Some studies have been conducted in Ethiopia to analyze the predictive factors associated with recovery or mortality in children with acute malnutrition, but no recent studies carried out in Oromia have analyze nutritional recovery status in this children. we studied the factors affecting nutritional recovery for survival in acutely malnourished children Southern Ethiopia. cohort study that included the children admitted to the (blinded for review) hospital (Oromia, Ethiopia) for acute malnutrition from January 2015 to December 2016 (n = 440). Kaplan–Meier tests and log-rank tests were used to describe the survival. Chi-squared tests and Spearman and Mann–Whitney U correlation tests were also employed. The mean survival time was shorter in children with severe versus moderate malnutrition at admission (49 days vs. 101 days; log-rank p = 0.042). The survival time was shorter in children with severe acute malnutrition at the time of admission. Survival time of children with moderate acute malnutrition was shorter in children who came from rural areas compared to urban areas. Severe acute malnutrition was associated with hospital stays, death rates, or transfer to another hospital. Practical implications: the results of this study may improve the care of children with malnutrition.
A 25 year old HIV- seronegative client was diagnosed with pulmonary tuberculosis and placed on Category I (CAT I) treatment. After two months, acid fast bacilli (AFB) persisted in sputum. Rifampicin (Rif) resistance was detected with the GeneXpert MTB-Rif Assay® (Xpert; Cepheid, Sunnyvale, CA, USA), leading to a change in treatment to CAT II after completing CAT I in the third month. Continuous detection of Rif resistant species and persisting ‘Scanty’ results (1-9 AFB found in 100 microscopic fields) from sputum smear microscopy (SSM) after one (1) year was suggestive of treatment failure to CAT II [possible extensively drug-resistant (XDR) species]. Category II treatment was continued for the next eight months as we anticipated the arrival of XDR medicines. Before commencement of XDR medication, SSM and GeneXpert were repeated. The SSM result was negative (no AFB seen), while Rif resistance persisted. The controversy was eventually clarified with the Bactec Mycobacteria Growth Indicator Tube (MGIT) liquid culture, which indicated no growth for M. tuberculosis. Since the rapid molecular GeneXpert will persistently detect Rif resistance even after months of treatment, we support the use of MGIT to confirm when treatment should be halted. This case study also showed tolerance to prolonged treatment with CAT I and II drugs and confirms evidence in existing literature.
This study evaluated the renal biofunction potentials of ethanolic extract of Solanum melongena Linn fruit on monosodium glutamate-intoxicated rats' and kidney histology using standard protocol. Twenty four Wistar rats that weighed 105.00 ± 7.00 g were used. The rats were assigned into 6 groups of 4 each and fed thus: Group 1 (control, feed and distilled water only), Group 2 (8000mg/kg body weight monosodium glutamate (MSG)), Group 3 (300mg/kg body weight (bw) the sample extract), Group 4 (8000mg/kg bw MSG + 100mg/kg bw the sample extract ), Group 5(8000mg/kg bw MSG+ 300mg/kg bw the sample extract) and Group 6 (8000mg/kg bw MSG+ 500mg/kg bw the sample extract) daily for 14 days. The results were expressed as mean ± S.E.M and one-way analysis of variance (ANOVA), followed by a Duncan posthoc test was done to test for significance using SPSS version 22.0. The exposure of MSG resulted in a significant (P =0.05) increase in the activities of serum urea, creatinine, potassium ion, chloride ion, and sodium ion compared to the control. MSG and ethanolic extract of Solanum melongena Linn fruit co-treated groups at different concentrations were significantly (P =0.05) reduced to become comparable to the control group. MSG consumption in high concentration alters renal biofunction and this is also evident in the histology of the studied rats' kidney sections. However, the protective roles of ethanolic extract of Solanum melongena Linn fruit were notably at 500mg/kg of body weight in rats, a pointer to the dose-dependent function.
