Journal of Advances in Medicine and Medical Research

Aims: To describe the sociodemographic details and indications for the use of anti-vascular endothelial growth factor (anti-VEGF) injections at the Eye Foundation Centres in Nigeria.

Study Design: Retrospective, observational analysis.

Place and Duration of Study: Eye Foundation Hospitals in Lagos, Ijebu-Imushin and Abuja, Nigeria between January 2011 and December 2014.

Methods: Records of all anti-VEGF injections given were assessed. All consecutive cases were taken in proportion seen in the 4 centres. Age, sex, occupation, diagnoses and types of injection were recorded in the data sheet prepared for the study.

Results: This study included 1072 eyes of 540 patients. Mean age was 60.37(12.74) standard deviation years. The age range is from 10 – 92 years. 326(60.4%) males and females 214(39.6%) were seen. Patients that presented were mostly currently employed 40.8%, previously in paid job 25.8% and businessmen and women 24.5%. Total injections were 2443, given during the study period. Anti-VEGF agents used were Bevacizumab (2278; 93.2%) and Ranibizumab (165; 6.8%). Indications for injection were: proliferative diabetic retinopathy (PDR) 27.4%, retinal vein occlusion (RVO) 17.6% and vitreous haemorrhage (VH) due to proliferative diabetic retinopathy and sickle cell retinopathy 10.6%. There was an association between sex and disease (p < 0.001) and age and disease (p < 0.001).

Conclusion: The use of anti-VEGF injections are on the increase especially bevacizumab. The most common indications are proliferative diabetic retinopathy, retinal vein occlusion and VH. The treatment was done more for males, middle class and the rich.

Aim of the Work:  evaluation of direct fluorescent assay (DFA) in the detection of RSV in nasopharyngeal secretions of infants with acute LRT infections and revealing the rate of RSV infection in these patients.

Patients and Methods: This study included 100 infants less than two years of age who diagnosed as cases of acute LRT infections During the 6 month study period, from October 2013 till April 2014. Cases were presented as an outpatient clinic and/or were hospitalized in the pediatric hospital of Tanta University.

Results: 20% of infants included in the study were positive for RSV by DFA. The results revealed a significant relationship between RSV infections and younger ages with mean age 3.5 months. The incidence of RSV infection was also significantly increased with bronchiolitis, wheezy chest, congenital heart disease, prematurity, family history of asthma and winter season. Conversely, there was an insignificant relationship between RSV infection and type of feeding and antibiotics consumption.

Conclusion: So, DFA can be used as an effective tool in screening large numbers of cases for rapid diagnosis of RSV infection.  This can help in early treatment with specific anti-viral and avoid unnecessary use of antibiotics, where most of cases are treated as bacterial infections.

Beta-carotene (βC), an abundant natural antioxidant in fruits and vegetables may possess the Ability to modulate oxidative stress and leptin-insulin signaling. This study was designed to evaluate the biochemical effect (hormonal and oxidative enzyme markers) of βC on Wistar rats fed high dietary fat. Thirty (30) male Wistar rats were randomly divided into six (6) groups of five rats each. Group A was taken as the control and received distilled water, Group B received high-fat diet of (60% fat and 40% rat chow), Group C received 300 mg/kg body weight (bw) of βC, Group D received high-fat diet for 12 weeks and was treated with 300 mg/kg bw of βC for 2 weeks, Groups E received 300 mg/kg /bw of βC for 2 weeks and then received high-fat diet for 12 weeks while Group F received high-fat diet for 12 weeks and was treated with 150 mg/kg bw of βC for 2 weeks. At the end of the experimental period of 16 weeks. The animals were humanely sacrificed, and blood samples were collected by cardiac puncture, Leptin and insulin hormonal assay and oxidative enzyme markers were evaluated using the respective standard methods. The data were analyzed with SPSS version 20.0 at a value of P<0.05. The result showed the mean values of leptin, insulin and Malondialdehyde (MDA)were higher for group B when compared to the rest of the groups (P<0.05) but this increase was reversed following βC administration. Superoxide dismutase (SOD), Catalase (CAT), has decreased values in group B, these values were increased upon administration of βC (P<0.05). When compared to group A, group C showed increased value for the variables SOD, CAT and is equal to A in the variable insulin. Group F is greater than group D and E for the variable leptin, MDA and equal to group D (P<0.05). The findings of this present study suggest that β carotene extract at high dose can be very effective in treating oxidative stress, lipid peroxidation, insulin and leptin resistance.

