RE the the data and statistical analysis ABSTRACT Objective: To assess and compare the awareness on Primary Health Care amongst medical students from different academic years of medical universities in Karachi, Pakistan. Background: The primary health care (PHC) system in Pakistan is not well developed yet, with lack of access to basic health services and a shortage of primary care physicians. Evaluating the awareness medical students from different years of study have about PHC and whether that influences their career decision-making (medical specialty choices) is important to assess the current state of PHC and predict its future in Pakistan. Hence this study aims to analyze awareness about PHC amongst medical students from different academic years of medical universities. Methodology: This cross sectional study was conducted amongst medical students from different academic years of Karachi, Pakistan. Sample size of 400 medical students was calculated by WHO (World Health Organization) sample size estimation calculator and 25% medical students from each year were obtained by non probability quota sampling technique. Data was collected through a structured, self-administered questionnaire. SPSS version 21 was used for data analysis. Results: Total 400 medical students from different academic years responded in this study with mean score obtained by them is 15.0 ± 2.67. On the basis of mean score obtained by students, the data is dichotomized into two groups i.e. average and above (score > 15) and below average (score <15). Most of the medical students from 1 st to 4 th year of MBBS showed average or above average awareness about PHC. Statistically significant differences were seen in the awareness about some aspects of PHC among 1 st and 4 th year medical students. Conclusion: This study highlights key features on the differences in students’ awareness about concept of primary health care throughout their medical study. It also identifies challenges related to medical students’ level of understanding of the functioning of primary health care system.
Aims: To analyze the ultrastructure of internal interstitial amacrine cell, dislocated amacrine cell, ganglion cells, oligodendroglia, Müller cells, in MT2 ultramicrotome and with periodic acid for Retinal morphology revealed external interstitial amacrine cells as the most voluminous cell above inner plexiform layer. Dislocated amacrine cells described by the first time, localized at the inner plexiform layer, had clear cytoplasm, few ribosomes, few vesicles of rough endoplasmic reticulum and elongated mitochondria with clear matrix. Dark and clear amacrine piriform cells were characterized by glycogen density, and their functional contacts described. External horizontal cells, dark piriform amacrines, stellate amacrines and Müller cells exhibited the highest glycogen concentration in teleost fish retina. Conclusion: This paper is a comprehensive analysis of ultrastructure of five retinal cells, adrenergic terminals inner plexiform layer and glycogen distribution in the retina, finding one new cell, the dislocated amacrine cell and also describing the amacrine interstitial external cell the most voluminous cell in teleost retina.
Objective: To describe patterns for conventional magnetic resonance imaging (MRI) of the cranium in pediatric patients with neuromyelitis optica (NMO). Methods: A retrospective, descriptive study of cephalic lesions and classification of abnormality patterns on MRI of the cranium in pediatric patients with NMO was conducted using the criteria established by Wingerchuck and colleagues, 2006. There viewed cases were from patients treated between 1999 and 2015 at the Center for Demyelinating Disease in Rio de Janeiro, Brazil. Results: Of 55 patients treated for NMO at our center, 12 (21.8%) had their first neurological symptoms before the age of 18 and were thus included in this study. Nine (75.0%) were female and of African descent. IgG-NMO test were positive in 8 patients (66.7%) and negative in 4 (33.3%). The average age of the onset of neurological problems was 11 years old. Transverse myelitis was documented in 7 patients (58.3%), unilateral optic neuritis (ON) in 3 (25.0%), and bilateral ON in 2 (16.6%). The types of MRI patterns were: Absence of a lesion in the cerebral hemispheres and brain stem - The only patient AQP4-seropositive (8,3%) without a lesion detected by head MRI. Unespecific hemispheric lesions - They were found in 2 patients AQP4-seropositive (16,6%). Lesions in the ependyma infratentorial, brainstem and bulbomedular junction associated were present in only one. Hemispheric lesions similar to MS in conjunction with lesions specific to NMO - They were found in 2 patients (16,6%), one was AQP4-seropositive and the other AQP4-seronegative. Lesions in the ependyma supratentorial and brainstem were associated in both cases. Lesions specific to NMO – This type was revealed by MRI in 5 patients (41,6%). Two patients had no lesions in the cerebral hemispheres, but the brainstem was involved in both. In patient AQP4-seronegative there was lesion in the medulla oblongata and the patient AQP4 seropositive there was an extensive lesion in the brainstem, area postrema and infratentorial ependyma. In 3 patients there were lesions in corticospinal tract and the brainstem. Lesion in the ependima supratentorial was found in only one. Extensive hemispheric lesions were demonstrated by MRI in 2 patients AQP4-seronegative (16.7%). Others lesions in 1 patients were found in medulla oblongata and bulbomedular junction. Conclusion: We observed five patterns of conventional head MRI findings in pediatric patients with NMO. Typical signs of NMO, using current criteria, were found with in all of the imaging patterns and were present in patients regardless of their AQP4 status. This case series showed a wide range of clinical and imaging MRI presentations of NMO. Conventional MRI protocols for the study of the brainstem, optic nerves and corticospinal tract showed specific signs and should be included in routine NMO diagnosis protocols.