Background: Malaria remains one of the most important causes of morbidity and mortality in endemic areas, primarily affecting children under five years of age. The highest death burden occurs in young children who have not yet developed protective immune mechanisms against the parasite. Objective: This study was undertaken to investigate the effect of Plasmodium falciparum infection on liver function in malaria patients in Ikare Akoko, Ondo State Nigeria. Methods: Blood samples taken from 101 patients (children between the ages of 6 months – 5years) at the State Specialist Hospital Ikare Akoko Ondo State Nigeria between August to October, 2012 were examined. After screening, the patients were grouped into two. Group 1, the test group (those who tested positive to falciparum malaria) and a total of 101 children were selected into this group while 101 children who tested negative to malaria were selected into group 2 (control group). Changes in the activities of serum enzymes were determined in both groups using normal range values as baseline. Results: In falciparum malaria patients, the serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) activities respectively were 63.10+2.76, 138.46+5.04, 70.50±4.33 and those of the non infected patients respectively were 62.39+2.96, 131.46+4.38 and 65.57 ±2.39. This indicates the serum levels of ALT, AST and ALP in infected patients were significantly (P = 0.05) elevated relative to their non-infected counterparts, an indication of defective liver function. Conclusion: This study suggests that malaria parasites could be responsible for derangement of the liver functions in patients and could therefore contribute to organ damage in affected individuals if not treated.
Making a differential diagnosis between schizoaffective disorder with major depressive episode and paranoid schizophrenia is difficult. The patient is at the threshold of neurotic versus psychotic, the intensity of ideation phenomenon being very high and specific to both disorders, it is required an assessment based on life and disorder history information, but also the emotional presence of the patient in the clinical interview. In this case study we suggest a literature comparison but also an evaluation profile of the disorder, marked by a psychiatric illness in which the person shows both affective symptoms (depressive or maniac) and symptoms of schizophrenia (such as delusions, hallucinations). Hypothesis: symptoms of the patient are oscillating between paranoid elements (paranoid schizophrenia) and affective elements (schizoaffective disorder). These oscillations are based on a fragile Ego structure with cognitive rigidity. The study outlines an immature-dependent personality profile, based on interpretativity, with passive-aggressive elements, hypersensitivity, psychotic operation and through psychotic elements manifested in the past (auditory hallucinations, as voices). Also, the basis of the transfer and counter-transference elements identified, the emotional resonance is low, with a risk of psychotic decompensation. Conclusions: Depressive schizoaffective disorder is characterized by presence of both depressive and schizophrenia symptoms in the same time period. Depressive symptoms includes: depressed mood, reduced interest, sluggishness, low energy, difficulty concentrating, insomnia, feelings of despair. During the same episode are present symptoms of schizophrenia: hallucinations, delusions of control, state of hyper-vigilance, delusions injury. Clinical examination cannot be a chance encounter because the history of mental suffering tight interfere with subject's essential history in that it creates a gap and that subjectivity psychiatric symptoms inferred immense emotional and personal participation of the subject.
Introduction- Lipoma is the most common and most widely distributed tumor seen in the body. The most common clinical presentation is a gradually increasing, soft and non-tender mass. These tumours are very rare in hands and if they are present then they are of small size and usually one in number. Herewith we are presenting a case of Palmar Lipomatosis which had a large tumour and 4 small size tumour in same palm. Case report- Herewith we are reporting a case of a 40 years old female, presented with the complaints of multiple swellings in the right palm. She first noticed a small swelling on the thenar aspect of palm about 1½ years back; which was slowly, progressively increasing in size since then. Meanwhile patient also noticed some other swellings in the same palm. Incisions were given over thenar, hypothenar and at the bases of finger. All the tumors were removed en-masse. Biopsy report was fibrolipoma. Conclusion- Palmar lipoma is very rare tumour. Palm has very limited space for these tumours to grow but still these tumours can be found in palm. Very limited case reports about the lipoma of hand are present in literature. Here we presented a rare case of palmer lipomatosis which has multiple lipomatous swellings in same plam. They were removed successfully without any residual deformity.
