Open Access Case Study

Heterotopic Ossification of Left Hip after Sport Injury; Imaging Techniques and Features in Early and Late Presentation

A. J. Adekanmi, O. M. Atalabi

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/41422

Aim: This report is aimed at highlighting the plain film features in late presentation of heterotopic ossification and other imaging features as well as raise awareness about heterotopic ossification, an uncommonly diagnosed and neglected sequalae of traumatic injuries in Nigeria.

Presentation of Case: A 43-year old man who had been experiencing post recreational sport recurrent dull pain and worsening limitation of movement in his left hip following an initial sports injury he sustained three years before presentation.

Discussion: Plain radiograph features were consistent with matured heterotopic ossification of the left hip. This was observed in the 4th decade of life though commoner in younger people.

Conclusion: Plain film is still a useful modality in the evaluation of matured heterotopic ossifications. It should be considered among differential diagnosis of recurrent joint pain following history of trauma by attending physicians, to prevent the possible sequalae of improperly treated traumatic joint injuries, to aid early treatment and avoid long term complications

Open Access Original Research Article

Molecular Detection of Herpes Simplex Virus Types [1 and 2] in Oropharyngeal Squamous Cell Carcinoma (OSCC) in Khartoum Dental Education Hospital

Razan Abdalla Bashir, Wafa Ibrahim Elhag

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2018/41717

Background: Oral Squamous cell carcinoma (OSCC) is the most frequent oral cavity malignancy accounting for over 90% of oral cancers. The aim of this study was to detect of Herpes simplex virus types [1 and 2] in Oral Squamous Cell Carcinoma (OSCC).

Methodology: Paraffin embedded well differentiated oropharyngeal squamous cell carcinoma tissues and benign lesions from 50 patients attending the Cancer Department in Khartoum Dental Education Hospital during 2015-2016, were examined for the presence of HSV-1 and HSV-2 genes using polymerase chain reaction (PCR).

Ethical approval was obtained from Al Neelain University research ethical bord and informed consent was taken from patients after full explanation of the purpose of the study.

Results: Out of a total 50 samples: among 40 OSCC paraffin-embedded tissues specimens, HSV-1 and HSV-2 were identified in 3 (7.5%) and 6 (15%) of samples respectively. While 2 (5%) samples were co-infected with HSV type 1 and 2. Among 10 benign tumors specimens 1 (10%) sample was positive for both HSV types 1 and 2 (co-infection).

Conclusion: This study showed a higher prevalence of HSV-2 compared with HSV-1. Further studies are needed to investigate relationship between HSV-2 and behavioral factors (smoking, tobacco and alcohol use, or change of sexual behaviors) in developing of OSCC.

Open Access Original Research Article

Utilization of Equipment for Emergency Obstetric Care in the Sub Districts Level Facilities in Bangladesh

Md. Shafkat Hossain, Abu Sayeed Md. Abdullah, Abdul Halim, A. K. M. Fazlur Rahman, Md. Jahangir Hossain, Animesh Biswas

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/JAMMR/2018/38503

Background: Comprehensive Emergency Obstetric Care (C-EmOC)  equipment were provided to 47 Upazila Health Complexes (UHCs) and Basic Emergency Obstetric Care (B-EmOC) equipment to 192 UHCs in 2003-2004. The tools required for repairing the equipment were also provided to the National Electro-Medical Equipment Maintenance Workshop and Training Centre (NEMEW&TC) in Dhaka and District Electro-Medical Equipment Maintenance Workshops (DEMEW) in 18 districts. Japan International Cooperative Agency (JICA) provided financial support to purchase and distribute of these logistics. This study explored the utilization of EmOC equipment in the sub-district facilities.

Methodology: A mix-method, includes both qualitative and quantitative approach, was used to conduct the study during the period of January to June 2014. The study was conducted to understand the status of logistics after 10 years of distribution and utilization in the health facilities. Status of equipment was collected through a self-administrated questionnaire in all facilities (n=213). In-depth information was collected using a structured checklist in randomly selected 26 UHCs and 11 DEMEWs. Research Officers also visited additional 7 UHCs to validate the information received, of which 3 were the highest performing, 2 were lowest performing and 2 UHCs from where authority informed about not receiving any instruments from JICA.

