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May 2024
Almekhlafi KaylaCorresponding author
This exploratory study investigates factors and consequences of underdiagnoses or late diagnoses of attention deficit hyperactivity disorder (ADHD) in females favoring males in the referral, diagnosis, and treatment processes resulting in gender disparities. A literature review in PubMed, PsychINFO, PsychArticles, and PsychiatryOnline from 2010 to 2023 underscores significant implications of delayed ADHD diagnosis in females, hindering timely access, support, and interventions during critical developmental years. Factors associated with underdiagnosis of ADHD among girls include gender differences in symptomology presentation, comorbidity, and gender bias among parents, teachers, and healthcare providers. We highlight the role of ethnicity and cultural factors. This bias prevents girls from receiving necessary ADHD support and treatment, impacting their health, social, and economic outcomes into adulthood. We summarize strategies to urgently address gaps in ADHD research and practice. Raising awareness among communities, healthcare providers, educators, and parents is vital to alleviate these gender disparities. By illuminating factors contributing to delayed diagnoses, the study informs policymakers and stakeholders, facilitating targeted interventions to improve early detection and treatment outcomes for females with ADHD.
Dec 2025 DOI 10.14302/issn.2641-4538.jphi-25-5886
Y. Talbert PatriciaCorresponding author
Objective Diabetes poses significant public health challenges, with many individuals remaining undiagnosed and at risk of complications. This study aimed to evaluate the performance of decision tree ensemble methods for predicting diabetes onset using the Framingham Heart Study Teaching Dataset and to explore sex-specific risk patterns relevant to AI-driven interventions. Methods We analyzed data from 11,627 participants, incorporating demographics, vital signs, smoking status, medication use, and laboratory measures. Random Forest classifiers were developed to predict diabetes incidence at approximately 6-year (Period 2) and 12-year (Period 3) follow-ups. Class imbalance was addressed using undersampling, oversampling, and the Synthetic Minority Over-sampling Technique (SMOTE). Results The models demonstrated robust performance, achieving an Area Under the Curve (AUC) of 0.856 in Period 2, and moderate predictive ability in Period 3 (AUC = 0.732 in males, 0.786 in females). Key predictors included glucose level, BMI, systolic blood pressure, age, and heart rate. Notably, differences emerged in predictive accuracy between men and women, suggesting potential sex-specific vulnerabilities that merit further study. Conclusion Machine learning approaches, particularly Random Forests, show promise for medium- and long-term diabetes risk prediction, supporting early identification and intervention efforts. Future work should focus on hyperparameter tuning and explainability techniques, such as SHapley Additive exPlanations (SHAP) values, to improve model precision, interpretability, and fairness. Equity-focused strategies remain critical to ensure AI-driven tools benefit diverse populations and do not exacerbate existing disparities in diabetes care.
Dec 2025 DOI 10.14302/issn.2690-6759.jpar-25-5496
Chigozie Divine OnwukaCorresponding author
Intestinal parasitic helminths pose a significant public health burden, particularly among children. This cross-sectional study investigated the prevalence and risk factors of intestinal parasitic helminths among 550 school children aged 4-12 years in Oru-West L.G.A, Imo State, Nigeria. Stool samples were examined using parasitological techniques, and questionnaires were administered to collect data on risk factors. The overall prevalence of intestinal parasitic helminths was 49.1% (270/550), with Ascaris lumbricoides being the most prevalent (30.37%). Multivariate analysis revealed significant associations between intestinal parasitic helminths and lack of hand-washing, insufficient toilet facilities, consumption of unwashed vegetables, and poor environmental sanitation. Males had a significantly higher infection rate than females (P < 0.05). Age-related prevalence was highest among children aged 4-6 (51.85%). Occupational status and educational level of parents were also significant predictors of infection. These findings highlight the need for public health education, provision of basic sanitation facilities, and regular de-worming as preventive measures.
Dec 2025 DOI 10.14302/issn.2574-4496.jtc-25-5497
Silva FriedaCorresponding author
Our study gathered information on the diagnosis, treatment, and long-term outcome in adult and pediatric Hispanic patients with Well Differentiated Thyroid Cancer. Methods We performed a retrospective review of the clinical and imaging nuclear medicine records of cases of WDTC evaluated and treated in the Nuclear Medicine CLINICc. Evaluation included the clinical PROFILE, histology, radioiodine (RAI) therapies and treatment response, long-term outcome and survival. The data was ASSESED using the 2015 ATA Risk level guidelines and recommendations. Results Three hundred eleven cases were reviewed, 81% females, 19% males, median age of 41 years. Eleven percent (34 patients) of the patients were in the pediatric group and 49% were between 16-45 years. The tumor histology was 60.5% Papillary, 28.2% Papillary-Follicular variant and 11.3% Follicular type. All patients had a total thyroidectomy. A total of 287 (92%) of the patients were treated with RAI. The median RAI dose was 128 mCi. Patients in the low risk group received a dose range of 25-105 mCi, 73 cases in the intermediate RISK group received 106-160mCi and 104 cases in the high-risk group received doses greater than 160 mCi. The overall median cumulative dose was 151 mCi (55-926 mCi). Annual follow up was done in all cases , WITH A median follow-up OF 5-10 years. Residual functioning tissue in the neck was found in 52% of the cases by US and/or RAI imaging. of those, 43% belonged to the low risk group, while 57% were in the intermediate and high-risk groupS. The mean treatment dose received by those with persistent functional thyroid tissue in the neck was 157 mCi. Recurrent disease was found in 15% of the patients, 85% of them belonged to the intermediate and high-risk GROUPS. Forty-seven percent of the patients with recurrent disease had residual disease. Conclusion We believe ablative and/or adjuvant RAI treatment early in the disease is important to decrease residual thyroid tissue and/or residual disease, and to improve disease-free survival. We recommend total thyroid surgery in all tumors above 1 cm, post-operative evaluation with RAI Whole Body (with 123-I or 131-I), planar and SPECT/CT imaging and RAI ablation to remnant tissue. Follow-up post treatment evaluation is also recommended.
Oct 2025 DOI 10.14302/issn.2329-9487.jhc-25-5726
Okwunu Abah RoseCorresponding author
Background Hypertension in adolescents has been shown to tracks into adulthood, as well as causing premature cardiovascular and renal diseases. Objectives To determine the prevalence of elevated blood pressure and hypertension among adolescents of ages 10-19 years old attending secondary schools in Benue South, Nigeria; characterise their demographics and determine factors associated with the development of high blood pressure. Materials and Methods A cross-sectional descriptive study of secondary school adolescents selected through multistage sampling from across three Local Government Areas of Benue South, Nigeria. All the participants had their blood pressure measured using mercury sphygmomanometer and their height and weight taken for the calculation of their body mass index. A dipstick urinalysis with was carried out on their urine samples. Data analysis was with SPSS version 25. Results Atotal of 260 adolescents were studied, males were 132 (50.8%) and the mean age was 13.65 ±2.01 years. The prevalence of elevated blood pressure and hypertension was 5.4% and 2.3% respectively. Fifteen females (75.0%) had elevated blood pressure/hypertension as against five males (25%) and it was statistically significant. Adolescents in mid-adolescence age (60.0%) and lower social class (70.0%) had higher rate of high blood pressure. Significant proteinuria (+) was found among eleven (55.0%) of those with high blood pressure. Conclusion The prevalence of elevated blood pressure and hypertension among the adolescents was 5.4% and 2.3% respectively; being female, within mid-adolescence age and from lower social class are associated factors. Recommendation Regular blood pressure measurement should be part of school health programme.
Aug 2025 DOI 10.14302/issn.3066-8042.jac-25-5652
Amiri DavoudCorresponding author
Background Attention-deficit/hyperactivity disorder (ADHD) in adulthood is increasingly recognized not only as a psychiatric condition but also as a trait with behavioral and occupational implications—particularly in high-stakes, fast-paced financial environments. Traits such as impulsivity, sensation seeking, and altered reward sensitivity may influence decision-making among individuals engaged in stock trading or high-risk investment professions. Objective This systematic review and meta-analytic synthesis aims to investigate the relationship between ADHD, impulsivity, gender differences, and financial risk behavior, with a particular focus on decision-making outcomes in real or simulated trading contexts. Methods Seventeen peer-reviewed studies published between 2008 and 2025 were included. Studies employed behavioral experiments, fMRI paradigms, neurochemical analysis (e.g., glutamate levels), and ecological financial assessments to examine impulsive traits and investment behaviors among adults with and without ADHD. Both clinical samples and occupational cohorts (e.g., brokers, retail investors) were analyzed. The analysis followed PRISMA 2020 guidelines. Results ADHD symptoms—particularly impulsivity and reward hypersensitivity—were associated with increased delay discounting, higher risk-taking, and diminished cognitive control in financial tasks. Neuroimaging data revealed hypoactivation in prefrontal control regions and hyperactivation in reward-related circuits (e.g., ventral striatum). Gender-stratified analyses showed that males with ADHD displayed stronger preference for immediate rewards, higher portfolio turnover, and greater volatility. Preliminary evidence also suggests an overrepresentation of ADHD traits in high-frequency trading roles. Conclusion ADHD-related impulsivity significantly modulates financial risk behavior, particularly in high-stakes and fast-paced contexts such as trading. A convergence of behavioral, neurobiological, and ecological findings suggests that males with ADHD are disproportionately prone to rapid, high-risk financial decisions, whereas females may demonstrate greater regulatory control. These insights underscore the need for gender-sensitive interventions, occupational screening, and tailored psychoeducation. As financial environments become increasingly automated and fast-paced, understanding the neurocognitive vulnerabilities of individuals with ADHD may not only protect personal outcomes but also enhance systemic financial stability.
Dec 2024 DOI 10.14302/issn.2641-4538.jphi-24-5358
Kar SonaliCorresponding author
Background Injuries, particularly unintentional ones, are a neglected public health concern and are preventable or avoidable. Children in urban slums are especially vulnerable due to hazardous living conditions, inadequate supervision, and lack of safe sojourns or play areas. Since these injuries result in seeming spontaneous recovery, appropriate care being initiated by the primary care giver is questionable. Objective To assess the burden of unintentional injuries of unintentional injuries in pre-school going children aged 2-6 years in urban slums of Bhubaneswar, Odisha. To compare the knowledge of the 1st level care post-injury among the primary care givers against standardized prescribed care. Methods A cross-sectional descriptive observational study was conducted for over 2 years in urban slums under the Bhubaneswar Municipal Corporation (BMC), the capital city of Odisha. A total of 285 children aged 2-6 years, whose mothers consented to participate, were included in the study. Data regarding the type of injury and its management, as well as, associated socio-demographic factors, were collected using a pre-designed, pre-tested questionnaire. Descriptive statistics was used to derive the burden of unintentional injuries in children. The knowledge of the 1st level of care to be given after the common injuries was assessed among all the primary caregivers to detect the treatment and care gap. Results The majority of primary respondents were mothers aged 21-30 years (82.1%), The frequency of an episode of unintentional injury (occurrence in last 3 months) in the study population was found to be 58%. The most common type of injury reported was skin lacerations or tears, common site being in the upper and lower limbs. Males were more affected as compared to females (54.64 %) The reporting of unintentional injuries among the children was found to have significant association with the occupation of the father. Fathers who were unemployed or working as unskilled labor, their child’s probability of reporting an unintentional injury was found to be high, with p value coming to be statistically significant. Conclusion The study highlights the complex interplay of sociodemographic factors influencing unintentional injuries among children in urban slums and the need to create awareness among the primary caregivers, about the immediate management, so that chronic complications may be averted. It is difficult to avert injury as this age group is agile and nowadays supervision is challenging. Still, the knowledge of management would not just empower the caregiver, but also the growing child, who can attend to their younger siblings or themselves, whenever they get injured next. Further research with larger sample sizes is warranted to validate these findings and develop effective prevention strategies.
Sep 2024 DOI 10.14302/issn.2690-4721.ijcm-24-5126
D. N Girah.Corresponding author
The development of medical therapy and patients profile has led to a rise in the incidence of nosocomial fungal infection. The frequency of candidiasis has surged worldwide, and the prevalent of healthcare diseases are now Candida species. Candida species causes a range of human infections known as Candidiasis. The non-albicans Candida (NAC) species have recently superseded Candida albicans as significant opportunistic pathogens. The study was conducted to determine the prevalence and antifungal susceptibility of Candida species isolated from various Clinical samples in Rivers State University Teaching Hospital, Port Harcourt, Nigeria. A total of 206 clinical specimens from male and female patients of all ages were sampled in the Department of Microbiology, Rivers State University Teaching Hospital, Port Harcourt, to investigate suspected Candida infections. The isolation and identification of Candida species was done by culture on SDA, Gram stain, sugar fermentation and phylogenetic profiling. Antifungal susceptibility pattern was done by Disc Diffusion method using Fluconazole, Ketoconazole, Miconazole, Nystatin and Itraconazole. The results showed that out of 206 specimens, 44 isolates (21.4%) were identified, with the majority (56.82%) from high vaginal swabs (HVS), followed by urine (31.82%) and oral swabs (11.36%). The age of patients ranged from four months to 73 years giving a Mean Age 1.86+ 0.344, with females (85.4%) outnumbering males (13.6%). Prevalence of Candida spp revealed Candida albicans (50%), Candida krusei (18.2%), Candida parapsilosis(11.4%), Candida glabrata and Candida tropicalis (9.1%) respectively and Candida pelliculosa (2.2%), with C. albicans being the most prevalent. The antifungal susceptibility testing among the azoles showed that Fluconazole (79.5%) and Ketoconazole (77.3%) were most sensitive agents against isolates from HVS, urine and oral swabs respectively and Itraconazole (34.1%) was most resistant especially to those from oral swabs. This study highlights the increasing prevalence of NAC species over Candida albicans and the growing resistance of Candida isolates to commonly used antifungal drugs. Diagnosis of these species of Candida and sensitivity to antifungal agents are critical components to treatment, particularly for patients with severe underlying illnesses who are hospitalized.
Apr 2024 DOI 10.14302/issn.2994-6743.ijstd-24-5005
Khatoon Hossein Mehdi Poor NargisCorresponding author
Objectives This study examined the frequency and dynamics of syphilis in the United Arab Emirates (UAE) between 2018 and 2022. Recognizing the significance of understanding syphilis trends, this study intends to conduct further research on sexually transmitted diseases in the context of the UAE. Methods This was a retrospective cross-sectional study. This study focused on patients who underwent syphilis screening between January 2018 and December 2022. Cases were classified as conclusive only if they passed the first screening and subsequent confirmatory tests. Results The findings demonstrate that Syphilis frequency varied throughout the UAE during the study period. Demographic trends and sex variations were discovered, providing insight into how syphilis patterns change. Additionally, this study identified a broad spectrum of clinical manifestations, confirming the complexity of the disease. It was also noted that males had a higher frequency of syphilis than females. Conclusion Understanding the complexity of the frequency of syphilis is critical for developing effective public health interventions. Variations in frequency, demographic trends, sex disparities, and clinical manifestations indicate the need for personalized preventive and control measures. This study provides important information that may be utilized to motivate focused initiatives to address the difficulties associated with syphilis in the UAE, thus enhancing overall public health.
Dec 2023 DOI 10.14302/issn.2324-7339.jcrhap-23-4634
Makura AlfredCorresponding author
Introduction Human Immunodeficiency Virus (HIV) remains a persistent global public health challenge. In 2020, approximately 37.9 million individuals were living with HIV globally, including 1.7 million children <15 years old, with a global HIV prevalence of 0.8% among adults. A larger portion of people living with HIV are found in low-and middle-income countries, and Sub-Saharan Africa (SSA) is home to about 68% of people living with HIV in the world. Strikingly, with increased uptakes in PMTCT, challenges in ART programs, and high viremia among children and adolescents in SSA, the success rate of ART might be quickly compromised, with possible HIVDR emergence, particularly after years of paediatric ART exposure. Therefore, monitoring ART response in children and adolescents in terms of HIVDR patterns and other socio-economic determinants of disease progression might help achieve better treatment outcomes at individual levels. At a programmatic level, this can guide further optimization of treatment options for SSA especially Zimbabwean rural where there is paucity of information on HIVDR prevalence in children and adolescents. Methods We enrolled 89 children and adolescents experiencing virologic failure from Chidamoyo Christian Hospital in Hurungwe. We managed to amplify all the 89 using nested PCR and 32.5% (29) had resistance to at least one ART drug and analysis was done using the 29 samples. Results Among the 89 participants with virologic failure,29 were resistant to at least one of their ART drugs. 39.2% of males and 23.07% of females had HIV-1 with resistance to at least one medication. Among 29 participants with HIVDR mutations, the prevalence of at least one HIVDR mutation to protease inhibitors (PIs), Nucleotide Reverse Transcriptase Inhibitors (NRTI), and Non-Nucleotide Reverse Transcriptase Inhibitors (NNRTI) were 6.47% ,46.76% and 46.76% respectively. Of the 29 participants who had HIVDR 19 (65.5%) had resistance to a drug they were currently taking and they needed to be switched to a better effective ART regimen Conclusion Use of HIVDR testing in guiding and monitoring development of HIVDR at the start of ART or at 1st failure can be very important in treatment options and patient management.
Nov 2023 DOI 10.14302/issn.2693-1176.ijgh-21-3909
safari YahyaCorresponding author
Background & Objective Changing people’s attitude toward the environment is an important approach to the prevention of environmental damages. The present study aimed to evaluate environmentally responsible health-oriented behaviors in students. Materials and Methods This research was performed on 360 medical students (180 males and 180 females) who were selected via stratified random sampling. Data were collected using a responsible environmental behaviors questionnaire. Data analysis was performed in SPSS version 21 using linear regression analysis and Pearson’s correlation-coefficient. Results The scores of the environmental attitude, environmental knowledge, and environmental behaviors of the participants were estimated at 52.63±5.74, 74.43±5.99, and 103.37±11.51, respectively. An insignificant correlation was observed between the environmental knowledge and environmental behaviors of the students (r=0.07; P=0.20). However, the correlation-coefficient between the environmental attitude and environmental behaviors of the students was positive and significant (r=-0.54; P<0.001). A negative, significant correlation was also denoted between the environmental knowledge and environmental attitude of the students (r=-0.39; P<0.001). Conclusion Despite relatively poor environmental awareness and attitude, the majority of the students had proper environmental behaviors. Therefore, it seems that having an environmentally responsible behavior does not rely on environmental attitude and knowledge. In fact, behaviors influenced by social conditions and structure encourage and facilitate environmental behaviors.
