British journal of medicine and medical research最新文献

{"title":"Epidemiology of Road Traffic Crash Injuries as Seen in the Emergency Room of a Tertiary Hospital in Delta State, Nigeria","authors":"D. Odatuwa-Omagbemi, A. Oruma, R. Enemudo, C. Otene, G. Iwegbu, M. Okeke, E. Akpojevwe","doi":"10.9734/bjmmr/2017/32752","DOIUrl":"https://doi.org/10.9734/bjmmr/2017/32752","url":null,"abstract":"Background/Objective: Road traffic crashes are an important source of frequent trauma with resultant morbidities and mortalities in Nigeria and worldwide. We aim to highlight important epidemiological characteristics and injury patterns in road traffic crash victims presenting at our centre and make suggestions on possible ways to alleviate the problem. Patients and Methods: Consecutive adult road traffic crash victims who presented with various injuries at the emergency room in our health facility within the study period and agreed to participate in the study were included. Data on age, sex, type of vehicle and circumstances of crash, types of injuries etc were collected on already prepared forms by attending emergency room physicians. Data analysis was carried out using SPSS version 17 (SPSS Inc. Chicargo, Illinois. USA). Results: Data were collected for 88 eligible adult road crash victims during the study period. There were 53 males and 35 females (M:F = 1.5:1). Mean age was 37 ± 14 years. Most of the victims fell within the age groups of 20 -29 years (33.3%) and 30 – 39 years (22.7%). Motorcycles were the most commonly involved (40.4%). Sixty five point two per cent (65.2 %) of the crashes involved commercial vehicles. Over speeding was adjudged as the most probable cause of crashes by 30.1% of victims. Passengers were the victims in 46.6% of cases and drivers in 37.5% of cases the rest being pedestrians. The head was injured in more than 40% of cases followed by lower extremity injuries. The victims sustained a total of 58 fractures the tibia and fibula being the most frequently fractured bones. Most of the victims (70.5%) were conscious and stable at presentation. Nearly all the victims (95.5%) were rescued and brought to hospital by other road users, fellow passengers and relatives. Conclusion: Road traffic crashes frequently affect males and the most productive age groups with its attendant dire consequences on the socio-economic life of the people. Human related factors such as over speeding significantly contribute to its occurrence. There is almost non-existence of rescue and pre-hospital care in our environment. The need for drivers / road user’s education, road maintenance and putting in place a well organized rescue and pre-hospital care team is emphasized.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85828174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pattern and Outcome of Severe Trauma Using the Trauma and Injury Severity Score (TRISS) Methodology in a Dedicated Trauma Centre in Nigeria","authors":"S. Ibeanusi, S. Harcourt","doi":"10.9734/BJMMR/2017/33392","DOIUrl":"https://doi.org/10.9734/BJMMR/2017/33392","url":null,"abstract":"Background: Trauma is a leading cause of mortality and a major contributor of disability as measured by Disability Adjusted Life years lost to inury in various parts of the world. Pattern of injuries and quality of care given to trauma patients differ in various parts of the world. The quality of care given in a particular centre can be assessed and compared with that from other centres by utilising an established standard method of assessment such as the Trauma Research and Injury Severity Score (TRISS). In this observational study, the pattern of presentation of severe trauma and quality of care given to severely injured patients at a trauma centre in Nigeria is evaluated using the TRISS methodology. The findings are compared with those reported from other countries. Methods: Data required for trauma demographics and TRISS calculation was extracted from the trauma registry of Teme Hospital, Port Harcourt Nigeria and analysed. Trauma demographics, type of care and the probability of survival of included patients were evaluated using the TRISS methodology. Results: Seven hundred and sixty two patients were seen with severe trauma but 746 patients had enough information required for analysis. Most of the trauma patients seen at the centre were males with a mean age ± standard deviation of 28.5 ± 11.3 years. Road traffic collision was the commonest cause of injury (41.2%) but gunshot injuries contributed a sizable number of the injuries (36.7%). The median Injury Severity Score (ISS) was 20 (range = 16 – 75) while the mean Revised Trauma Score (RTS) ± SD was 7.1 ± 1.3. The median probability of survival was 0.98 with a range between 0.00 and 0.99. The M, Z, and W statistics were 0.87, - 8.5, and -7.0 respectively. From TRISS analysis, 38 patients (5.1%) were expected to die but the observed mortality was 12.4%. Most mortality was related to severe head injuries. Conclusion: Trauma burden is an identified problem at Teme Hospital Nigeria. Severe trauma constitutes only 12% of trauma cases seen at the centre but it is the main contributor to trauma deaths. The observed mortality is higher than the expected as calculated using TRISS methodology and this call for improvement in the quality of care at the centre.