Background: Pruritus is one of the most common symptoms encountered in patients with HIV and it arises from a spectrum of dermatoses of diverse etiologies; a few are peculiar to patients with HIV while others are not. Pruritus without the presence of dermatoses (pruritus sine materia) is also common and may be severe enough to provoke sleep loss and significant psychological stress.

Aim: To compare pruritus sine materia in HAART experienced and HAART naive patients in the University of Benin Teaching Hospital, Benin City, Nigeria.  

Methods: This was a comparative cross sectional study that involved 330 HAART experienced patients and 330 HAART naive patients. Patients were evaluated for idiopathic pruritus.  P value of < 0.05 was considered statistically significant.

Results: The mean age of the HAART experienced group and HAART naïve group were 42.39± 10.1 yrs and 39.9±11.2 yrs respectively. The HAART naive population was 330 (218 females and 112 males) with a female to male ratio of 1.9:1.The HAART experienced population was 330 (247 female and 83 males) with a female to male ratio of 3:1.  The median CD4 count of the HAART naive group was significantly lower than the HAART experienced group (275.5 vs 487 cells/µ p<0.01). The prevalence of pruritus sine materia was 19(5.8%) in the HAART naïve group and 6(1.8%) in the HAART experienced group (p<0.01). 

Conclusion: Pruritus sine materiae was more common in HAART naive HIV infected patients compared to HAART experienced patients.

Aims: Children with special health care needs often have poor oral health and depend on caregivers for oral care. This study looked at the prevalence of malocclusion among a group of such children and the awareness of pediatric orthodontic care among their parents

Methodology: Clinical examination of 100 children aged 7-18 years who were physically/ mentally challenged or with speech or hearing deficits was carried out in a school. A validated questionnaire was given to 52 parents

Results: Class I malocclusion was seen in 77.8%, Class II in 6.1% and Class III in 8.1%. Other findings were anterior crowding (43%), spacing (19%), deep bite (12%), open bite (6%) and cross bite (10%). Class I malocclusion was most common in all the three groups (p=0.144); physically challenged (73.3%), mentally challenged (82.8%), speech and hearing disorders (76.4%). Other abnormalities in the above groups in order with the ‘p” value are as follows.; spacing (12.5%,31%,14.5%,p=0.144); crowding (50%,37.9%,43.6%,p=0.729); open bite (6.3%,6.9%,5.5%,p=0.790); deep bite (18.8%,0%,16.4%,p=0.060). 69.2% of the parents were not aware of these abnormalities. Due to malalignment, 57.7% of the parents were not able to maintain oral hygiene. Though 53.8% preferred correction, only 51% were aware of the treatment options. The reasons for not obtaining treatment were the cost (55.1%), coping issues (24.5%) and lack of access (8.2%).

Conclusion: Some form of malocclusion is prevalent in children with special health care needs, Class I malocclusion, anterior crowding and spacing being more common. Majority of the parents were not aware of the abnormalities and the barriers to treatment were affordability, lack of access and the coping issues. Creating awareness among caretakers and making the treatment more accessible will improve oral health of children with special care needs.

The incidence of leptomeningeal carcinomatosis (LC) has been increasing, due to advances in the cancer and the improved overall survival of cancer patients. Breast and lung cancer are the most frequently reported causes of LC among solid tumors. LC occurs very rarely in patients with colon cancer. Leptomeningeal carcinomatosis is characterized by multifocal seeding of the leptomeninges by malignant cells that originate from a solid tumor. The median survival of untreated patients is 4 to 6 weeks. Although the diagnosis may be challenging, an early treatment before the setting of neurological deficits is required in order to improve the clinical outcomes. The treatment requires a multidisciplinary approach by a combination of chemotherapy and targeted therapies administrated systemically or via intra-cerebrospinal fluid route, surgery and radiotherapy. Here, we describe a case of leptomeningeal carcinomatosis in which the primary tumor was colon cancer that has progressed to LC but responded significantly to our treatment strategy. Also, we review the literature on carcinomatosis in solid tumors.

The “Type of Article” of this paper is “Letter to the Editor”. This paper discuses about: “Placental Heteroplasmy Rate Variability of mtDNA Variants Prevents Prediction of the Phenotype”. No formal abstract is available. Readers are requested to read the full article.