Aims: To analyze the ultrastructure of cones, rods, horizontal, bipolar and amacrines cells from Mugil brasiliensis teleost retina as well as all the connections found between the cells. Methodology: The retina was fixed with glutaraldehyde and osmium tetroxide and radial and tangential sections stained with lead citrate and uranyl acetate to be analyzed in a horizontal and bipolar cells in a triad structure around the synaptic band. Piriform amacrine cells were described with dark cytoplasm due to numerous glycogen granules and with clear cytoplasm with scarce glycogen granules, both sending prolongations to the inner plexiform layer. Conclusion: This paper is a comprehensive analysis of ultrastructure of seven retinal cells, finding two new cells in teleost retina, 1- tubular cells forming an extensive tangential net below internal horizontal cells, with characteristic structures not seen in the literature on retina before and, 2-undulate amacrine cells that surrounds many bipolar cells across the retina. Functional contacts structured by bilaminar membranes were found between digital terminals of horizontal cells and bipolar cells in rods and cones, between bipolar dendrites, tubular cells, stellate amacrine cells, piriform amacrine cells, as well as between lateral expansions of horizontal cells.
Aims: To observe safety of fasting in patients with type 1 diabetes during Ramadan. Methods: A prospective, case control study was conducted in the Out-patient department of Baqai Institute of Diabetology and Endocrinology from June to September 2013. The study was carried out in two phases; Pre-Ramadan recruitment phase (Visit A) and Post-Ramadan follow-up phase (Visit B) of the same patients. In visit A, Ramadan-specific diabetes education was delivered by health care providers in group session and educational material provided to each patient. Results: Sixty two patients with type 1 diabetes (42 in fasting and 20 in non-fasting group) participated in the study. No significant change (p > 0.05) observed in weight and HbA1c of fasting and non-fasting groups before and after Ramadan. During Ramadan, out of 1380 blood glucose readings in fasting group, there were 98 (7.1%) and 570 (41.3%) episodes of hypoglycemia and hyperglycemia respectively. None of the patients developed diabetic ketoacidosis and none required hospitalization. No significant difference (p > 0.05) observed in the frequency of hypoglycemia while hyperglycemia increased (p < 0.05) when glycemic status during Ramadan was compared with Pre-Ramadan. No significant difference (p > 0.05) observed in the frequency of hypoglycemia and hyperglycemia when Ramadan was compared with Post-Ramadan. Conclusion: We observed that majority of patients with type 1 diabetes did not have serious acute complications of diabetes during Ramadan. Safety of fasting can be ensured in patients with type 1 diabetes with Ramadan-specific diabetes education and medical supervision.