Sep 2023 DOI 10.14302/issn.2576-2818.jfb-23-4605
S. Aljaied YasserCorresponding author
Background Immunological abnormalities are currently under scrutiny to potentially unravel the etiology of frustrating cases of unexplained female infertility (UFI). Objectives To explore the prevalence of immunological abnormalities in the levels of total immunoglobulins and complements in the cases of UFI. Methods Females with a history of UFI were included in this cross sectional study. They were consulted at the clinical immunology clinic at the King Abdulaziz University Hospital (KAUH). Their demographics, clinical features, total immunoglobulins and complements tests results were collected and analyzed for any relationship. Results One hundred and twenty-one cases of UFI with an average age of 34 ± 5.6 (range from 23 to 49 years old) were studied. Secondary infertility was predominant in 99 cases (81.8%). An overall prevalence of at least one abnormal level of total immunoglobulins or complements was found in 65 cases (55.1%). The predominant immunological abnormalities were elevated levels of immunoglobulins (hypergammaglobulinemia) in 51 cases (43.2%), high IgG in 26 cases (22%), high IgA in 14 cases (11.9%), and high IgM in 11 cases (9.3%). This was followed by elevated levels of complements (hypercomplementemia) in C4 in nine cases (8.5%). A significant association was found between high C4 group and some parameters of infertility, including primary infertility (p = 0.005), no pregnancy (p = 0.001), no abortion (p = 0.047), in comparison to normal C4 group. Moreover, a statistically significant association was found between high IgA group and abortion in comparison to normal IgA group (p = 0.054). Conclusion At least one abnormal level of total immunoglobulins or complements was detected in more than half of the UFI cases. The commonest abnormalities were hypergammaglobulinemia (IgG, IgM, IgA) and hypercomplementenemia (C4), which showed a potential association with some infertility parameters. These findings may encourage the screening of general immunological tests to explore promising new immunopathology in UFI.
Jul 2023 DOI 10.14302/issn.2691-6622.ijar-23-4578
Fleurette Moumegni Monthe LilianeCorresponding author
The growth characteristics of Conraua goliath (Boulenger, 1906), an endemic and endangered species in Cameroon, were evaluated in its natural habitat between October 2021 and November 2022 in order to contribute to its domestication and conservation. For this purpose, 139 specimens (55 males, 55 females, and 29 individuals of undifferentiated sex) were collected by fishermen from 3 sites (Loum, Penja, and Nlonako) in the Department of Moungo, Coastal Region of Cameroon. The frogs were measured, and their growth parameters were determined after dissection and macroscopic and microscopic observations. The maximum size observed is 33.5 cm (SVL) and 2529 g body weight (BW), and the minimum size is 5.3 cm (SVL) and 12 g body weight (BW). This species is more abundant in the rainy season, in frogs between 18 and 24 cm, and has a Caucasian and uni-modal size structure. Independent of sex and season, this species has a significant and high regression coefficient between length, weight, and isometric growth pattern. However, this growth varies according to sex. It ranges from isometric in males (b = 2.82) and undifferentiated sexes (b = 2.85) to negative allometry in females (b = 2.21). The condition factor K ranges from 3.28 to 14.24 (mean: 7.80 ± 1.95) and fluctuates according to the sex and size of the frog. According to our results, this species has a large size and a high growth rate and could therefore be an excellent candidate for domestication to ensure its conservation. However, studies on reproductive characteristics are needed to complete this work.
Jun 2023 DOI 10.14302/issn.2379-7835.ijn-23-4587
Bhoite RachanaCorresponding author
Background Cachexia is highly prevalent in cancer patients and is responsible for as much as 20% of all cancer deaths. Nevertheless, there is little emphasis on cachexia in routine clinical practice. This study looks at the efficacy and tolerability of a protein and energy-dense nutritional supplement with immunonutrients on cachexia in cancer patients. Methods This was a three-month, prospective, open-label study of patients undergoing radiotherapy and/or chemotherapy for head and neck or gastrointestinal or lung cancer. Efficacy endpoints were mean change in muscle strength, acute phase proteins (albumin and pre-albumin), C-reactive protein (CRP) levels, weight, Glasgow prognostic score (GPS), and nutritional status at the end of the study period. Results The study population consists of 47 (79.66%) males and 12 (20.34%) females with a mean age of 47.98 ± 12.16 years. The mean change in muscle strength, albumin, pre-albumin, CRP levels, and weight for the overall study population was 0.17 ± 12.09 kg (P=0.9145), -0.05 ± 0.53 g/dl, (P=0.5888), -0.01 ± 0.09 g/dl (P=0.2951), 0.50 ± 37.41 mg/dl (P=0.9258), -0.59 ± 3.70 kg (P=0.2265), respectively. At the end of the study period, there was a significant improvement in the nutritional status concerning total calories, protein, and fat intake. Conclusion Protein and energy-dense nutritional supplement with immunonutrients might help in the improvement of muscle strength, GPS, and dietary intake. The addition of the supplement to the diet regime of patients with cancer cachexia increases their daily consumption of proteins which might translate to multimodal clinical benefits.
Mar 2023 DOI 10.14302/issn.2576-9383.jhhr-22-4178
Abdulwahab Al-Shamahy HassanCorresponding author
The study aimed to assess the oral health condition and its impact on the quality of life (QoL) among a sample of Yemeni population. The study including 256 individuals who responded to the Oral Health Impacts Profile (OHIP) through completing a face-to-face survey of the OHIP-14 Arabic version. The data were collected by one dentist trained in the terms of oral health-related quality of life (OHRQoL). The study revealed that the impact of OHRQoL among the study sample was found with a weighted OHIP-14 score of 1.1 (±0.9). Physical pain (3.7±2.3), followed by physical disability (2.4±2.2), and psychological disability (2.1±2.3) were the highest scoring. A significantly higher effect (p < 0.05) was found for the adults (18-44 years old) compared to those elderly individuals (> 64 years). The OHRQoL was better in male than in female and in employees than in both pensioners and un-employees. Females had a significantly higher effect when compared to males in the OHRQoL (p < 0.05). The unemployed subjects were significantly higher than those pensioners and employees in the OHRQoL (p < 0.05). The OHRQoL was also better in subjects with higher income and education than those participants with low. However, there were no significant differences for OHRQoL with respect to the educational level and monthly income of participants (p > 0.05). Conclusion, the quality of life is greatly affected by the oral health conditions of the elderly. This impact of oral health on quality of life has an association with individual and contextual variables.
Feb 2023 DOI 10.14302/issn.2379-7835.ijn-23-4430
A. Talal LillianCorresponding author
Background To determine the acute effects on postprandial lipemia and glycemia by supplementing a high-fat meal with either white button (WB) or shiitake (SH) mushroom powder. Methods Nine healthy participants (4-male, 5-female, 23.3±1.3 years, 17.8±6% body fat, 56.2±11.4kg fat free mass) consumed a control hamburger. At one-week intervals, after consumption of a control meal, participants consumed hamburgers in random order, supplemented with 14g of either WB or SH mushroom powder. Peripheral blood for lipids (triglycerides, high-density lipoprotein HDL, low-density lipoprotein LDL), and glucose was obtained at baseline (t=0 hours) and postprandially every two hours for six hours. Data were analyzed using linear mixed effects models. Results Lower LDL levels were observed for both SH and WB burgers compared to the control burger (p=0.0007) over the six-hour period. Mushroom powder content did not alter triglyceride, HDL, or glucose levels. Gender affected triglyceride and HDL levels over the treatment course. Triglyceride levels were higher in males (p=0.0084), and HDL levels were lower in females (p=0.0005). Triglyceride and glucose levels were higher, (p< 0.001 and p< 0.0001 respectively), during the postprandial time course (t=0, 2, 4, 6 hours). Conclusions Supplementing SH or WB mushrooms during a high-fat meal may lower serum LDL levels.
Oct 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4338
Banerjee Bhattacharya MayuriCorresponding author
Bio Renesis is biotech health tech company working for nutraceuticals and health care services
Corona pandemic resulted in huge burden on health care service sectors. Although pharmaceutical is the one of the largest industry in the world and predominant in health care services yet sudden outbreak of disease has questioned our ability of fighting back. The people across the globe have become more aware regarding health and wellness, hence they looking for other natural, reliable, affordable and available options. The nutraceuticals or functional foods are expected to have various health benefits and people are looking for more advance nutraceuticals for better immunity. An intensive exploratory study was conducted in one of the most reputed Banerjee’s Clinic located at Khamtarai region, Raipur, Chhattisgarh where 237 female participated in the questionnaire survey. The study result revealed that majority of women (52%) age 34-41 years use neutraceuticals for better health and to boost their immunity. Furthermore, the females who are working both public and private sectors and are financially independent are aware of health benefits of nutraceuticals/functional foods and spend on nutraceuticals for overall wellness. Moreover, the women preferred tablets form of nutraceuticals rather than powder or liquid form as mode of consumption.The study further shows that women who are professionals prefer to take daily functional foods or nutraceuticals for good health, immunity and beauty.
Sep 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4328
Dias De Souza GleimCorresponding author
Radiologist at Núcleo de Radiologia e Imagenologia do Hospital Regional da Asa Norte-HRAN-Distrito Federal-Brasília-Brazil
Objectives To evaluate the diagnostic accuracy of chest CT for the diagnosis of COVID-19 associated with the clinical presentation and in relation to the PCR-RT. Sensitivity, specificity, positive predictive value and negative predictive value, gender, age group and degree of lung involvement will be evaluated. Methods We evaluated 1545 patients with chest CT, delineating the age range and degree of lung involvement, and 306 patients with chest CT and PCR-RT. Results Of the 1545 examinations, 53% were men and 47% were women, there was greater involvement in the 50-59 age group. In the pulmonary study, 55.05% were COVID-19. In the degree of lung involvement 37.70% were mild, 35.76% were moderate, and 26.54% were severe. In the distribution by age, there was a greater involvement between 50-59 years with 56% between moderate (27.6%) and severe (28.0%). Between tomography and PCR-RT, the sensitivity was 68.8%, specificity 59.5%, accuracy 91.3%, with prevalence 31.9%, positive predictive value 44.3% and negative predictive value 80.3%, in females, sensitivity 55.3%, positive predictive value 37.1%, negative predictive value 75.3%, in males, sensitivity 81.6%, positive predictive value 50, 6 and negative predictive value 86.6%.The sensitivities are different between the genders with p of 0.005 and specificity of 0.938, with age effect, starting at 45 years we have a p of 0.057 that decreases to 0.006 at 80 years for sensitivity and specificity. Conclusions The sensitivity and accuracy of CT scan in relation to PCR-RT was significant. Sensitivity increases with prevalence and in the older age group and in men.
Sep 2022 DOI 10.14302/issn.2329-9487.jhc-22-4252
Kumari Nuthalapat RamaCorresponding author
Additional Professor of Cardiology, Department of Cardiology, Nizams institute of medical sciences, Panjagutta, Hyderabad, Telangana state, India
Background Prevalence of coronary artery disease is between 7-13 percent in urban and 2-7 % in rural India1. The alarm in rise in the prevalence of coronary risk factors like diabetes, hypertension, dyslipidemia, smoking, central obesity and physical inactivity2. The correlation between these risk factors and the severity of coronary atherosclerosis, assessed by angiography which may be either single or multivessel is less consistent with studies reporting conflicting results 3,4. Therefore our study aims to understand the proper correlation between risk factors and severity of coronary artery disease in an Indian population Methods This study was conducted in the department of cardiology, NIMS hospital Hyderabad which receives patients from the urban as well as rural areas of Telangana. the patients admitted in the department of cardiology, NIMS hospital Hyderabad that presented with acute coronary syndromes and diagnosed to have coronary artery disease (single vessel/multivessel disease) on coronary angiography taken for study. Sample Size is 150 Results Among the 150 subjects, males were 111(74%) and females were 39(26%). Mean age of the study population is 55.2 ± 11.4. Among SVD group 73.65% were males &26.3% were females. Among MVD group 76.2% were males & 23.7% were females. Mean age for SVD was 53±14.4 years, while mean age foe MVD was 58.6±14.5 years. For ACS mean age of presentation for females is 60.7±11.4 and for males mean age of presentation is 55.1±12.6. MVD (57.2%) were more common among smokers than SVD. In <45 years age group SVD (69.2%) were more common than MVD (30.8%). In 45- 70 years age group and >70 years age group MVD were more common than SVD with 69.6% and 66.6% respectively, which is statistically significant. MVD (60%) were more common among hypertensives than SVD. Among non-hypertensives MVD (41.8%) was less common than SVD (58.2%) MVD was common among all age groups, which is statistically signicant. Among STEMI group SVD (58.3%) was more common than MVD (41.7%). Among NSTEMI group MVD (62%) was more common than SVD (38%).Correlation between groups was statistically significant. Among SVD study group, LVEF was commonly between 30-45% & very few with LVEF <30% MVD was associated with more severe LV dysfunction as compared to SVD in acute MI. The difference in ejection fraction between the two groups was statistically significant P value=0.0002. In hospital MACE Among SVD there was 1 MI (due to stent thrombosis) who had to TVR (primary PCI) & rest were asymptomatic and discharged in normal state MVD there were in hospital deaths (due to refractory cardiogenic shock) rest were asymptomatic and were discharged in normal state. This difference between the two groups was statistically insignificant. Conclusion Multivessel disease in ACS were seen more commonly among elderly as compared to young subjects where single vessel disease were more common. Females especially elderly more commonly have multivessel disease. Mean age for multivessel disease was higher than single vessel disease. Among <45 years age group, SVD was more prevalent among smokers, obese and physically active. Multi vessel disease is more prevalent among patients with risk factors like diabetes, hypertension, dyslipidemia and physically inactive. Subjects with family history of premature CAD presented early and correlated well with prevalence of SVD.NSTEMI presented more with multi vessel disease. In echocardiographic wall motion analysis, a depressed regional segment of infarcted area with remote hyperkinesis predicted SVD where as remote area hypokinesis predicts more multivessel disease. In hospital outcomes were seen among multi vessel disease as compared to single vessel disease although not statistically significant.
May 2022 DOI 10.14302/issn.2641-4538.jphi-22-4189
Rutayisire ErigeneCorresponding author
Department of public Health, Mount Kenya University Rwanda Kigali Rwanda
In Rwanda, CVDs accounts around 14% of all death. Studies on knowledge, attitude, and practice (KAP) would be of great value in helping public health professionals develop targeted programs and measure the effectiveness of interventional programs. The main objective of this study was to analyze the KAP about CVDs among adult patients attending public health centers located in the City of Kigali, Rwanda. A total of 384 adult patients were enrolled in this study. A structured questionnaire was used. Data entry and analysis was done using SPSS version 21. Findings were presented as frequencies and percentages in tables. For determining the KAP-levels, the overall scores were determined for each respondent by adding up the scores through the KAP-related questions. The mean age was 36.4 years, primary school (57.3%), married (62.8%), self-employed (40.9%), and females predominated (61.5%). The knowledge mean score was 14.2 and 76% had high level of knowledge of CVD risks and prevention. The average attitude score for all respondents was 17.6 and 22.9% of the respondents showed negative attitude towards CVDs prevention. Research findings revealed that 36.5 % were not practicing physical activity and exercise. The mean practice score for all respondents was 3.9 and 70% of respondents had negative practice towards CVDs prevention. Poor CVDs prevention practices were observed among the study participants. Therefore, it is necessary to establish more effective educational interventions intended to promote positive health behaviors related CVD prevention
Feb 2022 DOI 10.14302/issn.2329-9487.jhc-22-4067
O AmaewhuleCorresponding author
Department of Paediatrics, University of Port Harcourt Teaching Hospital. Nigeria.
Introduction Congenital Heart Defects (CHDs) are structural abnormalities of the heart and intra-thoracic great vessels that are present at birth and may be of functional significance. They are the most frequently occurring congenital anomalies and babies born with severe forms of these defects are likely to die in the neonatal period. Objectives The aim of this study was to determine the prevalence of CHDs among neonates delivered in Port Harcourt, Rivers State, Nigeria Methods Using a stratified sampling technique, 530 neonates were selected from three hospitals in Port Harcourt. The biodata of the parents and socio-demographic information were obtained through an interviewer-administered questionnaire to the mothers. Physical examination and echocardiograghy were performed on all the neonates. Results Five hundred and thirty (530) neonates aged 0-7days (5.2±1.8) participated in this study and the male to female ratio was 1.1:1. Forty-three neonates were found to have CHD giving a prevalence of 8.1% 95%CI: 6.0. Thirty-nine were acyanotic and four cyanotic. Congenital Heart Defects were found in 21 (48.8%) males and 22 (51.2%) females. The more common heart defects were isolated Atrial Septal Defect in 16(37.2%), isolated Patent Ductus Arteriosus in 11(25.6%) and isolated Ventricular Septal Defect in 6 (13.9%). The most common cyanotic CHD was Transposition of the Great Arteries in 2 neonates (4.7%). The clinical features identified in neonates with CHD were tachypnoea, dysmorphia, cyanosis, hypoxia and murmur Conclusion The prevalence of CHD is considerably high in Port Harcourt and further studies need to be carried out to ascertain the risk factors.
Dec 2021 DOI 10.14302/issn.2691-8862.jvat-21-3999
Pino Marrero KatiaCorresponding author
Holguin's university of medical sciences, Cuba.
Vaccines symbolize the main pandemic control tool in the world, which is why they are the object of study in many investigations. In this work, the Abdala vaccine was characterized in terms of adverse reactions by conducting a survey and statistical processing of the data taken through distribution graphs of the same, developed in the Minitab software 16. Of the people involved, 47.67% presented Symptoms that were mild to moderate with the presence of pain in the area of the injection, drowsiness and decay, mainly. Based on the distribution of the data in histograms, the duration of these symptoms was approximately 1 day. Likewise, it was observed that the symptoms occur mainly in females, for 33.72% of the cases in the first dose and 23.26% after the second dose was applied.
Nov 2021 DOI 10.14302/issn.2577-2279.ijha-21-3925
Kumar Sah SurendraCorresponding author
Assistant Professor, Department of Anatomy, Nobel Medical College Teaching Hospital, Biratnagar, Nepal
Introduction The nose is one of the important component of the face which is considered as the major clue for the ethnic origin. The proportion of the nose is determined on the same principal as that of the skull.The external nose extends the nasal cavities onto the front of the face and positions the nares so that they point downwards. The shape of the nose is pyramidal with its apex anterior in position. The upper angle of the nose between the openings of the orbits is continuous with the forehead. Materials and Methods This study was carried out among residents of Ramnagar Gaupalika-7, Sarlahi,Nepal, one of the core region of Madhesh Nepal dated Jan 2021 to April 2021.The cohort consists of independent adults of age group 17-45 and consenting adults from the metropolis. Ethical approval was sought prior to conducting the study from the supervising ethical committee of the Nobel Medical College Teaching Hospital, Biratnagar, Nepal. Written consents were taken from the subjects for the recruitment in the study. Results The present study involved 100 subjects of equal males and females subjects of age groups 17-45 years from Madheshis community of Nepal. The table 1, table 2, table 3 below shows the values obtained for different parameters for males and females. The mean value of nasal height for male and female is 52.59±1.89 and 50.27±2.16 mm and the nasal width for male and female is 37.64±1.72mm and 35.42±2.04mm and the value of mean nasal index for both the sexes are 71.59±2.31and 70.58±3.04 respectively. The dominant type of the nasal morphology in both the sexes are the mesorrhine type and the leptorrhine type as well. Conclusion The human nose is a dominant feature in facial region which differs in anatomy and morphology among racial groups and of the most characteristic differences during the analysis of ethnic and racial differences. The dominant type of the nasal index is the mesorrhine type in both the male and female of the Madheshis community. Hence the data obtained here will be useful for the differentiation of different ethnic groups of Nepal as well as in the field of forensic science and rhinoplastic surgery.
