Open Access Macedonian Journal of Medical Sciences
ISSN / EISSN : 1857-9655 / 1857-9655
Current Publisher: ID Design 2012/DOOEL Skopje (10.3889)
Total articles ≅ 2,368
Latest articles in this journal
Published: 8 November 2020
Open Access Macedonian Journal of Medical Sciences, Volume 8, pp 807-814; doi:10.3889/oamjms.2020.4841
BACKGROUND: There is a lack of evidence of whether degenerative cervical myelopathy (DCM) is best treated through cervical laminoplasty (CLP) or cervical laminectomy with lateral mass fusion due to the lack of prospective randomized studies that are well designed. We conducted the largest prospective randomized trial to date to determine the comparative effectiveness and safety of both approaches. METHODS: In this prospective, randomized trial, we randomly assigned patients who had symptoms or signs of DCM to undergo either cervical laminectomy and lateral mass fixation (CLF) or CLP. The primary outcome measures were the change in the Visual Analog Scale (VAS), neck disability index, modified Japanese Orthopedic Association (mJOA) score, and Nurick’s myelopathy grading 1 year after surgery. The secondary outcome measures were the intraoperative, post-operative complications, hospital stay, C2-7 Cobb’s angle, and Odom’s criteria. The follow-up period was at least 1 year. RESULTS: A total of 30 patients (mean age, 54.5 ± 5.5 years, 70% of men) underwent prospective randomization. There was a significantly greater improvement in neck pain (VAS) in the CLF group at 1 year (p < 0.05). The improvement in the mJOA and Nurick’s myelopathy grading showed insignificant improvement between both groups. Furthermore, there was no significant difference in the patient’s post-operative satisfaction (Odom’s criteria). The mean operative time was significantly longer in the CLF group (p < 0.001), with no significant difference in the post-operative complications, however, there was a higher rate of C5 palsy, dural tear and infection in the CLF, and a higher rate of instrumentation failure in the CLP. The mean hospital stay was significantly longer in the posterior group (p < 0.05). Finally, there was a significant better improvement in the C2-7 Cobb’s angle at 1 year in the CLF group (p < 0.05). CONCLUSION: Among patients with multilevel DCM, the CLF approach was significantly better regarding the post-operative pain and Cobb’s angle while the CLP was significantly better in terms of shorter hospital stay and operative time.
Published: 19 October 2020
Open Access Macedonian Journal of Medical Sciences, Volume 8, pp 699-705; doi:10.3889/oamjms.2020.4886
BACKGROUND: Uncoupling proteins (UCP) and β3-adrenergic receptor (ADRB3) gene polymorphism have been implicated in the susceptibility to type 2 diabetes mellitus (T2DM) but the results are inconsistent and inconclusive. AIM: The aim was to investigate the relationship between -3826A/G (rs1800592) of UCP 1 and ADRB3 Trp64Arg (C/T) (rs4994) gene polymorphism and the incidence of T2DM among Saudis. METHODS: Genotyping of both UCP1 and ADRB3 genes was carried out in 110 healthy controls and 108 unrelated Saudis with T2DM using polymerase chain reaction-based restriction fragment length polymorphism. RESULTS: The genotype and allele frequencies of the UCP1 gene did not differ significantly between diabetic subjects and controls (p > 0.05). However, the CT genotype and the T allele of ADRB3 were higher in diabetic subjects compared with the controls while the CC genotype and C allele were higher in the controls relative to the diabetic subjects (Odds ratios [OR]: 7.85, 95% confidence interval [CI]: 4.23–14.59, p < 0.001 and OR: 7.434 95% CI: 4.026–13.39, p < 0.001, respectively). CONCLUSION: The UCP1 -3826A/G polymorphism may not be associated with the susceptibility to T2DM among Saudis while T allele of ADRB3 may be related to the risk of T2DM, whereas the CC genotype and C allele may confer protection to T2DM.