Background: Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are major causes of liver disease worldwide and can cause acute and chronic hepatitis which may lead to hepatic cirrhosis or even cancer, thus creating a significant burden to healthcare systems due to the high morbidity/mortality and costs of treatment. Aim: To determine the seroprevalence of hepatitis B surface antigen (HBsAg) and antibody to hepatitis C virus (anti-HCV) among adult males in Beit al-Faqih districts, Hodeida, Yemen. Study Design: A cross sectional study. Place and of Study: Samples were collected from 4 areas in Beit al-Faqih district, Hodeidah city, Yemen, during the period November 2012 - December 2015. Methodology: Blood samples were collected from 1289 adult males, screening test of HBV surface antigen and antibodies against HCV were performed through enzyme linked immunosorbent Assay. Results: HBV and HCV were detected in 208 (16.1%) subject. The prevalence rate of HBV and HCV were found in 187 (14.5%) and 21(1.6%), respectively. Conclusion: This study demonstrates that the prevalence of HBV and HCV infections is high among adult males in Beit al-Faqih District, Al-Hodeidah Governorate, Republic of Yemen.
Aim: Stress is a major causative factor for the progression of major depressive disorder (MDD). The present study aimed to know the association of serum prolidase activity (SPA) and oxidative stress with the progression of MDD. Methodology: 80 patients with MDD and 80 healthy controls of matched age and genders were selected. Serums SPA, total oxidant status (TOS), oxidative stress index (OSI) and total antioxidant status (TAS) were measured spectrophotometrically. Results: Increased SPA, TOS, and OSI were observed in patients with MDD than healthy controls (all P < 0.001). However, TAS was significantly decreased (P < 0.001). SPA, TOS and OSI were also increased in patients with > 1 years of MDD than patients with ≤ 1 years of MDD. Positive, linear and significant correlations were observed between duration of MDD and SPA, and TOS, and OSI (all P < 0.001). However, negative, linear and significant correlation was observed between duration of MDD and TAS (P < 0.001). Conclusions: The study concluded that SPA and oxidative stress have been significantly increased in the patients with MDD than healthy individuals. Increased SPA and oxidative stress might be significantly correlated to progression of MDD and may be responsible for its pathogenesis.
Aims: To detect the sporadic involvement of shiga toxin producing Escherichia coli (STEC) O157:H7 or any other enterohaemorrhagic E. coli in gastro-intestinal (diarrhoeal) infections. Study Design: The study is a cross sectional survey for bacterial causes of diarrhoea in the study area. Place and Duration of Study: The study was conducted over a six months period (January to July) within Abuja, Nigeria. Methodology: One hundred and six faecal samples were collected and analyzed. Direct inoculation of diarrhoeal stool samples on Sorbitol MacConkey agar and Cefixime-Tellurite Sorbitol Original Research Article Asamole-Osuocha et al.; BJMMR, 19(5): 1-12, 2017; Article no.BJMMR.30184 2 MacConkey agar for the isolation of E. coli O157: H7 alongside Enrichment culture in modified peptone water followed by immunomagnetic separation (IMS) with magnetic beads coated with an antibody against Escherichia coli O157 was used. For the identification of non-O157 STEC among the Non-sorbitol fermenting E. coli isolated, PCR for virulence markers was carried out. Verocytotoxicity Assay was used to detect free faecal toxin in the stool samples for the identification of other Enterohaemorrhagic E. coli (EHEC) infections. Routine methods were used for the isolation and identification of bacterial isolates in the specimens. Results: Enteric bacterial pathogens detected in the study include V. cholerae (1.9% of subjects), S. typhi (1.9%), S. paratyphi B (0.95%), S. paratyphi C (0.95%), unidentified Shigella species (0.95%), Shigella dysenteriae A1 (1.9%), Shigella flexneri (4.7%). No E. coli O157:H7 was isolated. Eleven NSF E. coli isolated and screened for shiga toxin/verocytotoxin (st/vt) genes via PCR and latex agglutination tests were negative. However, free faecal toxin was demonstrated in 16 (15.09%) of the 106 faecal samples analyzed indicating the possible involvement of non-O157 VTEC in diarrhoeal diseases. None of the non-sorbitol fermenting E. coli was found to be STEC. Conclusion: Findings mean that none of the sorbitol-negative E. coli isolated from this study is VTEC/STEC. Results point to the presence of non-O157 VTEC in the study area. This pathogen should be considered as a routinely sought after agent in diarrhoeal illnesses especially among children.