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85910089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Evaluation of Risk Factors for Cerebral Palsy in Children in Jos, Nigeria","authors":"E. Ejeliogu, A. Ebonyi, C. John, E. Yiltok, B. Toma","doi":"10.9734/BJMMR/2017/33226","DOIUrl":"https://doi.org/10.9734/BJMMR/2017/33226","url":null,"abstract":"","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84116674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and Fetal Outcome after Assisted Conception in Port Harcourt, Nigeria","authors":"N. Orazulike, J. Alegbeleye","doi":"10.9734/BJMMR/2017/30044","DOIUrl":"https://doi.org/10.9734/BJMMR/2017/30044","url":null,"abstract":"Background: The introduction of assisted reproductive technology (ART) has played a major role in reducing the burden of infertility among couples. Although most pregnancies following assisted conception will progress normally without any increased risk to the mother or baby, studies have shown that some women who conceive in this manner as well as their babies are indeed at increased risk of complications. Objective: To evaluate the maternal and neonatal outcome after assisted reproductive technique (ART) in Port Harcourt, Nigeria. Materials and Methods: A retrospective case control study of 51 women who conceived via ART (subjects) and 51 women who conceived spontaneously (control) managed at the obstetric unit of the University of Port Harcourt Teaching Hospital, (UPTH), Nigeria over an 8-year period was conducted. Data obtained from theatre records and case notes of patients were analysed using the statistical package SPSS 20. Results: The rate of multiple pregnancy was 47% (24 women) in the ART group compared with Original Research Article Orazulike and Alegbeleye; BJMMR, 19(7): 1-9, 2017; Article no.BJMMR.30044 2 6% (3 women) in the control group and this was statistically significant (p = 0.001). Thirty-one (61%) of the women had adverse outcomes in the ART group compared to 9 (18%) in the control group and this was statistically significant (p = 0.001). Early pregnancy bleeding (p =0.03), hypertensive disorders of pregnancy (p = 0.05), pre term delivery (p = 0.002) caesarean delivery (p = 0.001), low birth weight (p = 0.001) neonatal admission (p = 0.02) and perinatal deaths (p = 0.03) were significantly commoner in the assisted conception group. The rates of antepartum haemorrhage, diabetes mellitus, postpartum haemorrhage, maternal death and mild birth asphyxia were not statistically different between the two groups. Conclusion: ART pregnancies are associated with more adverse feto-maternal outcomes compared with spontaneously conceived pregnancies.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79926286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, Isolation and Detection of Virulent Gene in Escherichia coli from Duck","authors":"S. Majumder, M. Akter, Islam, K. Hussain, Shobhan Das, I. Hasan, K. Nazir, Marzia Rahman","doi":"10.9734/BJMMR/2017/32003","DOIUrl":"https://doi.org/10.9734/BJMMR/2017/32003","url":null,"abstract":"Aims: This study was conducted to determine virulent genes in Escherichia coli prevalent in duck population by multiplex Polymerase Chain Reaction. Methodology: A total of 60 cloacal swab samples were collected from two duck farms of Bangladesh Agricultural University and Shamvuganj. Initially the samples were screened for the detection of E. coli on the basis of cultural, staining and biochemical properties, followed by molecular detection of E. coli using genus specific primers to amplify 16s RNA. Results: According to the results, out of 60 samples, 26 (43.33%) were confirmed to be E. coli positive. Among the E. coli positive samples, 12 (46.15%) samples were found positive for Stx -1 and 11 for Stx -2. Among 26, 11 (42.31%) samples possess both Stx -1 and Stx -2 genes, whereas only one isolate had Stx -1 gene. The prevalence of both Stx -1 and Stx -2 in Bangladesh Agricultural University Poultry Farm was 41.66%, and the prevalence of Stx -1 and Stx -2 in Shamvuganj was 50% and 42.86%, respectively. Conclusion: This is the first report on the detection of virulence genes in E. coli of duck origin in the context of Bangladesh. This study indicates that duck may play role for the transmission of Shiga-like toxin producing E. coli (STEC) to human or its environment through fecal contamination or eggs or meat.