Open Access Case Report

Massive Ameloblastoma and Reconstruction with Free Fibular Graft

Linda Jana Sintaningtyas, Joko Purnomo, Affandi Wiramur

Journal of Advances in Medicine and Medical Research, Page 88-93
DOI: 10.9734/jammr/2021/v33i830891

Aims: To report a case of massive ameloblastoma in mandible with wide excision and reconstruction with free vascularized fibular graft and titanium plate.

Case Description: A 49- year-old male patient complained right facial mass since 5 years ago. Patient underwent right hemimandibulectomy with general anesthesia and pathologic examination revealed folliculare ameloblastoma. The large defect after resection reconstructed with free fibular graft. Fibula was osteotomised and resembled with mandible shape and reconstructed by plate with intact pedicle. Care was taken to protect the periosteal branch of the peroneal artery before performing an osteotomy. Shaping of the resected fibula was done according to the preoperative template. A titanium miniplate with locking screws was used to secure the osteotomized fibula and the mandible. To secure the airway, we performed tracheostomy. Followup after operation, patient still got a defect facial asymmetry in right mandible.

Discussion: Ameloblastoma is histologically benign but locally aggressive tumor originating from odontogenic epithelium. After hemimandibulectomy, reconstruction continued with microvascular free fibular graft and titanium plate. Osteotomies were performed with the pedicle still attached.

Conclusions: Free vascularized fibular graft with titanium plate is preferrably reconstruction option for large defect after wide excision of mandibular ameloblastoma.

Open Access Original Research Article

The Diagnostic Performance of Chest Ultrasonography in the Up-to-date Workup in Patients with Chest Diseases

Esraa Mohammed El Zaablawy, Mohamed Fouad Sherif, Faten Mohammed Salem, Rasha Mahmoud Dawoud

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/jammr/2021/v33i830879

Background: Application of chest radiography for all patients with chest diseases is associated with a significant increase in total costs, exposure to radiation, and overcrowding of the emergency department in case of emergency. Ultrasound has been introduced as an alternative diagnostic tool in this regard. The aim of the work is to determine sensitivity, specificity and diagnostic accuracy of chest ultrasonography as an easy and fast form of imagery for different thoracic conditions.

Results: This prospective study was carried out on sixty patients. The majority of patients presented with lung masses (20%) and pleural effusion (16.7%). Chest US findings showed great concordance or agreement with the chest CT findings. The only lower concordance is noted in the diagnosis of pulmonary nodules or mass, where chest US reported pulmonary nodules or mass in 33.3% of patients compared to 46.7%% by chest CT. US showed a highly comparable diagnostic performance in chest-related pathological entities, compared to chest CT. Chest US had 100% sensitivity in detecting all pathological chest entities except for lung collapse (83.3%) and pulmonary nodules (71.4%). However, chest US was more specific than sensitive. It had 100% specificity in all pathological entities except for lung collapse consolidation. Chest US had 100% diagnostic accuracy in all chest-related pathological entities except for lung collapse consolidation and pulmonary nodules or masses. However, when presenting these findings among male and female patients, Chest US had better overall diagnostic accuracy among female patients than male patients.

Conclusion: US examination of the chest is a noninvasive and promising bedside tool for the examination of respiratory problems patients. Consequently, chest ultrasonography can be adjoined in the up-to-date work-up of the outpatients as an ancillary tool aiding in disease diagnosis.

Open Access Original Research Article

Willingness to Accept COVID-19 Vaccine and Its Determinants among Nigeria Citizens: A Web-based Cross-sectional Study

Olanrewaju Davies Eniade, Abayomi Olarinmoye, Agofure Otovwe, Funke E. Akintunde, Omowumi O. Okedare, Adebukola O. Aniyeloye

Journal of Advances in Medicine and Medical Research, Page 13-22
DOI: 10.9734/jammr/2021/v33i830881

Background: The peculiarity in Nigerians’ demographic, socio-economic and cultural pattern necessitated the need to explore potential COVID-19 vaccine acceptance. This study investigated the determinants of willingness to receive COVID-19 vaccine in Nigeria.