This study was undertaken to assess analgesic and anti-inflammatory properties of seed extract of Carica papaya . Aqueous extracts of the plant at doses of 100, 200, and 300 mg/kg body weight were used for the study on fifty adult white albino wistar rats weighing between 150 to 200 g. The extracts were evaluated for analgesic activity through tail immersion test using 25 rats while antiinflammatory assay was performed by fresh egg albumin-induced paw oedema using 25 rats. For each model, the rats were divided into five groups of 5 rats each. Group 1 served as the negative control group, group 2 served as the positive control group while groups 3, 4 and 5 received 100, 200 and 300 mg/kg body weight of the plant extract respectively. Pethidine and aspirin were employed as a standard (positive control) for analgesic and anti-inflammatory studies respectively. Normal saline was used as negative control. Results showed statistically significant analgesic and anti-inflammatory properties in a dose and time dependent manner (p<0.05). The results thus validate the ethnomedicinal usage of Carica papaya seed extracts in the management of pain and inflammation.
Aims: To investigate changes in the gender ratio (M/F) at birth, fertility and stillbirth rates in England and Wales. Study Design: Analysis of average GR (1974-2010) for 570 UK local government areas. Reanalysis of average GR for births in the UK (2007-2014), by place of birth of the mother. Trend analysis of monthly births and stillbirths. Analysis of annual births (2001-2014) with small area data aggregated to 74 social groups. Place and Duration of Study: England and Wales, 1974 to 2015. Methodology: Average GR ±95% CI over a 35-year period in local government areas, role of population density and deprivation. Analysis of year-to-year volatility in the GR. GR by place of birth of the mother re-analyzed by proportion of countries outside an assumed Poisson distribution. A running 12-month total of monthly births or year-to-year differences in annual male and female births in 181,408 small areas. Results: No evidence for an overall change in the GR between 1974 and 2010. Average GR ranges from 1.004 ± 0.021 in Bridgnorth (Shropshire) to 1.108±0.032 in Maldon (Essex). High population density and levels of deprivation, act to reduce the GR. Country of birth of the motherleads to instances of higher or lower than average GR. Low levels of nuclear radiation are associated with higher GR. Year-to-year volatility in the GR is independent of the average GR and is not influenced by population density or deprivation. After adjusting for size the average volatility ranges from ± 2.28% in Brighton to ± 10.06% in Nottingham, i.e. both average GR and the volatility are independently influenced by the local environment. The running 12-month total (moving total) of births reveals a series of events where the fertility rate suddenly jumps stays high for around 12 months, and then suddenly reverts to the baseline. The GR also jumps to a higher level, as does the stillbirth rate. Mini-outbreaks of a presumed infectious agent can occur at any time, but appear to cluster at certain times to create larger national events. Different social groups show higher levels of penetration and magnitude of the increase in births or change in the gender ratio. Preliminary analysis of increased hospital admissions associated with these outbreaks reveal increases in a range of conditions affecting reproduction, pregnancy, neonates and specific types of congenital malformation. Conclusion: The GR is sensitive to place of birth of the mother, population density, deprivation, location and social group. Year-to-year volatility in the GR is location and social group specific. Fertility rate, gender ratio and stillbirth rate respond to outbreaks of a presumed infectious agent. Fertility, GR and stillbirths all stay high for around 12-months before reverting to baseline. Social behaviors play a role in the magnitude of the effect. The increased fertility rate associated with these outbreaks has capacity implications for maternity units. It is likely that the proposed agent exerts its effect in the period 2 to 15 weeks after conception when female fetal mortality is highest. The primary effect of the proposed agent is likely to be via immune manipulation. A potential role for the immune modifying virus, cytomegalovirus, is discussed.
