Open Access Short Research Article

Prevalence of Hypertension and Diabetes Mellitus among Haemodialysis Patients at Elobied Haemodialysis Unit –West Sudan

Abdelsalam Mohamed Hamed Elfaki, Samia Tarig Abdalla Mohamed

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/jammr/2019/v29i330071

Background and Objectives: Hypertension and diabetes mellitus are major risk factors of end – stage renal disease (ESRD). This study aimed to determine the prevalence of hypertension and diabetes mellitus among haemodialysis patients at Elobeid haemodialysis unit.

Patients and Methods: The study was a single – centre cross - sectional study including 130 patients on chronic haemodialysis in Elobeid hospital haemodialysis unit. Each patient was personally interviewed by the co-author in the haemodialysis unit using a structured questionnaire prepared by the investigators. Data collected include: socioeconomic data (gender, age, residence, and occupation), history of hypertension, diabetes mellitus, treatment of hypertension, treatment of diabetes mellitus, duration of hypertension, duration of diabetes mellitus and duration of dialysis. Hypertension was defined as blood pressure ≥ 140/90 or the use of antihypertensive medications. Diabetes mellitus is defined by use of insulin therapy. In this study both hypertension and diabetes mellitus were already diagnosed and on regular medications. Statistic package for social sciences (SPSS) version 20 was used for data analysis.

Results: One hundred and thirty patients were recruited. More than two thirds of patients were males with male to female ratio of 2.2: 1. Patient’s age ranged from 12 years to 90 years. The mean age was 46.3 ± 17.8 years. Forty (32%) patients were above 56 years of age. Ninety eight (75%) patients were hypertensive, the majority of hypertensive patients were males (90%). Eighty six hypertensive patients were on calcium channel blocker (88%). Amlodipine was the commonly used antihypertensive used. Twenty five (19%) patients were diabetics and all of them were males. All diabetic patients were also hypertensive. Fourteen diabetic patients (56%) were on insulin therapy, while 11 patients were using metformin.

Conclusion: The prevalence of hypertension among haemodialysis patients was high while the prevalence of diabetes is less than that reported globally. The blood pressure should be tidily controlled specially in diabetic patients and patients with impaired renal function. For early detection of chronic kidney disease and elevated blood pressure as a sequel, routine blood pressure measurement is highly recommended in adult patients attend the clinic for any reason.

Open Access Original Research Article

Utilization of Maternal Health Care Services in India: A Community Based Cross-sectional Study in Rural Belgaum

Maginsh Dahal, Kushalata Baral, Mubashir Angolkar

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/jammr/2019/v29i330069

Introduction: Sub Centre (SC) is the peripheral unit of the existing health care delivery system under the allopathic system of medicine in India. These basically provide preventive, promotive and the curative services and are facilitated by Female Health Workers (ANM) and Male Health Workers (MHW). They are the integral part of health care delivery system. Also, key to achieve a goal of health for all and to promote the community people for their overall development.

Methods: A community based descriptive cross-sectional study was conducted from August 2011 to February 2013 in all 9 sub centers of Kinaye PHC of Belgaum district, all 14 maternal health care workers were selected  and 272 beneficiaries were selected from catchments area of these sub-centers were interviewed by administering structured, pretested interview schedule. Data were analyzed by SPSS (20 Version).

Results: Study revealed that (85%) of the workers had correct knowledge but could not transform it into practice completely. This is due to multiple problems that encounter such as include lack of equipments(85.71%), transport facilities (77.78%), delay in decision-making by community to seek care (77.78%), lack of supportive supervision (>20%). Besides these, they were lacking in career development opportunities. There are no promotional avenues and low remuneration and benefits. The acceptance of service provided through sub centers was satisfactory (>90%) among beneficiaries and ANMs (98%) were most accepted than MHW. Beneficiaries faced many problems to access services such as lack of need based services (60%), poor attention by health service provider towards the need of consumers (5.2%) and difficulty in reaching to sub health post (21%).

Conclusion: The regular supply of necessary equipments and medicines needs to be ensured          at the sub centre and frequent in-service trainings and career development opportunities to be given to health workers to maintain the enthusiasm and devotion towards the profession.                Also there is a need to provide skill development opportunities and ensure the convenience of service at all sub centers and communication between health workers and beneficiaries to be emphasized.

Open Access Original Research Article

Renal Scarring in Children with Primary Vesicoureteral Reflux Disease

Khalid Kawoosa, Rahid Rasool Malla, Wasim Ahmad Wani, Mudasir Nazir, Syed Heena Kubravi

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/jammr/2019/v29i330070

Aims: To determine the incidence of renal scarring among patients with primary vesicoureteral reflux (VUR) and the possible risk factor(s), we studied 69 children (42 girls and 27 boys) with VUR attending the Pediatric opd.

Study Design: Prospective Observational study.

