Open Access Original Research Article

Knowledge about Diabetes and Its Effect on Quality of Life among Diabetic Patients in King Abdulaziz University Hospital, Jeddah

Hatoun Elazhary, Abdulhaleem Noorwali, Nisar Zaidi, Reem Alshamrani, Maram Aljohani, Duaa Khan, Hadeel Saati

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/JAMMR/2018/40083

Background: Quality of life (QOL) is an essential part in Diabetic patients since low QOL can decrease self-care which can lead to increased mortality and complications. The purpose of this study is to determine the effects of diabetes on QOL in Saudi Arabia, and to assess the knowledge about diabetes among these patients in order to know if there is a relation between diabetes knowledge and patient's QOL.

Methods: Cross sectional study done in king Abdul-Aziz university hospital in Jeddah. The sample was on type 2 diabetic patients (N=300), they were recruited from hospital wards and outpatient clinics during 2016. The questionnaire consisted of 3 sections: demographic and medical characteristic, knowledge of diabetes and QOL assessed by 4 dimensions.

Results: The mean age of the study population was 55.6±10.1 years and 189 (63%) were female. The median duration of having diabetes was 10 years. The mean score of diabetes knowledge was 8.57±1.8 out of 12 indicating good level of knowledge. The worst score was for alcohol’s effect on blood glucose, only 21.7% answered correctly. The mean score QOL was 34.1±7.7 out of 50 which indicates average level of lifestyle. Regrading effect of the knowledge on QOL, there was positive correlation with no significant association.

Conclusion: Diabetes impairs QOL of patients, and the knowledge about diabetes affects QOL. We recommend the engagement of health professionals in educational settings in order to enhance health-related knowledge. Seminars, counseling sessions and workshop should be arranged periodically for diabetic patients to increase their awareness.

Open Access Original Research Article

Comparing the Glucose Results by Glucometer and Laboratory Methods: A Prospective Hospital Based Study

O. Otokunefor, R. Ogu

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/40923

Introduction: Diabetes Mellitus is a rising global concern. Monitoring of blood glucose is an integral part of the management of diabetes. The use of glucometers is prevalent in clinical practice and has beneficial effects. There is need to ensure that reliable results are produced all the time.

Aims: The aim of this study was to compare the glucose level results obtained from the point of care glucometer with that obtained from the laboratory and to establish if there was a statistical significant difference between the two.

Study Design: This is a prospective descriptive study.

Location of Study: This study was conducted in the University of Port Harcourt Teaching Hospital antenatal clinic and the medical out-patient clinic.

Methodology: Fifty patients were selected for the study after institutional ethical committee’s clearance was obtained. The glucose level of each patient was assayed using both the glucometer and glucose oxidase method with the specimen run in duplicates and measured simultaneously. The results were compared using means, standard deviation, the error of means and correlation.

Results: The means were 4.02 mmol/l and 4.91 mmol/l from set one and 5.02 and 4.22 mmol/L from set two. The variation between the results were 46 and 70% respectively as against the maximum of 20% which is globally acceptable. The standard error of the mean was statistically significant. (p= <0.0001 and <0.001 respectively).

Conclusion: The percentage difference between the two sets of results was greater than the global recommendation. Despite the popularity and ease of glucometer use, standardization and quality assurance are imperative to accurately assessing blood glucose levels.

Open Access Original Research Article

Revamping Infection Control through International Non-governmental Support in Autoclaving Training for Low Capacity Hospitals in the Sub-sahara

Mukoro Duke George

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/JAMMR/2018/39980

Introduction: The control of infection in hospital setting cannot be overemphasize nor undermined, even in poor resource settings with low human capacity especially in insurgency prone regions of the world. 

Aim: The manuscript reported the lessons learnt and practical changes emanating from technical workshop model provided by International Non-Governmental organization such as ICRC. The autoclaving model was for Hospitals located in insurgency prone regions and compared with minimum international standards and requirements.

Materials and Methods: It entails steps for developing a capacity for infection control through sponsored training and retraining in autoclaving techniques, instrumentation handling, storage and transport within hospital premises with limited or poorly trained personnel. Lessons learnt were summarized, and pictorial descriptions of steps were highlighted. 

Results: The Central sterilization unit was set up, and motivation was given in the form of stipends (money) to enhance continuity and sustainability. In addition, control standards for monitoring the quality of their work in autoclaving was impacted to the staffs during the technical workshop and currently serves as resource model for training workers from surrounding health centres in remote suburbs where insurgency have been subjugated relatively.

Discussion: The workshop had proven that hospitals with staff shortfall in sub-Sahara Africa and regions ravaged by war, militancy or insurgency could be equipped with standard autoclaving techniques and instrumentation handling skills by training non-health professional as well as equipping support staffs. This model of technical support allows for inaccessible health facilities to gain focal and modern medical, scientific techniques, capacity building in autoclaving and instrumentation handling. It allows the use of local firewood for energy supply where electricity supply is not sustainable for continuity. This model also provides minimum infection control standards for poor resource hospital and may be used in mobile health missions in remote settings.

Conclusion: Therefore interventions such as Autoclaving using model pressure pots should be part of strategies employed in reducing and controlling infections and sterilization of instruments during NGOs health mission projects.

Open Access Original Research Article

The Relationship between Psoriasis and Serum Levels of Vitamin D

Riham Tajjour, Roula Baddour, Faisal Redwan, Fouz Hassan

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/JAMMR/2018/39538

Introduction: Psoriasis is a common chronic inflammatory skin disease with complex pathophysiology. The role of vitamin D has recently arisen in many skin and systemic diseases including psoriasis through its modified effect of inflammatory and immunological mechanisms. Several studies have demonstrated its effects on keratinocytes' proliferation and differentiation, cutaneous immune system, regulating the microbial flora and the response to infective diseases.

