Open Access Short Research Article

Development of a Lymphoid Variant of Acute Leukemia after Five-fold Treatments of Ovulation Induction

L. A. Ivanova, I. V. Korol, U. S. Kovalenko, E. A. Kokova, A. V. Mezinova, F. A. Dzhanchyatova, E. O. Gumenuck

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/jammr/2018/v28i1230043

Ovarian hyperstimulation syndrome is a complication of IVF procedure. Describes the case of a 31-year-old patient with body mass index 22 kg/m 2. After 5 IVF procedures with the previous stimulation of ovulation she complaints of weakness, dyspnea, pain in the chest, unproductive cough, epigastric pain, fever, pain in the hip and spine, ascites, hydropericardium, hydrothorax, acute respiratory distress syndrome reveal themselves. "Ovarian hyperstimulation syndrome" was made.  The treatment with glucocorticosteroids improved the condition of the patient. After a bone marrow puncture the diagnosis "lymphoid variant of acute leukemia" was confirmed.

Open Access Original Research Article

Sonographic Features Predictive of Thyroid Nodule Malignancy in a Nigerian Population

Owoyomi Oluwatoyin Rebecca, Asaleye Christianah Mopelola, Komolafe Akinwumi Oluwole

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/jammr/2018/v28i1230041

Aims: To determine the ultrasound malignancy score (UMS) and identify the ultrasound (US) features of thyroid nodule (TN) associated with malignancy, in our study population, using fine-needle aspiration cytology (FNAC) as the gold standard.

Study Design: A prospective observational study.

Place and Duration of Study: Departments of Radiology and Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ile Ife, Nigeria, between June 2016 and May 2017.

Methodology: We studied 110 thyroid nodules in 110 adult subjects (97males and 13males). Neck ultrasound scan (USS) to evaluate and score 7 sonographic features of the nodules for their malignant potential as well as simultaneous Ultrasound Guided Fine Needle Aspiration (USG-FNAC) was done. The findings were compared and data was analyzed using Statistical Package for Social Science (SPSS) version 20.

Results: USG-FNAC findings showed that of the 110 thyroid nodules studied, 107(97.3%) were benign while 3(2.7%) were malignant. Receiver operating characteristic curve showed that at sensitivity and specificity of 66.7% and 88.8% respectively giving UMS of 4.5. All the 3 nodules that were malignant on USG-FNAC had micro calcification and irregular margins on ultrasound (p=0.05).

Conclusion: Using USG-FNAC as the gold standard, thyroid nodules with UMS of 4.5 are likely to be malignant. Ill-defined margins and micro calcifications on ultrasound are suggestive of malignancy in thyroid nodules.

Open Access Original Research Article

Profile and Antimicrobial Susceptibility Pattern of Bacterial Isolates from Infected Wounds of Patients Attending Berekum Holy Family Hospital in Ghana

Isaac Dadzie, Nicholas Quansah, Emmanuel Kingsley Dadzie

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/jammr/2018/v28i1230042

Background: Wound management and care after an infection has been known to present a major concern to healthcare professionals. Its association with increased trauma, discomfort and financial burden to patients bring to bear the need for aggressive intervention. This study sought to investigate the bacterial profile and their antimicrobial susceptibility pattern of infected wounds in patients who reported to Berekum Holy Family Municipal Hospital in Ghana.

Methodology: A total of 150 consenting patients with wound infections of diverse aetiologies were recruited. Wound swabs were aseptically obtained, macroscopically analyzed, gram stained and cultured on differential media. Antibiotic susceptibility testing was performed by Kirby-Bauer disk diffusion technique.

Results: The prevalence of wound infection was 84.67% with cellulitis (35.43%) accounting for the most cause. Gram-negative bacilli (84.5%) were the most isolated bacteria with Pseudomonas aeruginosa (28%) being the most predominant pathogen isolated. Polymicrobial infections were identified in 33 (19.64%) of the infected wounds with Pseudomonas aeruginosa/Proteus mirabilis being the most common association (36.4%). The isolated gram-negative organisms were absolutely susceptible (97%-100%) to amikacin. Gentamicin, Ciprofloxacin and Levofloxacin exhibited moderate to higher susceptibility. Gentamicin exhibited maximal susceptibility against the gram-positive organisms with tetracycline being the most resistant antibiotic against the isolated organisms.

Conclusion: With the increased detection of bacterial pathogens causing wound infections and their susceptibility to the tested antibiotics, we recommend that patients with wound infections should immediately report cases to health facilities for early intervention.

Open Access Original Research Article

The Effect of Stress on Cardiovascular Parameters among University Students in Buea during and Out of Examination Periods

Orelien Sylvain Mtopi Bopda, Irene Ngole Sumbele, Bih Andrine Nji

Journal of Advances in Medicine and Medical Research, Page 1-14
DOI: 10.9734/jammr/2018/v28i1230044

Objectives: This study aimed at evaluating the effect of examination stress on the cardiovascular parameters amongst undergraduate students of the University of Buea, out of examination period (OEP) and during examination period (DEP). 

