British journal of medicine and medical research最新文献

{"title":"Microbial Profile of Paediatric Ear Infections in a Tertiary Hospital in the Niger Delta Region of Nigeria","authors":"K. Pondei, O. Peterside, E. Totyen","doi":"10.9734/BJMMR/2017/30087","DOIUrl":"https://doi.org/10.9734/BJMMR/2017/30087","url":null,"abstract":"Background: Ear infections are common in childhood. The diagnosis and management of these infections in children is often difficult due to absence or non-implementation of clinical guidelines in developing countries like Nigeria. Empiric treatment is very common. Methods: In order to determine the microbial agents responsible for ear infections in the paediatric population, the records of children sent for ear infection investigations over a twenty-eight month period were analysed. Results: Positive cultures were obtained from 60.8% of the patients. The incidence was greatest in the zero to twelve months and one year to three years age groups. There was a male preponderance of subjects with ear infections. Only 47 (23.6%) of the subjects had full ear Original Research Article Pondei et al.; BJMMR, 19(3): 1-9, 2017; Article no.BJMMR.30087 2 examinations by the Otorhinolaryngologist, with 17 (8.5%) of these having perforations of the tympanic membrane. Gram negative organisms accounted for 60.5% of all isolates. Staphylococcus aureus and Pseudomonas aeruginosa were the most frequently isolated organisms, accounting for 32.5% and 30.2% of all isolates respectively. Candida albicans was isolated from six subjects and Serratia marcescens from one patient’s specimen. Staphylococcus aureus, Pseudomonas aeruginosa and Proteus species exhibited multi-drug resistance In vitro, being resistant to three or more classes of antibiotics. Generally, most of the isolates were susceptible In vitro to the quinolones, but resistant to the cephalosporins and nitrofurans. Most of the subjects did not return for follow-up treatment, with only 3 subjects continually being seen by the ENT specialists. Conclusion: Ear infections are common in children, but differentiating the types of ear infections is not usually done due to treatment guidelines being vague and not well developed. There is a need for collaborative multi-disciplinary approach in the management of childhood ear infections.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":"77 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83942925","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":"Catatonia as a Syndrome Characterized by GABAergic Interneuronal Dysfunction Mediated by NMDA Receptors","authors":"R. Bota, L. Groysman, Austin Momii","doi":"10.9734/BJMMR/2017/30718","DOIUrl":"https://doi.org/10.9734/BJMMR/2017/30718","url":null,"abstract":"Efforts to elucidate the pathophysiology of catatonia have hitherto been unsuccessful largely due to its variegated clinical presentation and seemingly disparate treatment modalities. Catatonia manifests with marked behavioral and cognitive changes, often producing a significant decrease in speech and motor output. Generally, catatonia can be treated with GABA-agonists with impressive symptomatic relief. ECT is also used as a second-line therapeutic intervention if GABA-agonists fail to produce significant symptomatic relief. However, there is uncertainty regarding additional treatment if the aforementioned therapeutic interventions fail to provide symptomatic relief. In the present paper, suggest utilizing pharmacotherapy that modulates NMDAR activity on the basis that catatonia can be fundamentally a syndrome characterized by excessive glutamatergic stimulation of NDMAR on cortical GABAergic interneurons leading to a dysregulation of horizontal and vertical processing.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":"68 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82790947","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":"Pattern of Thyroid Functional Derangements in Patients with Metabolic Syndrome","authors":"A. Ali, A. Deeb, A. Orabi, M. Abdu, A. Gad","doi":"10.9734/BJMMR/2017/32311","DOIUrl":"https://doi.org/10.9734/BJMMR/2017/32311","url":null,"abstract":"Aim: To study the pattern of thyroid functional derangements in patients with metabolic syndrome. Methods: The current study was designed as a cross sectional descriptive study of 130 patients with metabolic syndrome. Results: The mean age was 57.5, with 88 [67.69%] females. According to HOMA-IR estimation; 129 (99.2%) of the studied patients were found to have insulin resistance. Subclinical hypothyroidism was diagnosed in 34 (26.15%). There was no age or sex difference between patients with and without subclinical hypothyroidism however a significant higher prevalence of dyslipidemia (high triglyceride, 25[73.53%] vs. 33[34.38%,], p=0.001) and (low HDL-C, 34[100%] VS. 81[84.38%], P=0.01) in patients with compared to without subclinical hypothyroidism respectively. Also, the mean ± SD waist circumference (138.6 