Results: The study explored that 95% instruments were available and 52.9% were currently being used, 17.4% were not being used, 5.9% repairable and 6.4% damaged equipment. Most of the EmOC instruments were found at labour room and in operation theatre at the usable stage. Some instruments were found in the emergency room, storerooms, nursing room, pathology rooms, and doctors' room and in the computer room. In some of the UHCs, almost all the instruments remained intact in the storeroom or operation theatre. In UHC 36.3% of the respondents reported that some of the equipment was not functioning and 51.5% of the respondent knows regarding the Government regulatory policy for maintenance of EmOC equipment. Maternal and neonatal deaths were lower in health facilities with Comprehensive equipment than those of who had received Basic instruments. In DEMEWs 04 respondents among 11 reported that they had required a number of tools for maintenance EmOC instruments.

Conclusion: The study identified a gap between supplies and utilization of essential equipment for emergency obstetric care. It needs to explore further on how best optimum unitization of equipment can be ensured within the available resource.

Open Access Original Research Article

A Study Based on Perception towards the Radiation Exposure to Adult Patients at King Abdul-Aziz Medical City, Riyadh, Saudi Arabia

Ali Aldhebaib, Oinam Gokulchandra Singh, Zyad Almutlaq, Abdulrahman Alaqeel, Rakan Saleh M. Alkhalifah, Turki Nasser I. Alnasser, Fahad Falah M. Alharbi, Faisal Hisham A. Alshaalan

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/JAMMR/2018/41907

Background: Radiologic diagnostic procedures using ionizing radiation carry potential health risks to the patients. So, patient’s knowledge about ionizing radiation would play a key role in reducing unnecessary imaging and its impacts.

Aims: To investigate patient’s perception of ionizing radiation and its associated risks towards the radiation exposure to the adult patient.

Materials and Methods: We included 204 adult patients (175 males and 29 females; age range 18- 51 or above and suitably structured questionnaire was used. A cross-sectional survey was conducted, using a suitably structured questionnaire consisting of 16 questions divided into multiple parts. Descriptive statistics were used to explain the demographic characteristics and information regarding radiation knowledge of the respondents. This study was conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia in the Radiology Department between October and January 2017.

Results: A total of 204 patients responded to this study. It is clarified that there were (85.8.3%) male and (55.4%) female, their age's ranges between 18 to 51 years and above, and educational level ranges from less than higher secondary to Ph.D. level Furthermore, we found that the number of the respondents was agreed with questions. It was a surprising result that the majority of respondents did not know about the imaging modalities that do not use ionizing radiation. In addition, the large numbers of undecided and disagree responses (41.7% and 33.3%) for the exposure to radiation when you are during travel by airplane along with 59 respondents were given "No" answer for the source of their information and they did ask their physician about radiation risks prior to X-ray examinations.

Conclusion: It is clear from the study that most of the patients have a good knowledge and recognized a correlation between ionizing radiation and its associated risks. In the conclusion, similar studies with a large sample size may be required to order to get enough empirical data about the radiation knowledge of the patients

Open Access Original Research Article

A Study to Check Correlation between Panoramic Radiographic Image and Protrusive Inter-Occlusal Record in Male and Female Dentulous Patients for Depicting Condylar Guidance Angle: A Pilot Study

Pratibha Katiyar, Kaushik Kumar Pandey, Mariyam Ali, Abhishek Gaur, Fauzia Tarannum, Anant Agarwal

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/41980

Purpose: To study and compare the sagittal condylar angles set on a Hanau articulator using intra-oral protrusive records to angles found using a panoramic radiographic image in male and female dentulous patients.

Materials and Methods:  A total of 20 subjects (10 male and 10 female) Aged between 21 to 30 years, free of signs and symptoms of temporomandibular joint disorders and with intact dentition were selected. Impressions were made using irreversible hydrocolloid and all dental stone casts (type- III), were mounted on a Hanau articulator using a spring bow type of face bow. For all patients, the protrusive records were made with polyether bite registration paste when the mandible was moved forward by approximately 4- 6 mm, using compound jig. All procedures for recording, mounting, and setting were done on the same day and the obtained condylar guidance angles were tabulated.

A panoramic radiographic image of each patient was made with the Frankfurt horizontal plane parallel to the floor of the mouth and the horizontal reference lines were marked by joining the orbitale and porion after tracings of the radiographic images. The most superior and most inferior points of the curvatures were identified. These two points were connected by a straight line representing the mean curvature line and the Angles made by the intersection of the mean curvature line and the horizontal reference lines were then measured. The results were subjected to statistical analysis using Independent Student’s t-Test, ANOVA.