Nov 2021 DOI 10.14302/issn.3070-3360.ijco-21-3995
U. Nwoha PolycarpCorresponding author
Centre for Scientific Investigations and Training, Owerri, Imo State, Nigeria
Proceeding to hospital immediately stroke occurs is important for early intervention that would minimize the consequences of stroke. But most stroke patients in developing countries prefer herbal centers than hospital. Reasons for this attitude have not been established. Two well-trained assistants were used to interview 117 stroke survivors who attended Bebe Herbal Center (BHC) in Nigeria for at least two visits. The survivors self-reported their experiences in hospitals visited and at BHC. Data obtained were analyzed using Independent t-test, Pearson’s chi-squared test, on SPSS package version 23. Significant value was set at p<0.05. Results showed the survivors comprised 48.7% males and 51.3% females, with mean age 63.98±10.41 years (range: 40-84 years). Following onset of stroke, 61.5% went firstly to hospital, 21.4% to traditional healing places, and 17.1% to BHC. Eventually all survivors went to BHC and 99.1% said they were satisfied with treatment received at BHC. Seventy-nine (68.1%) said they experienced substantial recovery under one month, 25.9% between 1-6 months. All the survivors who went firstly to hospitals said they received inadequate care in them. None of the hospitals they visited had CT or MRI equipment. Pearson’s chi-squared test showed that the impact of stroke had a significant difference between males and females regarding checking of blood pressure after stroke (χ2=7.62; df=3; P<0.05). The inadequate care received in hospitals and the early satisfactory recovery in BHC influence stroke patients in Nigeria to reject going to hospital.
Oct 2021 DOI 10.14302/issn.2377-2549.jndc-21-3977
Shakeel Iqubal S.M.Corresponding author
Department of General Science, Ibn Sina National College for Medical Studies, Al Mahajar Street: 31906, Jeddah 21418, Kingdom of Saudi Arabia
In Saudi Arabia most of the individuals give very little attention to issues like health or no priority to medical checkup. This investigation was carried out to measure knowledge, practice of periodic medical checkup in Kingdom of Saudi Arabia people. A cross-sectional investigation was conducted among 1015 participants. A structured interviewer administered an online questionnaire were distribute by social media and whatsApp. We collected data and analyzed using SPSS version 21. Association between categorical variables were explored using bar chart and tables, Level of significance was set at 5%. The main age of the respondents was 21-30 years, 78.4% were females and 64.2% were married. About 42.1% have ever heard of periodic medical check-up , 57% of those who haven’t ever heard of periodic medical checkup and only 21.9% among those who had ever done it had frequent medical check-up and 78.1% didn’t do it. Attempt is required in ensuring that periodic medical check-up is urged. There is a need to study the factors associated with the uptake of medical check-up among the study population and effort should be made by health agencies to educate traders on the various types of medical check-up, their indications and benefits as well as its practice encouraged
Aug 2021 DOI 10.14302/issn.2644-1101.jhp-20-3655
Kayani SumairaCorresponding author
Ph.D. Zhejiang University China
The present study examined the effects emotional intelligence on self-Efficacy of tertiary education students. Two scales Schutte Self-Report Emotional Intelligence Scale 44 and Schwarzer & Jerusalem Self Efficacy Scale 47 were used. The pilot study was conducted to assess the reliability of the instrument and main study was conducted to assess the results on sample of the study. A sample of 50 students (25 males, 25 females) were taken from universities of Islamabad and Rawalpindi. Both questionnaire were administered to the sample. The psychometric properties of pilot study were found satisfactory. In second phase main study was conducted which considered of sample of 200 university students (100 males and 100 females). The psychometric properties of main study were also satisfactory. Scores were analysed using SPSS software. Results of demographic variables such as age, birth order, mother education, father education and number of siblings are positively correlated with both scales and sub scales. The results were significant at (p<0.05) of mean differences with gender, education and family system. This survey consists of three hypotheses, which were accepted.
Jun 2021 DOI 10.14302/issn.2641-4538.jphi-21-3859
Erigene RutayisireCorresponding author
Public Health Department, Mount Kenya University Rwanda
In Rwanda, 38% children aged 6-59 months are stunted. In Ngoma District, stunting rate is estimated at 41% among the children aged below 5 years. The study objective was to evaluate the prevalence and factors contributing to under nutrition among children aged 6- 59 months in Ngoma District. Cluster sampling was used to determine the study participants for each sector within 14 sectors by considering the sample size of 442. The WHO Anthro software version 3.2.2 was used to determine the nutritional status of the children. SPSS version 24 was used for analysis. Of 442 children participated in the study 50.9% of them were females, 24.4% were aged 15-23 months and the majority of children (89.8%) born with normal birth weight. Study findings revealed that the prevalence of under nutrition was 33.7% for stunting, 3.6% for wasting and 6.6% underweighted. Poor sanitation facility (AOR: 4.1, 95%CI: 1.83-9.3, p=0.001), poor diet (AOR: 1.9, 95%CI: 1.18-3, p=0.008) were significantly associated with stunting. Factors such as lack of hand-washing facilities (AOR: 2.5, 95% CI: 1.013-6.3, p=0.047), not eat vegetables (AOR: 4.4, 95%CI: 1.7-10.96, p=0.001), and not eat fishes (AOR: 4.1, 95%CI: 1.6-10.6, p=0.003) were associated with wasting. Short breastfeeding duration (AOR: 4.5, 95%CI: 2.9-7.2, p=0.001), not eat vegetables (AOR: 1.9; 95%CI: 1.1-3.05, p=0.008), and not eat eggs (AOR: 2, 95%CI: 1.3-2.9, p=0.001) were associated with underweight. Poor families with under-five children need continuous support that will assist them to improve nutritional status of their children.
May 2021 DOI 10.14302/issn.2766-8681.jcsr-21-3783
Yilmaz MuratCorresponding author
Department of Neurosurgery, Dokuz Eylul University Medical Faculty, Izmir, Turkey
Background Klippel-Feil Syndrome (KFS) is described as the clinical triad of short neck, low posterior hairline, and limitation of neck mobility. Objective Topresent our clinical experience with KFS patients who also had adjacent segment disease (ASD) and to propose a novel classification system for these patients. Methods This retrospective study was performed in the neurosurgery department of our tertiary care center. Data were gathered using the medical records of 22 KFS patients (10 males, 12 females) with ASD. Diagnosis was confirmed with imaging modalities including X-ray, computerized tomography, and magnetic resonance imaging. Clinical and radiological findings as well as therapeutic outcomes were noted. Results The average age of our series was 56.09 (range: 41 to 67) years. The operative technique was selected as for our novel “Yilmaz-Yucesoy Classification System”. Accordingly, one patient (4.54 %) received non-surgical treatment (Yilmaz-Yucesoy Grade 1), six cases (27.27 %) underwent anterior cervical arthroplasty, seven patients (31.81 %) underwent anterior cervical discectomy or corpectomy and fusion with cervical cage and plate (Yilmaz-Yucesoy Grade 3). Eight patients (36.36 %) with cervical spinal instability had anterior cervical discectomy or corpectomy and fusion with cervical cage and plate (Yilmaz-Yucesoy Grade 4). No mortality or remarkable complications were detected. Conclusion Appropriate and timely recognition and classification of patients with KFS and ASD based on our newly proposed “Yilmaz-Yucesoy Classification System” yielded promising treatment outcomes. However, further prospective, randomized, controlled trials are warranted on larger series to validate our preliminary results.
Apr 2021 DOI 10.14302/issn.2575-1212.jvhc-21-3759
Ferdinand NgoulaCorresponding author
Animal Physiology and Health Research Unit, Faculty of Agronomy and Agricultural Sciences, University of Dschang, P.O. Box 188, Dschang, Cameroon
The present study was initiated to improve the farm animals’ productivity through the use of medicinal plants. More specifically, to determine in female cavies the effects of aqueous extract of avocado seed powder (AEASP) on the estrous cycle, the levels of LH, estradiol and tissues (ovarian and uterine) biomarkers of oxidative stress. For the trial, 24 female cavies with regular estrous cycles were selectedamong 40 trough observation of 4 estrous cycles. They were randomly shared into 4 groups of 6 females each, comparable in term of body weight (bw) (463.60±77.69 g). They received by gavage 1 mL/kg bw of distilled water for the control and 100, 200, 400 mg/kg bw of AEASP respectively for the groups EA100, EA200 and EA400. Subsequently, 3 estrous cycles were studied every day during all the treatment period. At the end, the cavies were slaughtered at the estrus phase; blood, ovaries and uterus were collected for analysis. As result, the AEASP significantly (p<0.05) increase the duration of the estrus phase in females of group EA100, without affecting significantly the duration of the estrous cycle as referred to the control. It significantly reduce the serum level of total cholesterol and increase (p<0.05) the serum concentration of LH in cavies of group EA100 compared to the control. AEASP significantly increase the serum concentration of estradiol in all treated females as referred to the control. It significantly increase the level of malondialdehyde (MDA) in the ovaries of the females of group EA400. In the uterine tissue, superoxide dismutase (SOD) increase significantly in the cavies of group EA200 compare to the control. We can conclude that the AEASP increase the duration of the estrus phase of cavies without affecting the duration of the estrous cycle. Subsequently, it increases the serum concentration of LH and estradiol.
Mar 2021 DOI 10.14302/issn.2474-3585.jpmc-20-3557
E. ADETONA AdesojiCorresponding author
FWACP (LAB. MED), FMCPath, MPH (Health Policy and Management), MBBS; UCH, Ibadan
Background Breast cancer is one of the most common types of cancer affecting women globally. It has shown increasing morbidity and mortality rates over the past years. Several screening methods ranging from simple breast self-examination to a highly sensitive test procedures for early detection and treatment are available, but uptake is a challenge. Lack of a national screening programme in the country makes available regional screening programme unsuccessful. This study aims to assess the factors affecting the uptake of breast cancer screening programme among female staff in a tertiary hospital, Southwest Nigeria. Method This descriptive cross-sectional study involves 375 participants selected by a stratified random sampling technique, with proportional allocation to population size and the use of a semi-structured questionnaire. Respondents were questioned on their basic knowledge of breast cancer symptoms, risk factors and treatment, over a score of 50 and above, were set as the cut-off mark to determine good knowledge of breast cancer. Patients attitudes towards breast cancer screening as well as factors affecting uptake were also measured. Descriptive statistical analysis was done using SPSS-20 while the predictors of the uptake of screening were determined using logistic regression at p ≤ 0.05. Results There were 360 respondents, comprising of 13.3% clinical and 86.7% non-clinical female staff within the age bracket of 20 to 58 years (38.2±0.42 years). Out of the respondents, 97.8% have heard about breast cancer but only 52.3% had been screened while 65.5% had “Good knowledge” of breast cancer. Positive attitude to breast cancer screening was displayed in 52.5% while over 90% claimed to be practicing breast self-examination. Only 36.1% of respondents above 40 years old have had mammography done. Most frequent barriers to screening uptake include cost, poor accessibility to screening facilities, shyness (unfamiliar screener), unavailability of female doctors, careless attitude, fear of cancer and other more pressing family problems. Using logistic Regression at p ≤ 0.05, females with a negative attitude, young unmarried (less than 30years) and lack of easy accessibility to screening facilities were significant factors affecting uptake of breast cancer screening services. Conclusion Due to knowledge-uptake gap of breast cancer screening revealed in this study. It is therefore obvious from these findings that a concerted effort is needed to actively remove these barriers by repeated education, training and re-training strategies among health workers and to improve their uptake and level of advocacy and campaign for breast cancer screening among their patients and clients.
Jan 2021 DOI 10.14302/issn.2324-7339.jcrhap-20-3633
E.E Enwereji,Corresponding author
College of Medicine and Health Sciences, Abia State University, Uturu Abia State.
Introduction HIV prevention services to in-school adolescents need good planning and management. HIV risk reduction interventions are geared toward measuring sexual risk behaviour outcomes of adolescents that predispose them to HIV infection. The sexual behaviour of adolescents, especially in-school adolescents should be assessed in the process. Adolescents have been identified as the most vulnerable group for acquiring human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) and as such, measures should be taken to prevent them from infection. One important reason for higher HIV prevalence among adolescents, especially girls, is the frequent practice of age-discrepant partnering, where older men, who are more likely to be infected with HIV, form sexual partners with younger girls. The objective of this study is to assess the knowledge and sexual behaviour of in-school adolescents in the prevention of HIV and AIDs in rural areas of Abia State. Materials and Methods This is a descriptive cross-sectional survey that was conducted between January and March 2020. Information was collected from 66 students of a community secondary school in the state. Participants were selected by a multi-stage sampling method and data were obtained using a semi-structured pre-tested questionnaire. Results Respondents consisted of 40(60.6%) females and 26(39.4%) males with ages ranging from 13 to 19. Some of the respondents 28 (42.4%), are living with parents while 24(36.4%) live with close relatives. A good number of the respondents 39(59.1%), accepted that their friends are HIV positive. Majority of them 49(74.2%) have not been approached for sexual relationships. About 17(25.8%) of the respondents accepted that they have boyfriends and girlfriends. Out of this number, 12(18.2%) of them said they have been approached for sex and only 2(3%) of them accepted having sexual relationships with the opposite sex. Finding showed that only 1(1.5%) of the respondents claimed to have ever used condoms during sex. Of the sexually active respondents, 49(74.2%) of them are aware that HIV is a virus infection caused by having multiple sex partners while 14(21.2%) were not sure whether HIV is a virus or bacterial infection. Conclusion The study revealed a gap in the knowledge of HIV prevention as well as inappropriate sexual behaviour among the respondents. Therefore, meaningful strategies that will be culturally sensitive to modify adolescent sexual risk behaviours should be adopted.
Dec 2020 DOI 10.14302/issn.2578-2371.jslr-20-3362
V. Shirale VaishaliCorresponding author
Department of Surgery, ESIC Medical College, Faridabad, Haryana, India
Background and Aim Gallbladder (GB) cancer is a highly fatal malignancy and approx. 10% new cases are diagnosed every year in India. The GB cancer has poor prognosis due to progressive nature. Understanding of risk factors that lead to GB development is urgently required for better management of the disease. Presence of stones in gall bladder generates varied mucosal reactions, which leads to different types of histopathological changes in mucosa. Here, our aim is to study the correlation between various types of mucosal responses e. g. inflammation, hyperplasia, metaplasia and carcinoma with different characteristics e. g. number and morphology of gallstones both in males and females. Materials and Methods A retrospective study of gallstones was performed on 438 cases of cholecystectomies operated laparoscopically based on the histological changes. Out of 438 cases, 394 (89.95%) were associated with gallstones and the rest 44 (10.05%) belonged to acalculous cholecystitis. The mucosal changes in calculous gall bladder were studied in 394 cases and its correlation with number and types of observed gallstones were evaluated. Tissue sections were taken from the fundus, body, neck and abnormal area of gallbladder for histopathological studies. Results Our study has revealed the higher incidence of inflammatory changes in males, while gall bladder hyperplasia, intestinal metaplasia and cancer cases were found mostly in females. Conclusion Our study showed that changes in the number and morphology of gallstones are directly associated with the mucosal changes in gallbladder e.g. inflammation, hyperplasia, metaplasia and gall bladder carcinoma.
Dec 2020 DOI 10.14302/issn.2474-3585.jpmc-20-3672
M. Chaudhary SanjeevCorresponding author
Associate Professor, Department of Community Medicine, Government Medical College, Akola.
Background Prevalence of Metabolic syndrome is high among Asians including Indians, and is high among those having sedentary occupations. Teaching is one of the important occupations, which demands no strenuous physical activity. However, there is little information available about the prevalence of metabolic syndrome among teaching staff of engineering college. Hence, the present study was conducted to study its prevalence, certain risk factors and co-morbidities among teaching staff of engineering institutes. Methods Teachers from engineering colleges of Nagpur city were the study subjects. Data was collected by interview technique. Clinical examination and laboratory investigations like Fasting blood glucose, High Density Lipoproteins and Serum Triglycerides were done. National Cholesterol Evaluation Programme (NCEP) Adult Treatment Panel Three (ATPIII) criteria were used to study Metabolic syndrome. Blood pressure and anthropometric measurements like height, weight and waist circumference were obtained by standard methods. Results The prevalence of metabolic syndrome was found to be 20.5%. It was 25.32% in females and 19.31% in males. It was more common in subjects of higher age group, muslim religion, and among widows and separated. Alcohol consumption, smoking and sedentary life style was found to be significantly associated with presence of metabolic syndrome. Frozen shoulder, fungal infection and stroke were common co morbidities found among subjects having metabolic syndrome.
Dec 2020 DOI 10.14302/issn.2693-1176.ijgh-20-3613
Lawson HenryCorresponding author
Empathy has been described as a multi-dimensional construct with cognitive and emotional components, both of which are concerned about responsivity to others. It has been touted as a skill essential for medical practice and thus useful to all healthcare professionals. It has been assessed in several countries and among several healthcare cadres however, there is a yawning gap in Ghana about its level in medical students. This study utilised a cross-sectional design to assess empathy using the Multi-Dimensional Emotional Empathy Scale in medical students of the University in Ghana. The scale has an alpha reliability of 0.88. One hundred and eleven students, aged 24 years ±1.5 years completed the study. Overall, there were more males than females. The mean empathy score for the cohort was 101SD 13 and this was adjudged to be low. There was no statistical difference between age, gender and clinical year and empathy in this cohort. The authors recommend that empathy, especially its cognitive aspects, should be taught in medical school curriculum of the University of Ghana Medical School, Accra.
Nov 2020 DOI 10.14302/issn.2577-2279.ijha-20-3591
Pal BaidyanathCorresponding author
Biological Anthropology Unit, Indian Statistical Institute, Kolkata, India
Objectives Aim of the study was to develop a ‘composite body size score’ (CBSS) using anthropometric traits to estimate body size and to assess the nutritional status of each study individual on the basis of CBSS. Materials and Methods Data on seventeen anthropometric traits were collected from 710 individuals (Male, Female) from fishermen community inhabiting coastal villages of West Bengal, India. For estimating body sizes, Structural Equation Model (SEM) was constructed with Path Analysis (PA). Later, second order Confirmatory Factor Analysis (CFA) was applied on SEM to determine CBSS. It was hypothesized in the models that CBSS is composed with three sets of latent variables viz., linear, circular and skinfold, constructed from anthropometric traits. Applying new derived optimal cut off points of CBSS was used to determine lean, normal and robust body sizes. Individuals with negative values of CBSS were categorised as lean body size,. Positive values of CBSS were categorised into two categories- normal and robust body size. Results On the basis of CBSS, result showed that 50.6%, 48.8% and 0.6% of the individuals were categorised under lean, normal and robust body size respectively. Females showed relatively higher percent of lean body size i.e. under nutrition (73.8%) compared to males (26.2%). Conclusion The hypothesized model estimate more accurate composite body size score, based on anthropometric traits. All the traits are highly significant on the model. The lean body size category can be use in predicting ‘Undernutrition’.