Place and duration of Study: Department of pediatrics, Sher I Kashmir Institute of Medical Sciences, Srinagar, Kashmir between June 2017 to June 2018.

Methodology:  All the patients were assessed for VUR grade by voiding cystoureterography and for presence of renal scarring by (99 m) technetium dimercapto–succinic acid scintigraphy.

Results: Grade of reflux and number of urinary tract infection (UTI) episodes (≥3) were found to be statistically significant risk factors for renal scarring (P <0.05). However, there was no significant association with gender, familial history and laterality of the disease (P >0.05). Similarly, there was no statistically significant difference of frequency of renal scarring among the different age groups (P >0.05).

Conclusions: It was concluded that recurrences of UTI and VUR severity are significant risk factors for renal scarring in children with VUR. Therefore, identification of VUR at an early age may offer the opportunity to prevent episodes of UTI and possible formation of renal scars that may result in end-stage renal failure.

Open Access Original Research Article

Associated Risk Factors and Seroprevalence of Hepatitis B among Pregnant Women Attending Antenatal Clinic in a Rural Setting of Cameroon (Penka-Michel)

Laure Brigitte Kouitcheu Mabeku, Constantin Tchakounte, Tchouangueu Thibau Flaurant, Francois-Xavier Etoa

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/jammr/2019/v29i330072

Background: Vertical transmission is an important route of transmission for hepatitis B virus infection. Despite the introduction of HBV vaccine in the extended immunization program in 2005, Cameroon has remained a hyper-endemic area. The aim of this study was to determine the seroprevalence of hepatitis B Virus among antenatal clinic attenders in Penka-Michel-Cameroon, and to identify potential risk factors associated with the infection for a better prevention of the disease.

Study Design: The study was a case control study conducted in four reference hospitals in Penka-Michel, a rural area in west region of Cameroon during April to July 2014.

Methodology: Six hundred and forty three (643) pregnant women were recruited. The DiaSpot HBsAg in vitro diagnostic test strips were first used. Positive samples were further confirmed for HBsAg, HBeAg, anti-HBs, anti-HBe and anti-HBc using an immunoassay kit. Liver enzymes (ALT, AST and ALP) were also evaluated for HBsAg positive samples using TECO DIAGNOSTICS kit.  A structured questionnaire was used to collect information on sociodemographic parameters and predisposing risk factors of hepatitis B from each patient. Data collected was analyzed using Graph Pad prism version 5.03.

Results: The prevalence of hepatitis B infection (HBsAg) in our setting was 4.7%. Fifty percent of HBsAg positive women were also HBeAg positive and 46.7% of them lack antibodies against hepatitis B e antigen. All the HBsAg positive women had previous contact with HBV and just 3.3% of them were immunized against HBV. Women in the age groups 31–35 years were significantly more affected (X2 16.95, P = .0045). Only a history of a contact with hepatitis B infection was significantly associated with HBsAg and HBeAg positivity (X2 27.45, P = .0001; X2 25.31,                 P = .0003).

Conclusion: Administration of HBIG in combination with hepatitis B vaccine as post-exposure prophylaxis for infants born to HBV infected mothers is of paramount importance. In addition, universal HBsAg screening of all pregnant women will greatly assist in reducing the maternal transmission of HBV in Cameroon. 

Open Access Original Research Article

Knowledge, Attitudes and Practices Regarding Dengue Fever in a Cohort of Nursing Students

Mansoor Shueai Al Awfi, Bushra Anaam AL Sharabi, Abdullah Al Alimi, Mohammed Abdo Abkar

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/jammr/2019/v29i330073

Background: Good knowledge, attitudes and practices (KAP) on dengue fever will result a significant effect on prevention and control. Conversely, poor KAP help spread of dengue vectors and virus resulting in dengue epidemics.

Objective: This study aimed to evaluate the knowledge, attitudes and practices regarding dengue fever among a cohort of nursing students in faculty of medicine and health sciences, Hodiedah University, Hodiedah, Yemen.

Methods: Data was collected from 80 students using questionnaire method consists of a set of questions during 2016–2017educational year. KAP were assessed as satisfactory or unsatisfactory using a scoring system. Data was analyzed by using the Statistical Package for Social Sciences (SPSS®). Chi-square test was used for testing associations. 

Results: According to KAP scores, 12.5%, 97.5% and 25% of respondents had satisfactory knowledge, attitudes and practices respectively. While 87.5%, 2.5% and 75% of them had unsatisfactory knowledge, attitudes and practices about dengue fever. There is significant association between knowledge and practices (p= 0.001). However, there is no significant association between knowledge and attitudes (p= 0.588) about dengue fever.

Conclusion: Present study concluded that 87.5 % and 75% of participants nursing students have unsatisfactory knowledge and practices regarding dengue infection. Therefore, it is importance to enhance their knowledge and practices before graduation and employing them for health care services in the community.