Published: 19 October 2020
Open Access Macedonian Journal of Medical Sciences, Volume 8, pp 935-937; doi:10.3889/oamjms.2020.4752
BACKGROUND: Approximately 50% of the world population are suffering from Vitamin D insufficiency. Vitamin D is one of the steroid hormones, which is a fat soluble vitamin that has a critical role in maintaining the homeostasis of bones. Low-energy fractures are defined as falling from the level of standing height or even less that usually should not result in fractures. Another study that was done in Jeddah on a sample of 510 children between the age of 4–15 taken in the pediatric clinic at Jeddah Clinic Hospital-Kandarah. 59% had relative deficiency, and 27% had a deficiency in 25-hydroxyvitamin D. AIM: Therefore, this research is conducted to collect more evidences to assess the association between vitamin D level and low-energy fractures in children. METHODS: The study group consisted of 14 children aged 3–15 years old with low-energy fractures and the control group consisted of 24 children in the same age without fractures. Vitamin D level was measured in each one of them and X-ray was obtained from the cases to prove the presence of low-energy fracture. The analysis plan that was used in this research is Fisher’s exact test to overcome the small sample size. RESULTS: Vitamin D levels were found deficient in four cases, and eight of them were insufficient. Whereas, the normal level of Vitamin D was found in only two of the cases. On the other hand, in the control group the level of Vitamin D was deficient in four participants, and 15 others were found to be insufficient. Also, five of the participants were found to have a normal Vitamin D level. According to the results, low levels of Vitamin D were observed in both groups. A total of 23 out of 38 children enrolled in the study were found to have an insufficient Vitamin D level. The result of p = 0.718 which is not significant to prove the correlation between Vitamin D insufficiency and low-energy fractures. CONCLUSION: In conclusion, this study did not show any relation between Vitamin D level and the presence of low energy fracture. Future studies are required to include more subjects and centers to their study or to compare the low energy fracture and high energy fracture in term of Vitamin D level.
Published: 15 October 2020
Open Access Macedonian Journal of Medical Sciences, Volume 8, pp 158-165; doi:10.3889/oamjms.2020.4509
BACKGROUND: Stability and retention of mandibular complete denture are a chronic complaint in elderly patients and it may have potential effect on dementia. AIM: The study was conducted to evaluate the impact of the long-term soft liner (LTSL) for mandibular dentures on brain activity and cognitive function of completely edentulous elderly patients. PATIENTS AND METHODS: Thirty elderly completely edentulous denture wearer patients were selected to participate in the study. Patient’s brain activity and cognitive function were investigated before and after the relining of the mandibular complete dentures with an LTSL material. Patient’s brain activities were investigated by electroencephalograms, while patient’s cognitive functions were evaluated by the aid of mini-mental state examinations. RESULTS: Statistical analysis of obtained results revealed a significant difference in patient’s brain activity as well as a cognitive function before and after the relining of the mandibular complete dentures. CONCLUSIONS: Long-term soft-lined mandibular dentures seemed having an impact on brain activity and cognitive function for elderly completely edentulous denture wearers.
Published: 15 October 2020
Open Access Macedonian Journal of Medical Sciences, Volume 8, pp 938-942; doi:10.3889/oamjms.2020.5114
BACKGROUND: Soil-transmitted helminth (STH) infections were the highest infection in children aged 5–15 years old. They lead to iron deficiency anemia and folic acid deficiency. One of the strategies to treat the issues is anthelmintic administration with iron-folic acid supplementation. AIM: This study aims to evaluate the effectiveness of single-dose albendazole and albendazole with iron-folic acid supplementation on hemoglobin (Hb) levels in children with STHs. METHODS: This was an open-label randomized clinical trial conducted in Batubara Regency from September to November 2018. Subjects were primary schoolchildren with STH infections. They were grouped into albendazole and albendazole with iron-folic acid supplementation groups. The data were analyzed by independent t-test and Mann–Whitney U-test. RESULTS: From 139 children, 72 children received albendazole single dose and 67 children received albendazole with 30 mg iron and 250 μg folic acid weekly for 3 months. The median of baseline hemoglobin level was 12.2 gr/dL, whereas after intervention was 12.7 gr/dL. The hemoglobin level increases did not differ significantly between the two groups (p > 0.05). However, clinical improvement was observed. CONCLUSION: Iron-folic acid supplementation in addition to albendazole did not show any benefit for primary schoolchildren with STH infection in Batubara Regency, North Sumatera, Indonesia.