Methods: An online cross-sectional study among the general population in Nigeria. Data were collected using an electronic questionnaire.  A total of 368 individuals participated in the research. The outcome variable was willingness to accept COVID-19 vaccine coded as “Yes=1 and No=0.”  Basic socio-demographic information of participants and other information related to COVID-19 were obtained. Stata MP 14 was used for the statistical analysis. Descriptive statistics were presented, test of association were carried out using chi square and a binary logistic regression was used to assess the determinants of willingness to accept COVID-19 vaccine. All analyses were performed at 5% level of significance.

Results: The mean age of the respondents was 29.4 + 9.65 years.  Majority of the study participants were female (58.9%), Yoruba (74.7%) and dwellers of urban area (68.5%). Also, 85.6% have attained tertiary level of education. Two-fifth (40.5%) of respondent reported their willingness to take the COVID-19 if made available. Majority (69.8%) of those that are willing to take the vaccine would prefer a live attenuated form and 39.6% would prefer the vaccine administered intramuscularly.

Age group≥40 years (AOR: 5.20, CI: 1.02- 26.41), currently married (AOR: 2.81, CI: 1.05 – 7.53) and susceptibility to COVID 19 infection (AOR: 2.52, CI: 1.21 – 5.26) were associated with likelihood of willingness to accept COVID-19 vaccine.

Conclusion: Despite the fact that majority were at risk of COVID-19 infection, willingness to receive COVID-19 vaccine was low among Nigerians. Level of maturity in terms of age and marriage as well as susceptibility to COVID-19 infection increased the likelihood of accepting COVID-19 infection. In Furtherance, younger ones, unmarried and non-susceptible individual may require more efforts tailored towards enrichment of understanding about the importance of COVID-19 vaccine in other to improve the acceptance of COVID-19 vaccine in Nigeria.

Open Access Original Research Article

Demographic Predictors of Cultural Practices Regarding Female Genital Mutilation among Married Women in Ebonyi State, Nigeria

Lois N. Omaka-Amari, Edith N. Obande-Ogbuinya, Christian O. Aleke, Afoke N. Eunice, Jude N. Nwafor, Onyechi Nwankwo, Precious I. Igwenyi

Journal of Advances in Medicine and Medical Research, Page 23-31
DOI: 10.9734/jammr/2021/v33i830882

Background: Peoples’ life and quality of health are usually dependent on the cultural practices and norms of the community.

Objectives: This study investigated Female Genital Mutilation Practices and Associated Factors among Married Women in the Ebonyi State of Nigeria.

Methods: The descriptive survey research design was adopted for the study. The study was conducted from August 2019 to January 2020.  Out of 260 questionnaires distributed, only 7 copies were discarded and a total of 253 women were drawn for the study through multi-stage sampling technique. Frequency, percentage, and logistics regression were the statistical tools used for data analysis.

Results: The majority of the participants: aged 25-34 years (37.9%); Christians (76.3%); urban dwellers (50.2%); had tertiary education (36.4%); had 3-4 children (32.0%); and were in business (29.2%) respectively. The cultural practices regarding FGM among married women in Ebonyi State were high (60.5%). Also, the majority of the participants (67.7%) were circumcised. Age by birth, religious affiliation, location, level of education, number of children, and occupation were predictors of the cultural practice of FGM with obvious variations. There is no significant difference existed with respect to religious affiliation, level of education, number of children, and occupation (P-value>0.05) while the difference was observed on the age by birth and location (P-value<0.05).

Conclusion: The high cultural practice of FGM is influenced by certain demographic predictors. Thus, there is a need for the Ebonyi State government in collaboration with other health agencies to adopt effective interventions, public health enlightenment, and mass education focusing on the negative consequences of FGM practices.

Open Access Original Research Article

Knowledge, Attitude and Prevention Practice of COVID-19 in South-West Nigeria

Olanrewaju D. Eniade, Dolapo E. Agbana, Bridget O. Afam

Journal of Advances in Medicine and Medical Research, Page 32-39
DOI: 10.9734/jammr/2021/v33i830883

Introduction: To assess knowledge, attitude and prevention practice of coronavirus disease 2019 (COVID-19) in Southwest, Nigeria. This was an online cross-sectional study among dwellers of southwest Nigeria.

