in Amaoba Ikwuano and Amaba Ugwueke Abia State Nigeria

A. N. C. Amadi, P. A. C. Ndukwe, P. E. Agbai

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/JAMMR/2018/39225

Diabetes Mellitus is a genetic disorder with a high degree of inheritance and the importance of human blood group in human blood transmission is well established. Studies to establish the relationship between blood group and diabetes are varied. This study was to screen and determine the association between diabetes mellitus and ABO blood grouping in the study areas. Accu-check glucometer strip and anti-sera were used for the study. Out of the 209 samples from urban and rural areas, males were 120 (48.8%) and females 107 (51.20%). Majority of the subjects male and female (39.70% and 58.6%) from the urban area and male and female (35.29% and 24.44%) from the rural area are O+ respectively, followed by A+ male and female  (29.41% and 29.03%) from the urban area and male and female (5.88% and 35.55%) from rural area respectively.  Then B+, male and female (10.29% and 9.67%) from urban area also male and female (11.76% and 28.88%) from rural area.  More males and females (52.94%, 35.56%) in the rural area were Diabetic than those in the urban area (38.24%, 24.19%) respectively this is statistically significant (p < .05).  majority of the males and females with blood group O+ (28.57%, 77.78%) from the urban area and (40.00%, 43.75%) from the rural area were Diabetic, followed by those with blood group A+ (42.86%, 22.22%) from the urban area and (10.00%, 37.59%) for the rural area.  There is statistical difference between the occurrence of Diabetes Mellitus among the various blood groups (p < .05).  More subjects that were overweight male and female (67.85%, 61.11%) from the urban area and (60.00%, 50.00%) from rural area have Diabetes Mellitus. Questionnaire analysis shows that the causes  of diabetes mellitus in the urban area were identified by most (31.6%) respondents to be high consumption of starchy food followed by high consumption of sugar (6.5%) while the rural area majority (56.6%) of the respondents indicated high consumption of sugar followed by witchcraft and the least (16.5%) had no idea about the cause of the ailment.  Management of the disease in urban area was identified to be adhering to diet (28.3%) followed by adhering to medication (28.3%) then routine screening (25%) than the least was no idea (3.30%) while most (56.60%) of the respondents from the rural area have no idea on what are the management practices, than adhering to diet (20.60%) and exercise (2.60%) had the least response. In the treatment of the disease in both urban and rural area, majority (74.62%) of the respondents agreed that diabetes mellitus is best treated in the hospital while most (41. 77) in the rural area believe in visiting the chemist respectively, However some in both urban and urban area still  patronize herbal houses for treatment. There is therefore the need for proper  public health  enlightenment and education of the populace for regular screening test and management practices to immunize and avert the risk of complications that many arise.

Open Access Original Research Article

Relationship between Exclusive Breastfeeding and Childhood Obesity among Under-five Children in Ibadan North and Ido Local Government Areas, Oyo State; Nigeria

Oladejo Thomas Adepoju, Olanike Bukola Bamisaye

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2018/39637

Aim: This study aimed to investigate the relationship between exclusive breastfeeding and obesity among under-five children in Ibadan North and Ido Local Government Areas (LGAs), Oyo State, Nigeria.

Study Design: The study was cross-sectional in design

Place and Duration of Study: The study was carried out within Ibadan metropolis using one urban and one rural Local Government Areas between November and December 2015.

Methodology: A four-stage random sampling technique was used to select 450 (214 males and 236 females) under-five children from Ibadan North and Ido Local Government Areas of Ibadan, Nigeria. Pre-tested, interviewer-administered semi-structured questionnaire was used to collect information on demographic characteristics of the children and breastfeeding practices of mothers. Anthropometric indices were taken and categorised according to WHO standards. The risk categories were defined using age and sex-specific body mass index (BMI) percentile. Data were analysed using descriptive statistics and Logistic regression with a level of significance set at p<0.05.