Published: 15 October 2020
Open Access Macedonian Journal of Medical Sciences, Volume 8, pp 887-891; doi:10.3889/oamjms.2020.5174
BACKGROUND: The global prevalence of type 2 diabetes mellitus (DM), a chronic metabolic disorder, has been steadily increasing. Increasing blood sugar levels (BSL) are reliably measured by glycated hemoglobin (HbA1c). AIM: The aim of this research is to observe the relation between lipid profile with glycemic control at uncontrolled and controlled type 2 DM, early detection of abnormalities in the lipid profile can minimize cardiovascular complication risk in patients with type 2 DM. METHODS: Collecting medical data record, for example, blood pressure, height and body mass index, duration of disease, family history, and medicine treatment. Laboratory examination such as BSL, HbA1c levels, and lipid profile such as cholesterol, low-density lipoprotein, high-density lipoprotein, and triglycerides (TGs) was evaluated. The study was conducted by implementing cross-sectional methods, among 112 patients with type 2 DM who were admitted from various primary health-care centers in Medan city and the surrounding areas in North Sumatera. The sample criteria are type 2 DM’ patients and both genders. The exclusion criteria of the samples are those with type 1 DM and critical disease. RESULTS: There is a difference between the average lipid profile level (high-density lipoprotein and TG) in controlled and uncontrolled type 2 DM. Furthermore, there is also a difference between the average HbA1c value in controlled type 2 DM and uncontrolled type 2 DM (p
Published: 15 October 2020
Open Access Macedonian Journal of Medical Sciences, Volume 8, pp 866-870; doi:10.3889/oamjms.2020.5043
BACKGROUND: Preeclampsia (PE) is a possible etiology of obstetrical and neonatal complications which are increased in resource-limited settings and developing countries. AIM: We aimed to find out the prevalence of PE in Iraqi ladies and specific outcomes, including gestational weight gain (GWG), cesarean section (CS), preterm delivery (PD), and low birth weight (LBW). METHODS: All singleton pregnant women visiting our tertiary center for delivery were involved over 3 years. PE women were compared with non-PE ladies. Complete history and examination were done during pregnancy and after delivery by the attending obstetrician and neonatologist with full documentation in medical records. RESULTS: PE prevalence was 4.79%, and the affected women had significant (p < 0.05) higher age, body mass index, and GWG, but lower gestational age at delivery. The mean significant difference of GWG in PE and non-PE patients was 1.82 kg. PD and LBW had significant higher frequencies in PE. After considering several confounding factors, crude and adjusted odds ratio (OR) of PE with 95% confidence interval (95% CI) were significant in CS (crude OR = 2.25 and 95% CI = 1.42-2.87 while adjusted OR = 2.89 and 95% CI = 1.43–3.06) and PD (crude OR = 2.41 and 95% CI = 1.73–2.46 while adjusted OR = 3.96 and 95% CI = 2.65–6.37). On the other hand, only the crude model touched significance in LBW (crude OR = 3.67 and 95% CI = 2.51–4.99). CONCLUSIONS: Prevalence of PE in Iraqi pregnant females was higher than other neighboring developing countries. In PE ladies, maternal parameters, including GWG and operative delivery, and neonatal complications, including PD and LBW, were significantly higher than pregnant women without PE.
Published: 13 October 2020
Open Access Macedonian Journal of Medical Sciences, Volume 8, pp 164-166; doi:10.3889/oamjms.2020.4918
BACKGROUND: Gallstone ileus is a misnomer of intestinal obstruction. This rare entity of gallstone disease happens after episodes of acute cholecystitis, Mirizzi’s syndrome, or even after endoscopic intervention. CASE REPORT: A 17-year-old lady with acute cholecystitis, hepatolithiasis, and choledocholithiasis was endoscopically managed through endoscopic retrograde cholangiopancreatography. She was initially well but complicated with intestinal obstruction the next day. The abdominal radiograph and computed tomography showed a dilated small bowel secondary to gallstone ileus. An emergency laparotomy was performed to relieve the obstruction. CONCLUSION: Gallstone ileus is a rare cause of intestinal obstruction. It must be suspected in a patient with underlying gallstone disease, especially after an endoscopic biliary intervention. Emergency enterotomy and stone extraction are the imperative surgical intervention if the stone is not able to pass out spontaneously.
