Open Access Original Research Article

Nonlinear Analysis Using Multiple Cutoff Frequencies for Local Cerebral Blood Flow during Biofeedback Training

Toru Tanimura, Daisuke Iida, Yusuke Jono, Masumi Takada, Yasuyuki Matsuura, Hiroki Takada

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/JAMMR/2018/45371

Biofeedback (BF) is expected not only as a means for gaining control of bodily processes to increase relaxation, relieve pain and improve health, but also to develop and improve the brain's body control function. The aim of the biofeedback training (BFT) is to promote the recovery and the development of physical dysfunctions under consciousness. A BF instrument has three tasks. First is to monitor (in some way) a physiological process of interest. Second is to measure (quantify) what is monitored. Third is to present what is monitored or measured as meaningful information. One technique for non-invasive measurement of brain activity that has been developed in recent years is brain functional imaging using near-infrared spectroscopy (NIRS). Compared to other techniques of measurement of brain activity, NIRS is a low-restraint and non-invasive measuring technique. In addition, it enables a user to take electrophysiological measurements such as Electromyography and Electrocardiography during training activity or other movements. In recent years, NIRS has a high profile for investigations of the relationship between physical control and brain function.

Here, we investigated the connection between BFT and local cerebral blood flow, by performing cranial NIRS with simultaneous electromyogram (EMG), recording from the rectus femoris muscle. Our results suggest that We have succeeded in findings of the nonlinearity for hemodynamics in the cerebral blood flow on the frontal lobe during the muscle contraction and the post-rest.

Open Access Original Research Article

Knowledge and Attitude of Physical Therapists towards Sleep Quality Assessment

Ume-Aiman ., Natasha Nabi, Sara Sadiq

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/JAMMR/2018/45374

Aims: The aims of the current study are to determine the knowledge of physical therapists towards sleep and to analyse attitude of physical therapists towards sleep quality assessment.

Study Design: This is a cross-sectional study.

Place and Duration of Study: The study was conducted among the physical therapists of government and private hospitals of Nawabshah, Hyderabad and Karachi between July 2017 and January 2018.

Methodology: Modified form of “Assessment of Sleep Knowledge in Medical Education (ASKME) Survey” questionnaire was distributed among 170 physical therapists of government and private hospitals of Nawabshah, Hyderabad and Karachi. Questionnaire consists of 4 parts, including demographics questions, assessment of patient’s sleep, physical therapist’s attitude towards sleep quality and assessing their basic sleep knowledge. Data was analysed on the basis frequency and percentages.

Results: The results of our study confirm that sleep medicine knowledge was generally low in physical therapists. Among all the physical therapists only 9.5% had higher score while remaining 90.5% had obtained low score in sleep knowledge. Majority of the physical therapists 57.6% routinely assessed their patients sleep by asking subjective information about the quality of sleep and sleep habits. A small number of respondents 23.4% referred their patients to sleep specialists if they suspected any sleep issues. Moreover 49.4% routinely assessed the factors that disturb patients sleep. While only small population 18.4% agreed that they did not know how to assess sleep quality of the patients.

Conclusions: The current study concluded that the majority of physical therapists agreed that sleep is important to people's health and they routinely assessed their patients sleep by asking subjective information about the quality of sleep and sleep habits. On the other hand, sleep medicine knowledge was generally low among physical therapists.

Open Access Original Research Article

Prevalence of Painful Diabetic Peripheral Neuropathy among Patients with Diabetes Attending a Tertiary Outpatient Diabetes Clinic in Nigeria

Ekenechukwu E. Young, Chidimma B. Nwatu, Oluchi S. Ekenze, Obinna D. Onodugo, Belonwu M. Onyenekwe, Ejiofor T. Ugwu, Chidi Ezeude, Chioma H. Ezike

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/JAMMR/2018/45911

Aims: To determine the prevalence of painful diabetic peripheral neuropathy (pDPN) and its associated risk factors using the Douleur Neuropathique en 4 (DN4) questionnaire in a cohort of patients with diabetes attending a tertiary hospital in Nigeria.

Study Design: The study was a cross-sectional descriptive study.

Place and Duration of Study: The study was conducted in the outpatient diabetes clinic of the University of Nigeria Teaching Hospital, which is a tertiary hospital located about 15 km outside Enugu. Enugu is a town in South East Nigeria. The study was conducted between June and August 2017.

Methodology: A systematic random sample of 1 in 4 diabetic patients attending the outpatient clinic were recruited and screened following informed consent. Socio-demographic data was collected and fasting blood glucose recorded. The DN4 questionnaire was administered and the total score calculated. A DN4 score of ≥4 was recorded as diagnostic of pDPN. Data collected was analyzed using SPSS V23.

Results: A total of 272 patients; (46.3%) males were recruited. Type 2 diabetes was present in 95.6% and 57.4% had hypertension. Poor glycemic control was present in 79.2% and 44.5% had pDPN. In addition, pDPN was more prevalent in those on insulin (P =.007, OR =1.96) and diabetes duration more than 10 years (P = .004, OR = 1.92) and was not significantly associated with age, gender, body mass index or glycemic control. Significant predictors of pDPN in the regression model were, treatment with insulin (P = .022, CI - 1.100 - 3.347) and diabetes duration greater than 10 years (P = 0.015, CI - 1.141 - 3.365).

Conclusion: pDPN was common in diabetic patients and associated with insulin use and diabetes duration > 10 years.