Methods: Data were collected online with kobo toolbox and analyzed using the Statistical package for social sciences (SPSS, 2018) and the descriptive statistics, test of independence and binary logistic regression were presented.

Results: Of the 286 study participants, 96.1% had good knowledge, 99.3% had positive attitude towards control of COVID-19, while 77.3% had good practices for prevention of the virus. Majority of the participants (86.9%) had tertiary education, 11.3% were 40 years or older. Age and education were independently associated with COVID-19 prevention practice. After adjustment for some selected socio-demographic factors, only age of 10 – 19 years (OR: 3.83, CI: 1.05, 14), age 20-29 years (OR: 2.99, CI: 1.18 -7.55), and 30 -39 years (OR: 4.35, CI: 1.49-12.67) were more likely to have good practice of COVID-19 prevention compared to age >=40 years.

Conclusion: The result revealed a high prevalence of good practices, and the majority had good knowledge of COVID-19 and positive attitude towards control of COVID-19. Age and education were identified to be associated with practice of COVID-19 prevention. Further exploration revealed that elders (>=40years) were not likely to have good practice of COVID-19 prevention. We deduced that good practice of COVID-19 prevention was high in southwest Nigeria but notably low among elders and those who attained below tertiary education in southwest Nigeria. However, people of older age and poor education should be given much attention for proper enlightening and prevention strategies in this pandemic.

Open Access Original Research Article

Interleukin Deficiency Disorder Patient Responses to COVID-19 Infections

Bruce S. Gillis, Igor M. Gavin, Farnaz Barkhordar, Gayatry Mohapatra, Ming Jin, Frederick G. Behm

Journal of Advances in Medicine and Medical Research, Page 40-45
DOI: 10.9734/jammr/2021/v33i830884

Background: The chemokine, cytokine interleukin deficiency disorder defines the immune deficiency disease of fibromyalgia and a reduced ability to produce IL-6 and IL-8. Recent research has demonstrated improved outcomes in COVID-19 infections treated with IL-6 antagonists.9 These fibromyalgia cytokine deficient patients were screened for COVID-19 infections and associated morbidity and mortality rates.

Methods: Two cohorts of FM/a test positive fibromyalgia patients were evaluated.  Initially, 4,631 patients were screened to determine the occurrence of known COVID-19 infections. Subsequently, 2,195 FM/a test positive patients underwent COVID-19 antibody testing. 

Results: A total of 7,375 fibromyalgia patients were screened for the occurrence of COVID-19 infections. Of these, 4,631 individuals responded to an email-based inquiry to determine the occurrence of documented COVID-19 infections. Only 10 reported having symptoms consistent with and were diagnosed with COVID-19 by a healthcare professional, making for an incidence of .22%. Another 2,195 fibromyalgia patients completed health questionnaires and COVID-19 antibody testing and 82 had evidence of COVID-19 antibodies with 42 exhibiting symptoms and confirmed diagnoses. Of the remaining, 23 were asymptomatic.  There were no deaths and only 1 hospitalization in this group.

Conclusion: Individuals with FM/a test positive fibromyalgia have a reduced ability to produce IL-6 and IL-8 which play significant roles in the cytokine storm complications associated with COVID-19 infections. When screened for evidence of past COVID-19 infections, these patients experienced an extremely low incidence of COVID-19 infections based upon antibody testing, there were no mortalities and the level of morbidity was significantly below what has been reported in general populations.

Open Access Original Research Article

Clinico-Epidemiological Study of Viral Warts in University of Port-Harcourt Teaching Hospital, Rivers State, Nigeria

Dasetima D. Altraide, Dieprebi Agnes Aladeh, Bolaji Otike-Odibi

Journal of Advances in Medicine and Medical Research, Page 46-51
DOI: 10.9734/jammr/2021/v33i830885

Background: Warts are benign epidermal neoplasms resulting from infection with human papilloma viruses.

Aim and Objective: To determine the clinico- epidemiological profile of patients with warts.

Materials and Methods: A retrospective study was carried out in University of Port-Harcourt Teaching Hospital, Rivers State, Nigeria. All patients with warts that attended the dermatology clinic from June 2013 to June 2020 were included. Data of the patients were searched for detailed history, complete cutaneous, systemic examinations and retroviral screening. Analysis was done using Microsoft excel, 2013 software.