Experimental Design: This was a cross-sectional study.

Place and Duration of the Study: The study was carried out at the University of Buea (Cameroon). The field and laboratory work was carried out from January to June 2016 within which are two examination periods and two weeks of first semester break.

Methodology: A structured questionnaire was used to document student’s demographic information and number of hours slept. Blood pressure and heart rate were measured using automatic arm sphygmomanometer. Blood samples were collected for full blood count analysis using a haematology analyser. Stress was measured using Cohen Perceived stress scale (PSS) while salivary alpha amylase (sAA) concentrations were measured by ELISA. Data was collected and analysed from 772 (OEP=378 and DEP= 394) participants.  Mann-Witney U-test and students T- test were used for statistical analyses. The significance level was set at P<0.05.

Results: The prevalence of stress was 98.2% (387) DEP vs 97.4% (368) OEP (P=0.372) with PSS of   (23.41±4.88 vs. 22.31± 4.53, P=0.002). The sAA concentrations was higher DEP (24.659 ± 16.384) than OEP (18.789±5.865) (P< 0.001). Among the haemodynamic and haematological parameters, SBP and HR were significantly higher DEP than OEP. There was a positive correlation between HR and sAA within both periods. WBC%, Lym%, Mon%, and MCHC were significantly lower (P<0.05) while Gran%, Plt and Pct increased DEP than OEP (P<0.05) with respect to stress.

Conclusions: The prevalence of stress OEP vs DEP implies stress is an important problem in students. This is proven by the increase in PSS and sAA concentrations during examinations and can lead to impairment of cardiovascular parameters.

Open Access Original Research Article

Toric and Phakic IOLs for the Treatment of Astigmatism and/or High Myopia: Our Experience at Prince Hashem Hospital Zarqa

Nancy Al Raqqad, Naser Al Fgara, Mohammad Dros

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/jammr/2018/v28i1230045

Aim: to share our experience in treating patients with high myopia and or astigmatism  using toric and phakic intraocular lenses at Prince Hashem Hospital in Jordan.

Patients and Methods: This is a retrospective study of fifty eyes of 36 patients who were treated between June 2015 and July 2016 at Prince Hashem Hospital in Jordan. Patients’ age ranged between 22 years and 54 years. All patients had high myopia (≥6 dipoters) and/or astigmatism and were not eligible for surface laser ablation and intolerant to contact lenses. Preoperative best corrected visual acuity BCVA, ophthalmological slit lamp examination, manifest and cycloplegic refraction, corneal topography using Oculus Pentacam and IOL master were obtained in all patients.

Results: In all the patients preoperative refraction ranged between -4 to -33 sphere and -3.5 to -8 cylinder. Phacoemulsification and implantation of toric intraocular lenses (IOL) was done in 21 patients, Visian implantable collamer lens (sphere and toric ICL) were implanted in 18 patients and toric iris claw lenses (Ophthec Artisan/ Artiflex) were used for the remaining 11 patients. All surgical procedures were done under local anesthesia. All patients showed improvement in their visual acuity after surgery and spectacle independence.

Complications were minimal in the form of lens rotation resulting in decrease in BCVA seen in 3 patients with toric IOLs and two Visian ICLs patients.  High intraocular pressure was seen in one patient.

Mean follow-up period was between 6 months to 1 year.

Conclusion: Toric and phakic IOLs can be very useful in correcting astigmatism and or myopia. Proper patient selection and counseling is essential to ensure best refractive outcome and avoid complications.

Open Access Review Article

Obstetric Fistula: The Agony of Unsafe Motherhood. A Review of Nigeria Experience

C. O. Njoku, A. N. Njoku

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/jammr/2018/v28i1230040

Obstetric fistula is a dehumanizing complication of childbirth that has severe psychosocial impact; though almost non-existing in developed nations, it is still a public health problem in Nigeria and other countries in sub-Saharan Africa. In Nigeria, about 100,000–1,000,000 women are living with obstetric fistula and estimated 50,000-100,000 new cases occur annually.

To review the relevant literature on obstetric fistula in Nigeria, literature search was carried on epidemiology, prevalence, risk factors, causes, reasons for delay in intervention, complications and preventions using Google search. Additional information was obtained from text and journal in medical library of University of Calabar library.

The main cause of obstetric fistula in Nigeria is prolonged obstructed labour, which most often occur due to delay in seeking medical attention because of social and financial reasons. Other causes include inadequate facilities for emergency obstetric services, especially caesarean section, poor access to existing ones, and delay in intervention on reaching the health facilities as a result of limited number of skilled obstetric personnel and/or equipments.

There is need to increase collaboration and education of local communities on the cultural and social factors that influence and increase risk of obstetric fistula as well as improving the health-system’s response to emergency obstetric care.