cm ± 1.4 vs 118.9 ± 9.9, p=0.001) and waist/hip ratio (1.24 ± 0.08 vs. 1.098 ± 0.09, p= 0.001) were significantly higher in patients with compared to without subclinical hypothyroidism respectively. There was no statistically significant difference between the two groups regarding HOMA-IR. In addition, there was no significant correlation between HOMA-IR and either free thyroxine (FT4) or thyroid stimulating hormone (TSH). However, TSH was significantly positively correlated with triglycerides; R= 0.2, P=0.02 and negatively correlated with HDL-C; R=-.02, P=0.01. There was significant strong positive correlation between TSH and obesity parameters (waist circumference; R=0.6, P=0.001 and waist/hip ratio; R=0.5, P=0.001), while a significant negative correlation was found between FT4 and fasting insulin; R= -0.2, 0.04, waist circumference; R= -0.2, P=0.01 and waist hip ratio; R= -0.3, P=0.002. The area under the ROC (95% CI) was 0.93 (0.88-0.97), P=0.001 for the waist circumference as a predictor of subclinical hypothyroidism with a sensitivity of 97% and specificity of 81%, while that of waist / hip ratio was 0.86 (0.79-0.91), p=0.001, with a sensitivity of 91% and specificity of 77%. Conclusion: Subclinical hypothyroidism is prevalent among patients with metabolic syndrome. TSH is significantly associated with metabolic syndrome parameters particularly dyslipidemia and obesity indicators.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":"39 8 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82819539","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":"Performance of First Response® and CareStart™ Malaria Rapid Diagnostic Tests for the Detection of Plasmodium falciparum in a Tertiary Hospital in Ghana","authors":"Bernice Ameyaw, M. Mutocheluh, M. Owusu, A. Khalifah, R. Duneeh, P. Narkwa","doi":"10.9734/BJMMR/2017/30892","DOIUrl":"https://doi.org/10.9734/BJMMR/2017/30892","url":null,"abstract":"Background: Malaria poses a major public health problem in sub-Saharan Africa. In Ghana, millions of people are potentially at risk of Plasmodium falciparum infections annually. The current study evaluated the performance of two Histidine rich protein 2 (HRP-2) rapid diagnostic tests (First Response® and CareStart™) using giemsa stained microscopy (microscopy) as the gold standard. This cross-sectional study which took place at the Komfo (KATH) in Kumasi from October 2014 to March, 2015 was done to monitor the performance of RDTs that are used regularly in Ghana. Methodology: A total of 400 children (239 males, 161 females; age range 1-17 years) with fever or history suggestive of malaria were included in the study. First Response® and CareStart™ diagnostic accuracy results were compared with that of microscopy. The strength of agreements (kappa) between the microscopy and the two RDTs were also calculated. Results: Of the 400 blood films that were examined using microscopy, Plasmodium parasites were detected in 33 (8.3%) of them. First Response® showed positive results in 65 (16.3%) and CareStart™ showed positive results in 68 (17.0%). The sensitivities of both First Response® and CareStart™ when compared with microscopy were 97.0% (95% CI: 84.2-99.9) and 97.0% (95% CI: 84.2-99.9) respectively. The specificities were First Response® 91.0% (95% CI: 87.6-93.7) and CareStart™ 90.2% (95% CI: 86.7-93.0). The strength of agreement (kappa) between microscopy and First Response® and CareStart™ with 95% confidence interval was good for the First Response® (giemsa stain microscopy vs First Response®: 0.61) and moderate for CareStart™ (giemsa stain microscopy vs CareStart™: 0.59). Conclusion: The diagnostic accuracy of the First Response® and CareStart™ RDTs to detect malaria was good with no significant differences between the two rapid test kits when compared with microscopy. The RDTs are a suitable alternative to microscopy to test for malaria in rural areas. Therapy (ACT), Special Program for Research and Training in Tropical Disease (TDR), Foundation for Innovative New Diagnostics (FIND), and the Centre for Disease Control and Prevention (CDC), Paediatric Emergency Unit (PEU), Komfo Anokye Teaching Hospital (KATH), Accident and Emergency (A&E), Ethylenediaminetetraacetic acid (EDTA), Complete Blood Count (CBC), High power fields (HPF), White blood cells (WBCs), Red blood cells (RBCs), Positive predictive value (PPV), Negative predictive value (NPV), Plasmodium lactate dehydrogenase (pLDH), Plasmodium aldolase (pAldo), Polymerase chain reaction (PCR).","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":"18 7","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91474739","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":"Etiopathogenesis and Stem Cell Treatment Outcomes in Avascular Necrosis of the Femoral Head: A Review of 50 Cases","authors":"Pradeep V Mahajan, S. Subramanian, A. Jadhav, A. Danke, Siddhesh C Parab","doi":"10.9734/bjmmr/2017/32227","DOIUrl":"https://doi.org/10.9734/bjmmr/2017/32227","url":null,"abstract":"Background