Aim: this study aimed to compare serum levels of vitamin D in patients with psoriasis with its levels in control subjects without this disease, and to analyze the presence of a relationship between vitamin D status and the clinical features of psoriasis.

Methodology: This analytic observational case-control study included 174 patients (88 with psoriasis and 86 control subjects without psoriasis) all of them were resident in Latakia during a period of one year. Levels of 25-OH vitamin D were determined using ELISA test.

Results: Serum levels of vitamin D were significantly lower in the psoriatic patients than control individuals (12.51±9.57 vs. 16.53±7.22, P-v=0.002). There was no statistically significant correlation between serum vitamin D levels and the duration of disease, its clinical type, or the presence of nails, joints or palms and soles involvement. On the other hand, there was a significant negative correlation with severity of disease.

Conclusion: It is necessary to bear in mind that vitamin D deficiency is more common in psoriasis patients than controls and that infers the role of vitamin D in the pathogenesis of the disease.

Open Access Original Research Article

Space Occupying Lesions (SOL) of the Brain - Clinical Manifestation with Subtle Neurological Symptoms in Emergency Department

Ahmed Sajjad, G. Y. Naroo, Zafar Khan, Zulfiqar Ali, Bina Nasim, Anis Sheikh, Hussain Shah, Laji Mathew, Nayeem Rehman, Tanvir Yadgir

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2018/38701

A space-occupying lesion of the brain is commonly due to malignancy but could be other underlying pathologies as well [1]. The effects of SOL may be local or due to compression of adjacent brain structures. Patients may also have behavioral disturbances or cognitive dysfunction [2,3].

Aims & Objectives:

           1. To identify SOL patients presenting with elusive symptoms in Emergency Department.
           2. To avoid diagnostic delay of SOL.
           3. To find the underlying cause and to initiate early management.

Methods: This is a retrospective study involving 150 patients who presented in ED Rashid Hospital with neurological symptoms over a period of 12 months commencing from 01/01/2015 until 31/12/2015.

Results: As for presenting symptoms, 81 (54%) presented with Seizures, 31 (21%) with a headache, 17 (11%) had both a headache and vomiting, 8 (5%) with unconsciousness and those by abnormal behavior (3%). Five (3%) were having a motor deficit, and two (1%) had vomiting without a headache and confusion.

As for underlying diagnosis, 78 (52%) were diagnosed with infectious causes and 62 (41%) with a brain tumor. Among the infectious causes, 58 (74%) presented with seizures, 11 (14%) with an isolated headache and 4 (5%) with both a headache and vomiting.

On the other hand, the headache was the commonest presentation in brain tumor patients, i.e., 18 (29%) followed by seizures in 17 (27%), headache and vomiting in 11 (18%) and neurological deficit in 10 (16%) patients.

Conclusion: A headache with or without vomiting, seizure and acute psychological disturbances may be a warning sign of a wide variety of an intracranial space occupying lesion (SOL) including malignancy.

Open Access Original Research Article

Acute Childhood Poisoning in Azare North Eastern Nigeria

Iragbogie Al-Mustapha Imoudu, Dalhat S. Afegbua, Maurice Elike, Ibrahim Ishola, Anas Abubakar

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2018/41050

Aim: To describe the clinical profile of acute poisoning amongst children admitted into the Federal Medical Centre Azare, Nigeria.

Study Design: Cross-sectional retrospective.

Place and Duration of Study: The study was conducted at the department of paediatrics, Federal Medical Centre, Azare, Nigeria from 1st January 2013 to 31st December 2017. 

Methodology: Medical records of children admitted with complaints of undue exposure to poison agents were retrieved and analysed. The information collected includes, the age, sex, poisoning agent, place of occurrence of the event, the time between occurrence and presentation to the hospital, route of poisoning, circumstances of the event, presenting symptoms, elicited clinical signs, outcome, and duration of hospital stay. The collected data was analyzed using SPSS version 20.0.

Results: Acute poisoning accounted for 0.68% of the total admissions giving a prevalence of 684 per 100,000. The male to female ratio was 1.4:1. The children were aged 9 months to 12 years. However, the majority of subjects (73.2%) were aged 1-4 years.

The most frequently encountered poison agent is organophosphate with kerosene being the next most common. Vomiting was most indicative of organophosphate poisoning while cough, dyspnea, and tachypnea were indicative of kerosene poisoning. Thirty-eight patients (92.7%) were successfully managed and discharged without sequelae. One death was documented, giving a mortality rate of 2.4%. The relationship between poison agents and outcome was statistically significant (χ2 = 22.55, df = 10, P = .013).

Conclusion: Acute childhood poisoning is more common in Azare than most other parts of Nigeria. Organophosphates constitute the most frequent poison agent. However, kerosene poisoning is the most likely to cause mortality.

Open Access Review Article

Assessment of Extra-analytical Phase: Improving Laboratory Service and Patient Safety

Tunji Akande

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/JAMMR/2018/40742

Background: Laboratory quality management plans with pre-analytic, analytic and post-analytic components are key elements in ensuring patient safety. The greatest impact for overall improvement would be to focus on pre-and post-analytic services where most errors occur.

Objectives: To develop and maintain high quality practice standards for laboratory testing, to ensure patient safety by minimizing medical errors associated with laboratory service.

Methods: A review of quality management of the extra-analytic phase of the test system for improving patient safety

Results: The proportion of errors associated with the two extra-analytical phases is 4-5 times that seen in the analytical phase with the pre-analytical phase consistently representing over half of the all errors in published studies.

Conclusion: The current focus on analytical quality of the total process alone has to be expanded to include the extra-analytical phases. Laboratories need to take greater responsibility for activities, outside their immediate control for an effective laboratory service.