Open Access Original Research Article

Radiation Exposure of Personnel Categories at the Center of Oncology and Hematology at Mohammed VI Hospital in Marrakech

Bouchra Amaoui, Abdennasser El Kharras, Mohammed Aabid, Oum Keltoum Hakam, Abdelmajid Choukri, Slimane Semghouli

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/jammr/2019/v30i1030239

Objective: This study aims to estimate the annual doses for personnel categories following their exposure to ionizing radiation during their occupation in the external radiotherapy department of the Center of Oncology and Hematology (COH) at Mohammed VI Hospital in Marrakech.

Materials and Methods: Operational dosimeters PACK MGP DMC 3000 were used to measure the dose rates around the machines operating with ionizing radiation. In order to assess the reliability of the measurements made by these dosimeters, they were checked against measurements made at the same position by the Inspector detector. The annual effective dose was calculated by multiplying the average dose rate measured during a procedure by the overall treatment time throughout a year.

Results: Regarding the reliability check of the measuring instrument, the recorded error is between 2 and 10% with an average of 7%. For personnel category A, the measured dose rate ranges from 0.066 to 0.083 µSv/h, with an average value of 0.075 µSv/h. For category B, it varies between 0.066 and 0.083 µSv, with an average value of 0.092 µSv/h. It is 0.074 µSv/h for category C. The annual dose for category A ranges from 0.089 to 0.113 mSv/year, with an average value of 0.101 mSv/year. For category B, it varies between 0.089 and 0.113 mSv/year, with an average value of 0.100 mSv/year. It is 0.100mSv/year for category C.

Conclusion: The annual effective doses to personnel categories, assessed by this study, are very low compared to the regulatory standards set by the International Commission on Radiological Protection (ICRP). As a result, workers benefit from good radiation protection conditions within the Center of Oncology and Hematology at Mohammed VI Hospital in Marrakech.

Open Access Original Research Article

Assessment of Biventricular Function in Patients with Obstructive Sleep Apnea and Atrial Fibrillation: A Cross-sectional Study Using Two-dimensional Speckle Tracking Imaging

Mghaieth Zghal Fathia, Boudiche Selim, Sammoud Kais, Ayari Jihen, Ben Ammar Jihen, Rekik Bassem, Farhati Abdeljelil, Ouali Sana, Larbi Noureddine, Ben Halima Manel, Mourali Mohamed Sami

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/jammr/2019/v30i1030240

Background: Obstructive sleep apnea syndrome (OSA) is a common but often under diagnosed condition. According to literature, OSA prevalence in atrial fibrillation (AF) patients varies from 21 to 85%. OSA is increasingly recognized as a risk factor for biventricular dysfunction. The present study aimed to compare left and right ventricular functions, assessed by conventional echocardiographic parameters and speckle tracking imaging, in non-valvular atrial fibrillation (NVAF) patients with and without severe OSA.

Methods: A cross-sectional analytic study was conducted. Forty successive patients with NVAF were included. All of them had a clinical screening for symptoms suggestive of OSA and underwent polysomnographic study. Patients were divided into two groups (group 1: without severe OSA with an apnea-hypopnea index (AHI) < 30 events per hour (e/h), and group 2: having severe OSA with an AHI ≥ 30 e/h). Echocardiography was performed in all patients. Left and right ventricular function parameters were measured including global longitudinal strain (GLS) and myocardial performance index (MPI).

Results: OSA was diagnosed in 90% of NVAF patients. The average AHI was 22.1 ± 13 e/h. Eleven patients (27.5%) had mild OSA, 9 patients (22.5%) had moderate OSA, and 16 patients (40%) had severe OSA. General clinical characteristics were comparable between groups. A statistically significant association was demonstrated between severe OSA and impairment of left ventricular GLS (-17.3 ± 4.5 vs. -14.9 ± 3%, in group 1 and 2 respectively, p = 0.02) and left ventricular MPI (0.37 ± 0.09 vs. 0.49 ± 0.13, in group 1 and 2 respectively, p = 0.01). Right ventricular lateral wall strain was non significantly lower in group 1 compared to group 2 (-22.5 ± 8.4 vs. -18.4 ± 5.8%, in group 1 and 2 respectively, p = 0.15). On multivariate logistic regression analysis, left ventricular GLS impairment (> -18%) and MPI > 0.37 were independent predictors of severe OSA.

Conclusion: Severe OSA was diagnosed in 40% of NVAF patients. Impairment of left ventricular GLS and left MPI were statistically associated with severe OSA.

Open Access Original Research Article

Facial Nerve Palsy: A Report on the Prevalence, Intervention and Outcome in a Tertiary Hospital in the South- South Region of Nigeria

Uju Matilda Ibekwe

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/jammr/2019/v30i1030242

Background: The facial nerve is an important and complex nerve whose course predisposes to various affectations.  Most work has been focused mainly on Bell’s palsy and not much has been done on other aspects of the nerve affectation.