Results: One hundred and eighteen (118) patients were clinically diagnosed with viral warts during the study period. 36 (30.51%) had genital warts while 82 (69.49%) had non-genital warts. Males were more affected than females and the mean age at presentation was 25.04 years. The most common type of warts seen in children and adults was common warts. High risk behaviours was noted in 85% of patients with genital warts.

Conclusion: Common warts were the most common warts with male preponderance. The head and neck were the most common site, but the extremities were more common in children. Patients in the second decade of life were mostly affected with majority concerned about the cosmetic appearance.

Open Access Original Research Article

The Efficacy of the Absorbable Polydioxanone (PDO) Thread Lift in Lower Face (Marionette Line) Rejuvenation

Marian W. Gerges, Ghada F. R. Hassan, Walid A. Mostafa, Iman H. El- Maadawy

Journal of Advances in Medicine and Medical Research, Page 52-60
DOI: 10.9734/jammr/2021/v33i830886

Aims: To evaluate the efficacy of PDO thread lifting in lower face (marionette line) rejuvenation.

Study Design:  Quasi experimental study.

Place and Duration of Study: Dermatology and Venereology Department, Tanta University Hospital, between January 2018 and April 2019.

Methodology: The study included 10 patients asking for lower face rejuvenation who were treated by PDO absorbable threads (2 threads in each side of marionette line).

Results: The mean validated grading scale for marionette line score before treatment was of 3.30 ± 0.82 while the mean score immediately after treatment was 1.70 ± 0.82. There was statistically significant improvement according to validated grading scale of marionette line after compared to before. These results were preserved after 1, 3 and 6months.

Conclusion: PDO threads is a simple, rapid, immediately effective and office technique procedure.

Open Access Original Research Article

Community Pharmacies Treatment Practices of Malaria and Residents’ Pattern of Antimalarial Drug Use in Abura Community, Cape Coast Metropolis-Ghana

Etornam Abla Tettey, Edem Kojo Dzantor, Edwin Akomaning

Journal of Advances in Medicine and Medical Research, Page 79-87
DOI: 10.9734/jammr/2021/v33i830889

Background: Community pharmacies are health care facilities that allows the public access to their medications, counselling, and advice about their health. Community pharmacies play critical role in the health delivery systems of several countries especially in developing countries and serve as the first point of call for the treatment and management of many ailments, including malaria. The study therefore examined community pharmacies treatment practices of malaria and residents’ pattern of antimalarial drug use in Abura Community, in the Cape Coast Metropolis of the Central Region of Ghana.

Methods: We conducted a community-based cross-sectional survey involving 301 study participants from the Abura Community (Cape Coast Metropolis). A structured questionnaire was used to collect information from the study participants using accidental sampling technique. Descriptive statistics was performed using SPSS version 23.0 and Microsoft Excel 2010.

Results: The age range of our study was between 15 and 60 years. Females were the majority (52.5%). The self-reported use of unprescribed antimalarial drugs was 41%. The source of the drugs were mainly community pharmacies, licenced chemical shops, self-herbal preparations, and left-over antimalarial drugs.

Conclusion: A high proportion of our study participants reported self-medication of non-prescribed antimalarial drugs. These antimalarials included both orthodox and herbal medications, which were sourced from outlets like community pharmacies, licenced chemical sellers, and home herbal preparations. There is the need to intensify monitoring, public health education on self-medication and the training of staff of community pharmacies to ensure effective treatment and management of malaria at the community level.

Open Access Original Research Article

Risk of Bleeding in Patients with Chronic Kidney Disease Undergoing Bronchoscopy

S. Venkatram, D. Pena Evertz, B. Bajantri, J. Perez Lara, G. Diaz-Fuentes

Journal of Advances in Medicine and Medical Research, Page 94-102
DOI: 10.9734/jammr/2021/v33i830892

Background: Complications rates from bronchoscopy are low, however chronic kidney disease (CKD) is considered a risk factor for procedural bleeding. The aim of the study is to evaluate bleeding complications CKD patients undergoing bronchoscopy with either transbronchial (TBLB), endobronchial biopsies (EBBX), Endobronchial Ultrasound transbronchial needle aspiration (EBUS-TBNA) and/or brushings.