Results: values obtained, using panographic method were on average 5.51º greater than the values obtained by protrusive interocclusal record method. The mean condylar guidance angles between the right and left side using both the methods were not statistically significant.

Conclusion: Within the limitations of this study, it was concluded that the protrusive condylar guidance angles obtained by panoramic radiograph may be used for the programming of semi-adjustable articulators

Open Access Original Research Article

Disseminated Intravascular Coagulopathy; a Condition to Monitor in the Management of Leukaemia Patients

Olufemi E. Akanni, Bamisaye E. Oluwaseyi, Yusuf N. Olawale, AbdulAzeez Ibn AbdulAzeez, Njoku Azuka, Adetola Adebisi, Ajayi A. Olubunmi

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/JAMMR/2018/40379

Background: Disseminated intravascular coagulopathy is a consumption coagulopathy which mostly results from an underlying disease. It occurs as a result of the activation of the coagulation cascade leading to the formation of thrombi which results in haemorrhage due to the excessive consumption of platelet and coagulation factors. Malignancy is associated with hypercoagulable state and increased risk for thrombohemorrhagic complications and leukaemia is no exception. Bleeding manifestations are common in acute leukemias, especially in acute myeloblastic leukemia, and are prominent features of an initial stage of the disease. This study assessed disseminated intravascular coagulopathy (DIC) in leukaemia patients in Nigeria.

Materials and Methods: One hundred and sixteen (116) subjects consisting of 58 leukaemic subjects (AML, CLL, and CML) and 58 age and sex-matched healthy control subjects were recruited into the study. The parameters estimated in this study were packed cell volume (PCV), platelet count, white blood cell count (WBC), prothrombin time (PT), the international normalised ratio (INR), activated partial thromboplastin time (aPTT) and D-dimer assay.

Results: The mean ± SD values of the parameters assessed in the leukaemia patients include 3.7±3.1 µg FEU/mL, 67.5±55.7 seconds, 1.8±0.1, 77.3±31.8 seconds, 194±103 cells/mm3, 74±124 cells/mm3, 30±5% for D-dimer, PT, INR, aPTT, platelets, WBC and PCV respectively. The results display a significant statistical difference between the leukaemic and the control subjects (p<0.05).

Conclusion: The abnormality of these haemostatic parameters occurring in the leukaemic subjects (AML, CLL, and CML) is highly indicative of the occurrence of disseminated intravascular coagulopathy in these patients. This study, therefore, shows that disseminated intravascular coagulopathy can occur as a complication of various types of leukaemia studied and this requires prompt and appropriate management

Open Access Review Article

Cautery Looked through the Lens of Clinical Perspective: Indications, Contraindications, Adverse Effects and Complications

N. A. Qureshi, S. O. Salem, I. M. A. Gazzaffi, S. M. Alsanad

Journal of Advances in Medicine and Medical Research, Page 1-16
DOI: 10.9734/JAMMR/2018/42035

Background: Cautery (in Arabic Kaiy) is an ancient healing practice and indicated in a variety of diseases around the world.

Objective: This review aimed to describe and synthesize the literature on clinical perspectives of cautery specifically indications, contraindications, complications and adverse consequences. Methods: Electronic searches of three databases (Pub Med, MEDLINE, Google Scholar, Ovid SP) using the Boolean operators and keywords were conducted and a number of pertinent articles (N=9256) published in scientific English literature were retrieved for extensive appraisal by two independent reviewers. Finally 84 articles were included in this narrative review.

Results: Cautery is reported to have definite indications and contraindications along with certainadverse effects and complications. The adverse consequences or complications mostly occur when cautery is used in patients with potentially complicated multiple physical diseases by unqualified and untrained traditional healers and professionals.

Conclusion: Cautery, a well-recognized complementary and alternative therapy used in many diseases is very safe in the hands of trained experienced professionals and traditional healers. Although cautery is recommended as a last choice in resistant complicated medical and surgical conditions, many patients with variegated diseases first consult traditional practitioners due to their unique culture and strong belief system and vice-versa is also factual. This study calls for conducting rigor research for assessing its outcome in prioritized medical-surgical conditions and elucidating its underlying basic mechanisms of actions and effects