Aim: To determine the prevalence of facial nerve palsy, possible aetiology and the treatment outcome in our environment.

Patients and Methods: This is a retrospective study of all patients diagnosed with facial nerve palsy seen in the ENT Surgery department and the Physiotherapy department of Teaching hospital university of Port Harcourt within the period of January 2015 to January 2018. The patients` case files, clinic and ward registers were the source of data. The patients` demographics, presenting complaints, side affected, type of lesion, aetiology, intervention and outcome, were sought from these records. Data was analyzed with IBM SPSS version 20 and results presented in statistical tables.

Results: There were altogether 76 patients seen within the period under study. There were more females than males 57.9% and 42.1% with a ratio of 1.4:1. Age ranged from 20-83 years with a mean age of 48.9+/- 14.1 years. Highest incidence was among the age range 50-59 years. Commonest presenting complaint was facial weakness-80.3% outright facial deviation was seen in 17.1%. The left side was more affected and upper motor neuron lesion was the commonest type of facial nerve palsy encountered 80.3%. Hypertension was the commonest aetiology. About 69.7% had a good response to management. The outcome of treatment in relation to the type was statistically significant.

Conclusion: Facial nerve paralysis is not rare in this region and hypertension is a common aetiology with UMNL as the commonest type. Majority recover after the paralysis with steroid treatment.

Open Access Original Research Article

Quality of Life in Pediatric Cancer Patients

Amal Hegazy, Hussain Al Bar, Sultan H. Alamri, Fatimah Ahmad Almahmoudi, Wafa Saleh Al Ghamdi, Esraa Abdulgader

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/jammr/2019/v30i1030243

Background: In recent years the survival rates for children diagnosed with cancer has increased as result of successful treatment. Evaluation of health related quality of life during the process of treatments is important for recognition of acute dysfunction related to therapy and disease.

Aim: Aim of the study is to identify the health-related quality of life in pediatric cancer patients and to detect the potential predictors of a total quality of life and its domains.

Materials and Methods: It is a cross-sectional study done on convenient sample of pediatric cancer patients. Their diagnosis was confirmed at pediatric hematology clinic and day care unit at King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

Results: A total number of 51 children participated in this study, their age ranging from 8-15 years with mean 10.15± 2.52. Hematological malignancies represented 70.5% of the sample, with the highest percentage for acute lymphocytic leukemia (45%). The mean value of the total quality of life is 73.48, which is referred to as a good quality of life. The best scores of subscales were cognitive problems (92.54), communication (82.67), and nausea (76.86), otherwise poorer score was detected. Although the value of total quality of life was relatively good however visiting the hospital more than 3 times per month, male gender, duration of therapy and duration of diagnosis more associated with more pain and hurt, great worry and treatment anxiety.

Conclusion: Higher frequency of hospital visits, male gender, longer duration of diagnosis, longer duration of therapy, and increased intensity of therapy were all associated with more pain and hurt, great worry, nausea, and treatment anxiety which reflect a poor quality of life among the study group.

Open Access Original Research Article

KAP Study of Tobacco Users among the Garment Workers at Dhaka City in Bangladesh

Md. Aynul Islam Khan, Masuda Islam Khan, Israt Jahan, Mohammad Jahangir Alam Sarker, S. M. Shahidul Islam, Harun Ar Rashid, S. M. Muraduzzaman, Md. Ranzu Ahmed

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/jammr/2019/v30i1030244

The readymade garment (RMG) industry is a key sector of Bangladesh economy. This sector brings in about 78% of the country’s total merchandize export earnings. More than 3.2 million people are working in this sector and mostly females from underprivileged social classes. Employment in this Ready-made garment sector in Bangladesh provides workers with economic benefits and some empowerment.

A descriptive cross-sectional study followed by a qualitative approach was utilized. Through proportionate quota sampling, 560 garments workers were recruited from 6 (one large, two medium, and three small) garment factories in Mirpur area of Dhaka city.

Almost all of the garments workers knew that both smoking and smokeless tobacco (98.4%) is harmful for health. Knowledge on specific health hazards of smoking (96.96%) tobacco was relatively higher than those of smokeless (90%) tobacco. Electronic media (Radio/TV/Cinema) was the most common source of their knowledge (92.9%).  In case of smoking tobacco, cancer (63.6%) was the mostly reported disease caused by smoking tobacco, followed by lung cancer (15.7%) and heart attack (11.3%). On the other hand, for smokeless tobacco, cancer (29.8%), followed by oral cancer (26.6%) and lung cancer (15.0%) was mostly reported diseases by the garments workers. Garment workers’ knowledge on tobacco control policy was found to be very low. Only 35.0% knew about the policy. Although few garments workers know about the rules for prohibition of tobacco product in public place (25.7%) and public transport (11.3%), other specific rules under tobacco control policy were not known to majority of them.