Sep 2020 DOI 10.14302/issn.2693-1176.ijgh-20-3545
Ezinna E EnwerejiCorresponding author
Department of Public Health, College of Medicine, Abia State University, Uturu, Nigeria
Public health professionals working in rural communities are aware of the health disparities which result from lack of physicians, limited services, and income during the pandemic. Also they are aware that some populations are more vulnerable than others. People in the rural areas are experiencing problems on their physical, social and economic life styles because the pandemic is exacerbating some inequities. Individuals especially women and children in the rural areas are facing barriers in accessing health care services due to lack of resources and availability of health care providers in the communities. With COVID-19, women are less likely to seek services, including sexual and reproductive health services. Such services may be postponed to limit exposure to COVID-19 infection. This is particularly disturbing because in addition to the women maintaining their own health, they are also responsible for taking care of the mental, emotional and physical health needs of their families as well as all domestic responsibilities. As such, women in rural settings face special challenges as a result of these significant roles they play. Therefore, the impacts of COVID-19 are exacerbated on women by virtue of their sex and the roles they play in the family. This is a qualitative study that reviewed the reports of the 36 health care professionals under the aegis of members of COVID-19 committee working in partnership with state government to control, prevent and cushion the effects of COVID-19 in the society. This study is therefore, a summary of the observations of the COVID-19 committee members made up of 10(27.8%) females and 26(72.2%) males. The study focused on exploring how individual lifestyles in the rural areas have been affected in the face of COVID- 19 pandemic by identifying the vulnerabilities in social, political and economic systems which can amplify the impacts of the pandemic. Findings showed that preventive measures like lockdown and social distancing rules, wearing of face mask, hand washing with soap, and environmental cleanliness were not observed. The study noted that health seeking behaviours, sexual and marital life including income, education, employment and social interactions were all negatively affected. Most hospitals were battered and health care professionals boycotted the hospitals for fear of being infected. It was found that lack of health workers in the hospitals caused a good number of individuals to engage in self-medications. Also most pregnant women delivered their babies at home and few with traditional birth attendants. Some of the women who had deliveries at home experienced complications during and after delivery. Unfortunately, the report showed that governments’ financial supports to these women and their family members were insignificant as the government was more concerned with mitigating the spread of COVID-19 than assisting women to have safe deliveries. Therefore, the vulnerable groups especially women, children, and the elderly who experienced threats to their safety and wellbeing as a result of the services that were disrupted during the pandemic, should be assisted so as not to lose their lives to preventable diseases.
Jul 2020 DOI 10.14302/issn.2576-6694.jbbs-20-3466
John AkighirCorresponding author
Department of Biochemistry, College of Science, Federal University of Agriculture, Makurdi P.M.B. 2373 (970001) Nigeria
Background and Objective The use of medicinal plants in industrialized societies for extraction and development of many drugs and other chemotherapeutics and traditionally for herbal remedies has increased in recent times. Plant–based medicine is essential in health care services with about 80% global population relying on it because of its cheap source and availability. Jatropha tanjorensis is one such plant used by males and females of childbearing age for treatment of reproductive problems such as infertility. Literature on isolation and characterization of the secondary metabolites in this plant may not be common. Against this backdrop, this research work was carried out to isolate, characterize and determine the effects of J. tanjorensis on the gonadal hormones of male wistar rats. Materials and Methods The secondary metabolites were isolated, characterized, and identified using nuclear magnetic resonance. The experiment was conducted using 25 male wistar rats weighing between 180-200 g randomized into 5 groups, 3 controls and 2 treatment groups of 5 rats each. The treatment groups received 25 mg/kg body weight of phytol and lupeol orally by gastric lavage for 14 days. The animals were anaesthetized and blood samples collected for hormonal assay. Result The experimental data was analyzed using one-way analysis of variance (ANOVA) with Statistical Package for Social Sciences (SPSS) version 17.0, while the post hoc test assessed using Duncan Multiple Range Test at p ≥ 0.05. There was a significant decrease (p ˂ 0.05) in the levels of FSH, LH and TST in the treatment groups when compared to the control groups. The motility and sperm count decrease significantly (p ˂ 0.05) when treatment groups were compared to the control animals. The secondary metabolites, phytol and lupeol present in the leaf extract of Jatropha tanjorensis were responsible for the decrease in some of the gonadal hormones studied.
Mar 2020 DOI 10.14302/issn.2691-6622.ijar-20-3257
Nsangou Amidou KpoumieCorresponding author
Department of Animal Sciences, University of Dschang, Cameroon
In order to contribute to the improvement of aquaculture production, reproductive parameters of three populations of Oreochromis niloticus of Cameroon were studied between March and May 2019 at the research station of Foumban. At this effect, a total of 81 parents (27 males and 51 females with respective weight 124 ± 6g and 144 ± 5g) coming from three hydrogeographicals origins (Niger, Sanaga and IRAD Station) were randomly distributed in triplicate in nine concrete tanks of a m² each with a sex ratio of one male for two females (1♂/2♀). Throughout the test, six females carrying eggs in the oral cavity were collected in each population and 45 days after the start of the trial, all the offspring were collected and the adults sacrificed. At the end of experiment, the IRAD population presented highest significant values (p ≤ 0.05) regardless of the performances considered. The values of the gonado-somatic and the gonado-metric characteristics significantly lower (p ≤ 0.05) were obtained in Niger population (GSR = 0.04 ± 0.02, GSI = 0.05 ± 0.03 and GMR=0.19 ± 0.08;GMI= 0.24±0.07). Considering sex, males presented the lowest significant values (p ≤ 0.05) for all the characteristics studied (GSR = 0.04±0.01, GSI = 0.04±0.01 and GMR= 0.23±0.08;GMI= 0.29±0.09).
Mar 2020 DOI 10.14302/issn.2577-2279.ijha-20-3254
O. Stephen SakaCorresponding author
Department of Human Anatomy, College of Medicine and Health Sciences, Afe Babalola University Ado Ekiti
The aim of this physical anthropometric study is to determine sex by foot measurements. Dismembered human remains are frequently found in cases of mass disasters and criminal mutilation. It is therefore of interest to use foot dimensions for the determination of sex (gender) of an individual in order to assist in establishing personal identity. Another application of anthropometrical measurement is in ergonomics which is the design of working space and the development of industrialized products such as furnishing, cars, tools, shoe designing etc. 500 adult subjects(250 males, 250 females)aged 18-50 years without any foot disability within Ogbomosho North Local Government, Oyo State were randomly selected for the study. The males had an average foot length about 1cm greater than females and foot breadth in males was about 1cm greater as compared to females. Difference in foot length and foot breadth in males and females of the population was highly significant. With the statistical analysis, any foot with length lesser than 26cm and breadth lesser than 11cm can be suggested to be that of a female while any foot with length greater than 26cm and breadth greater than 11cm can be suggested to be that of a male. Therefore, 26cm can be taken as the cut-off point for foot length and 11cm as the cut-off point for foot breadth in this locality.
Feb 2020 DOI 10.14302/issn.2768-0207.jbr-20-3194
Mohammed AL-Namnam NisreenCorresponding author
Departmet of Oral Biology and Biomedical sciences, Faculty of Dentistry, MAHSA University, 42610 Bandar Saujana Putra, Malaysia
Rhinosinusitis is one of widely spread diseases in the region and the role of the anatomical variations in its pathogenesis remains unresolved. A retrospective study using CBCT scan was employed to locate and measure the diameter of 320 primary maxillary ostium (PMO) (n = 160 subjects) among the Malay and Chinese populations (Mongoloid race) in Malaysia. Image analysis was performed using the i-CAT Vision Software, employing the multiplanar reconstruction window in which axial, coronal and sagittal planes were visualized in 0.3 mm intervals. The mean diameter of the PMO was significantly larger in the Chinese than the Malay. Females had larger size than the male and bilateral asymmetry was noticed, where the right side PMO was larger than the left side (p < 0.05). In addition, PMO opened more in the posterior third position of the hiatus semilunaris (61.9%) than anterior and middle third. The PMO showed a statistically significant posteriorly placed position in the Chinese than the Malays and this was more evident in the right side PMO (p < 0.01). In conclusion, the PMO commonly opens in the posterior third of the hiatus semilunaris and its diameter is significantly greater in the Chinese female with evidence of bilateral asymmetry. Awareness the anatomical variation of the Ostium diameter and location among the Malay and Chinese populations potentially has important clinical effects during surgical procedures.
Jan 2020 DOI 10.14302/issn.2690-4837.ijip-19-3145
Bajaj AnubhaCorresponding author
MD. (Pathology) Panjab University, Department of Histopathology, A.B. Diagnostics, A-1, Ring Road, Rajouri Garden, New Delhi, 110027, India.
Idiopathic granulomatous mastitis was initially scripted in 1972 by Kessler and Wolloch and is cogitated as an infrequent, benign, chronic inflammatory disorder. It commonly implicates females of reproductive age group, especially women who have breast fed in the preceding five to six years. Idiopathic granulomatous mastitis is commonly discerned in Asia and Mediterranean region although true incidence is undetermined. Diverse ethnicities delineate a diverse disease prevalence. Elimination of adjunctive causes of granulomatous inflammation makes idiopathic granulomatous mastitis a diagnosis of exclusion. As per the natural history, idiopathic granulomatous mastitis is designated as a self limiting disorder 1.
Jan 2020 DOI 10.14302/issn.2474-3585.jpmc-19-3146
K. Sharma SaritaCorresponding author
Associate Professor, Department of Community Medicine, Government Medical College Nagpur
Background Emotionally intelligent doctors are better able to perceive the need of the patient. In today’s world, where patient satisfaction is one of the most important criteria for a successful medical practice, emotional intelligence of doctors plays a vital role. Objectives To study emotional intelligence of post graduate medical students. Methods It is a cross-sectional study conducted in Government Medical College and Hospital, Nagpur during January- February 2019. The study participants were one hundred first - year post graduate students. Data collection was done using quick emotional intelligence self administered questionnaire. Data was entered in Microsoft office excels and analyzed with the help of epi info. Results In the present study total 100 post graduate students were assessed of which 56% were male. Emotional awareness and emotional management was better in male post graduate students in comparison with the females and the difference was found to be statistically significantly. The scores of the other two domains were almost equal in both. More than half of the study participants had a satisfactory EI score i.e. 25-34. Conclusion Male post graduate students had better EI. Most of the study participants had a satisfactory EI score.
Oct 2019 DOI 10.14302/issn.2689-5773.jcdp-19-3044
Bajaj AnubhaCorresponding author
MD. (Pathology) Panjab University, Department of Histopathology, A.B. Diagnostics, A-1, Ring Road , Rajouri Garden, New Delhi, 110027, India.
Cutaneous ciliated cyst is cogitated as a benign, exceptional lesion and can be additionally termed as cutaneous Mullerian cyst or a cystadenoma. Cutaneous ciliated cyst was initially described by Da Hess in 1890 and further elucidated in 1978 by Farmer and Helwig as a cyst predominantly occurring in young females within the second and third decades of life 12. Cutaneous ciliated cyst is a lesion of post- pubertal females, can appear in the reproductive phase and frequently enlarges during menstruation or pregnancy due to hormonal effects. Cutaneous ciliated cyst is commonly situated within deep-seated dermal or subcutaneous tissue of the upper extremities and perianal region. Cutaneous ciliated cyst delineates as Mullerian derivation in females and a distinct, foetal eccrine duct origin in males 12.
Sep 2019 DOI 10.14302/issn.2574-450X.jom-19-3000
Hayat Khan SikandarCorresponding author
Department of pathology PNS HAFEEZ
Background Polycystic ovarian syndrome (PCOS) is increasingly being diagnosed and treated with sometimes variable lifestyle advice and pharmacological interventions. Obesity is considered as the sole culprit and variable definitions in clinics compound the understanding of pathogenic heterogeneity of this syndrome. We evaluated the differences between various simple to calculate anthropometric indices along with some anthropometric-biochemical equations in subjects with or without PCOS. Objective To compare traditional measures like waist to hip and height ratio (WHpR and WHtR), BMI, newer markers depicting central obesity like Abdominal Volume index(AVI), Body roundness index (BRI), A Body Shape index (ABSI), Conicity index (C-index) along with biochemical-anthropometric equations like lipid Accumulation Products (LAP), Visceral Adiposity Index (VAI) and Chinese Visceral Adiposity Index (CVAI) for diagnosing PCOS as per the Rotterdam criteria Design Cross-sectional analysis Place & Study Duration Naval hospital, Islamabad from Jan- 2018 to July- 2019 Subjects and Methods From our finally evaluated 333 female subjects we initially compared the differences for the presence of hirsutism as per modified Ferrimen Gallwey scores and biochemical hyperandrogenism by measuring free androgen index (Total testosterone/SHBG x 1000. We evaluated waist circumference, BMI, WHpR, WHtR,AVI, BRI, ABSI, C-index along with biochemical-anthropometric equations like LAP, VAI and CVAI for differences in subjects diagnosed to have PCOS by Rotterdam criteria or ultrasonography alone. Results Differences in hirsutism as defined by modified FG score between subjects defined to have PCOS or otherwise as per Rotterdam defined criteria were as [(PCOS=169, Mean=17.33 + 9.05) (No PCOS=164, Mean=8.21 + 5.74), p< 0.001] and ultrasound [(PCOS=87, Mean=16.95 + 9.57) (No PCOS=246, Mean=11.38 + 8.51), p< 0.001]. Similarly, the differences in FAI between subjects defined to have PCOS or otherwise as per Rotterdam criteria and ultrasound were as [(PCOS=169, Mean=6.41 + 4.88) (No PCOS=164, Mean=2.77 + 1.79), p< 0.001] and [(PCOS=87, Mean=5.75 + 5.01) (No PCOS=246, Mean=4.22 + 3.68), p= 0.011]. Anthropometric measures and anthropometric-mathematical equations were raised in non-PCOS subjects than PCOS subjects. Lean-PCOS demonstrated lower degree of hirsutism and biochemical hyperandrogenism in comparison to obese-PCOS. Conclusion Hirsutism and free androgen indices were raised in PCOS females. Anthropometric based measurements were not different in PCOS cases and non-PCOS females. Lean-PCOS demonstrated lower degree of hirsutism and biochemical hyperandrogenism in comparison to obese-PCOS.
Aug 2019 DOI 10.14302/issn.2574-450X.jom-19-2987
Aljabri K.S.Corresponding author
Department of Endocrinology, King Fahad Armed Forces Hospital, Jeddah, Kingdom of Saudi Arabia
Introduction It has been demonstrated that vitamin D deficiency is associated with type 2 diabetes mellitus (T2DM). We conducted a cross sectional study to investigate the prevalence severe vitamin D deficiency in patients with T2DM. Method A cross-sectional single centre study was conducted in 4053 patients with T2DM. Patients with T2DM attended the Diabetes Centre at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia between January 2018 and December 2018 were recruited. Results There were 4053 patients with T2DM, 1145 male and 2908 female (28 % vs.72% respectively). The mean age was 53.9 ±16.5 years. The mean and median 25-OHD concentrations were 57.8±30.5 and 51.9 respectively. Severe vitamin D deficiency (25-OHD<25 nmol/l) was found in 1916 (9.5%). Moreover, severe vitamin D deficiency was not statistically significant more prevalent among females than males with male to female ratio 1:2.3 (70% vs. 30% respectively, p=0.6). In addition, severe vitamin D deficient patients were statistically significant younger than non-vitamin D deficient (48.0±16.7 vs. 54.6±16.3 respectively, p<0.0001). Severe vitamin D deficient patients have statistically significant higher HbA1c than non-vitamin D deficient (8.3 ±2.3 vs. 7.6±1.9 respectively, p<0.0001). The mean 25-OHD was upward as age advanced with highest frequency of vitamin D deficiency was found in the age group ≥60 years (27%) with males statistically significant most frequent than females in the age group ≥60 years (39 s, 22 respectively, p=0.003). Regression analysis of odd ratio of risk factors for patients with severe vitamin D deficiency showed that age and HbA1c were statistically significant associated with vitamin D deficiency. Conclusions The prevalence of severe vitamin D deficiency in patients with T2DM is low and that more females with T2DM are affected with vitamin D deficiency than males.
Jul 2019 DOI 10.14302/issn.2470-0436.jos-19-2904
Y. Tiu RonaldCorresponding author
Department of Ophthalmology, Rizal Medical Center, Pasig City, Philippines
This case series presents 2 patients (67 and 58 year old females) with resolving vitreous hemorrhage in the setting of diabetic retinopathy. Both patients had around 50% of the retina still visible and the hemorrhage was confined at the posterior vitreous cavity near the retina, hence, a partial pan retinal photocoagulation (PRP) was feasibly applied. On B-scan, both cases showed a liquified vitreous with posterior vitreous detachment (PVD). For both patients, vitreous hemorrhage resolution occurred at less than 4 months from onset and consequently PRP was completed. Vitreous hemorrhage differs with bleeding in other tissues due to the presence of vitreous collagen matrix which promotes rapid clotting and hinders resolution of hemorrhage by preventing passive diffusion and delay in inflammatory cellular response. The prognosis for clearing hemorrhage was better when the fundus reflex was brighter and the retina adjacent to the ora serrata was visible. Clearing occurred sooner when hemorrhage was retrohyaloid rather than in the vitreous gel. In diabetic eye, the vitreous undergoes metabolic derangements resulting in premature liquefaction and abnormal vitreoretinal adhesion leading to traction and membrane formation. Partial PVD has also been associated with higher rate of diabetic retinopathy progression since it serves as scaffold for growth of neovascular tufts.
Jul 2019 DOI 10.14302/issn.2997-2108.jcc-19-2889
Adetona A.ECorresponding author
College of Medicine, University of Ibadan / University College Hospital, Ibadan. Nigeria
Background This study aim to assess the factors affecting uptake of cervical cancer screening programmes among female staff of the University College Hospital (UCH), Ibadan in 2014. Method A descriptive cross-sectional study involving 375 participants selected using a stratified random sampling technique with proportional allocation to population size and interviewed using a pre-tested self-administered semi-structured questionnaire. Information on their basic knowledge on cervical cancer were scored to determine good knowledge. Patients’ attitudes toward cervical cancer screening as well as factors affecting uptake were also assessed. Data analysis was done in 2014 using descriptive statistics while screening uptake predictors were determined using logistic regression at p ≤0.05. Results Completed questionnaires were returned by 360 respondents; 13.3% were clinical while 86.7% were non-clinical staff of age range 20 to 58 years (38.2±0.42 years). Majority of the respondents, (95.5%), had heard about cervical cancer with 61.9% having “good knowledge”, but only few (34.2%) had been screened. Averagely, 47.5% displayed positive attitude to cervical cancer screening with Pap smear being the most reported screening procedure. The common barriers to screening uptaking include indecision, inadequate information and feeling of good health. Others were staff hostility, lack of privacy, and cost. Using logistic Regression at p ≤0.05, females with negative attitude and those with children were less likely to uptake cervical cancer screening services. Conclusion The knowledge-uptake gaps of cervical cancer screenings were high as revealed in this study. Therefore, there is a need to further educate eligible women on uptake of cervical cancer screening.
Jul 2019 DOI 10.14302/issn.2641-4538.jphi-19-2860
Takele Melku AbulieCorresponding author
Madda Walabu University Goba Referral Hospital School of Health Science Department of Nursing, Assistant Professor (PhD) Mobile: +251911060837
Background Adolescents is the transition from childhood to adulthood .Which is a time of opportunity, but also one of risk. In Ethiopia, sexual and reproductive health problems of adolescents are increasing from time to time related to many parents not feeling happy to discuss sexual matters in addition to early sexual commencement among adolescents. Objective This study was intended to assess parent-adolescent communication on sexual and reproductive health matters and associated factors among secondary and preparatory school students in Robe Town, Bale Zone, South East Ethiopia, 2017. Methods Institution based cross sectional study was conducted among 394 secondary and preparatory school students in Robe town from April 10-25, 2017. Simple random sampling technique was used. Data was obtained through the use of a self administered questionnaire and supplemented by focus group discussion with parents. Data was entered using Epi Data 3.1 and analyzed by SPSS 20. Descriptive statistics and logistic regression analyses were done. Data quality was assured through careful questionnaire design, pretest and training. Results One hundred eighty six (47%) of the study participants had discussed at least two SRH issues with their parents. Grade eleven students were about nearly five times more likely discussed on sexual and reproductive matters with their parent compared with grade nine students (AOR: 4.88, 95% CI: 1.76, 13.54). Those living with relatives were 3.13 times less likely discussed as compared to those students are living with both parents (AOR: 0.32, 95%CI: (0.12, 0.80) and the odds of discussion on SRH matters is 2 times higher among females compared with their counterpart (AOR=2.02, 95% CI: 1.25, 3.26). Conclusions Communication on sexual and reproductive health matters between adolescent and parent was low. Majority of student preferred to discuss with their peers than parent. Being ashamed, parents lack of communication skill and parent knowledge on SRH issues were the major reasons mentioned by the students for not discussing about SRH matters with their parents. Therefore; comprehensive family life education needs to be initiated for the students and parents. Sexual information exchange between peers needs to be strengthened.