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80320067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Plasma-leptin on Cardiac Disorders with Type 2 Diabetes-patients","authors":"N. Al-Aama","doi":"10.9734/BJMMR/2017/29482","DOIUrl":"https://doi.org/10.9734/BJMMR/2017/29482","url":null,"abstract":"Background: The net mechanism by which visceral fat concentration is still unclear because of its interference with autonomic dysfunction which could be simply modified by leptin through the dorosomedical hypothulumus. This work studies the potential correlations between visceral fat concentration, cardiac autonomic dysfunction having diabetic disorder (type 2) and leptin. Methods: The present work includes 90 cases with cardiovascular risk parameters and diabetic patients and 90 (age- and gender-matched) non diabetic. Typical measurements for cardiovascular risk factors have been measured in addition to plasma visceral fat area, heart variability, leptin and soluble leptin receptor standards. Results: Visceral fat area is highly inversely dependant on the parameters of heart rate variability (p < 0.05 and standard deviations of NN (normal RR) intervals during the 24-hour period r = -0.239, p =0.003 . Similarly, the plasma standard of leptin is also important (p < 0.05) showing reverse dependence with the parameters of heart rate variability standard deviations of NN (normal RR) intervals during the 24-hour period r = -0.238, p = 0.017 . In case of non diabetic patients, Data Article there are almost zero dependence between leptin and any of heart rate variability parameters. Conclusions: Patients having visceral obesity and type 2-diabetes are strongly affected with hyper-leptinemia which may lead to cardiac autonomic dysfunction. recorded for minutes: Estimated glomerular filtration rate, presence of hypertension and dyslipidemia, the age, male gender, hemoglobin A1c, and duration of diabetes as covariates, duration of diabetes.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80327320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-relative Study of Serum Prolidase Activity and Oxidative Status in Patients with Diabetic Neuropathy","authors":"R. Kumari, R. Srivastava, A. Verma, N. Agarwal","doi":"10.9734/BJMMR/2017/30938","DOIUrl":"https://doi.org/10.9734/BJMMR/2017/30938","url":null,"abstract":"Objective: Diabetic neuropathy is one of the most common long term complication of diabetes. Associaton of oxidative stress have been reported in diabetes. The study was aimed to evaluate oxidative status in diabetic neuropathy patients by estimation of serum total oxidative status (TOS), total antioxidant status (TAS) and prolidase activity. Methods: Sixty (60) patients of diabetic neuropathy were included in the study and 60 normal subjects were taken as control. TOS and TAS were measured in serum extract by colometric test. Along with these laboratory parameters, demographic and neurological examination was also done. Original Research Article Kumari et al.; BJMMR, 20(1): 1-9, 2017; Article no.BJMMR.30938 2 Results: The activity of TOS, TAS, oxidative stress index (OSI) and serum prolidase activity were higher in cases as compared to control.TOS (p<.0001) has a weak positive correlation with very low density lipoprotein (VLDL). TAS (p>.05) is negatively correlated with basal metabolic index, serum triglyceride (STG), serum cholesterol (SC), very low density lipoprotein (VLDL), high density lipoprotein (HDL), fasting blood sugar (FBS), post prandial blood sugar (PPBS) and HbA1c. In our study prolidase activity was elevated in cases as compared to control that was not significantly different (P>.001). A significant positive correlation with HDL (r= .418) and moderate negative correlation with HbA1C (r = -.318), VLDL (r = -.308), STG (r = -.301) was found. Conclusion: Thus, our study concludes that TOS and OSI have a significant role in diabetic neuropathy. In addition to this increased serum prolidase activity in diabetic neuropathy patients may be due to increased collagen turnover. Increase in TAS activity needs to be further investigated as the sample size of this study was small and although it was an accidental finding.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82454548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Infection of Staphylococcus aureus: Nasal Carriage, Skin Carriage and Multi-antibiotic Resistance in Healthy Individuals","authors":"E. Nmema","doi":"10.9734/BJMMR/2017/32307","DOIUrl":"https://doi.org/10.9734/BJMMR/2017/32307","url":null,"abstract":"Aims: The study investigated the nasal and skin carriage of Staphylococcus aureus in healthy individuals and the antibiotic resistance profile. Study Design: A descriptive laboratory based surveillance study. Place and Duration of Study: Department of Biological Sciences, Ondo State University of Science and Technology, Okitipupa, between May and November 2016. Methodology: Eighty samples were obtained from anterior nares and skin of 40 healthy volunteers aged 19 to 35 years. Isolates were identified by cultural characteristics on Mannitol Salt Agar, biochemical tests. Percentage carriage of S. aureus was calculated separately for nasal and skin samples. Antibiotic susceptibility testing was performed by the disk diffusion method to determine the multi-antibiotic resistance (MAR) profile. Results: From 40 nasal samples, 17 (42.5%) yielded S. aureus from 12 (30.0%) female and 5 (12.5%) male volunteers. Out of 40 skin samples, 17 (42.5%) samples yielded S. aureus from 8 (20.0%) female and 9 (22.5%) male volunteers. There were no differences in the number/percentage of nasal and skin samples yielding S. aureus ; but there were differences in the number/percentage