Open Access Original Research Article

The Effect of Graded Doses of Caffeine on Intraocular Pressure in Niger Delta, Nigeria

Nwosu, Fidelma, Ejimadu, Chibuike Sydney

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/jammr/2019/v29i930117

Aim: To determine the effect of graded doses of caffeine on intraocular pressure in a Nigerian population.

Methods: This was a prospective, observer‐masked, cross‐over study carried out in the Eye clinic of the Ahoada General Hospital.

A total One hundred subjects comprising 46 males and 54females aged 20 – 76 years were chosen. Graded doses of caffeine were administered to the subjects in four groups. The fourth group was the control and subjects here were given water only without caffeine.

Intra Ocular Pressure of each subject was determined at different times after oral ingestion of coffee.

Data was analysed using SPSS program for windows (statistical package for the social sciences Inc., version 16).

Results: The group which consumed 3.5 mg/kg body weight of caffeine had the maximum mean increase in IOP (5.20±0.08 mmHg) after 60 minutes, the pressure remained the same after 90 minutes and then reduced to 4.28±0.13mmHg after the 120 minutes while Group A which consumed 0.7mg/kg body weight of caffeine had the minimum mean increase in intraocular pressure (2.32± 0.82 mmHg) after 60 minutes, 2.2± 0.65mmHg after 90 minutes and then reduced to 1.4± 0.81 mmHg after the 120 minutes (p<0.005).

Maximum effect was observed after 60 minutes of ingesting caffeine and gradually returned to baseline values after 120 minutes. There was no significant change in IOP of subjects who ingested only water.

Conclusion: This study revealed a significant rise in intraocular pressure in normotensive human eyes and this increase was dose-dependent. Moderation in caffeine consumption remains very vital and calls for more public awareness platforms. Therefore we recommend that caffeine be consumed with caution especially in patients with glaucoma. Future studies relating to caffeine’s effects via inhalation and monitoring of caffeine’s effect on IOP beyond 120minutes is equally important.

Open Access Original Research Article

Diabetic Foot and Self-awareness of This Entity

Irma Aide Barranco-Cuevas, Alexa Itaí Bello-Mora, Juvencio Reyes-Bello, Miguel Ángel Jacinto-López, Álvaro José Montiel-Jarquín, Akihiki Mizuki González-López, Eduardo Vázquez-Cruz

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/jammr/2019/v29i930121

Aims: To determine the relationship between the diabetic foot stages and the self-awareness about self-care of the feet in patients attending first level medical facility.

Study Design: This is a descriptive, cross sectional study.

Place and Duration of Study: This study was conducted in Unit Number 57 of the Family Medicine in the Mexican Institute of Social Security in Puebla, Mexico between January and June of 2017.

Methodology: We included 360 patients whom we surveyed to correlate between the level of knowledge about self-care of the feet in diabetic patients and its stages. We used a questionnaire in which the variables included gender, age, level of education, occupation, marital status, number of years since they were diagnosed with diabetes mellitus type 2, stage of the diabetic foot and level of knowledge related to this entity. Descriptive statistics and X2 were used.

Results: We included 360 patients who met the inclusion criteria. Their average age was 55.75 years, the average number of years with the diagnosis of diabetes mellitus was 6.07. There was a significant statistic association between the level of knowledge and the stage of the diabetic foot P = .049 a value of P= .05 was considered statistically significant.

Conclusion: There is an association between the stage of the diabetic foot and the knowledge about the self-care of the feet among patients.

Open Access Original Research Article

oprD Genes Detected in Pseudomonas aeruginosa Isolates from a Teaching Hospital but Lost in a Carbapenem-Resistant Strain

Eucharia E. Nmema, Chioma S. Osuagwu, Eunice N. Anaele

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/jammr/2019/v29i930122

Aims: The aims of the study were to evaluate the multidrug resistance profile and mechanisms of carbapenem resistance in Pseudomonas aeruginosa clinical isolates using phenotypic and genotypic methods.

Study Design: A descriptive laboratory based study.

Place and Duration of Study: Microbiology Laboratory, Ondo State University of Science and Technology, Okitipupa, and Biotechnology Laboratory, Ladoke Akintola University of Technology, Osogbo, Nigeria, between June 2017 and November 2018.

Methodology: Ten P. aeruginosa isolates were recovered from patients at Lagos University Teaching Hospital, and susceptibilities to imipenem (10 µg), meropenem (10 µg) and a panel of antibiotics were performed by the disk diffusion method. Genotypic methods including Polymerase Chain Reactions (PCR) and agarose gel electrophoresis were carried out according to established protocols. oprD and blaIMP gene primers were used for the PCR amplification.