Aims: This Policy Article, which includes data synthesis, seeks to evaluate the effectiveness of demographic-based forecasting of future hospital admissions, and hence for hospital bed numbers. A role for the absolute number of deaths, as a proxy for persons approaching the end-of-life, will also be investigated, especially as this is the principle factor behind the volatility in bed occupancy. Study Design: Literature review plus supporting analysis of relevant trends. Place and Duration of Study: Studies from a variety of countries, analysis of data relating to the NHS in England, additional analysis relating to the Kings College Hospital, London. Findings: Demographic forecasting is subject to the constant risk fallacy, namely, admission rates are changing over time. A variety of factors can be seen to lead to changes in admission rates. Policy Article Beeknoo and Jones; BJMMR, 19(2): 1-27, 2017; Article no.BJMMR.29984 2 There is strong evidence that it is the trend in the absolute number of deaths, rather than demography which drives most of the marginal changes in bed demand. Up to 55% of a person’s lifetime bed utilization may occur in the last year of life. However, the ratio of deaths per 1,000 population ranges from 4 to 16 (inner city communities to more rural and retirement locations). Deaths per GP also ranges between 5 to 27, while the crude mortality rate in English hospitals ranges from 1.3% to 5.4%. These imply that in some locations end-of-life has a greater impact not only on primary, secondary and social care resources, but also on the volatility in resource requirements. There are 20 deaths per GP in the Torbay integrated health and social care organization indicating that the 30% fewer bed days per death achieved in this organization may not be replicated elsewhere. Same-day-stay admissions require separate forecasts since they rely on technological trends driving day surgery rates (elective admissions) and the need for observation and rapid diagnosis in medicine (both elective but mainly emergency admissions). In England, an obsession with fewer beds on behalf of the Department of Health (now NHS England) has been a key factor bringing the NHS into crisis. The worst affected hospitals now run at close to 100% average occupancy. However, the period 22 weeks prior to death appears to mark a watershed for acute care, where surgical, medical and critical care interventions become increasingly futile. A shift to a more palliative-based model of non-acute care is recommended, and will lead to considerable savings in occupied beds. A new generation of models are desperately required, as are supporting biochemistry, vital sign and frailty-based algorithms to enable care to be diverted out of acute hospitals during the last weeks of life.
Objective: The aim of this study is to investigate the practice of laparoscopic gastric plication (LGP) in Syria with particular emphasis on efficacy and complications, and to explore the concept of bariatric surgery in times of crisis with its related issues and concerns. Materials and Methods: A prospective cohort study included all patients who underwent LGP between February 2011 and September 2014. The main outcome was the percentage of excess weight loss (%EWL). Secondary outcomes included operative time, hospital stay, postoperative complications, and improvement of related comorbidities. Results: Of the 129 patients who underwent LGP in the study period, 96 patients were included in the final analysis. The mean body mass index was 39.5 kg/m (32–49 kg/m). No cases of conversion to laparotomy, leak, intraabdominal infection, or mortality were seen. Vomiting was the most common postoperative complaint, which was encountered in 91.6% of patients. Two patients required operation reversal because of protracted vomiting. Mean %EWL was 60%, 65%, 70%, 67%, 66% and 65% at 6, 12, 18, 24, 30 and 36 months respectively. Obesity-related comorbidities were present in 33 patients (34.4%), and they showed considerable improvement or complete Original Research Article Hammadieh et al.; BJMMR, 19(3): 1-9, 2017; Article no.BJMMR.30714 2 resolution in 57-100% of cases. Weight regain was seen in 7 patients (7.3%) after 36 months, three of whom (3.1%) requested reoperation. Conclusions: LGP is a feasible and safe operation for the treatment of morbid obesity, and it is comparable to other restrictive bariatric operations with fewer rates of serious complications. It is an appropriate technique in times of crisis due to low cost and ease of follow-up.
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.