of nasal samples of male and female volunteers colonized by S. aureus , while little difference was found in the number/percentage of skin samples of male and female volunteers colonized by S. aureus . MAR for nasal isolates was 66.7% to 77.8%, and for skin isolates 66.7% to 88.9%. The isolates showed 100% resistance to six antibiotics; but zero resistance to ofloxacin. MAR index for nasal and skin isolates ranged from 0.67 to 0.89. Conclusion: S. aureus carriage of 42.5% in the nasal cavity and skin, combined with high MAR index of 0.67 to 0.89 are serious risk factors for infection when the immune system is compromised. Nasal decolonization, proper hand washing, use of hand gloves and appropriate use of antibiotics will reduce the risk of S. aureus colonization, transfer and infection, and the consequent high morbidity and mortality.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81387903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"5 Case Reports of Maternal Experiences during Pregnancy, Peripartum and Infancy Periods of their Profoundly Deaf Children under the Socioeconomic Situation in Nigeria","authors":"R. Kalu, J. Fulton, K. Etim","doi":"10.9734/BJMMR/2017/30785","DOIUrl":"https://doi.org/10.9734/BJMMR/2017/30785","url":null,"abstract":"The incidence of profound hearing loss is global, but the challenges and perception of mothers during pregnancy, peripartum and infancy of their children with profound hearing loss appear to differ from country to country and between developed and developing countries. The aim of this study was to investigate the experiences of five mothers of profoundly deaf children in Calabar, Southeastern Nigeria, during pregnancy, peripartum and infancy of such children, including how Case Report Kalu et al.; BJMMR, 20(5): 1-11, 2017; Article no.BJMMR.30785 2 these 5 mothers interpreted their children’s disability, relative to the socioeconomic situations in Nigeria. A qualitative methodology aimed at having a holistic and indepth understanding of the experiences of these 5 mothers, was employed. The results revealed that these 5 mothers were initially suspicious of their children’s disability when they noticed the children’s developmental delay, resulting in frustration and worry. There was no newborn screening test for the disability as done in developed countries, thus denying parents expeditious preventive measures. Mothers’ ignorance of the aetiological factors of the abnormality, wrong diagnosis by unskilled health workers in available hospitals and spiritual belief, coupled with socioeconomic factors such as poverty and very strange healthcare system, all were the experiences of mothers which of course, obstructed choices of solution to the abnormality. The information collected from these 5 mothers indicates socioeconomic impediments, ignorance and spiritual belief system will continue to negatively affect the management of profound deafness in Nigeria.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86309863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Morphology of the Lumbosacral Articular Processes in Adult Chinese and Its Biomechanical Implication","authors":"Lilt Xin, Yuanyuan Xia, Qingyong Ma","doi":"10.9734/bjmmr/2017/29233","DOIUrl":"https://doi.org/10.9734/bjmmr/2017/29233","url":null,"abstract":"Aim: The morphology of the lumbosacral intervertebral joints in the Chinese race was investigated in the present study to understand the relationship between the articular joint interface and intervertebral disc prolapses. Methods: Spine specimens (N=30) from both male and female adults with ages ranging from 30 to 60 years old were used. They were fixed with 3% formaldehyde, frozen and cut through the intervertebral joints and the intervertebral disc. The angle between the facet joint interface and the median sagittal line on both sides was measured for each joint. Results: The angle between the facet joint interface and the median sagittal line increased gradually from the L1-L2 joint to L5-S1 joint, and the angles in the L4-L5 and L5-S1 joints were both significantly wider than those of other lumbar intervertebral joints. When the angles on the left side were compared with those of the right side, those on the left side were significantly wider than those on the right side. Since the force acting toward the intervertebral disc can be decomposed into one component perpendicular to the facet joint interface and one parallel to the facet joint interface, when the facet joint interface is in a more sagittal position, it blocks less shearing force that acts to slide the vertebra anteriorly. When the facet joint interface is in a more coronal position, it blocks most of the force. Conclusion: Although the L1 –S1 are more coronal in positions on the left side, most disc prolapses happen on the left side, suggesting that some adaptive processes might contribute to the more coronal orientation of these facet joint interfaces or the shearing force act more along the facet joint interface on the other side.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86320261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}