Results: Fifty percent (50%) of the isolates showed multiple drug resistance. Four isolates (40%) were carbapenem resistant (CR). oprD gene was detectedin 90% (9/10) of the isolates. 75% (3/4) of CR strains were among the strains showing oprD gene. 25% (1/4) CR strain (PA1421) was oprD negative. Loss or mutation of oprD gene seems to be the mechanism of carbapenem resistance in strain PA1421.

Conclusion: Loss or mutation of oprD gene was identified in this study as a mechanism of carbapenem resistance. oprD gene encodes the outer membrane protein (OprD) porin in P. aeruginosa whose deficiency confers resistance to carbapenems, especially imipenem. Surveillance of the antimicrobial susceptibility patterns of P. aeruginosa is of critical importance in understanding new and emerging resistance trends, reviewing antibiotic policies and informing therapeutic options.

Open Access Original Research Article

Screening for Oral High-risk Human Papillomavirus (HPV) among a Pediatric Patient Population

Douglas Bowen, Karl Kingsley

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/jammr/2019/v29i930124

Introduction: Human papillomavirus (HPV) is a known cancer-causing virus that has been primarily linked to cervical cancers. Recent studies have shown that HPV may also induce cancer in other tissues, including oral epithelia and mucosa. To determine the presence of oral HPV infection among pediatric patients, salivary samples were assessed to determine oral prevalence of high-risk HPV.

Methods: Using existing pediatric saliva samples from pediatric clinic patients (aged 6 - 16 years), this retrospective study involved isolating DNA for PCR screening for both high-risk strains of HPV (HPV16, HPV18). A total of n=98 patient samples were available for analysis.

Results: Demographic analysis of these samples revealed the majority were derived from females (63.2%) and mostly from Hispanics (54.1%). DNA was successfully isolated from 95.9% of samples (n=94/98) with an average concentration of 142.5 ng/uL. PCR screening demonstrated only a subset of patient samples harbored high-risk strains, HPV16 (n=9) and HPV18 (n=6), which represents 15.9% of the total sample population - and were concentrated among the older patients (>13 years old).

Conclusions: Although this retrospective study does not have a sufficient sample size to provide more robust analysis of other risk factors (race, sex, sociodemographic), these results to demonstrate that oral HPV infection may be successfully detected among a pediatric population. As more studies demonstrate oral HPV infection in children, these data are of significant value to other dental, medical, oral and public health professionals who seek to further an understanding of oral health and disease risk in pediatric populations.

Open Access Original Research Article

Assessment of Mitigation Measures in Preventing Bacterial Infections in Selected Public Health Centres in Akure, Ondo State

F. O. Omoya, A. O. Momoh, K. O. Ajayi

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/jammr/2019/v29i930125

Introduction: Hospital acquired infection (or nosocomial) is an infection whose development is favored by hospital environment. They are usually acquired by either a patient during a hospital visit (or when hospitalized), hospital staff or patients’ relatives that visit when the patient is on admission in the hospital. Nosocomial infections can cause severe pneumonia and infection of the urinary tract, wounds, blood stream and other parts of the body. Nosocomial infections are commonly encountered in Africa and in Nigeria in particular. Factors such as hospital hygiene / cleanliness, personal hygiene of patients, overcrowding hospital wards and illiteracy increases the risk of nosocomial infection. 

Methods: The assessment of mitigation measures put in place to reduce bacteria present in surfaces of facilities (pillow, bed sheets, door handles, toilet seats and the floor) in wards of selected basic health centres (Arakale, Aule, Ayedun, Isolo, Oba-Ile and Orita-Obele) in Akure was evaluated using both questionnaire and on-sight assessment techniques.

Results: The results showed that there was a direct relationship between the hand washing or sanitizer used and the bacterial load present in the various surfaces examined.

Conclusion: Therefore, adequate ward hygiene in these health centres is necessary to reduce the risk of nosocomial infections for both patients and visitors.

Open Access Original Research Article

Knowledge, Attitude, Practice towards Breast Cancer and Breast Self-examination among Female Undergraduate Students in Karachi, Pakistan

Saba Rasool, Maham Iqbal, Ammarah Siddiqui, Ramna Ahsan, Sahrish Mukhtar, Shagufta Naqvi

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/jammr/2019/v29i930126

Aims: The study was aimed at investigating knowledge, attitude and practice towards breast cancer and breast self-examination among female undergraduate students in Karachi, Pakistan.