Result: Mean age of the children was 29.8±17.0 months with 52.4% being female. Prevalence of overweight, obesity and exclusive breastfeeding among the children was 14.4%, 20.2% and 17.3% respectively. Child’s sex and practice of exclusive breastfeeding were significant predictors of overweight and obesity in the LGAs (p<0.05). Male children were 1.6 times more likely to be overweight or obese than the female children (OR=1.6; 95% CI=1.06-2.41), and children residing in urban LGA were 2.7 times likely to obese or overweight than those from rural LGA (OR=2.7; 95% CI=1.56-4.71). Exclusively breastfeed children were 6.7 times less likely to become obese than non-exclusively breastfed children (OR=6.7; 95% CI=1.21-36.46).

Conclusion: Exclusive breastfeeding has protective factor against obesity among under-five children. Efforts geared towards increasing exclusive breastfeeding practice among mothers are needed to prevent childhood obesity among under-five children in these communities.

Open Access Review Article

Aerosolized Coal Fly Ash: Risk Factor for Neurodegenerative Disease

Mark Whiteside, J. Marvin Herndon

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/JAMMR/2018/40072

Aims: Coal fly ash (CFA), the major waste product of coal-burning utilities, is trapped and contained in Western nations, but not generally in India and China, where it is a major component of air pollution. In Western nations, the CFA trapping is inefficient, exposing downwind populations to the toxic aerosols. Similarly, CFA industry workers and those living downwind of coal ash piles may be exposed to the wind-blown toxins.  Aerosolized coal fly ash, especially as used for climate manipulation, is a particularly hazardous form of air pollution. Our objective is to review the multifold components of coal fly ash, linked to neurodegenerative disease, which is rapidly increasing world-wide.

Methods: We review the interdisciplinary scientific and medical literature.

Results: The recent finding of spherical exogenous magnetite (Fe3O4) nanoparticles in the brain tissue of persons with dementia suggests an origin in air pollution produced by coal fly ash. The primary components of coal fly ash, iron oxides and aluminosilicates, are all found in the abnormal proteins that characterize Alzheimer's dementia. The presence of these substances in brain tissue leads to oxidative stress and chronic inflammation. Energy absorbed by magnetite from external electromagnetic fields may contribute to this neuropathology.

Conclusions: Considering the well-known and manifold toxicities of CFA, the public should be made aware of the potential risks for neurodegenerative disease posed by aerosolized CFA, including its use in climate alteration activities. We have set forth the basis for understanding how this kind of pollution may damage cognitive abilities. It is a form of pollution that should be halted altogether.

Open Access Review Article

Novel Pedagogical Methods for Conditional-Probability Computations in Medical Disciplines

Rufaidah Ali Rushdi, Ali Muhammad Rushdi, Fayez Ahmed Talmees

Journal of Advances in Medicine and Medical Research, Page 1-15
DOI: 10.9734/JAMMR/2018/40240

There is a definite need for representations of and tools for conditional probability that enhance understanding, simplify calculations, foster insight, and facilitate reasoning. Such representations and tools are useful in a wide variety of disciplines, but their utility in medical contexts and applications are stressed herein, so as to address a clinical rather than a mathematical audience. We employ a plethora of time-tested pedagogical representations or tools of conditional probability including: (a) Visualization on Venn diagrams or Karnaugh maps, (b) Reformulation as natural frequencies, (c) Entity interrelations via Signal Flow Graphs, as (d) Specification of certain problem formats such as the format of Trinomial Graphs. The new representations or tools have well known histories of pedagogical advantages, but are still to be tested in the specific realm of conditional probability. Further assessment of the novel representations or tools proposed herein is needed. Each of these is to be taught to a group of students, and a control group of students is to be instructed via the conventional representation. Detailed statistical analysis of the outcomes is warranted. Similar investigations were performed earlier, but they were on a limited scale. Therefore, the need arises for an explorative study that exhausts all proposed representations or tools.