Aim: Aim of this present study is to quantify, evaluate and assess the therapeutic benefits of honey on the treatment of recurrent apthous ulcer. Materials and Methods: Sixty patients with minor oral ulcers were attended by Dept. of Oral Medicine and Radiology for treatment for oral ulcers. A double blinded clinical trial was carried out by topical application of honey or placebo therapy and the reduction in size and duration of complete elimination of ulcerations were noted. Results: The ulcers had reduced in size considerably after 3 days of treatment by honey dressings, some with complete remission after another 3 days.
Gorlin–Goltz syndrome is an autosomal dominant disorder, with mutations in the patched tumor suppressor gene (PTCH1) leading to a wide range of developmental anomalies and neoplasms of cutaneous, dental, osseous, ophthalmic and neurological origin. It commonly presents as multiple keratocystic odontogenic tumors (KCOTs) of the jaws, basal cell carcinomas (BCC) of skin, calcifications of the falx cerebri, ocular hypertelorisms, palmar-plantar pits, bridging of sella turcica and macrocephaly. In addition to these major criteria, more than 100 minor criteria have been described. We hereby, present one such case of Gorlin-Goltz syndrome reported to our dental clinic in Jabalpur, India. A 20 year old male patient presented with complaint of foul fluid discharge Case Study Tripathi et al.; BJMMR, 20(10): 1-8, 2017; Article no.BJMMR.32469 2 from a peri-apical sinus of an over retained, mobile Deciduous Maxillary left canine tooth. Patient’s general physical examination revealed macrocephaly, wide nasal bridge, ocular hypertelorism, numerous naevi and a sebaceous cyst. Panoramic and CT examinations revealed presence of multiple keratocystic odontogenic tumors (KCOT) in both the jaws, bridging of sella turcica, patchy calcifications of falx cerebri and tentorium cerebelli. Though, multi-disciplinary examination revealed no evidence of neoplasm, multi-disciplinary treatment along with genetic counseling was provided to the patient. Lifelong surveillance was offered to prevent future morbidity and mortality associated with this syndrome. This case, illustrates the importance of thorough dental and physical examination including examination of draining oral sinuses, missing teeth, deciduous teeth, macrocephaly and frontal bossing. Additionally, detailed investigations in patients with lesions suggestive of aberrant phenotypic characteristics are mandatory.
HIV and HCV are neurotrophic viruses with great potential to cause neurocognitive impairments (NCI). Yet, results of neuro studies among Coinfected individuals are still inconclusive. This study pooled estimates to define the neurocognitive profile and neuroepidemiology of Coinfection in relation to monoinfection. Data from the qualified studies was grouped in to seven neurologic domains to yield weighted average effect sizes (WAES) which were pooled together in metaanalyses. Further assessments were meta-regression analysis, sensitivity analysis and computation of heterogeneity diagnostic indices. From eleven studies the pooled estimates showed that only the Coinfected group had a medium effect size (ES) in speed of information processing (SIP). Other neurologic domains exhibiting a medium ES across all the study groups were executive function (EF) and attention/working memory. These neurocognitive deficits epidemiologically translates in to NCI prevalence of 47% among Coinfected group who were also twice more likely to be neurocognitively impaired compared to HIV monoinfection group. Despite substantial heterogeneity, Kernel density plot of WAES approximates to normal distribution making publication bias unlikely. Coinfection is associated with deficit in SIP, EF and attention/working memory with substantial risk of global NCI underscoring the need for medical and psychosocial interventions to improve the lives of affected individuals.
Background: Systemic sclerosis is a chronic autoimmune inflammatory disease with wide-spread fibrosis of the skin and internal organs. The hypoparathyroidism associated with systemic sclerosis is infrequent and rarely reported in literature. Case Report: A 48 year-old female patient applied to our clinic with headache, increasing pallor and bruising cold of the hands. Physical examination revealed sclerodactyly and hardening on the skin of forearms and face. Centromeric type anti-nuclear antibodies were detected in the serum, and the patient and was diagnosed with systemic sclerosis. The same woman had also been Case Study diagnosed as epilepsy and she had been subjected on anti-epileptic drug therapy for 14 years. We found that she had also hypocalcemia (4,6mg/dl). She was diagnosed as pseudohypoparathyroidism. Conclusions: Pseudo-hypoparathyroidism associated with systemic sclerosis is a very rare entity. And pseudo-hypoparathyroidism should also be kept in mind in autoimmune disorders.