This study is among major epidemics in the world and Turkey is conducted to evaluate the seasonality of the risk factors of the disease bovine tuberculosis. The seasonal distribution of Turkey’s outbreak of bovine tuberculosis in the 2005-2014 year was investigated in this study. Office International des Epizooties outbreak data was used to determine Turkey’s monthly bovine tuberculosis outbreak data at the provincial level for this evaluation. Turkey's 81 provinces, seven geographic regions, and 12-month outbreak data are evaluated. The distribution of the four seasons of the outbreak to the coast and inland are analyzed for the determined seasonality of the disease. In the study, it was found that Turkey reached the highest number of outbreaks of the disease throughout the summer at a rate of 29.44%. In the study, the risk of bovine tuberculosis disease, diseases of the seasonality of the summer months when the investigation come to the fore, has been carefully assessed in terms of planning for disease control measures. As a result, reveals how it should be used in the identification of disease-specific risk that results obtained in the fight against the disease in this study and the importance of the fight against the disease. Taking control of the disease and timely measures for the disease will contribute to the reduction of costs related to the disease.
The abnormalities of the kidney can be identified by ultrasound imaging. The kidney may have structural abnormalities like kidney swelling, or change in its position and appearance. Kidney abnormality may also arise due to the formation of stones, congenital anomalies, blockage of urine etc. For surgical operations it is very important to identify the exact and accurate location of stone in the kidney. The ultrasound images are of low contrast and contain speckle noise and could affect human body in some situations like pregnancy. This makes the detection of kidney abnormalities rather challenging task. Thus, microwave imaging could be a good alternative. A microstrip patch antenna scanning system allows to identify the exact and accurate location of stone in the kidney. A physical testing system will be developed in order to generate antenna response surfaces on material which could represent the human body. The serum is used in the experimental measurement because it has similar dielectric properties as human body. In order to represent stone presence in an homogenous medium, small calcium sto ne bearings of different sizes embedded are used to simulate the abnormality. Compact microstrip patch antenna were designed and tested at different frequencies in ISM band : 2.26 GHz, 2.38 GHz, 2.5 GHz, and 2.62 GHz for the RF investigation imaging system in order to detect and localize stones in the kidney.
Rickets, a condition caused by a deficiency of vitamin D, has a myriad of presentations and affects children all over the world. Infants who are exclusively breastfed by mothers who are vitamin D deficient are affected, particularly in the absence of vitamin D supplementation during pregnancy. While breast feeding is encouraged, breast milk is deficient in vitamin D thus; exclusively breastfed infants require vitamin D supplementation. This case describes a three-week-old male infant with a continuum of rickets, which went undiagnosed from the initial presentation of noisy, difficult breathing and snoring at the pediatric emergency department. This case emphasizes that rickets may not always have a classical presentation.
This review employed to establish frequency usage of clinical markers and diagnostic tests for childhood apraxia of speech. following databases were searched for published papers between 1980 and 2015 looking for clinical studies used the six introduced tests for motor speech performance; Web of Science, Scopus, CINAHL and Pubmed. . The review considered articles which for children at or below elementary school age with diagnosis of childhood apraxia of speech. Fifty seven articles met the inclusion criteria. Studies included other developmental motor speech disorders as well as childhood apraxia of speech were excluded. Twenty four articles excluded from the study and thirty three studies were reviewed. Twenty articles were in diagnostic tests and thirteen articles were in clinical markers. The Verbal Motor Production Assessment for Children is the most reliable diagnostic test for diagnosis of childhood apraxia of speech, and Inconsistency as well as vowel errors are the most frequent clinical markers.
Herpes simplex virus type 2 (HSV-2) infections is a sexually transmitted infection worldwide, which has a public health implications especially as a driving force behind the Human Immunodeficiency Virus (HIV) epidemic. It is known to cause genital ulcer as well as lesions. It is a lifelong recurrent disease with no cure. Due to the lack of documented HSV-2 studies among HIV patients in this study area with an estimated HIV prevalence of 38.7%, there was a need for estimating the seroprevalence of HSV-2 infection in the study population. The sera of 223 consenting HIV positive patients were screened for HSV-2 specific IgG using an ELISA test kit (Cortez Diagnostic, Inc, USA). The chi-square test was performed to identify possible risk factors associated with the viral seropositivity. The overall seroprevalence of the viral infection was 77.6%. Females recorded a prevalence of 84.5% and males 51.0% (p > 0.05). Participants aged ≤ 20 and ≥ 61 years recorded a prevalence of 100%, while the lowest prevalence (66.7%) was observed in those aged 51-60 years (p > 0.05). There was a statistically significant association between the seroprevalence of HSV-2 in HIV patients in relation to locality. Patients from the rural setting had a higher prevalence (85.2%) of the infection than those from the urban setting (72.6%) (p ≤ 0.05). However, in this study, marital status, occupation, level of education, antiretroviral therapy (ART) status and CD4 counts, had no statistically significant association with HSV-2 infection (p > 0.05). Awareness campaigns that will promote behavioral change might be the most important strategy to mitigate transmission as most of the infected persons usually show no clinical symptoms. The role of vaccination and condom use among high risk groups may help in combating the transmission.