Open Access Original Research Article

The Effect of Chronic Occupational Exposure to Petroleum Products on Haematological and Biochemical Parameters of Petrol Attendants

Antoinette Nwamaka Eze, Blessing C. Eluke, Chidi C. Eluke, Eyiuche Ezigbo, Ijeoma Uzoma

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/JAMMR/2018/31745

Aim: The aim of this study was to evaluate the effect of chronic occupational exposure to petroleum products on Hematological indices and liver biochemical profile among petrol station attendants in Enugu, Nigeria.

Subjects and Methods: Ninety participants in Enugu metropolis were recruited comprising of 30 control group (shopkeepers), thirty (30) petrol attendants exposed to these fumes for < 2 years and thirty petrol attendants exposed for > 2 years. Blood samples were collected from all participants for the determination of full blood count and biochemical parameters such as zinc, copper, lead, liver enzyme markers: aspartate and alanine transaminase.

Results: The result revealed a statistically significant decrease (P<0.001) in the mean values of total white blood cell count of the group exposed for >2 years (4.74±0.36 ✕109 /L) when compared to the group exposed for <2 years (5.36±0.70 ✕ 109 /L) and control group (5.77±0.70 ✕ 109 /L). Furthermore, there was a significant decrease (P=0.05) in the mean granulocyte % in the group exposed for >2 years (43.86±10.34%) when compared with the control group (50.89±7.62%). The result also showed a statistical significant decrease (P<0.01) in the mean levels of copper and a statistical significant increase in lead levels (P<0.01) between test group and control. The liver enzyme marker revealed a statistical significant difference (P=0.05) in the mean level of AST.

Conclusion: This study demonstrated that petroleum product and its toxic component have a suppressive effect on the total white blood cells, granulocyte, and increases lead content levels and may have an acute hepatotoxic effect with an exponential increase in exposure.

Open Access Original Research Article

Hepatitis B Core IgM Detection in Neonates Born to HBsAg and HBeAg Positive Mothers in Maiduguri, Nigeria

S. O. Oyinloye, M. Yusuf, E. S. Yedak, J. Oyebanji

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/JAMMR/2018/45262

Hepatitis B virus is a serious global public health problem and is endemic in Africa, including Nigeria. Infection of pregnant women during the second and third trimester poses a threat of 10 and 90% respectively for vertical transmission. A total of ninety two blood samples from consenting pregnant women were screened for HBsAg and HBeAg using ELISA kit (Cortez Diagnostic Inc, USA). Cord blood samples collected from five neonates of women positive for HBsAg and HBeAg were screened for HBcIgM using the same test kit. Questionnaire was used to collect data on demography, history of blood transfusion and presence of tribal mark from the pregnant women. Overall prevalences of 8.7% (8/92) and 5.4% (5/92) for HBsAg and HBeAg seromarkers, respectively were obtained. Mean age of the pregnant women was 25.75 with 27.2% within 20–24 years and 28.3% within 25–29 years, however this distribution was not statistically significant (p= 0.6840). Fifty percent (50%) of HBsAg positive women were within the age group of 25–29 years while 80% of HBeAg positive women were within the age group of 20 - 24 years. Blood transfusion (p= 0.002791) and tribal mark (p=0.00265) were found to be associated with acquisition of the virus. Eighty percent (80%: 4/5) of the neonates screened from HBsAg and HBeAg positive women were reactive for HBcIgM. The prevalence of surface antigen in this study suggests the endemicity of hepatitis B virus in the study area while the presence of both surface and envelope antigens in pregnant women portend infectivity. These results suggest the utmost need for establishment of a sustainable intervention measure that would protect not only pregnant women but women of childbearing age in order to mitigate spread of the virus. Screening for other hepatitis B virus seromarkers besides HBsAg before blood transfusion is also advocated.

Open Access Original Research Article

Cannulated Cancellous Screw and Ender’s Nail Fixation in Stable Intertrochanteric Femur Fracture in Elderly Patient with Co-Morbid Condition

Rohan R. Memon, Drashtant Patel, Nishant Juva

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/JAMMR/2018/46629

Background: Intertrochanteric Femur fracture is common in elderly patient with co-morbidity. There was a concept introduced for the biological fixation of intertrochanteric femur fractures by combined use of enders nailing and cannulated compression screws which provides additional rotational stability The clinical experience of authors revealed that Ender nailing alone cannot provide secure fixation in elderly patients with osteoporosis.

Aims and Objectives: We conducted a study to evaluate the functional outcomes of a combined fixation procedure using Ender nails and a cannulated compression screw for intertrochanteric fractures.

Study Design: This is a prospective observational type of study.

Place and Duration of Study: Department of Orthopaedics, NHL medical college between January 2015 to June 2018.

Methodology: 52 patients with intertrochanteric fractures were treated using intramedullary Ender nails and cannulated compression screw from January 2015 to june 2018. Elderly comorbid patients with osteoporosis and those which require stable fixation with less operative time and minimally invasive procedure were included in this study, Three Ender nails of 4.5mm each were passed across the fracture site into the proximal neck. This was reinforced with a 6.5 mm cannulated compression screw passed from the sub trochanteric region, across the fracture into the head.

Results: All the fractures showed radiological within 13 weeks. The functional assessment was done with modified Harris hip score (Tables 1, 2) and the mean was 86.3±3.41, 26 patients were excellent, 20 patients were good, 4 patients were fair and two patients were poor with respect to total score. The analysis of this study fulfils the objectives of good functional outcome.

Conclusions: The Ender nailing combined with compression screw fixation in cases of intertrochanteric fractures in high risk elderly patients could achieve reliable fracture stability with minimal complications.