and Aim: Avascular necrosis (AVN) is a progressive condition characterized by a vascular insult to the bone, which can lead to collapse of the bone and subsequent degenerative changes. Vascular impairment that results in AVN may occur due to compression of blood vessels that may be due to trauma, immunosuppressive medications or idiopathic etiology. The aim of this review was to identify the prevalence of AVN based on age, sex and causative factors. This review also aimed to analyze the outcome of autologous mesenchymal stem cell therapy in patients suffering from avascular necrosis of femoral head. Methods: 50 cases of avascular necrosis who had undergone autologous mesenchymal stem cell therapy were included in the study. Demographic and etiologic categorization was done based on Original Research Article Mahajan et al.; BJMMR, 20(12): 1-9, 2017; Article no.BJMMR.32227 2 data obtained from case history of patients. Outcome following cell based therapy was done based on Harris Hip Score and radiographic tests (X-ray, MRI). Results and Conclusion: Based on findings in this review, prolonged steroid medication was found to be the prime causative factor for non-traumatic AVN of femoral head. Autologous cell based therapy has been shown to be effective in arresting progression of the condition. Analysis showed statistically significant outcomes with respect to parameters of pain, joint function and range of motion following cell based therapy. This minimally invasive procedure is effective in management of all stages of the condition and aids in preservation/regeneration of joint structure.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":"114 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79600815","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":"A Novel Method to Distinguish Old Composite from Enamel: Spectrophotometric Validation","authors":"Roshni Sharma, Subhrajeet Sahoo, M. Kaushik, P. Reddy, N. Mehra, Uday Kumar","doi":"10.9734/BJMMR/2017/30403","DOIUrl":"https://doi.org/10.9734/BJMMR/2017/30403","url":null,"abstract":"Aim: To identify a dye for disclosing composite resin restoration margins using Results: The results of spectrophotometric analysis of enamel and composite staining showed that Methylene blue caused maximum composite staining (p<0.05). Erythrosine also showed a significant change in shade of composite, greater than enamel due to hydrophobic interaction between the resin and dye (p<0.05). The two hydrophobic food stains Coffee and Carmoisine showed no significant change in colour of composite and could not distinguish the boundary between composite resin and tooth enamel (p>0.05). Conclusion: The exposure of specimens to colored solutions resulted in significant colour alteration. Composite resin is more stainable by hydrophobic dyes compared to tooth enamel.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":"20 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83302108","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":"Screening for Gestational Diabetes Mellitus: Findings from a Resource Limited Setting of Nigeria","authors":"R. Ogu, C. John, O. Maduka, S. Chinenye","doi":"10.9734/BJMMR/2017/31966","DOIUrl":"https://doi.org/10.9734/BJMMR/2017/31966","url":null,"abstract":"Diabetes is a growing non communicable disease (NCD) epidemic. Current international guidelines dictate that in pregnancy, universal screening for GDM for early detection is essential to improve feto-maternal outcomes. However in resource limited settings, risk based screening is still in practice. We undertook records-based review of 837 women who accessed antenatal care between November 2014 and October 2015. The aim was to evaluate the pattern of screening and clinical outcomes of GDM in a resource limited setting of the Niger Delta region of Nigeria. Only 3.7% of the study population representing 31 women was screened for GDM, giving the Original Research Article Ogu et al.; BJMMR, 20(11): 1-8, 2017; Article no.BJMMR.31966 2 overall prevalence of GDM among study participants as 3.3% (28 women). A comparison of fetomaternal outcomes between women screened for GDM and those not screened for GDM showed comparable proportions for gestational age at delivery, mode of delivery and fetal outcome relating to hypoglycaemia, respiratory distress and neonatal jaundice. Also, a significantly higher proportion of babies born to mothers who were screened for GDM were admitted into the Special Care Baby Unit (SCBU). There was no significant difference between the prevalence of stillbirths, neonatal jaundice, hypoglycaemia and respiratory distress in babies born to women diagnosed with GDM compared with babies born to women not screened for GDM. Selective risk based screening for GDM may be leading to missed cases of GDM. The need for universal screening is hereby reiterated.