The current study aimed to demonstrate the hepatoprotective effect of chamomile extract and its role in relieving the ultrathin structure changes in liver tissue caused by 2, 4-Dichlorophenoxy acetic acid (2, 4-D) using electron microscopy.This experiment was performed on 12 -14 weeks old male Wistar rats divided into six groups (six animals each). The first group was kept as control. The second and third groups received orally accumulative doses of 75 and 150 mg/kg body weight (b.wt.), of 2, 4- D respectively. The forth group received orally Chamomile extract (500 mg/kg b.wt.) alone. The last two groups received Chamomile extract with either doses of 2, 4-D (75 or 150 mg/kg b.wt). At the end of the experimental period (4 weeks), the liver was dissected and examined by electron microscope. Histopathological examination of liver sections of rats administered 2, 4-D75 mg/kg showed differences in nuclear shapes and size, envelope and increase in heterochromatin masses. Adminstration of 2, 4-D150mg/kg showed pyknosis and changes inmitochondria, endoplasmic reticulum, Kupffer cells, increases in lysosomes and lipid droplets. Chamomile group showed the normal control ultra structure of the liver. In group treated with chamomile and 2, 4-D75,there was improvements in all degenerative changes induced by 2, 4-D75. Chamomile and 2, 4-D150 groupshowed partial improvement in both nucleus and the mitochondria. Chamomile reduces the oxidative damage induced by 2, 4-D due to its antioxidant properties. It is recommended that Chamomile extract can be taken to ameliorate hepatotoxicity.
Finding a reversible cause of pulmonary oedema due to left ventricular dysfunction in intensive care unit is very rare. Here we describe such an event in a young lady who has been diagnosed subsequently as Systemic Lupus Erythromatosus with cardiomyopathy and treated successfully. From ‘Do Not Resuscitate, to ‘doing well’ this is really an encouraging success story.
Retroperitoneal fibrosis (RPF) is a rare disorder manifested by fibrosis and chronic inflammation in the retroperitoneal tissue. It has been reported that retroperitoneal fibrosis is induced by tuberculosis infection (4). We wanted to present a case of latent tuberculosis, who presented with anuria and developed by bilateral hydronephrosis depending on idiopathic RPF, and treated with steroid therapy, since it is a rare case.
Objective: Necrotizing fasciitis is a surgical emergency often requiring prompt diagnosis and treatment. Delay in surgical intervention can have catastrophic results including death. The laboratory risk indicator for necrotizing fasciitis (LRINEC) score uses laboratory parameters to assess the severity of infection and helps in early recognition of necrotizing fasciitis. i?½In this study, we collected the data of 40 patients diagnosed and treated as necrotizing fasciitis to validate the reliability of this score in early diagnosis of necrotizing fasciitis. Materials and methods: This is a retrospective study. Data of 40 patients admitted to Fr. Muller Medical College Hospital, Mangalore from August, 2012 to August, 2014 with a clinical diagnosis of Necrotizing fasciitis was analyzed and relevant statistical tests were applied to evaluate the reliability of the LRINEC score. Results: A total of 40 patients were included in the study. A LRINEC score of > 6 had a sensitivity of i?½ 93.10 %, specificity of 90.91%, positive predictive value of 96.43%, and negative predictive value of 83.33%. The most common organism isolated on culture was Staphylococcus aureus. Conclusion: The LRINEC score is an impressive diagnostic tool to differentiate between necrotizing fasciitis and other less severe soft tissue infections. It aids in early recognition of necrotizing fasciitis enabling prompt and appropriate treatment.