Jun 2019 DOI 10.14302/issn.2474-3585.jpmc-19-2750
Konadu-Yeboah DominicCorresponding author
Orthopaedic and Trauma Surgeon, Komfo Anokye Teaching Hospital, Kumasi, Ghana, Part-Time Lecturer, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Purpose Foot injuries are common in low- and middle-income countries and continue to increase in incidence due to the surge in the use of motorcycles as means of transport.Yet, there is scanty data on the incidence and outcomes of treatment of open injuries to the foot in the developing world.We aimed to determine the incidence and functional outcomes of open foot injuries that are treated in a teaching hospital in Ghana. Methods We used a structured questionnaire to record the type of open foot injury, the mechanism of injury, any concomitant injuries, the time interval between injury and arrival at the hospital for treatment as well as the type of treatment instituted. Recruited patients were followed up for six months, complications resulting from the injury or its treatment were recorded for each patient. The function of the foot after healing of the injury was measured using a questionnaire-based visual analogue outcome scale of the American Foot and Ankle Society. Regression and chi-square analysis were used to evaluate potential associations. Results Over a four-month period, a total of 81 cases of open injuries to the foot were recorded. Out of this figure, 55 patients (67.9%) were males and 26 (32.1%) were females. It was found, that 66.7% aged between 19 and 49 years, 76.5% of the injuries occurred on the road and 29.7% was motor cycle related. Pedestrians are the most afflicted (61.7%). The treatment outcomes of traumatic amputations, open phalangeal fractures, dorsal skin degloving and lacerations were good. Gustillo-Anderson grade IIIB open fractures with associated plantar skin degloving had the worst outcomes with residual pain on weight bearing, bigger foot, inability to wear previous shoes and inability to tiptoe on the affected foot. Conclusions Open injuries to the foot are common in Ghana and exert a significant health burden, particularly on active young males. Long term disability may occur, even after adequate treatment of open fractures involving the foot.
Apr 2019 DOI 10.14302/issn.2379-7835.ijn-19-2579
Ghayour-Mobarhan MajidCorresponding author
Metabolic Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Objective Postmenopausal women are at an increased risk of Cardiovascular Disease. We aimed to investigate whether this risk differed between individuals with a naturally occurring and other reasons for menopause within a large population-based Iranian sample. Study Design A total number of 1763 postmenopausal women (defined by amenorrhea for more than a year, or FSH > 30-40 mIU/ml), 900 of them with a natural menopause and 863 of them with other reasons for menopause caused by (hysterectomy without oophorectomy or one side oophorectomy, hysterectomy with oophorectomy or two side oophorectomy without hysterectomy) were recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study. Biochemical and hematological risk factors were measured in all the subjects and the data were analyzed by SPSS software version 20 Results There was a significant difference in the presence of cardiovascular disease in the natural menopause group compared with other reasons for menopause group (p<0.05). There was also a meaningful difference between the prevalence of depression and anxiety in the natural menopause individuals compared with other reasons for menopause group (p<0.05). Discussion High prevalence of CVD, depression and anxiety in other reasons in menopause women were observed among Mashhad urban females. It should be considered as a noticeable message. Furthermore, studies are necessary to determine different parameters between evaluating CVD, depression and anxiety among menopauses women.
Apr 2019 DOI 10.14302/issn.2379-7835.ijn-19-904
Coppinger TaraCorresponding author
Cork Institute of Technology, Ireland
Background To date, no research has explicitly examined children’s knowledge and consumption of fluids at school, particularly during times of exercise (physical education (PE)). Methods Between May and July, 2018, 322 (213 females, 104 males; mean age = 8 years 5 months, SD ± 2 years 1 month) elementary school children from Ireland (n=237) and England (n=85) completed a questionnaire on their understanding of fluid intake and how much they perceived they drank on days when they did/did not participate in PE. Results Younger (<9 years) English children were most thirsty at the end of the school (68%), compared to younger and older (≥9 years) Irish children who were most thirsty after (38% <9 years; 39% ≥9 years) or during (21% < 9 years; 21% ≥9 years) PE. In both countries for <9 year olds, similar amounts were consumed on days when they did, and did not, partake in PE with 41% of all participants reporting intakes below daily guidelines. No child, of any age, was correct at predicting what their fluid intake should be on days when they took part in PE. Conclusion Young children in England and Ireland do not understand fluid recommendations, especially the increased need for fluid on days when they partake in PE. Further objective research is needed to ascertain whether actual fluid intake in children matches perceived intakes and whether the structure of the school day, and intensity levels of PE lessons, influence these intakes. Additional research needs to gauge the importance of the teacher and how they are a key influencer in supporting children in their learning of how, why and when to drink.
Mar 2019
Paula Sassoli Fazan ValeriaCorresponding author
Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Av. Bandeirantes 3900, Ribeirao Preto-SP, Brazil
We used a behavioral test to investigate long-term consequences of neonatal noxious stimulus in the anxiety-like behavior and describe differences between males and females. Male and female Wistar rats were submitted to either tactile (control groups) or noxious stimulus (pain groups) since birth, for 15 days and were followed up to 6 months of life. Experiments were performed on days 15, 30, 90 and 180 after birth. Rats of different groups, ages and genders were exposed only once to the elevated plus-maze (EPM), an apparatus largely used to detect anxiety-related behaviors in rats. For the open arms of the EPM, control animals showed an increase in the number of entries from 15 to 30 days of age followed by a decrease of this number at older ages. The comparison between treatments (control and pain) showed, for males, a reduced number of entries in the open arms in the pain group at 15 and 30 days and the opposite situation at 180 days. No differences were found between pain and control groups in females. Our results are in agreement with the literature that shows sex-dependent changes following chronic stress; stress being anxiolytic in males and anxiogenic in females. We point to the fact that acute painful stimulus in the neonatal period caused persistent changes in anxiety-like behavior in the adult life, independently of previously described intrinsic gender differences on memory, task performance, attention bias or other behaviors.
Feb 2019 DOI 10.14302/issn.2639-3166.jar-18-2576
Haroun Mohamed Adam AbubakerCorresponding author
Cotton mealybug (Phenacoccussolenopsis) is a serious devastating pest which goes on a wide array of plant families. The pest spread all over the world from cool to dry hot regions. The main objective of this study was to investigate the food preference and behavior of P. solenopsis Tinseley (Hemiptera:Pseudococcidae) towards selected host plants in Khartoum State, Sudan, where a multi-choice experiment under laboratory conditions was adopted. Eight plant species were screened for attractiveness and food preference to Cotton mealybug. Where the proportions of the 1st, 2nd and 3rd nymphal instars and the adult females were recorded at 2, 8 and 24 hours after release, and compared with Chinese rose (Rosa chinensis) the control. The result revealed that the proportions of the 1st, 2nd and 3rd nymphal instars and adult females were maximum on plants of family Malvaceae, particularly the Okra (Hibiscus esculentus) followed by Cotton (Gossypium sp.) and Hambouk (Abutilon pannosum) as compared with the control. However, in contrast, the proportions were very low on unpalatable plants like Zaleya (Locally known as Raba) (Zaleyapentandra) and Eggplant (Solanum melongenaL.). However, in contrast, the proportions were very low on unpalatable plants like Zaleya (Locally known as Raba) (Zaleya pentandra) and Eggplant (SolanummelongenaL.). In conclusion, the most favorable host plants of the Cotton mealybug belonging to the family Malvaceae, while the families of Solanaceae [Egg plant (SolanummelongenaL.)] and Aizoaceae (Raba) were found to be the least preferred host plants.
Dec 2018 DOI 10.14302/issn.2694-2275.jzr-18-2474
Emile MiégouéCorresponding author
Guinea pig diet is essentially based on the use of grasses associated with protein sources. Then, in to improve the herbivores nutrition, the evaluation of intake and In vivo digestibility of Pennisetum purpureum or Panicum maximum in guinea pigs (Cavia porcellus) was carried out in January 2017 at the University of Dschang research and experimental farm and animal production and nutrition laboratory. 20 adult animals of local breed on average weight 450 ± 50g and aged about 5 months were used. They were organized into two batches of 10 animals each (5 males and 5 females). The first batch received 250g of fresh matter of Pennisetum purpureum + 60g concentrate/animal/day, while the second received the same treatment with Panicum maximum as grasses. Leftover and animals were weighed every morning before food distributions, and drinking water containing vitamin C was served ad libitum. According to the results, the highest ingestion was obtained with Panicum maximum. However, the digestibility different nutrients was comparable between treatments; nevertheless, males fed on P. maximum digested crude cellulose (63.78%) better than males fed on P. purpureum (51.17%). With regard to the variation of the bacterial rate of the caecal flora, enterobacteria of animals fed P. maximum was high (11.20 CFU/ml) compared to those of the animals receiving P. purpureum (7.27 CFU/ml), although regardless of the treatment, the level of lactobacilli was higher than that of enterobacteria. In view of the results obtained, these grasses can be alternatively used in feeding guinea pigs.
Dec 2018 DOI 10.14302/issn.2641-4538.jphi-18-2464
Källestal CarinaCorresponding author
International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, SE 75185, Sweden.
Background Nicaragua has the highest prevalence of teenage pregnancies in Latin America. Knowledge regarding sexual and reproductive health plays an integral part in sexual behavior. The objective was to assess school going adolescents' knowledge about sexual and reproductive health and possible factors affecting it in the semi-rural community of Tololar, Nicaragua. Methods A cross-sectional study with a self-administered questionnaire on tablets was used for data collection. All 253 registered students at the school present at the time of fieldwork who gave written informed consent were deemed eligible for the study. A total of 225 participants in the ages of 11-19 years were included. Simple linear regression and multiple linear regression were performed analyzing the outcome knowledge. A p-value <0.05 was considered significant. Results The general knowledge about sexual and reproductive health was moderate; however, knowledge gaps were found such as prevailing myths and poor knowledge regarding human immunodeficiency virus (hiv) transmission and contraceptive methods. Being female and single were significant negative determinants of knowledge (p-value < 0.01) and knowledge increased significantly with age (p-value < 0.05). School teachers, websites, social networks, and TV were the most frequently chosen sources of information on the topic. Conclusions Increased education on sexual and reproductive health with new interventions particularly for young females is recommended. Using IT-based materials as a complement may be an effective way to reach out to adolescents.
Dec 2018 DOI 10.14302/issn.2574-4526.jddd-18-2521
Yagubovich Abdullaiev RizvanCorresponding author
Kharkov Medical Academy of Postgraduate Education, Kharkov, Ukraine
Introduction: Ultrasound study of locally advanced gastric cancer that has spread to adjoining tissue and lymph nodes. This tumor can be associated with T2 to T4 stages of cancer. A “Locally advanced gastric cancer” is a tumor, which may be categorized as ‘resectable’ cancer when compared with M1 advanced cancer. Objective: The aim of this study was to evaluate the Capabilities of transabdominal ultrasonography in assessment of structures and functional disorders of the locally advanced gastric cancer of diverse localization Materials and Methods: A total of61 patients with locally advanced gastric cancer were analyzed of which 36 (59,0%) were males (mean age 62.7 years) and 25 (41,0%) were females (mean age 59.3 years). All patients were managed surgically and underwent preoperative X-ray, virtual gastroscopy techniques, multidetector computed tomography and transabdominal ultrasonography (USG). Histopathology results found, in 58 (95,1%) cases adenocarcinoma, in 3 (4,9%) – ring-cell carcinoma (cricoidal) gastric cancer was established. Stage T2 was diagnosed in 16 (26.2%) cases, T3 - in 41 (67.2%) cases, T4 - in 4 (6.6%) cases. The stomach tumor in 29 (47.5%) cases was localized mainly in the antrum, 27 (44.3%) – in the body, 5 (8.2%) in the cardia and fundus (Table 1). In 24 (39,3%) cases, pyloric stenos was diagnosed - of which in 6 (9,8%) it was compensated, in 18 (29,5%) - sub compensated. All patients underwent preoperative X-ray, virtual gastroscopy techniques, multidetector computed tomography and transabdominal ultrasonography (USG). Normal ultrasound features were observed in 35 patients without gastric pathology. Ultrasonography was carried out with the convex and micro convex transducers in the frequency range of 2-5 MHz and 4-7 MHz respectively in B and color Doppler modes. Results: The polypoid type of gastric cancer was detected in 3 (4,9±2,8%) cases, the ulcerative type – in 18 (29,5±5,8%), the infiltrative ulcerative type – in 27 (44,3±6,4%) and the diffuse infiltrative type – in 13 (21,3%±5,2%) cases respectively. In 24 (39,3%) cases, pyloric stenos was diagnosed - of which in 6 (9,8%) it was compensated, in 18 (29,5%) – sub compensated. The layers of the gastric wall were not differentiated in all patients with sub compensated pyloric stenos. The gastric wall thickness of the affected area was 10,2±2,9mm in the case compensated pyloric stenosis, the length was 27,1±6,2mm, the diameter of the pylorus was 8,3±0,8mm. Among patients with sub compensated pyloric stenos, the thickness of the gastric wall was 19,8±4,1mm, the length was 43,6±4,5mm, the pyloric diameter was 4,3±1,1mm. Among the 61 patients studied, pathological vascularization was detected in 42 (68.8%) cases. It was observed that, all 4 (6.5%) patients with gastric cancer were stage T4 and 38 (62.3%) were stage T3. Vascularization was weak in 13 cases, in 24 cases - moderate, and in 5 cases - enhanced. Metastases to the regional lymph nodes were diagnosed in 52 cases. Ultrasonographically, they were detected only in 37 (71.2%) cases. Conclusions: In the diagnosis of locally advanced gastric cancer, ultrasonography demonstrates good capabilities for determining the extent and depth of the affected area. Color doppler mode allows the study of vascularisation of a locally thickened area, as well as nearby enlarged lymph nodes, which is very important to ascertain the degree of malignancy of the hyperplastic process. ltrasonography can independently determine the degree of pyloric stenosis in patients with distal gastric cancer.
Oct 2018 DOI 10.14302/issn.2768-5209.ijen-18-2412
Mohamed Ghamin NabilCorresponding author
Plant Protection Research Institute, Agricultural Research Center, Dokki, Giza, Egypt.
The peach fruit fly, Bactrocerazonata (Saunders) is a serious pest attacking a wide range of fruits. Field experiments were carried out, at Mansoura district, Dakahlia Governorate, Egypt to evaluate the efficiency of di- ammonium phosphate, ammonium carbonate and ammonium acetate in enhancing GF-120, as insecticidal bait, for B. zonata based on their pH level under high and low population levels of B. zonata. Results showed that di-ammonium phosphate enhanced the attractiveness of GF-120 the most, followed by ammonium carbonate and ammonium acetate. Without adding any of the ammonium compounds to the GF-120 bait, the bait attracted the fewest B. zonata flies regardless of population levels. As the concentrations of ammonium compounds increased, the pH-level increased as well in the prepared GF-120 solutions, resulting in increased numbers of B. zonata flies captured. In contrast to males, females of B. zonata were more responsive to increase concentrations of the three ammonium compounds tested. Accordingly, all treatments attracted females more than males. The sex ratio (as number of attracted females per one male) was generally higher under low than high fly population levels.
Sep 2018 DOI 10.14302/issn.2328-0182.japst-18-2281
Ali Arain AshiqueCorresponding author
Assistant Professor of Pharmacology.
The role that Vitamin D plays in human health is no more hidden in this modern age where every individual carries the knowledge treasure in the pocket (The internet) but the unjustified deficiency or insufficiency is still a research question waiting for the answer from research community all over the world. Normal levels (30-50 ng/ml) are necessary for the development of teeth and bones in children and bone mineralization in adults. The deficiency or insufficiency causes rickets, arthralgia, arthritis, osteoporosis and Osteomalacia. Study Design: Observational study. Study Setting: Department of Orthopedic LUMHS Jamshoro. Study Duration: from April 2017 to Oct 2017. Sampling: 600 patients were selected through Consecutive sampling. Statistical Analysis: Descriptive statistics like mean, Standard deviation, minimum, and maximum were calculated Using SPSS version 22.Mean of two genders was compared using t-test setting <0.05 as level of significance. Results: Mean serum vitamin –D level was 16.11+10.07ng/ml in men while it was 16.63+11.73 ng/ml in women. 62% of the study population was found deficient (<20ng/ml) while 16.33% were having insufficient levels (<30ng/ml) and only 12% showed normal levels (30-50ng/ml). There was no significant difference between the two genders, p value 0.59 Conclusion: Vitamin –D deficiency is very common in both genders with no significant difference between males and females.
Aug 2018 DOI 10.14302/issn.2577-2279.ijha-18-2221
Ahmed Abdelrahman NuggedAlla MotazCorresponding author
Faculty of Medicine and Health Sciences, Head of Department of Anatomy, University of Kassala.
Background: Faculty of Medicine and Health sciences at University of Kassala, Sudan was established 1990. It adopts the traditional curricula, which implemented in preclinical (basic sciences) and clinical phases. This study was held to explore students' perception and attitudes towards the basic sciences. Methods: A descriptive cross-sectional study was conducted during April- August 2017 among 251 medical students. Self-administered questionnaire was used to collect data. It was collected and analyzed using SPSS 16.0. Results: A total of 251 of participants in different phases of education in faculty of medicine and health sciences were included in the study; preclinical 116 (46.2%), 113 clinical (45.0%), and 22 (8.8%) were in internship. 95 (37.8 %) were males and 156 (62.2%) were females. The study revealed that physiology was the most preferable subject. Students' satisfaction to syllabus for anatomy, physiology and biochemistry was 61.4%, 43%, and 28.7% respectively. However, 46.6% of students spent a long time to understand biochemistry and 33.1% considered it as overloaded syllabus. Participants showed poor ability to link between theoretical and practical work in case of biochemistry (26.7%), where as anatomy and physiology were represented by 76.9% and 42.2% respectively. Less than half of students were able to integrate the subjects of basic sciences and basic with clinical sciences. Conclusion: In this study, the students determined the difficulties of recalling of information, poor integration between basic and clinical sciences and even integration within the subject. Development of integrated curriculum is necessary to improve the quality of education.
Aug 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2202
AA OkechukwuCorresponding author
Department of Pediatrics, University of Abuja Teaching Hospital, Gwagwalada.