The present study provides a scientific base regarding current tobacco using practice among garments workers in Dhaka city and their knowledge and attitude towards tobacco. Finding revealed from qualitative analysis of data suggested that now-a-days smoking is considered as a trend; people have to smoke for showing smartness or to maintain social status. Peer influence also plays an important role for initiating and maintaining smoking status. Socio-cultural influence for smokeless tobacco consumption was not well documented by this study which indicated a need for more focused qualitative study.

Open Access Original Research Article

Prevalence of qnr Genes among Multidrug Resistance Staphylococcus aureus from Clinical Isolates

Abdulrasheed B. Abdu, Tattfeng Y. Mirabeau

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/jammr/2019/v30i1030245

Objectives: Staphylococcus aureus (S. aureus) is regarded as an important aetiological agent of various human infections. Fluoroquinolones are routinely used in the chemotherapeutic management of these infections; nonetheless, in recent years, a growing rate of resistance to these drugs has been reported worldwide. The aims of this study were to isolate and discover the prevalence of plasmid-mediated (qnrA, qnrB, and qnrS) genes among the quinolone-resistant clinical S. aureus isolates in Bayelsa State, Nigeria.

Methods: A total of 25 (31.25%) clinical isolates of S. aureus were collected from hospitalized patients. The bacterial isolates were identified through standard laboratory protocols and further confirmed using the API Staph system (bioMérieux, France) test strips. The antimicrobial susceptibility and minimum inhibitory concentration (MIC) were determined by the standard disk diffusion and serial dilutions methods respectively. Polymerase chain reaction (PCR) was used for detecting qnrA, qnrB, and qnrS genes.

Results: Of the 25 S. aureus isolates, 19(76.00%) were resistant to ampicillin-cloxacillin, while 14 (56.00%) each were resistant to norfloxacin and Amoxicillin, 13 (52.00%) each to gentamicin and erythromycin, 11 (44.00%) were resistant to streptomycin, rifampicin and ciprofloxacin, respectively. The resistance pattern among the isolates to chloramphenicol and levofloxacin were 10 (40.00%) and 7 (28.00%) respectively. All the eleven ciprofloxacin resistant were high-level (1000 µg/mL) resistance isolates and only one (9.00%) of these isolates was positive for the qnrB gene.

Conclusion: The study results were indicative of the presence of low frequency of qnr genes among the clinical isolates of S. aureus in Yenagoa, indicating that other mechanisms are employed in resisting to these fluoroquinolones. This, however, emphasizes the need for establishing discreet policies associated with infection-control measures in hospital settings.

Open Access Review Article

Cardiovascular Complication after Kidney Transplantation

Ho Sik Shin

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/jammr/2019/v30i1030241

Patient mortality after kidney transplantation continues to be a major clinical challenge, with approximately 1 in 5 recipients dying within 10 years of engraftment. Cardiovascular disease (CVD) is the most common cause of death after the 1-year posttransplant and it has been estimated that the risk of cardiovascular events is 50-fold higher than in the general population. Because of this, post transplant outcomes are substantially influenced by cardiovascular disease. The presence of both traditional and non-traditional risk factors contributes to this overwhelming burden of cardiovascular disease in patients with chronic kidney disease (CKD).

Open Access Review Article

A Genetic Insight and Overview of Zika Virus Infection: An Important Emerging Viral Infection

Shuaibu Abdullahi Hudu, Saadatu Haruna Shinkafi

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/jammr/2019/v30i1030246

Zika fever is a febrile or sub-febrile illness caused by Zika virus, which mainly spreads through the bite of infected mosquitoes. Zika infection has as of late becoming an emerging infection of medical important. While clinical indications of the infection in adult cases are not serious and ailment isn't related with high death rates, Zika infection can affect foetogenesis and lead to extreme neuro developmental variations from the norm. For better understanding into various parts of Zika infection, this review was performed, with respect to the disease transmission, genetic and geographical distribution of Zika infection. We searched PubMed, Scopus, Embase, HINARI, AJOL, the Cochrane library, Web of Science, and Google Scholar. Zika virus is a member of the family Flaviviridae, which includes dengue viruses, West Nile, and yellow fever viruses. The most common symptoms reported in confirming Zika virus infections are fever, headache, malaise, maculopapular rash, fatigue or myalgia, arthritis and arthralgia. Zika virus was first isolated from the blood of a sentinel rhesus monkey from the Zika Forest in Uganda. The virus has a wide geographical distribution, including eastern and western Africa, south and Southeast Asia, and Micronesia, where in 2007, an outbreak of Zika fever was reported on Yap Island. Numerous conventional phylogenetic analyses of Zika virus genomes reveal the presence of two main viral lineages, that is, African and Asian lineages. However, it should be noted that phylogenetic analyses using E and NS5 genes reveal three major lineages of Zika virus with an additional lineage circulating in Africa which is designated African II lineage.