Journal of Advances in Medicine and Medical Research

Journal Information
ISSN / EISSN : 2456-8899 / 2456-8899
Published by: Sciencedomain International (10.9734)
Total articles ≅ 1,729
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Latest articles in this journal

Djamila Adjiri,
Journal of Advances in Medicine and Medical Research pp 7-12; https://doi.org/10.9734/jammr/2022/v34i1531393

Abstract:
A fundamental principle of the scientific approach is to justify the main precise facts, stated during the writing of the thesis by scientific, professional and popularization documents. Aim is to contribute to the improvement of the quality of the scientific medical writing of the theses Faculty of Medicine of Setif, in particular the references transcription. Its a comparative study “before – after” a training session on the quality of the scientific medical writing of 120 theses at the faculty of medicine during the two academic years 2014 - 2015 et 2015 -2016. The references transcription was more correct for the pharmacy department. Transcription anomalies were significantly less frequent and the proportion of theses with a correct chapter title was significantly for times greater (OR = 4.0; 95% CI = 1.4–11.2). The same result for titer was observed for the second year (OR = 10.5; 95% CI = 3.4–32.1), but with no significant difference for the number of transcription abnormalities. The insufficient level of knowledge of techniques of scientific medical writing show that the usefulness of training sessions is indisputable for improving the quality of scientific texts and promoting publications.
P. Chithambara Shathviha,
Journal of Advances in Medicine and Medical Research pp 13-19; https://doi.org/10.9734/jammr/2022/v34i1531394

Abstract:
Introduction: A fusion of the mandibular condyle with the base of the skull causes ankylosis of the temporomandibular joint (TMJ), which results in a lack of joint movement. The anesthesiologist is concerned about prolonged temporomandibular joint ankylosis because of the restricted airway, which makes intubation difficult. Despite the fact that TMJ ankylosis is a well-known risk factor for difficult airway management, the strategies used are based on the anesthesiologists' skill. It's never easy intubating a patient with temporomandibular joint ankylosis. The purpose of this study was to see how common problematic intubation was in TMJ ankylosis patients. Aim of the Study: The aim of the present study was to evaluate the incidence of difficult intubation in TMJ ankylosis patients. Materials and Methods: Among the overall data of patients attending Saveetha Dental College, a retrospective analysis of all the cases (patients who underwent TMJ ankylosis surgery) was extracted. Excel spreadsheets were used to enter the data. SPSS software version 19 was used to analyse the data collected. The data were statistically evaluated using the Chi square test. Results: In this study, it was discovered that the incidence of difficult intubation in TMJ ankylosis surgery was higher in the age group of 5-18 years than in the other age groups. Intubation in children is tough. The chi square test resulted in statistically significant findings (p<0.005). Conclusion: Nasal intubation and fiberoptic intubation were the most common modes of intubation used in TMJ ankylosis surgery, according to the results of this small sample retrospective analysis. The difficulty of intubation was increased in the paediatric age group (5-18 years).
Liudas Vincentas Sinkevicius,
Journal of Advances in Medicine and Medical Research pp 1-6; https://doi.org/10.9734/jammr/2022/v34i1531392

Abstract:
Background: Despite all efforts to ensure road safety, road deaths rank eighth in the world. More than 3,500 people die on the world's roads every day, almost 1.3 million. avoided deaths and around 50 million injuries annually. Aim  of  the  Study: The aim of the study was to investigate the links between risky driving and psychopathic traits. Materials  and  Methods: 257 drivers participated, ranged from 18 to 66 years. A multivariate linear regression analysis was performed to determine if psychopathy predicts risky driving. Methods used in the study: the Driving Behavior Questionnaire to measure risky driving and the Triarchial Psychopathic Measures Questionnaire to measure psychopathic traits. Results: Drivers with a higher degree of psychopathic disinhibition trait commit more driving errors, slips and lapses, aggressive and ordinary driving violations; Drivers with a higher degree of psychopathic meanness trait commit more aggressive and ordinary driving violations; Drivers with a higher degree of psychopathic boldness trait make fewer driving mistakes and have a lower overall risk of driving; Psychopathy traits can predict risky driving and the disinhibition trait of psychopathy has the highest prognostic value in predicting risky driving. Conclusion: Psychopathy traits shows relationship with risky driving and psychopathy trait disinhibition can prognose risky driving.
, Chidimma Deborah Okolie, Iniekong Philip Udoh, Ngozi Felicia Onyemelukwe
Journal of Advances in Medicine and Medical Research pp 68-78; https://doi.org/10.9734/jammr/2022/v34i1431390