Background: Ideally, disclosure of HIV status to infected children and adolescents should involve both health care workers and parents/caregivers. Most studies on disclosure in children have focus mainly on parents/caregivers with little information on health care workers. We conduct this study to evaluate the practice, perception of the healthcare workers in our health facility on disclosure to infected children and adolescents. It is envisaged that such information will help in the design of better strategies on disclosure in our environment. Methods: A cross sectional hospital based study was conducted among health care workers at the special treatment clinic, and heart to heart unit of the University of Abuja Teaching Hospital, Gwagwalada from January to March 2017 for the above objective. A structured questionnaire was used to collect information on disclosure among the healthcare workers, which include among others: their bio-data, knowledge, perception, and practice on disclosure in the two service areas of the hospital. Results: Of the 80 health care workers interviewed, 60(75.0%) were females, 11(13.8%) were doctors, 9(11.3%) nurses, 17(21.3%) monitoring/evaluation/record clerks, and 16(20.0%) were either voluntary counseling and testing counselors or adherence counselors. Their mean age and duration in service in the two areas were 39.70±7.10 and 7.93±4.99 years respectively. Over half 48(60.0%) of the health care workers were unaware of the hospital having guideline on disclosure, 64(80.0%) have not been trained, and 68(85.0%) does not know any key information on disclosure. While all 80(100%) felt that disclosure was a good practice for better adherence, only 16(20.0%) had actually disclosed, with 6(37.5%) not seeking any formal permission from parent/caregivers before disclosing. Ages 8-16 years was recommended by 60(75%) as the appropriate age to disclose, however 28(35.0%) recommended age 14-16 years. Over half of the respondents 58(72.5%) admitted that disclosure should be a shared responsibility between themselves and the caregivers, most however perceive their role as only preparing the parents/caregivers for disclosure, and providing ongoing counseling to both the parents/caregivers and the children and adolescents. Lack of training on disclosure, and none availability of guideline in the health institution were major setback on the ability of the healthcare providers to fully participate in disclosure process. Conclusion: While healthcare providers support the idea of disclosing at mid and late adolescent, their perceived role was that of support and provision of ongoing counseling. Lack of training and none availability of disclosure guideline affects their perceived role. There is need to train and retrain healthcare workers on disclosure guideline, and making such guideline available in the health facilities.
Aug 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2263
FA MagajiCorresponding author
Jos University Teaching Hospital, Jos, Nigeria.
Nigeria is one of the high-burden countries in sub-Saharan Africa for HIV/AIDS and contributes to reproductive health morbidities and mortalities. This study was aimed at determining the prevalence of HIV-discordant rate among pregnant women in Plateau state Nigeria. The study sought to determine the prevalence and trend of HIV sero-discordance among pregnant women in Plateau state, Nigeria. The study was a 5-year descriptive analysis of HIV sero-discordance among pregnant women accessing prenatal care and their partners in Plateau state, Nigeria based on data generated between January 2012 and December 2016. The data was disaggregated by year, HIV concordant negative, HIV concordant positive, and HIV sero-discordant prevalence in the software and analysis were done using excel to obtained the proportions and trend of HIV sero-discordant prevalence among the antenatal population. Out of a total of 7,851 partners of pregnant women studied, 969 (16.3%) were HIV sero-discordant, 5,795 (73.8%) were HIV concordant negative, and 773 (9.9%) were HIV concordant positive. HIV sero-discordant positive males accounted for 12.3% while females were 4.0%. The prevalence of HIV sero-discordance was low with a high proportion of HIV positive male partners in Plateau state with grave public health implications for new HIV infections among partners and eroding the gains made in the Prevention of mother-to-child transmission of HIV.
Aug 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2236
FA MagajiCorresponding author
Jos University Teaching Hospital, Jos, Nigeria.
Nigeria is one of the high-burden countries in sub-Saharan Africa for HIV/AIDS and contributes to reproductive health morbidities and mortalities. This study was aimed at determining the prevalence of HIV-discordant rate among pregnant women in Plateau state Nigeria. The study sought to determine the prevalence and trend of HIV sero-discordance among pregnant women in Plateau state, Nigeria. The study was a 5-year descriptive analysis of HIV sero-discordance among pregnant women accessing prenatal care and their partners in Plateau state, Nigeria based on data generated between January 2012 and December 2016. The data was disaggregated by year, HIV concordant negative, HIV concordant positive, and HIV sero-discordant prevalence in the software and analysis were done using excel to obtained the proportions and trend of HIV sero-discordant prevalence among the antenatal population. Out of a total of 7,851 partners of pregnant women studied, 969 (16.3%) were HIV sero-discordant, 5,795 (73.8%) were HIV concordant negative, and 773 (9.9%) were HIV concordant positive. HIV sero-discordant positive males accounted for 12.3% while females were 4.0%. The prevalence of HIV sero-discordance was low with a high proportion of HIV positive male partners in Plateau state with grave public health implications for new HIV infections among partners and eroding the gains made in the Prevention of mother-to-child transmission of HIV.
Jul 2018 DOI 10.14302/issn.2690-4837.ijip-18-2238
MugishaTaremwa IvanCorresponding author
Clarke International University, Kampala, Uganda
Background Colonization with methicillin-resistant Staphylococcus aureus (MRSA) is recognized as an association towards development of infections that may cause of morbidity among people living with Human Immunodeficiency Virus (PLWHIV). We report on the prevalence, antibiotic susceptibility pattern and risk factors associated with MRSA carriage among PLWHIV at Nyenga hospital, Buikwe district in central Uganda. Materials and Methods We conducted a cross-sectional study among PLWHIV attending Nyenga hospital anti-retroviral therapy (ART) clinic. Nasopharyngeal swab was collected from each participant, cultured to isolate Staphylococcus aureus, and drug susceptibility testing (DST) performed. Sociodemographic data and medical history was recorded. Results We enrolled 219 PLWHIV; of these, 58.4% (N=128) were females. The majority of participants (95.0%) were on ART. Ninety-eight (44.75%) of the nasopharyngeal swabs had growth, of which 41 (41.84%) were S. aureus. Of these, 11 (5.02%, 95% confidence interval: 3.67-7.02) were MRSA. Of 41 isolated S. aureus strains, only 8 (19.51%) were susceptible to all antibiotics tested. A total of three (7.32%) were multi-drug resistant (MDR), while one1 (2.43%) was a possible extensively drug resistant (XDR) strain. Deteriorating immunologic state as indicated by a low CD4 count showed a significant association with the MRSA colonization. Conclusion These results are reassuring that MRSA colonization is high among PLWHIV. As most of the antibiotics in use were resistant, it raises concerns of intricate clinical management in a low resource set up.
Feb 2018 DOI 10.14302/issn.2324-7339.jcrhap-17-1908
E.E.EnwerejiCorresponding author
Abia State University, Uturu, Nigeria
Introduction The practices of having extreme and permanent body modifications as in tattoos and scarifications are gaining popularity among youths especially those in the universities. Not minding the unbearable and painful pressure of sharp objects on the tissues and the risk of being infected with blood transmitted infections including HIV, youths still engage in these practices. This study aimed to examine the extent to which university students are aware of the risks of using improperly sterilized and disinfected sharp objects. Materials and Method First year students in three universities, Federal, State and Private Universities were used for the study. A random sample of ninety (90) students made up of 30 students from each of the three universities studied was used. Drama was used as an intervention that will create awareness on risks of utilizing sharp objects in making scarifications. The completed copies of self-administered pre- and post-drama questionnaire were collected and analyzed quantitatively using Tables and percentages. Results Results showed that a good number of students 29 (97%) in Michael Okpara University of Agriculture (MOUA) , 28(93%) in Abia State University (ABSU) and 27( 90%) in Rhema University viewed sharing sharp objects like razor blades and syringes as risk to blood transmitted infections especially HIV. A total of 28(31%) of students both males and females in MOUA, ABSU, and Rhema had marks (scarification and/ or tattoos) on the body. The main reason for having the marks was for traditional identification and this was more among students in MOUA than in others. Conclusion Based on the results of the study, drama proved to be a valuable and timely intervention strategy that created awareness among university students on the risks of using sharp objects to make marks on the body.
Feb 2018 DOI 10.14302/issn.2329-9487.jhc-18-1932
Erne PaulCorresponding author
Faculty of Biomedical Sciences, Universita della Svizzera Italiana, Lugano, Switzerland
The aim of this study was to assess the use of ambulatory acoustic cardiography during the initial data collection of the longitudinal study of a rural population in Switzerland (n=297, mean age 48.9 ±16.5 years, 57% female). Ambulatory acoustic cardiography non-invasively can assess sleep disordered breathing (SDB) and provides markers of left ventricular systolic and diastolic dysfunction. The percentage of the third heart sound detected during sleep decreased significantly across age groups (age < 40 years, 40-60 years, > 60 years) for both genders (males, p=0.04; females, p=0.02). The percentage of a fourth heart sound detected exhibited an increasing trend for both genders with age suggesting increased diastolic dysfunction with aging. Mean electromechanical activation time (EMAT) during sleep was within the normal range across age groups and both genders (male 93.7 ± 11.6 ms, female 94.6 ± 13.0 ms), and did not vary significantly with age. A large proportion of subjects had a high likelihood of sleep disordered breathing (17.6%). Baseline characteristics categorized by SDB severity indicate increasing age, male gender and being overweight (BMI ≥ 25) to be associated with greater SDB severity. Acoustic cardiography findings categorized by SDB severity reveal increased nocturnal non-dipping heart rate, presence of atrial fibrillation, prolonged QRS duration and QTc interval, increased percentage of fourth heart sound detected, and longer EMAT to be significantly associated with greater SDB severity. Overall, acoustic cardiography detected a very low prevalence of systolic dysfunction, age-related increases in diastolic dysfunction and a moderate prevalence of sleep disordered breathing.
Feb 2018 DOI 10.14302/issn.2641-5518.jcci-17-1880
A D Mettias BassemCorresponding author
ENT Department, Fayoum University, Egypt.
Objective: Presentation of rare case report of primary non-Hodgkin Lymphoma of temporal bone secondary to immunodeficiency after prolonged steroid administration in a diabetic patient. Then review the literature of similar case reports. Method: 49 years old female presented with hearing loss, facial paralysis and otalgia. Biopsy revealed high grade non Hodgkin’s B-lymphoma. She underwent chemotherapy and had remarkable response. Result: Rapidly progressive deafness, facial paralysis and otalgia are common presentations of external canal Non-Hodgkin lymphoma. The disease is common in middle age, females and has a fair response to chemotherapy, good to radiotherapy. Surgery is an alternative method in isolated lesions or recurrent cases. Conclusion: High dose steroid and type II diabetes are potential risks for acquired immunodeficiency. External Auditory canal lymphoma is uncommon sequel. Chemotherapy is very effective in treatment of isolated cases without B symptoms
Jan 2018 DOI 10.14302/issn.2471-2140.jaa-17-1927
V.I.PetukhovCorresponding author
Vladimir State University, Vladimir, Russia
The work is dedicated to the problem of the norm in the quantitative evaluation of metal content in the epidermal cells (hair) obtained by the method of spectrometry. Authors have analyzed the hair samples for Zn, Cu, and Fe content, which were obtained from 10000 healthy subjects (5000 males and 5000 females aged 20 to 45). The definition of the norm, in the authors’ opinion, is closely related to the basic positions of the theory of self-organized criticality (SC). The observed shifts in the homeostasis of essential metals are local and therefore cannot serve as a criterion of sufficient (or insufficient) metal content throughout the body.
Jan 2018 DOI 10.14302/issn.2474-7785.jarh-17-1911
K. Chesser AmyCorresponding author
Department of Public Health Sciences, Wichita State University
Falls continue to be a health concern for older adults. Gender and age are key predictors of falls, particularly for those with low health literacy. Data were collected by a State Health Department using the state-led supplemental question option for the Centers for Disease Control and Prevention (CDC) Behavior Risk Factor Surveillance System (BRFSS) survey. Specifically, trend data for respondents were examined by gender, geographic location and health literacy rate. Results indicated the highest mean number falls occurred with men for those within the metropolitan statistical area (MSA) city code, lowest in suburban areas. Females reported to have a higher estimated mean number of falls and injuries than males. For males, the number of falls and injuries tended to decrease with higher health literacy. The findings support the importance of addressing fall prevention for older adults. Long term implications for improving fall prevention and health literacy for older adults include impact on individual outcomes.
Dec 2017 DOI 10.14302/issn.2576-6694.jbbs-17-1853
Al-Zubiery TawfiqueCorresponding author
Department of Medical Laboratory, Faculty of Medical and Health Science, Taiz University Al-Turbah branch
Objective: To determine the current prevalence of HBs Ag, Anti-HCV Ab and anti-HIV Abamong blood donors. Methods: This descriptive study was conducted in three blood banks centers in Sana'a city. During the study period from January to November 2016, 11374 blood donor specimens were subjected for detection anti-HBs Ag, anti-HCV and anti-HIV, by using Cobas e 411analyzer. Results: The overall prevalence of HBs Ag, HCV and HIV among blood donors was (1.9%), (1.0%) and (0.3%) respectively. Out of 11374 blood donors screened, 11249 (98.9%) were males and 125 (1.1%) were females with mean of age 30 years. While, (1.6%), (0.9) and (0.0%) of females were seropositve for HBs Ag, HCV and HIV respectively. High prevalence rate of HBs Ag and HCV found among the age group more than 55(5.7%, 2.0%) and 26-35 years old (1.9%, 1.1%) respectively. Conclusion: This study revealed less prevalence rate of HBs Ag, HCV and HIV among blood donors.
Nov 2017 DOI 10.14302/issn.2641-5518.jcci-17-1806
Ralapanawa UdayaCorresponding author
Consultant Physician and Senior Lecturer in Medicine, Professorial Medical Unit, Teaching Hospital, Peradeniya, Sri Lanka.
Background Hypertension is one of the most prevalent risk factors for myocardial infarction, strokes, congestive cardiac failure and chronic kidney disease (CKD)and its prevalence is significantly higher inthe elderly population. Objectives To assess the demography, various presentations and the prevalence of risk factors among elderly hypertensive patients followed up in a tertiary care hospital in Sri Lanka. Materials and Methods This was a cross sectional descriptive study involving 250 patients whoseage was 60 years or above onantihypertensives for at least 6 months. Results Approximately 65.2% of the study population was female. The mean age was 70.17.Dizziness and chest pain were the most prevalent symptoms.The mean age at first detection was 58.17 years.Mean SBP and DBP were 128.5mmHg and 81.14mmHg respectively. The prevalence of alcohol consumption and smoking among men were 70.1% and 72.4% respectively. Approximately 54.7% were either overweight or obese.Approximately 81.6% females and 41.4% males had a waist circumference ofmore than therisk level with p-value<0.05. Approximately 36% had diabetes mellitus and 27.6% of the patients had at least one parent and 36.8% had at least one sibling diagnosed with hypertension. Approximately 61.3% of the patients hadadequate levels of physical activity while 31.8% had IHD,11.5% had stroke and 3.8% had CKD. Conclusion Dizziness and chest pain were the most disturbing symptoms while abdominal obesity among females,and alcohol consumption and smoking among males were the major risk factors in elderly hypertensive patients
Aug 2017
Fernandes Pires CatarinaCorresponding author
Adjunct Professor of Pediatrics, Federal University of Piauí, Brazil
Objectives: To identify the clinical epidemiological characteristics of patients with juvenile idiopathic arthritis (JIA) monitored at the Lucidio Portella Children’s Hospital (HILP) in northeastern Brazil and to ascertain the frequency and forms of presentation, the most affected joints, the most common joint involvement for each form, the frequencies of positive rheumatoid factor (RF+) and positive antinuclear antibodies (ANA+) in the various forms of presentation, and the most common complications. Methods: A study was conducted with 74 medical records of patients with JIA monitored at HILP between January 2010 and January 2013. Descriptive statistics were used for statistical analysis. Results: JIA was predominant in females with a mean age at onset of 5.2 years and a median disease duration of two years. The most frequent initial form of presentation was oligoarticular (63.5) arthritis, and the most affected joint was the knee (86.4%). The knee was most affected by oligoarticular arthritis, the wrist, knee, and ankle were affected by RF+ polyarticular arthritis, and the knee, ankle, and cervical spine were affected by systemic arthritis. RF+ was observed in 8.5% of the oligoarticular arthritis cases. ANA+ were present in 27.7% of the oligoarticular cases, in 22.2% of the systemic arthritis cases, and in 11.1% of the RF+ polyarticular arthritis . The most common complications were deformities (20.3%) and uveitis (14.9%). Conclusion: The findings for JIA patients in a referral hospital in northeastern Brazil were consistent with the literature regarding most of the evaluated criteria.
Aug 2017
Nevzat UzunerCorresponding author
Objectives Increased neurovascular (NV) reactivity has been shown in patients with relapsing-remitting multiple sclerosis (RRMS) during the acute exacerbation period. However, the NV reactivity after several attacks is not known. We, therefore, have investigated the patients by transcranial Doppler (TCD) using simple visual stimulation after the repeated attack periods. Patients and Methods Thirty patients (22 females and eight males, mean age 40 years) with RRMS were examined at least two times. The average TCD examination interval was 26.7 months (range 4-120 months). Mean attack number was 3.8 (range 2-8 times), average disease duration was 57 months (range 4-124 months), and average Expanded Disability Status Scale (EDSS) value was 2.5 (range 1-5.5). We performed transcranial Doppler recordings from the P2-segments of both posterior cerebral arteries simultaneously during simple visual stimulation. The NV reactivity was defined as a relative increase of the blood flow velocities during visual stimulation. Results The NV reactivity to simple visual stimulation was significantly lower in the second test on both sides (31.5±9.2% and 29.2±7.2%; right and left side, respectively) from those of the first test (38.3±11.9% and 36.0±11.9%; right and left side, respectively) (p<0.001). Conclusion The present study is the first study examining neurovascular reactivity in patients with RRMS during repeated attacks using the transcranial Doppler to our best knowledge. Our results suggest patients with RRMS after repeated exacerbation periods have less reactive neurovascular units in the occipital cortex. The possible explanation might be the repeated demyelination, and insufficient remyelination with longer disease duration may lead glial dysfunction resulting neurovascular unit impairment. If so, functional TCD may be useful for the determining of the disease progression. However, the exact cut-off point is not known.
Aug 2017 DOI 10.14302/issn.2574-612X.ijpr-17-1568
Xu WeiCorresponding author
Nanjing Normal University, Nanjing, China
This study examined the mediating role of alcohol use in the relationship between PTSD symptoms and trauma-related psychotic reactions. A total of 231 participants including 181 females were recruited via web advertisement and flyers. Alcohol use condition, trauma-related psychotic experience, and PTSD symptoms were measured by Feeling the need to Cut down, Annoyed by criticism, Guilty about drinking, and need for an Eye-opener in the morning (CAGE), Psychosis Screening Questionnaire (PSU) and Short screening scale for posttraumatic stress disorder (SSSP). All the participants were asked to finish the questionnaire package on the Internet and were interviewed later to validate the screening. Logistic regression was used to estimate the mediating effect of alcohol use. Results showed that alcohol use played a mediating role between PTSD symptoms and auditory hallucination while this effect didn’t exist between PTSD symptoms and paranoia. Findings indicated that hallucination and paranoia in people with PTSD symptoms were influenced by alcohol use in diverse ways.