Open Access Original Research Article

Nutrition Assessment and Factors Influencing Malnutrition among Children under Five in Adjumani District Uganda

Emurot Simon Peter, Sambo Haruna Aliyu, Rabiu Salisu Hassan

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/jammr/2019/v29i330074

Globally and specifically within the sub-Saharan African region, the nutritional status of children under five has remain a public health concern. Deficiency in nutrients has been documented as a cause of morbidity and mortality in children under five in most developing countries. The study was conducted to determine factors influencing malnutrition among children under five in Adjumani district in Uganda. The study design adopted was a descriptive and cross-sectional type. Three hundred children aged under five years together with either their mothers or adult care givers          were selected. An interviewer administered structured questionnaire was completed by 200 mothers/caregivers. Nutritional status was assessed by anthropometric measurements while focus group discussions with medical personnel and direct observation were also conducted. The result depicts that Wasting was significantly associated with sex of the children with females more likely to be wasted than males (p=0.023). Age of the studied children was found to be significantly associated with mid upper arm circumference (p<0.001). Also education level of mothers/care givers was significantly associated with malnutrition of children under five. (P value 0.013). Stunting and underweight were identified as the main nutrition problems in Adjumani District. Poor weaning practices, poor sanitation due to inadequate hand washing and poor maintenance of latrine as well as low income for house hold due to few loan/ credit facilities were identified as factors influencing malnutrition.

The study therefore recommends that nutrition survey for children under five should be done regularly at community level. Sanitation can be improved by availing hand washing facility for each latrine. Female education be encouraged while agriculture to should be modernized in order to boost household income and improve food security.

Open Access Original Research Article

Neopterin and Biochemical Parameters as Indicators of Predicting HIV Disease Progression and Treatment Response: A Cross-sectional Study in Ghana

Louis Boafo Kwantwi, Christian Obirikorang, Margaret Agyei Frempong, Dan Yedu Quansah

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/jammr/2019/v29i330075

Background: Surrogate markers have been identified to play significant role in the pathogenesis and prognosis of HIV infection. However, there is limited data on the utility of neopterin estimation in HIV infection. Therefore, the study sought to measure and ascertains the trends of serum neopterin and other biochemical parameters as indicators of predicting HIV disease progression and treatment response among HIV seropositive individuals.

Methods: A cross-sectional study with 298 HIV seropositive individuals consisting of 165 HIV on highly active antiretroviral treatment and 136 naïve highly active antiretroviral patients. Venous blood was drawn for the assay of neopterin and the other biochemical parameters.

Results: Neopterin was significantly lower (P<0.0001) in patients in the highly active antiretroviral therapy than those in the naïve highly active antiretroviral therapy group. Serum neopterin increased as the disease progresses and decreased as the duration of the therapy treatment increased (p=0.0001). At a cut of point of 54.5 nmol/L, neopterin gave a sensitivity of 97.5%, specificity of 95.9% and an area under the curve of 0.99.

Conclusion: Neopterin has shown to be to be good marker in predicting HIV disease progression especially in patients with CD4 counts less than 200mm-3 and a useful indicator of patient’s response to therapy treatment.

Open Access Original Research Article

Histological Assessment on Cadmium Induced Liver Damage Following Oral Administration of Moringa oleifera Oil and Anarcardium occidentale Nuts Oil in Wistar Rats

O. D. Omotoso, S. A. Adelakun, O. O. Oyewo, B. T. Adediran

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/jammr/2019/v29i330076

Background: Cadmium is a human carcinogen element and one of the most toxic pollutants in the environment. Present study aims at histomorphological study of some of the effects of Moringa oleifera oil and cashew (Anarcardium occidentale) nuts oil on Cadmium-induced liver damage in wistar rats.

Methods: Thirty-five Wistar rats (80-180 g) were randomly selected and divided into seven groups of five rats each after acclimatization for two weeks. Group A which served as control received phosphate buffer, Group B received Cadmium only (3.5 mg/kg body weight). Group C received Vitamin C and Vitamin E; Group D received Vitamin C, Vitamin E and Cadmium. Group E received Cadmium and Moringa oleifera oil, Group F received Cadmium and Cashew nut oil and Group G received Cadmium (3.5 mg/kg body weight) and Moringa oleifera oil and Cashew (Anarcardium occidentale) nut oil.

Results: Histological examination revealed normal histo-architecture of the liver, the central vein and the hepatocytes were seen clearly and there was orderly arrangement of the hepatocytes in Group A (control group). In group B, there was enlarged portal vein and there was distorted arrangement of the hepatocytes. In group C, the hepatocytes and the central vein were seen. In group D, the central vein and hepatocytes were seen though not orderly arranged. In groups E, F and G, there was restoration of the hepatocytes and the central vein was seen.

Conclusion: This therefore suggests that Moringa oleifera oil and Cashew (Anarcardium occidentale) nut oil have ameliorative effects which led to the restoration of the damaged and distorted hepatocytes.