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":"84 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88500538","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":"Anterior Maxilla Rehabilitation with Implants, Subepithelial Connective Tissue and Alloplastic Bone Grafts: A Case Report","authors":"A. Paleari, C. Presoto, G. O. M. Nascimento, L. Barros, A. Pero, M. Compagnoni","doi":"10.9734/bjmmr/2017/30770","DOIUrl":"https://doi.org/10.9734/bjmmr/2017/30770","url":null,"abstract":"The prosthetic rehabilitation of anterior teeth with osseointegrated implants is still a challenge in implantology. To avoid aesthetic complications in areas with bone or mucosal defects, it is often necessary to use bone and soft tissue grafts with the implants. This article describes the surgical and prosthodontic approach to such a patient where removal of the maxillary central incisors was Case Study performed and implants were immediately placed. To avoid the loss of bone and mucosal tissues, alloplastic bone graft and subepithelial connective tissue grafts were used. The prosthetic phase of treatment was performed after the period of osseointegration period, allowing for aesthetic harmony between the prosthesis and gingival tissue.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":"1 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89382921","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":"Screening of Random Blood Sugar in Women: A Critical View","authors":"K. Madhura, S. Patil, Mohd Wahab, S. Javali","doi":"10.9734/bjmmr/2017/31749","DOIUrl":"https://doi.org/10.9734/bjmmr/2017/31749","url":null,"abstract":"Diabetes mellitus is a group of metabolic disorders of carbohydrate metabolism in which glucose is underused, producing hyperglycemia. 250 million people currently have diabetes, by 2025 this number will reach 280 million. 80% among these live in developing countries .Analysis of the 20052006 National Health and Nutritional Examination Survey (NHANES) using both fasting glucose and oral glucose tolerance test (OGTT) shows prevalence of diabetes in US in persons 20 years of age and older of 12.9%. The prevalence of diabetes mellitus increases with age, and approximately half of all cases occur in people older than 55 years. Diabetes is the fourth common cause of death in the developed world. Because early detection and prompt treatment may reduce the burden of type 2 diabetes and its complications, screening for diabetes may be appropriate under certain circumstances. This Data Note Madhura et al.; BJMMR, 20(11): 1-5, 2017; Article no.BJMMR.31749 2 position statement provides recommendations for diabetes screenings performed in physicians' offices and community screening programs. This position statement does not address screening for type 1 diabetes or gestational diabetes mellitus (GDM). Because of the acute onset of symptoms, most cases of type 1 diabetes are detected soon after symptoms develop.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":"3 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91057846","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":"Rhinal Snuff: A Possible Gateway for Sinonasal Malignancy","authors":"Pratiksha Hada, Vikramjit Singh, Sakshi Sharma, S. Dubey","doi":"10.9734/bjmmr/2017/31300","DOIUrl":"https://doi.org/10.9734/bjmmr/2017/31300","url":null,"abstract":"Aim: To present a case report of malignancy of maxillary antrum invading the oral cavity associated with the habit of nasal snuff. Presentation of Case: We describe here a case of a 40-year-old man who developed malignancy of maxillary antrum invading the hard palate after 20 years of snuff usage. He reported to our Department with the chief complaint of swelling and nasal discharge from right nostril since 4 months. On further questioning, patient revealed that he noticed swelling on the right middle 1/3 rd of the face along with clear watery discharge from right nostril. Simultaneously, he also noticed a small pea sized swelling on the surface of hard palate which was gradual in onset and progressed to attain the present size. Discussion: Use of smokeless tobacco products is common worldwide, with its increasing consumption in the developing countries and nasal snuff being the primeval form. Malignancy of the maxillary antrum is an uncommon neoplasm with a small percentage of occurrences. Different studies revealed that continuous use of nasal snuff proved to be carcinogenic. Conclusion: Malignancy of maxillary antrum is relatively uncommon and its treatment poses several challenges to the head and neck surgeons, radiotherapists and medical oncologists. Nasal snuff is a deleterious habit and its prolonged usage proves to be fatal to the patient’s life, as happened in this case. Hence the use of tobacco in any form should be condemned in the society.","PeriodicalId":9249,"journal":{"name":"British journal of medicine and medical research","volume":"21 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89545243","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}