Jul 2017 DOI 10.14302/issn.2379-7835.ijn-17-1607
PhadkeMCorresponding author
Senior Advisor, Govt;
Background Severe acute malnutrition (SAM) is rampant in the children of hilly and inaccessible tribal region of Nandurbar, Maharashtra in India. It is estimated that nearly 5% of the children under five years have SAM. Objectives To assess the therapeutic efficacy of 3 types of nutrition protocols administered largely at home in SAM children from Nandurbar, Maharashtra. Methodology This study is a part of a larger three arm open label trial using 3 therapeutic feeds i.e. C-RUTF (Centrally produced ready to use therapeutic food), L-RUTF (locally prepared ready to use therapeutic food) and ARF (locally prepared amylase rich food) in children of SAM who attended the health facility and completed the treatment protocols for 8 weeks (All ‘per protocol patients’) and were between 1 to 3 years of age. The larger study included children aged 6 months to 59 months who were given same therapeutic feeding protocol. Findings A total of 450 SAM babies between 12-36 months. attended the outpatient therapeutic program during the period of July 2014 to December 2015 and completed the given protocol of therapeutic feeding program. 242(53.7%) were males and 208(46.2%) females. Out of these, 150 received C-RUTF, 150 received L-RUTF and 150 received ARF. Out of C-RUTF group 83(55.3%) recovered, in L-RUTF 70(46.7%) recovered and from ARF group 69(46.0%) recovered. The difference was statistically significant.(p=0.03) Total recovery rate was 49.3% in comparison to another under publication study by our group on 3418 children aged 6 months to 59 months, where recovery was 36.8%. Average weight gain per day was 3.54 ± 2.36 g/kg/day, 2.61 ± 2.12 g/kg/day, 2.60 ± 1.50 g/kg/day in the 3 arms respectively. Conclusion This study proves that domiciliary treatment with 3 types of therapeutic feeds gives recovery rate of 49.3%, there by meaning that SAM Children without complications can be treated at home with visit to health facility once a week. Of all the therapeutic feeding protocols C-RUTF had best recovery rates (55.3%) compared to others, the difference being statistically significant. Average weight gain per kg per day inC-RUTF group was 35.8 % higher than the other 2 groups.
Jun 2017 DOI 10.14302/issn.2329-9487.jhc-17-1493
Müller JanCorresponding author
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München
Objective: Studies suggest that cardiovascular risk of patients with congenital heart disease (CHD) is increased. This study aims on the predictive value of a single daily activity and exercise capacity assessments on the change of body-mass-index (BMI) and blood pressure in the future. Patients and Methods: We retrospectively analyzed all patients with CHD who underwent a daily activity assessment by triaxial accelerometry and accompanied cardiopulmonary exercise testing. From 276 patients 16 years or older (120 female, 28.6 ± 8.5 years) current BMI and blood pressure could be abstracted from their last outpatient visit. Results: After a mean follow-up of 5.5 ± 1.5 years, the BMI of the patients has increased from 23.0 ± 3.4 to 23.7 ± 3.5 kg/m2 (p<.001) corresponding to an annual increase of 0.14 ± 0.40 kg/m2 respectively. The systolic blood pressure decreased by -0.37 ± 3.14 mmHg (p=.049). The multivariable regression analysis corrected for confounders showed no association to annual BMI change according to baseline daily activity levels (p=.891) or peak oxygen uptake (p=.596). Only in patients with higher BMI at baseline (Beta= -.275; p<.001) and females (Beta= -.177; p=.009) increase in BMI was less. Also the blood pressure change was not associated with daily activity levels (p=.420) and peak oxygen uptake (p=.732) at baseline. Conclusions: Single daily activity or exercise capacity measures do not predict future BMI or blood pressure changes. Regular evaluation of functional status including exercise testing, activity assessment and tailored counseling are therefore recommended in patients with CHD.
May 2017 DOI 10.14302/issn.2381-862X.jwrh-16-1374
Deligeoroglou EfthimiosCorresponding author
Division of Pediatric-Adolescent Gynecology & Reconstructive Surgery, 2nd Department of Obstetrics & Gynecology, University of Athens, Medical School, “Aretaieion” Hospital, Vasilissis, Sofias Avenue 76, 11528 Athens, Greece
Objectives: The aim of this study is to assess the correlation between the degree (percentage) of occlusion due to labial adhesions and vulvovaginitis. Materials and Methods: Prospective study of pre-pubertal females who attended our Division, during the past 7 years, due to labial fusion. Medical history, clinical examination and Q tip culture of vaginal fluid samples were performed, after separation of the labia. Treatment of isolated pathogens was administered, based on antibiogram results. Results: 53 patients, with mean age 3.81 years (±0.88 years, SD:2.65, range:0.33-9.5 years) had a total of 89 vaginal specimens collected, as re-culture was performed in 17 patients due to labial fusion recurrence. In 32.08% no pathogen was isolated. Gardnerella vaginalis (24.51%) and Bacteroides spp (15.09%) were the commonest isolated pathogens of the rest 67.92%. Among labial fusion recurrences the commonest isolated pathogen was Gardnerella vaginalis (23.13%), while in 36.12% no specific pathogen was detected. Conclusions: The results suggest that non-specific vulvovaginitis is responsible for lower degree (<60% closure) of labial adhesions, as well as that recurrent infection plays a role in the formation of higher degree/percentage of labial closure, especially when there are one or more pathogens present. Furthermore, the presence of anaerobes at initial cultures, together with Gram negative bacteria at re-cultures, appear to further facilitate the creation of extensive adhesions.
Mar 2017 DOI 10.14302/issn.2476-1710.jdt-16-1332
Petrowski KatjaCorresponding author
Department of Psychotherapy and Psychosomatic Medicine, Dresden, Germany University Hospital Carl Gustav Carus Dresden, Technische Universitaet Dresden, Fetscherstr.
Background: Unemployment is a chronic stressor which is associated with higher levels of impaired physical and mental wellbeing, e.g. reduced heart rate variability (HRV) and decline in self-esteem and self-efficacy. The present study investigated the effectivity of a HRV-biofeedback-training in increasing HRV and general self-efficacy. Method: A total of n = 22 unemployed individuals with adjustment disorder participated in this study (14 females, mean ages 42.53 ± 8.88 years). All participants performed randomized the “stress tests” for heart rate (HR) and HRV assessment: timed breathing, d2-attention-stress-test and math-test drawn from the Trier Social Stress Test (TSST). Four sessions HRV-biofeedback à 20 min within 2 weeks were administered. HR and HRV were assessed before and after biofeedback training. ECG preprocessing and analysis were performed with the Stressball software program (BioSign GmbH, Ottenhofen, Germany). The RMSSD time domain measure was calculated as HRV index. Clinical outcome measures were the ADNM total score and the general self-efficacy scale (GSE). Results: Participants were well matched in terms of demographic and clinical characteristics. ANOVA didn’t demonstrate significant time x group interaction effects neither for HRV parameters (HR, RMSSD) nor for psychological parameters (ADNM, GSE). Conclusion: Our findings do not indicate that HRV-biofeedback can increase HRV nor general self-efficacy in unemployed subjects with adjustment disorder. Implications for future studies are discussed.
Feb 2017 DOI 10.14302/issn.2372-6601.jhor-16-1402
Tanwir FarzeenCorresponding author
University of Toronto, Faculty of Dentistry, Canada
Background Blood donation is a common practice in many countries of the world and it benefits many of the people suffering from conditions which require blood transfusions. The blood donated should be appropriately screened for certain infectious diseases such as HIV/AIDS, Hepatitis B, Syphilis and Gonorrhea through serological tests. Materials and Methods This cross sectional study was conducted from January 2014 to August 2014, Data was collected from eight dental hospitals in four provinces of Pakistan. Attendants of the patients admitted in the surgical ward with age more than 16 years were included. Knowledge and practices of the participants were evaluated through a self-administered questionnaire. Ethical consent was obtained from the ethical committee or concerned authority of all eight hospitals. Results Response rate was 84 %. In total 55% male and 45 % female participated with 15.5% of the total sample population was under the age of 20 years. The age group with the maximum number of participant was between 20 to 39 years of age. 26% and 22.5% of the males and female participants respectively had knowledge. About blood donation, lesser percentage of attendants, 7.2% of the males and 4.6% declared that they had donated blood in the past. Based on education levels, it was highest among graduates (3.5%) and less in primary educated (2.2%) and uneducated respondents was 0.7%. 18% of the males and 17% females asserted that they hold some kind of fear of blood donation. Conclusion The population is not adequately knowledgeable regarding blood donation. There is a need for proper campaign to educate masses at national level within Pakistan to promote more people to become regular volunteers.
Dec 2016 DOI 10.14302/issn.2474-3585.jpmc-16-1281
H. Alghamdi AhmedCorresponding author
Faculty of Medicine, Albaha University, Kingdom of Saudi Arabia.
Objectives This study describes and compares the epidemiological criteria of children with diabetes from 2007 to 2014. Methods A prospective study conducted with 372 children with diabetes mellitus. An access program was used for data collection, and SPSS 17 was used to analyses the results. Results A total of 372 cases with diabetes were studied and were divided into three groups according age. The first age group was between one day and six years and comprised 128 (34.4%) patients. The second group aged 7- 12 years of age comprised 174 (46.7%) patients. The third group aged 13-18 years of age comprised 58 (15.59%) patients. The average age was 8.32 years. Females constituted 52 % (194 cases) of all cases. T1DM constituted 95.4%, equal to 355 patients, T2DM constituted 1.88%, equal to seven cases. Monogenic diabetes affected three patients or 0.79%, with one case of monogenic neonatal diabetes confirmed by genetic study, and two other cases suspected to be MODY. The highest incidence was observed in the autumn months, with 105 children affected, constituting 27.8 % cases. The year 2012 had the highest incidence rate, with 59 children and adolescents affected at an incidence rate of 25.48 / 100000.Al-Baha region had the highest number of cases constituting 37.7 % of cases. Diabetic ketoacidosis was the first presentation and constituted 44.2% of cases. Conclusion. Diabetes in children is increasing significantly in recent years, requiring more detailed analysis of its epidemiological factors to find out any significant correlations which may help in its prevention.
Dec 2016 DOI 10.14302/issn.2381-862X.jwrh-15-846
Rafie SallyCorresponding author
UC San Diego Health
Sexual assault is a serious problem in the United States. It is crucial that the medical management of these patients is adequate. The Centers for Disease Control and Prevention (CDC) provides guidelines for appropriate management of these patients. The purpose of this study is to evaluate medical management of survivors of sexual assault at an academic medical center and identify opportunities for improvements in care. We conducted a retrospective, chart review study of patients aged 12 years and older presenting at an academic medical center following sexual assault or rape between 2009 and 2013. Descriptive statistical tests were used to analyze the data. A total of 29 females and 5 males were identified. The majority of patients presented to the medical center within 24 hours of sexual assault or rape and typically presented to the emergency department. Empiric treatment for infections were 8.8% for Hepatitis B, 29.4% for human immunodeficiency virus, 20.6% for gonorrhea, 17.6% for chlamydia, and 8.8% for trichomonas. Among women of reproductive age, 28.0% were provided with emergency contraception. This study found inconsistency in the medical management of sexual assault survivors. Among this small sample size, many patients were not provided with recommended medical treatments. With this knowledge, the medical center plans to implement institutional guidelines and a corresponding order set in the computerized prescriber order entry system to standardize the medical management of sexual assault survivors and educate healthcare professionals. Future studies are warranted to evaluate the impact of standardized guidelines and order set implementation.
Oct 2016 DOI 10.14302/issn.2470-5020.jnrt-16-1240
Kristoper P. de Guzman JanCorresponding author
Department of Neurology, Jose R. Reyes Memorial Medical Center
Background: Impulse Control Disorders (ICDs) are characterized as pathologicalbehavioral patterns of excess impulsivity which may result as part of the non-motor complications of Parkinson’s disease (PD). These significantly affect the patient’s overall quality of life and have impact on their care givers, as well. Currently, the prevalence of ICDs among adult Filipino patients with Parkinson’s disease is unknown and less reported. Objectives: The study is intended to determine the prevalence of ICDs and its severityamong adult Filipino patients with idiopathic Parkinson’s disease seen at Jose R. Reyes Memorial Medical Center. Specifically, this study will identify risk factors and the clinical correlates to these patients. Methods: Adult Filipino patients diagnosed withidiopathic Parkinson’s diseasewhowere seen at the outpatient department from March 2015 – September 2015 are screened for the study. The Modified Hoehn and Yahr staging was utilized to determine the stage of PD. With approval from the author, the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease-Rating Scale (QUIP-RS) was used for detecting the presence of ICDs and corresponding severity. Results: We were able to examine 66 patients (31 males and 35 females) withidiopathic Parkinson disease. Majority of the patients manifested with Tremor Dominant (50%) subtype, followed by Early Disease Onset (34.8%), and Non-Tremor Dominant (15.2%). Sixteen (16) out of 66 patients (24.2%) have ICD symptoms with the following incidence rates: hobbyism/ punding 56.25%, compulsive eating 50%, hypersexuality 18.75%, compulsive shopping 18.75, Dopamine dysregulation syndrome 18.75%, and gambling 12.5%. Overall average QUIP-RS score is 5.42. There is significant association of PD duration with occurrence of ICD symptoms; the longer the PD duration, the higher risk of having ICD symptoms (x2 20.41; p = 0.026). Patients with higher mean modified Hoehn and Yahr stage (2.66±0.94), t 2.735, df 64, p 0.008, have much higher incidence of ICD symptoms. Conclusion: Filipino patients with idiopathic Parkinson disease who are majority onlevodopa + carbidopa therapy may develop impluse control disorders (ICDs). Other contributory factors in development of ICDs include longer duration of PD and higher mean Modified Hoehn and Yahr stage.
Oct 2016 DOI 10.14302/issn.2574-450X.jom-16-1003
Daniel CottamCorresponding author
Introduction: The Roux-en-Y Gastric Bypass (RYGB) has been one of the most popular surgeries in the USA for years. While many models have been made to investigate the factors that affect weight loss, these factors are still highly debated. Objective: To create a model that predict performance of RYGB patients. Methods: 110 out of 344 patients who received a RYGB at a single institution between Jan 2010 and April 2014 were included in this study. Data was collected retrospectively. Patients were included if they had greater than 1 year follow up with at least three follow up points and could be modeled with r2>0.95. All patients were one year beyond surgery, while 40 were completely lost to follow up, 104 at 1 month, 138 at 3 months, 188 at 6 months, and 225 at one year. 9 patients were not included because they did not meet the criteria of the study. Patients were divided into quartiles based on percentage excess weight loss (%EWL) at one year. Multivariate analysis was performed to determine the significant factors that influence patients being in the first quartile of weight loss (17-60% %EWL). Results: Only males with a Body Mass Index (BMI) above 44 and females with a BMI above 64 were found to be predictive of patients being in the first quartile. Our model has Positive and Negative predictor values of 66% and 80% respectively with sensitivity and specificity of 29% and 95% respectively. Conclusions: An model to predict %EWL was created, only gender and pre-operative BMI were found to be significant factors. In general females have better outcomes with higher BMI’s than do males. This information should be discussed with patients when deciding a procedure. However, more studies are needed for validation of these results.
Aug 2016 DOI 10.14302/issn.2574-4496.jtc-16-1129
Silva FriedaCorresponding author
Nuclear Medicine Section, Radiological Sciences Department, School of Medicine, University of Puerto Rico
Objective: Radiation exposure to the general public and patients undergoing diagnostic or therapeutic procedures is of great concern, especially to the medical community. Revision of Nuclear Regulatory Commission rules several years ago yield new recommendations for the administration of therapeutic doses of 131-Iodine that included the release criteria. The guidelines for ambulatory treatment included patient education and radiation safety measures to minimize exposure and contamination. Our goal in this study was to evaluate patient compliance with the radiation safety instruction protocols given to them before the therapeutic dose and monitor radiation levels in different house areas at different times after an ablation therapy of 3700MBq or more. Method: Patients with well differentiated thyroid cancer being evaluated for ablation therapy with 131-Iodine were invited to participate. A thorough set of instructions on radiation protection were given verbally and in writing. Patient house was assessed with a Geiger Muller detector at 24 and 72 hours or above to obtain direct radiation levels in several areas. Patient radiation levels were also monitored. Results: A total of 12 patients have been included, 11 females and 1 male, median age was 53 years. Tumor histology was 10 papillary, 2 papillary-follicular variant and 1 follicular carcinoma; 92% of the cases were T1, N0, M0. Home location was urban in 77% and rural in 33% of the patients; 67% of the patients had an educational level between 9-12 grade. Radioiodine doses range from 3441-5994MBq. None of the patients had a relatives or companion in the house. Mean patient exposure 24 hours after the dose at 1 meter was 12mrem/hr, 0.120mSv/h; this represented a retained dose of 2181MBq (59mCi). Only one patient (T1, Nx, M1) had an exposure rate at 1 meter of 100mrem/hr (1mSv/hr) at 24 hours. At 72 hours the exposure changed to 4mrem/hr, 0.040mSv/hr, retained dose of 725.2MBq (19.6mCi). Higher exposure rates in the house were at 24 hours in the bed and pillows (7mrem/hr), kitchen trash (13mrem/hr) and bathroom sink (8mrem/hr). The exposure rates at the toilet and shower were similar (3-4mrem/hr). There was a significant decreased in the exposure rate at 72 hours in all house areas. Patients with the higher exposure rates were those with metastatic disease, and small living facilities. Patients living in rural or urban location had no difference in the exposure rate. The educational levels were not related either to the exposure rate. Conclusion: Patient compliance with radiation protection instructions and Nuclear Regulatory Commission release criteria was good. Radiation exposure levels in the house areas are safe. Special instructions must be design to minimize contamination in the bathroom and kitchen Caution is recommended in the release of patients with extensive metastatic disease and doses of 5920MBq or more.
Jul 2016 DOI 10.14302/issn.2474-3585.jpmc-16-1114
Okwundu Nwankwo InnocentCorresponding author
Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, Usmanu Danfodiyo University Sokoto, Nigeria.
Campylobacter infection has been detected in poultry processors at live bird markets in Sokoto, however the prevalence of Campylobacter species in more diverse group of the population is uncertain. For this purpose, 292 human fecal swabs from patients in four Government Hospitals in Sokoto State were analyzed for Campylobacter species using culture and phenotypic typing method. The prevalence rate of 55% was revealed in the tested samples while 56% and 55% were for males and females respectively. Campylobacter jejuni, C. coli and C. lari had 20%, 40% and 40% in males and 38%, 35% and 27% in females respectively. The prevalence rates of 60%, 52%, 45%, 41% and 80%,were revealed in age range of (less than 1-6, 7-13, 14-20, 21-55 and 56-76) yrs respectively. Furthermore, 70% and 43% prevalence rates were recorded in pregnant and non-pregnant women of reproductive age respectively. There was no statistical significant association (P>0.05) between Campylobacter infection and age range and sex, but the statistical association between infection and pregnancy was significant (P<0.05). The prevalence of Campylobacter species in patients as found in the various hospitals has revealed the level of environmental contamination in different homes in the state and the need to include Campylobacter in screening routine laboratory diagnosis of gastroenteritis in humans for appropriate treatment and management especially in young children, old adult and pregnant women.
Jun 2016 DOI 10.14302/issn.2329-9487.jhc-15-905
D. Raikou VaiaCorresponding author
Dpt of Medicine - Propaedaetic, National & Kapodistrian University of Athens, School of Medicine.