Methods: Retrospective analysis of patients with Chronic kidney disease who underwent bronchoscopy with biopsy, brushings and/or transbronchial needle aspiration from 2012 to 2019. Patients were grouped in 5 groups based on the National Kidney Foundation clinical guidelines. Bleeding was categorized as mild, moderate, and severe bleeding.

Results: 894 patients were identified; bleeding complications were seen in 103 (11.5%) patients. Mild bleeding in 51 (5.7%), moderate bleeding in 46 (5.1%) and severe bleeding in 6 (0.67%) cases. No association between CKD subgroups and bleeding complications. There were no differences in number of biopsies or passes done in CKD groups. 790 (88%) patients underwent TBLB followed by brushing in 329 (36.8%), EBBX in 300 (33.5%) and EBUS-TBNA in 290 (32.4%). Majority of bleeding complications occurred in patients undergoing TBLB. Patients with serum creatinine of 2 mg/dL or higher vs 3 mg/dL had no statistical difference for bleeding complication.

Conclusion: There is no correlation in bleeding complications in patients with CKD undergoing Bronchoscopic biopsies. Most of complications were mild or moderate and did not required major interventions; risk of severe bleeding remains low, in those patients.  There is no correlation between CKD stage or use of empirical serum creatinine cut off and risk of bleeding. Bronchoscopy remains a safe procedure in patients with CKD.

Open Access Review Article

Periodontitis, Cardiovascular Disease and Fetuin A: A Triad

Raima Bashir, Mervyn Hosein, Mervyn Hosein, . Zil-e-Rubab, Tahir Saghir, Fizza Saher

Journal of Advances in Medicine and Medical Research, Page 61-69
DOI: 10.9734/jammr/2021/v33i830887

Periodontitis and cardiovascular diseases are two most common and related pathologies which may aggravate each other’s pathophysiological impact. Long standing periodontitis leads to a systemic inflammatory response which elicits as well as exacerbates the cardiovascular disease process in the body. Fetuin A is an anti-inflammatory and anti-calcification glycoprotein, the levels of which decrease with ongoing inflammation in the body. Diminished Fetuin A levels due to persistent periodontitis, may promote inflammation and calcification which can predispose to multiple cardiovascular outcomes. Therefore the purpose of this literature review was to critically analyse the studies regarding Fetuin A, periodontal inflammation and cardiovascular diseases and find out a possible relationship between them. The studies published from the year 1976-2020 were reviewed for this article using Google Scholar, Pubmed, Research Gate & Semantic Scholar search engines using key words Periodontitis & Fetuin A, Fetuin A, Alpha-2- Heremans Schmid Glycoprotein, pathogenesis of cardiovascular diseases, periodontitis and CVD, CVD and Fetuin A, etc. It can hence be concluded from this review article that Fetuin A glycoprotein has a protective effect on the body owing to its anti-inflammatory and anti-calcification properties.  It also advocates that decreased levels of Fetuin A can be used as a potential diagnostic tool to assess the predisposing risk of cardiovascular diseases affected by calcification and inflammatory process in the body.

Open Access Review Article

An Overview of Iron Metabolism in Health and Disease

Nabiyev Abdusamat Utkurovich

Journal of Advances in Medicine and Medical Research, Page 70-78
DOI: 10.9734/jammr/2021/v33i830888

Human iron metabolism is the set of chemical reactions that maintain human homeostasis of iron at the systemic and cellular level. Iron is both necessary to the body and potentially toxic. Controlling iron levels in the body is a critically important part of many aspects of human health and disease. Iron deficiency states are the reason for a decrease in working capacity, an increase in susceptibility to viral diseases, especially in children and cause growth and development retardation. Iron overload and poisoning lead to the activation of processes that can cause cell death. Timely diagnosis of disorders of iron metabolism and subsequent monitoring of treatment require knowledge of not only pathophysiological mechanisms, but also methodological capabilities and correct interpretation of clinical and biochemical parameters of iron metabolism.