This work was carried out in collaboration between all authors. Authors RKDE, MEG and RCB designed the study, performed the statistical analysis, wrote the protocol and wrote the first draft of the manuscript. Authors MEG and CN managed the analyses of the study. Authors FOB and CN managed the literature searches. All authors read and approved the final manuscript. ABSTRACT Objective: This study investigated chronic kidney disease (CKD) and urine abnormalities in highly active antiretroviral therapy naïve (HAART-naïve) human immunodeficiency virus (HIV) infected adults, presenting to two antiretroviral therapy (ART) clinics in the Volta region of Ghana. Methods: A cross-sectional study of 100 newly diagnosed HIV/AIDS patients attending ART clinics of the St. Anthony’s and Ho Municipal hospitals both in the Volta region was conducted. Vital clinical history and socio-demographic data were recorded from the folder of eligible participants. Blood and urine samples were collected for serum creatinine estimation; urinalysis was performed with dipstick and light microscopy. CKD was assessed with the Kidney Disease Improving Global Outcome (KDIGO) guidelines. Results: Nine percent (9%) of the participants had CKD (eGFR<60 mL/min/1.73 m²). Prevalence of CKD was higher (88.9%) in females than in males (11.1%). Median creatinine levels were significantly higher in males than in females ( P =0.0103). Eighteen percent (18%), 13%, 11% of the participants had proteinuria, pyuria and haematuria respectively. On urine microscopy, we recorded 8% (8/100) crystalluria (7/8 -calcium oxalate and 1/8 -triple phosphate), 9% epithelial cells, 20% pus cells and 7% red blood cells among our participants. Participants with confirmed CKD had more pyuria and haematuria than those without CKD. Conclusion: This study revealed a 9% prevalence of CKD among our participants with the condition being more common in females. Urine abnormalities like proteinuria, haematuria, pyuria and crystalluria were common in our participants. Routine urinalysis and screening for CKD in HIV/AIDS patients should be strengthened as it will help in early detection of renal abnormalities.
Background: Port site infections though rare, shall be evaluated and studied so as to improve the quality of healthcare. The advantages of laparoscopic surgery are well known, but the question is, is it totally free of complications like port site infections? Does performing laparoscopic surgery guarantee, post-operative period free of infections? Port site complications are known to happen. We, in our study, intend to find out the prevalence of port site infections in patients undergoing various laparoscopic surgeries like Cholecystectomy, Appendectomy, Hernioplasty. Aims: To study the prevalence & nature of port site infections (PSIs) in cases of laparoscopic surgeries in all age groups in a tertiary health care centre in the rural setup. Materials and Methods: Patients of all age groups and both sexes undergoing Laparoscopic surgeries during a period of 1 year between June 2013 to June 2014 were followed up and Original Research Article Gupte et al.; BJMMR, 20(10): 1-9, 2017; Article no.BJMMR.33062 2 included in the study. Port sites were meticulously examined for any infections, and if suspected, swabs were sent for culture and sensitivity. Patients undergoing Laparoscopic surgeries were documented and studied against set parameters to evaluate the prevalence as also to ascertain the factors affecting the chances of PSI. Regular swab sticks were used to send swabs of those port sites where the infection was suspected. Results: Out of the total sample size of 100, two patients had port site Infections. Both patients’ portsite was contaminated during the procedure. The rate of PSI was not affected by age, sex, nature of procedure or duration of hospital stay in our study. Neither did the type of surgery or comorbidities affect the same. Statistical analysis used: Chi-square test. Conclusions: Port site infection is a rare complication of Laparoscopic surgery. The advent of laparoscopy has reduced the rate of postoperative morbidity. Chances of PSI were found to be significant though if the port site was accidently contaminated.