Backgroud: Metabolic acidosis, a common condition particularly in end stage renal disease patients, results in malnutrition and inflammation. In this study, we focused on the importance of metabolic acidosis on manifestations of cardiovascular disease in patients on peritoneal dialysis. Methods: We studied 20 patients on continuous ambulatory peritoneal dialysis (CAPD), 15 males and 5 females, on mean age 61.6 ±11.3 years old. Metabolic acidosis was determined by serum bicarbonate concentrations less than 22mmol/L, which were measured in gas machine. Dialysis adequacy was defined by total Kt/V/week for urea including peritoneal Kt/V for urea and residual GFR (ml/min/1.73m2). High sensitivity C-reactive protein (hsCRP) was measured using enzyme linked immunoabsorbed assay (ΕLISA). The concentrations of intact-parathormone (i-PTH) and beta2-microglobulin (beta2M) were measured by radioimmunoassays. Arterial stiffness was measured as carotid-femoral pulse wave velocity (c-f PWV) and augmentation index (AIx). We built a Cox regression analysis to predict coronary artery disease (CAD), congestive heart failure (CHF) and peripheral vascular disease (PVD). Results: Serum bicarbonate levels were inversely associated to beta2M, i-PTH and AIx (r=-0.451, p=0.04, r=-0.477, p=0.03 and r=-0.569, p=0.009 respectively). Cox- regression analysis revealed significant association of serum bicarbonate levels and PVD having as confounders traditional and specific for these patients risk factors. Conclusion: Metabolic acidosis may be an independent risk factor for arterial stiffening and peripheral vascular disease manifestation in patients on peritoneal dialysis.
Jan 2016 DOI 10.14302/issn.2379-7835.ijn-15-770
Jobim Benedetti FrancelianeCorresponding author
Nutritionist, Master’s Graduate Program in Health child and adolescent in Universidade Federal do Rio Grande do Sul (UFRGS) and Professor Graduate in Centro Univeritário Franciscano.
The objective of this study was to confirm the nutritional risk factors for asthma and obesity in adolescents using a cross-sectional survey. We included male and female adolescents aged 10 to 19 years of age in this study. The indicators of nutritional status used in this study were body mass index, the height-for-age index, and arm and waist circumferences. We used a food frequency questionnaire to estimate the average consumption of sodium. Physical activity was assessed using the International Physical Activity Questionnaire, and asthma characteristics were evaluated using the International Study of Asthma and Allergies in Childhood (ISAAC). Factors associated with asthma in bivariate and multivariate analyses were assessed using the Poisson regression analysis. The significance level was set at 5%, and the analyses were performed using the SPSS statistical package. We evaluated 1362 students with an average age of 15.65 ± 1.24 years. There was a positive risk for asthma between females (PR = 1.41) and asthma severity in adolescents with a high sodium intake (PR = 2.30). Within overweight adolescents, the prevalence for asthma risk washigher among females (PR = 1.66) and the high sodium intake group (PR = 1.98). An increased risk for asthma severity correlated with high sodium intake (PR = 3.07). There was a higher risk for asthma and its severity in females with high sodium intake. The same pattern was observed for adolescents with excessive weight.
Aug 2015 DOI 10.14302/issn.2372-6601.jhor-15-666
Zaichick VladimirCorresponding author
Radionuclide Diagnostics Department, Medical Radiological Research Centre, Obninsk 249036, Russia
Objectives: To clarify the role of trace elements in the etiology and the pathogenesis of the chondrosarcoma, a non-destructive neutron activation analysis with high resolution spectrometry of long-lived radionuclides were performed. Methodology: The silver (Ag), cobalt (Co), chromium (Cr), iron (Fe), mercury (Hg), rubidium (Rb), antimony (Sb), selenium (Se), and zinc (Zn)mass fractions and Co/Zn, Cr/Zn, Fe/Zn, Hg/Zn, Sb/Zn, Co/Rb, Cr/Rb, Fe/Rb, Hg/Rb, Sb/Rb, and Se/Rb mass fraction ratios were estimated in normal bone samples from 27 patients with intact bone (12 females and 15 males, aged from 16 to 49 years), who had died from various non bone related causes, mainly unexpected from trauma, and in tumor samples, obtained from open biopsies or after operation of 16 patients with chondrosarcoma ((3 females and 13 males, 8 to 65 years old). The reliability of difference in the results between intact bone and chondrosarcoma tissues was evaluated by Student’s t-test. Key Results: In the chondrosarcoma tissue the mass fractions of Co, Fe, and Se are significantly higher while the mass fraction of Rb is lower than in normal bone tissues. Moreover, significantly higher Co/Zn, Fe/Zn, Co/Rb, Cr/Rb, Fe/Rb, Sb/Rb, and Se/Rb mass fraction ratios are typical of the chondrosarcoma tissue compared to intact bone. In the chondrosarcoma tissue many correlations between trace elements found in the control group was no longer evident. Major Conclusions: In chondrosarcoma transformed bone tissues the trace element homeostasis is significantly disturbed.
Jun 2015 DOI 10.14302/issn.2324-7339.jcrhap-15-648
Immaculata UGWU NgoziCorresponding author
College of Health Sciences, Ebonyi State University, Abakaliki, Ebonyi State
HIV/AIDS has become a global scourge affecting mainly young people. Sexual behavior change remains the most effective way of preventing further spread. The aim of this study is to assess the knowledge, perception and practice of safe lifestyles towards prevention of HIV infection among students of a tertiary educational institution in Abakaliki, south eastern, Nigeria. A cross sectional descriptive study was carried out, and participants were selected using multistage sampling technique. Data was collected using a pretested, self administered questionnaire and analyzed using SPSS software, version 20. Three hundred and eighty seven participants were recruited for the study, including 199 (51.4%) males and 188 (48.6%) females. Mean age of participants was 23.6 ±2years. All (100%) of the participants were aware of the existence of HIV/AIDS, with the commonest source of information being electronic media (81.1%). Their knowledge of the routes of transmission and modes of prevention of HIV infection was high, though few of them have some misconceptions. Poor practice of safe lifestyles towards prevention of HIV infection as well as low perception of self-vulnerability to the risk of HIV infection was also found. There was poor practice of preventive lifestyles among the participants despite high knowledge of HIV transmission and preventive measures probably due to low perception of self-vulnerability to the risk of HIV infection. Health education should be intensified to impact sufficient comprehensive knowledge to change low perception of self-vulnerability among the students.
May 2015 DOI 10.14302/issn.2372-6601.jhor-14-382
Raddaoui EmadCorresponding author
Department of Histopathology, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
Background/Aims: Thyroid disorders are a common, worldwide clinical problem in general practice.It presents predominantly as a thyroid nodule. Each thyroid nodule has a risk of cancer. The incidence of thyroid cancer is much more common in Saudi Arabia in comparison to the West. There is a worldwide increase in the incidence of thyroid cancer. The objective of this study is to highlight in details the wide spectrum of histopathologic diagnosis encountered in patient undergoing thyroid surgery in the population of Riyadh region of Saudi Arabia. Patients and Methods: Retrospective review of all thyroid samples for 256 patients whom underwent thyroid surgery at King Khalid University Hospital, King Saud University, Riyadh, during the period between 2000 and 2009. Of those, 171 cases were non neoplastic and 85 neoplastic lesions. Females constitute 80% of non neoplastic lesions and 79% of all thyroid malignancies. The peak incidence of thyroid cancer was in the third decade. Papillary thyroid carcinoma was the most common cancer (71%). Conclusion: Thyroid cancer is a common cancer in Saudi Arabia; it is the second most common cancer in females. The increasing rates of thyroid cancer occur predominantly in women. Papillary thyroid carcinoma accounted for the bulk of this increase. Additional studies are needed to explain the rise in papillary thyroid carcinoma incidence in Saudi Arab as well as throughout the world and to search potential risk factors that are currently unrecognized.
Nov 2014 DOI 10.14302/issn.2574-450X.jom-14-564
S. Aljabri KhalidCorresponding author
Department of Endocrinology, King Fahad Armed Forces Hospital. Jeddah, Kingdom of Saudi Arabia
Objective: Obesity is a major public health problem worldwide. We designed this study to determine the prevalence of obesity among Saudis in the department of primary care at King Fahad Armed Forces Hospital. Methods: Cross section study of Saudis of both sexes, aged more than or equal to 12 years at the department of primary care at King Fahad Armed Forces Hospital between January 2008 and June 2009. Results: A total of 5968 were attending the department of primary care were included in this study. There were 2269 (38.0%) male and 3699 (62.0%) female. With age, a gradual increase was seen in the Body mass index (BMI) in both males and females, up to the age of 59 years, with a decrease occurring thereafter. In the females below 20 years of age, the BMI was lower than in the male group. Above 30 years, the BMI in females was higher than in the males of corresponding ages. The prevalence of BMI≥25 was 70.0%.The prevalence of BMI≥25 was non significantly higher in the male compared to the female,71% and 69.3% respectively, p=0.2.The prevalence of overweight ( BMI=25-29.9) was higher in the males compared to the females, while the reverse was true for obesity(≥30),where 62.0% of the total female population was obese compared to 49.7% of the total male population. The magnitude of the difference in prevalence of obesity in the males and females was significantly high ( p<0.0001). Conclusion: The prevalence of obesity is high among Saudi population at the primary care setting and represents a major clinical and might represent a public health problem. A national prevention program at community level should be implemented.
Nov 2014 DOI 10.14302/issn.2379-8572.joa-14-561
Elwany samyCorresponding author
Department of Otolaryngology, Alexandria medical School, Alexandria, Egypt
Pleomorphic adenomas are uncommon tumors of the nasal cavity. They arise from minor salivary glands, and usually originate from the nasal septum. The tumors are more common in middle-aged females. We present a series of 8 cases of intranasal pleomorphic adenomas. Seven of these tumors originated from the nasal septum, and only one of them originated from the lateral nasal wall. Histopathologic examination of the tumors showed that these tumors have higher epithelial and lower stromal components compared to pleomorphic adenomas of major salivary glands. Endoscopic resection was performed in all cases and the patients were followed up for one year. No recurrences or complications were observed in this series. Endoscopic resection is recommended as the treatment of choice because of its proven efficacy and low morbidity.
Sep 2014 DOI 10.14302/issn.2372-6601.jhor-14-499
L. Edwards ChristopherCorresponding author
Department of Psychiatry, Division of Medical Psychology, Duke University Medical Center.
Medical advances in obstetrics and hematology have encouraged researchers to investigate the reproductive risk in women with Sickle Cell Disease (SCD) attempting motherhood. However, few hematological studies have been completed focused specifically on the reproductive mental health of Black women with SCD. Historically women with SCD have been guided away from childbirth under the premise that they were not emotionally or physically capable of managing children. One question that remains unclear, from the limited research available in this area, is whether the presence of children serves to influence mood and pain in Black women with SCD. The current study examined the effects of the presence of children on self-reported pain and depressive symptoms and the relationship between pain and psychological functioning in African American women with SCD. Self-reported rates of depression, pain intensity, and pain severity were evaluated in 70 African American females with SCD. Results of Analysis of Covariance (ANCOVA) did not find differences in reported mood or pain between women with and without children. The current study serves as an initial observation upon which replication of the current findings and future prospective studies can be conducted. The study may ultimately mature into an area of research that guides reproductive decision-making for women with SCD and their doctors.
Feb 2014 DOI 10.14302/issn.2324-7339.jcrhap-12-157
Aryal NirmalCorresponding author
Division of Applied Health Sciences, Forester Hill Campus, University of Aberdeen, Aberdeen, Scotland, UK
Background: Human Immunodeficiency Virus (HIV) and antiretroviral therapy (ART) are found to be strongly associated with cardiovascular diseases. Data are sparse on the prevalence and distribution of cardiovascular risk factors among people being treated for HIV in South Asia region. Methods: A cross-sectional study of 103 HIV patients (51 women and 52 men) attending routine follow-up consultations at the largest ART centre in Nepal was conducted. Data on several cardiovascular risk factors were collected through interview questionnaires, biophysical measurements and consulting medical records. Results: The most common cardiovascular risk factors observed were central obesity 34.6% 95% Confidence Interval (CI): 25.3% to 43.9%, chronic kidney disease {20.7% (95% CI: 11.6% to 29.7%)} and tachycardia {20.6% (95% CI: 12.7% to 28.5%)}. Females were significantly more likely to have central obesity (male 9.8% vs. female 60%, p=0.016) and chronic kidney disease (male 15.4% vs. female 26.3%, p=0.003) as compared to the males. Participants were fairly active but a large proportion, especially men, had smoked {65% (95% CI: 57%-72.3%)}, used tobacco products {66% (95% CI: 56.4%-74.4%)} or drugs (53.8% of the men) and consumed alcohol {60.2% (95% CI: 50.5%-69.1%)}. Conclusion: A high prevalence of several cardiovascular risk factors was observed among patients being treated for HIV in Nepal. Further larger studies are warranted to better understand the relevance and public health impact of cardiovascular risk factors in this region.
Jan 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-187
Gust D.A.Corresponding author
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
Retention of sufficient numbers of participants in longitudinal research studies is a serious methodological concern, as retention influences the validity of the research findings. An assessment of participant retention or attending all study visits was made quarterly during a 12 month follow-up of an HIV incident cohort in Kisumu, Kenya. The study objectives were to determine 1) the proportion of participants attending all study visits and 2) demographic and behavioral factors associated with missing ≥ 1 visit. The Kisumu Incidence Cohort Study (KICoS) was initiated in January 2007 (N=831). Detailed contact information was collected from each participant to enhance retention. Bivariate and multivariable analyses were used to determine factors associated with missing ≥ 1 visit. Overall retention was 90%. Of those enrolled, 46.4% were females. The adjusted odds of missing ≥ 1 study visit were greater for participants who were female (AOR=2.85; CI=1.90-4.28) and who had technical training (AOR=2.51; CI=1.20-5.25) or college/university education (AOR=1.89; CI=1.10-3.24) compared to having no or only primary education. Retention was high in this HIV prevention cohort study. However, studies could benefit by tailoring retention strategies for women. Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of their respective institutions.
Nov 2013 DOI 10.14302/issn.2324-7339.jcrhap-13-266
Chandra Sadhukhan ProvashCorresponding author
I. C. M. R. Virus Unit Kolkata, I.D and B.G Hospital Campus, GB-4 (East Wing), 1st Floor, 57, Dr. Suresh Chandra Banerjee Road, Beliaghata, Kolkata-700010
Objective: Toanalyze the socio-economic pattern amongst HIV patients in eastern and north-eastern India as measured by different parameters such as educational status, wealth, marital status, sexual behaviour. Methods: This study involved 650 HIV seropositive individuals enrolled in a HIV Apex Clinic in a tertiary care hospital in Kolkata, India during 2006 to 2011. Socio-demographic data were obtained while keeping the names of HIV seropositive individual’s names confidential. HIV testing was done according to the guidelines of NACO, India. Diagnoses of different common opportunistic infections were also done. Results: Out of the 650 individuals, 53% reported to have presenting symptoms of low grade fever, 21% had weight loss, general weakness and malaise. 13% reported to have frequent skin rashes, 13% ported to severe seizures and lack of coordination. 41.07 % of them had an income ranging from Rs1000 - 1500 per month. These individuals mainly were daily workers, labourers who work in per day income basis. 44.13% (89 out of 202) of the females were married at a young age, 65 (32.17%) were widowed whose husbands succumbed to HIV. Assessment of the educational qualifications reveals that those individuals affected reveals that 65% of the males received education till standard VIII, 25% received elementary education till standard IV. Conclusion: The study highlights the sectors of the socio-economic class who need more attention to tackle the HIV burden. The analysis of the socio-economic status reveals the low income and lack of education are main contributing factors towards the spread of this disease in this region.
Nov 2013 DOI 10.14302/issn.2324-7339.jcrhap-13-227
Obiako ORCorresponding author
Departments of Medicine, Ahmadu Bello University Teaching Hospital, Shika, Zaria Kaduna State.
Background: In Nigeria HIV infection is transmitted mainly through heterosexual route, affecting mostly individuals within reproductive age groups. As a result, HIV/AIDS education is advocated as a strong component of family and reproductive health education in the school curriculum which should emphasize responsible sexual behavior, premarital chastity and protective sexual practice. Aims/ Objectives: To evaluate student’s knowledge of HIV/AIDS, premarital HCT, and reactions to possible discordant HCT results. Methods: Cross sectional questionnaire-based study of 600 students in 6 schools in Zaria/Sabon Gari LGAs. Exclusion criteria: students aged ≤13 years, married, in JSS 1-3, SS1. Results: 550 students completed questionnaire (92% response rate). 54.5% females (ᾱ age =17.5 ±2.7 years) versus 45.5% males (16.5 ±2.7 years), Muslims (53%) and Christians (47%) respectively. 76%, 57%, and 38% knew the meaning of AIDS, HIV and VCT respectively; while all knew both the routes of HIV transmission and preventive measures. More than two-third supported voluntary, free and self initiated premarital HCT, preferably in a private and confidential setting. None would marry a discordant HIV positive partner, while 61% would marry themselves if both have positive HIV results. Conclusion: Many students would shun marriage with discordant HIV+ partner.
Jun 2013 DOI 10.14302/issn.2324-7339.jcrhap-12-174
Rajesh RadhakrishnanCorresponding author
Radhakrishnan Rajesh M.Pharm, Asst Professor (Senior Grade), Department of Pharmacy Practice, Manipal College of pharmaceutical Sciences, Manipal University, Manipal- 576 104, Karnataka, India.
Background: In India, Human immunodeficiency (HIV) infected patients with highly active antiretroviral therapy (HAART) are at higher risk of developing adverse drug reactions (ADRs). Objectives: The aim of this study was to characterize the pattern of use of HAART, occurrence, incidence, severity and causality of ADRs to HAART in Indian HIV positive patients. Methods: This was a prospective observational study conducted between August 2009 and May 2012. Enrolled HIV positive patients were intensively monitored for ADRs with fixed dose antiretroviral therapy as per National AIDS Control organization (NACO).World Health Organization (WHO) definition of ADR was adopted to detect ADRs to HAART and classified based on WHO adverse reaction terminologies. Naranjo’s scale was used for causality assessment of ADRs. Preventability was assessed using Thornton and Schuman criteria and severity was assessed using the modified Hart wig and Siegel scale. Pattern of ADRs was assessed with patient demographics, ADRs characteristics, and pattern of drug and reaction characteristics. P-value <0.05 was considered as statistically significant. Results: A total of 426 ADRs to HAART were evaluated from 1982 HIV positive patients during the study period. The overall incidence of ADRs to HAART was 21.4%. Significant difference was seen in the incidence of ADRs in the age group of 41-60 years (p <0.001), CD4+T-cell counts of 350-500 cells/µl (p <0.001), females (p <0.001). Three fatal ADRs of with cutaneous drug eruptions of Steven Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) was 1.1%. Anemia (31.7%) accounted for majority of the reports followed by vomiting (15.5%), skin rash (12.9%) and peripheral neuropathy (10.7%). The suspected drug was withdrawn for the management of the ADRs in majority (27.9%) of the reports. Higher incidence rate of ADRs was noted with lamivudine (3TC) + nevirapine (NVP) + stavudine (D4T) (22.9%). In, naranjo's causality assessment, majority of the ADR reports were rated as possible (69%). Symptomatic treatment for ADRs was given in 91.8% of the reports and 86.4% of the reports the patient recovered from the suspected adverse reaction at the time of evaluation. Conclusion: In India, occurrence of ADRs to HAART in HIV infected patients was found to be higher with zidovudine induced anemia (31.7%). The higher percentage of ADRs to HAART was seen with female patients, age 41-60 years; CD4+ T-cell counts 350-500 cells/µl. Physician must focus for monitoring all lab investigations for early detection and prevention of adverse effects associated with HAART.