Published: 10 October 2020
Open Access Macedonian Journal of Medical Sciences, Volume 8, pp 602-607; doi:10.3889/oamjms.2020.4655
BACKGROUND: The prevalence of metabolic syndrome (MS) in children and adolescents has increased, along with increasing incidence of obesity. AIM: The aim of this study was to find out the polymorphism characteristic of cholesteryl ester transfer protein (CETP) -629C/A gene promoter and to prove that the CETP -629C/A polymorphism, serum CETP, and chemerin levels were risk factors of MS in obese adolescents. MATERIALS AND METHODS: A matched case–control study with obese adolescent aged 11–18 years was conducted from May to December 2017. Samples were consecutively recruited in seven junior and senior high schools in Denpasar. Case groups were obese adolescents with MS and control groups were obese adolescents without MS (non-MS obese). Both groups fulfilled eligibility criteria were matched by gender and puberty status. The study data were analyzed by Chi-square test and logistic regression with significant level p < 0.05. RESULTS: Analysis of CETP -629C/A polymorphism showed, AA and CA genotype were not a risk factors for MS when compared with CC genotype (OR = 0.81 [95% CI 0.23–2.88], p = 0.75 and OR = 0.95 [95% CI 0.38–2.37] p = 0.91, respectively). There was no significant difference between individual carriers A allele with individual carriers C allele to risk of MS (OR = 0.91 [95% CI 0.39–2.14], p = 0.83). The cutoff point of CETP levels was ≥2 μg/mL considered as CETP high levels, and
Published: 10 October 2020
Open Access Macedonian Journal of Medical Sciences, Volume 8, pp 762-768; doi:10.3889/oamjms.2020.4678
BACKGROUND: The normoglycemic patients with diabetes risk and prediabetes have insulin resistance and consequently endothelial dysfunction that possible causes macroangiopathy and adverse cardiovascular events and further mortality of it. An early diabetes risk identification using not only prognostic scales but also biomarkers is starting and crucial point of struggle with 2 type diabetes mellitus and its complications. AIM: The aim of the study is to estimate the impact of FABP4 biomarker on diabetes risk and cardiovascular events. METHODS: A cross-sectional study was conducted simultaneously among 389 respondents aged 18–65 years. We provided survey and clinical examinations. The risk of diabetes was assessed using the FINDRISC scale and cardiovascular risk (CVR) was assessed using SCORE scale. The serum FABP4 biomarker was studied using a multiplex assay, immunofluorescence using XMap technology, a Bioplex 3D instrument, and a MILLIPLEX® Human cardiovascular disease panel I reagent kit(Millipore). Results were considered statistically significant at p < 0.001. RESULTS: The group of type 2 diabetes mellitus (T2DM) high risk was 79 (20%) of all study participants. The level of the FABP4 marker significantly prevailed in high-risk group of T2DM and high CVR was also established this group. We found a positive direct average correlation(r = 0.59; p = 0.000) between FABP4 and FINDRISC scale. The logistic regression analysis indicated that the level of the FABP4 marker increases withing the increased risk of T2DM. The correlation between FABP4 concentration and CVR according to the SCORE scale (r = 0.24; p = 0,000) was lower than between FABP4 and diabetes risk. Risk factors were established affecting on the increasing CVR by SCORE scale in patients with T2DM risk. CONCLUSIONS: The level of FABP4 significantly prevailed in the group of diabetes and cardiovascular risk (CVR). The established correlations between FABP4 level and CVR or T2DM risk indicate on its increase in groups with a higher risk of type 2 diabetes and a high CVR.