Study Design:  Cross Sectional study.

Place and Duration of Study: This study was conducted for a period of four months in different universities of Karachi, Pakistan.

Methodology: The study was done using a self-administered questionnaire. A total of 381 undergraduate students of medical and non-medical universities were included.

Results: The mean age of participants was 20.45 ± 3.67 years.  97% of the candidates had heard about breast cancer out of which only 65.4% were aware about its high prevalence rate in Karachi, Pakistan. A good proportion of candidates i.e. 78% of participants had good knowledge of breast self examination out of which only 43.8% knew how to perform it but just 24.9 % actually performed it.

20.5% of female population had made arrangements for breast screening once in their lifetime however many of the candidates (39.1%) never experienced any symptoms of breast pathology thus never felt the need to screen themselves.

Various signs and symptoms were considered as indications of breast cancer though lump as a sign was answered the most by 76.1% students. Out of the several risk factors of breast cancer 70.9% of candidates responded as family history the most common risk factor and early menstruation as a risk factor was 22.8% (the least).

44.4% of the aware candidates stated that they acquired this knowledge from social media. 21.5% had a positive family history. Mammography as a diagnostic modality was considered the most helpful by 61.4% population.

Conclusion: The study points out to the sufficient knowledge and attitude of breast cancer among female undergraduates in Karachi, Pakistan. However, they lacked the practice towards breast self examination. We expect that our results may provide useful data that could be used by the department of health in Karachi, Pakistan to formulate their health programs to increase the knowledge, attitude and practice towards breast cancer and breast self-examination.

Open Access Original Research Article

E-Cadherin as a Marker for Nodal Metastasis in Head and Neck Squamous Cell Carcinoma

Saima Akram Butt, Anwar Ali, Lubna Avesi, Shoaib Khan, Tazeen Mustansir, Talat Mirza

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/jammr/2019/v29i930127

Aim: Head and neck cancers, all over the world, contribute greatly to the number of deaths, despite the advancements in the therapeutic strategies. It is characterized by locoregional disease with a tendency for metastasis to the cervical lymph nodes. The pre-operative detection of lymph node metastasis is critical for the effective treatment of patients with head and neck squamous cell carcinoma. Therefore the objective of this study was to identify E-cadherin as a marker for prediction of lymph node metastasis in head and neck squamous cell carcinoma (HNSCC).

Study Design:  Cross-sectional study.

Place and Duration of Study: Dow University of Health Sciences, Karachi. 1 Year duration.

Methodology: Cross-sectional analysis of 54 subjects with HNSCC, who underwent neck dissections, was carried out. Expression of E-cadherin was evaluated using immunohistochemical analysis and traditional histological parameters, and correlation of E-Cadherin with histologically verified presence of regional metastases was determined. Data was subjected to descriptive statistics and chi-square using Spss v.16.0.

Results: 54 patients included 33 males (61.1%) and 21 females (38.9%) aged from 18 to 73 (mean 44.8±12.7). A statistically significant relationship between the Downregulation of E-cadherin and histologically verified presence of nodal metastasis was established. (p value= 0.01).

Conclusion: This study shows that low E-cadherin expression is useful for predicting lymph node metastases in cases of head and neck carcinoma.

Open Access Review Article

Features of Genetic Polymorphism in Population with Diabetic Nephropathia: Literature Review

O. O. Jabborov

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/jammr/2019/v29i930123

The increasing prevalence of diabetes mellitus has led to a growing number of chronic complications including diabetic nephropathy (DN). In high prevalence of diabetes mellitus, DN is associated with high morbidity and mortality primarily due to cardiovascular diseases. Genetic factors play a significant role in the pathogenesis of DN and genetically susceptible individuals that can develop after being exposed to environmental parameters. DN is assumed to be a complex, polygenic disease. Genetic predisposition to diabetes is familial, and often with concomitant obesity. A number of detected polymorphisms in genes is a predisposing risk factor for the development of type 2 diabetes. Two main categories have been used to identify the genes associated with DN: (1) analysis of candidate genes, and (2) more recently genome-wide scan. A significant effort has been made to identify these main genes, whereas results are still inconsistent with different genes associated to a small effect in specific populations. A variety of genetic markers characteristic of different population groups confirms the special significance of the ethnic component for identifying hereditary risks, which determines the relevance and need for a detailed, comprehensive study of the genetic basis of type 2 diabetes.