Dengue fever is a fatal infection affecting the lives of the patients and this study was designed to further explore its pathological effects. A total of 200 consecutives of dengue viral infection were included in this prospective descriptive study conducted at the Department of Pathology, University of Veterinary and Animal Sciences, Lahore from October, 2009 to September, 2010. A special proforma was designed to collect all the relevant clinical information from each patient. All the strip positive cases of dengue virus were further confirmed by performing IgM capture ELISA and then analyzed for hepatic impairment through liver function tests including serum bilirubin, serum alkaline phosphatase, serum ALT and AST. The results were then gathered and analyzed. The already existing liver diseases like hepatitis A, B, C, E and inherited liver disorders were not included in the study. Total number of patients included in study with Dengue IgM +ve were 200. Out of 200 cases 130 were male and 70 were females. The patients were categorized into two classes according to severity of sign symptoms like puerperal rash on the body. The classes are dengue fever (DF) and dengue hemorrhagic fever (DHF). The total number of DF cases was 28.50% (57/200) and number of DHF cases was 71.50% (143/200). The patients of DHF group were found to have more liver derangement that is 90.20% (128/200) while the patients belonging to DF group were at a less risk for impairment of liver function that is 9.80% (15/200). The patients with dengue hemorrhagic fever are more prone to have liver enzyme derangement and it has a direct relation with the titer IgM in the body of patients infected with dengue virus. The liver enzyme which are found to be more raised are serum ALT and AST while serum alkaline phosphatase and serum bilirubin are not markedly raised.
Chondrosarcomas are frequent bone tumors, just after osteosarcomas, they represent 11 to 22% of all bone tumors. Proximal humerus localization occurs in about 9% of cases, the clinical picture is variable, imagery helps to establish the diagnosis, to give an exact lesion assessment and to guide therapeutic attitude and post treatment control. Confirmation is set by histology. We highlight through this case presentation clinical and radiological aspects of these tumors.
Introduction: Adamantinoma is a primary low-grade, malignant bone tumor, of unknown histogenesis which is a rare neoplasm, comprise only 0.1–0.5% of all primary bonetumors. It is slightly more common in men than women, with a ratio of 5:4. Wide tumour resection and limb salvage is the treatment of choice. Case report: A 24 year female reffered with chief complaints of pain and limping lasting for approximately 2 years. Plain X-ray showed an expansile multicystic lesion at the diaphysis of the left tibia anterior cortex with periosteal reaction . We used an oscillating bone saw to perform a total resection of the lesion preserving the anterior cortex. Tibial defect created with this resection was replaced with a 14 cm. long strut cadaveric femoral allograft that fixed to tibia with a dynamic commpresive plate (DCP) and screws. Discussion: In surgical treatment of Adamantinoma, total resection was not performed and remain intact posterior cortex to increased the patient satisfaction, at the same time, bone fixation and early weight bearing at the postoperative. We believe that the defect will be able to union with appropriate fixation of the allograft also be long size.
Ileostomy is a standard surgical procedure performed in order to protect the anastomosis and reduce the complication risk in colorectal surgery. Dehydration is one of the most important complications of ileostomy and dehydration-induced renal failure. We present three ileostomy cases that had undergone bowel resection for small bowel perforation, two of which due to mesenteric ischemia, and the other one due to a gunshot injury, all three developing acute renal failure. As ileostomy patients carry the risk of life-threatening renal failure and electrolyte and acid-base changes due to dehydration, clinicians should follow-up these patients closely considering the possible complications of ileostomy.
Saliva, a biologic fluid, recently has been a boon in the field of diagnostic science, as the presence of viable biomarkers in saliva elaborate its applications in multiplexed assays, disease diagnosis, clinical monitoring and for clinical decisions of patient care. Application of saliva in diagnosis is undeniable as ease in sample collection and conventional procedure. This article provides emerging evidence to provide an overview of salivary diagnostics in various fields of diagnosis and affirm its application as diagnostic Bio-Fluid.