Abstract:
Background: Extended -Spectrum Beta- Lactamases (ESBLs) are enzymes that confer resistance to a wide range of β-lactam antibiotics, including penicillins, third-generation cephalosporins, and aztreonam, but not to cephamycins or carbapenems, and are blocked by beta-lactamase inhibitors. Aim: To evaluate the antimicrobial susceptibility profiles of Escherichia coli and Klebsiella pneumoniae and to determine the prevalence of ESBL-producing Escherichia coli and Klebsiella pneumoniae isolates from the hospital and environmental samples. Methodology: The study was conducted from October 2020 to June 2021 in the Microbiological Laboratory of the University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu. A total of 150 non-duplicate bacteria isolates were recovered from urine, wound swab, high vaginal swab, stool, sputum, and environmental sources. Isolates were identified and characterized using standard microbiological protocols. Antimicrobial susceptibility was performed using the Kirby-Bauer disc diffusion procedure. Phenotypic detection of ESBL production was determined using Double Disc Synergy Tvest. Results:E. coli isolates from hospital samples were highly resistant to cefuroxime (100 %), cefixime (100 %) augmentin (100%), ciprofloxacin (91%), and cefotaxime(86.6%). However, nitrofurantoin and imipenem were highly potent 80.6 % and 76.1% respectively. Among the 67 strains of E. coli from hospital samples, 32(47.8%) were found to be ESBL producers. Of the 60 Klebsiella pneumoniae hospital isolates tested, 27(45%) were found to be ESBL-producers. Of the 18 strains of E. coli from environmental isolates, 12(66.7%) were found to be ESBL producers. Out of only five Klebsiella pneumoniae from environmental samples tested, 4(80%) were found to be ESBL producers. A total prevalence of 75(50%) ESBL producers from the 150 isolates were found. Conclusion: The findings of this study showed an alarming rate of 50% ESBL-producing E. coli and Klebsiella pneumoniae in Enugu Metropolis, Nigeria with a high antimicrobial resistance in both ESBL and non-ESBL-producing isolates.
Nidhi Chaturvedi, , Rani Bansal
Journal of Advances in Medicine and Medical Research pp 64-67; https://doi.org/10.9734/jammr/2022/v34i1431389

Abstract:
Autoimmune phenomena are commonly encountered in the female population either as the primary disease or in association with conditions like pregnancy or as a part of paraneoplastic syndromes. Exact pathogenesis of such immune reactions may be clearly defined in cases like Grave’s disease, SLE etc or may be secondary to unexplained phenomena .These patients however may manifest as hematological symptoms like anemia and thrombocytopenia, skin manifestations or co existing thyroid issues .Tumors commonly present with autoimmune paraneoplastic syndromes. These can be non-hematological and hematological. Common hematological manifestations we encounter are either ITP or autoimmune hemolytic anemias. Ovarian tumors rarely occur with autoimmune features. There have been documented cases of bilateral dermoid cyst with associated Immune thrombocytopenia (ITP) as well as autoimmune hematological anemias in recent literature. Here we discuss a case of a 26-year-old female with bilateral ovarian dermoid cyst, who presented with transfusion dependent anemia and thrombocytopenia. Her anemia responded to immunosuppression therapy but thrombocytopenia responded to lesser extent.
, Oladapo Mayowa Akinfolarin, Ken-Ezihuo Stella Urekweru, Ebirien-Agana Samuel Bartimaeus
Journal of Advances in Medicine and Medical Research pp 57-63; https://doi.org/10.9734/jammr/2022/v34i1431388

Abstract:
Background: In developed countries, heart disease and stroke are the major causes of death. One of the main risk factors of cardiovascular disease is dyslipidemia, and this could be due to increased lipoproteins and/or decreased plasma clearance. Pregnancy is marked with changes in metabolism in preparation for the developing fetus and lactation after delivery. Pregnancy causes long-term metabolic and vascular changes, which may raise the general risk of heart disease. Aim: The goal of this study was to see how cardiovascular indicators changed during pregnancy in hypertensive pregnant women at Rivers State University Teaching Hospital. Methodology: The study included 150 people who were divided into three groups: Non-pregnant hypertensive women (50), pregnant hypertensive women (50), and pregnant hypertensive women (50). (50 hypertensive pregnant women). After giving their consent, subjects were chosen using a simple random procedure. Total cholesterol (TC), high density lipoprotein (HDL), triglyceride (TG), low lipoprotein density (LDL), very low density lipoprotein (VLDL), uric acid (UA), C-Reactive protein (CRP), apoprotein A1 (APoA1), and apoprotein B (APoB1) were all measured in the lab using the venipuncture technique under fasting conditions (APoB). Results: The findings revealed that there was a significant difference in each of the examined parameters (P0.05). Conclusion: This study has shown that hypertensive pregnant women are potential future candidates of cardiovascular disease.
Hend Ahmed Ghoneem, Mohamed Elsayed Afandy, Ahmed Ali Abdel Hafez, Yasser Mohammed Amr
Journal of Advances in Medicine and Medical Research pp 48-56; https://doi.org/10.9734/jammr/2022/v34i1431387

Abstract:
Background: Patients with rib fractures or chest contusions are unable to cough or breathe deeply, which may lead to atelectasis and pneumonia. And the cornerstone of management of rib fractures is aggressive treatment of this pain. Ultrasound guided (US) regional techniques was linked with fewer adverse effects and higher efficacy if compared with systemic therapy with multiple rib fractures. We designed this work for comparing the efficacy and safety of thoracic paravertebral block (TPVB) versus erector spinae plane block (ESPB) in cases with multiple fractured ribs. Methods: This is a double-blinded prospective randomized controlled trial which was conducted on 60 patients aged ≥ 18 years of both sexes. The participants had unilateral multiple fractured ribs (≥ 3 ribs), and they were randomly enrolled into two equal groups. Group I had US guided TPVB. Bupivacaine 0.25% in a volume of 20 mL was injected in a bolus dose, then a continuous infusion of bupivacaine 0.25% at a rate of 0.1 mL/kg/hr. Group II received (US) guided ESPB. Bupivacaine 0.25% in a volume of 20 mL was injected in a bolus dose and then suspected to a continuous infusion of bupivacaine 0.25% at a rate of 0.1 mL/kg/hr. Results: Visual analogue score (VAS) decreased significantly after institution of blocks (p-value 0.05). And total morphine consumption was insignificant between two groups (P =0.836). Also, heart rate (HR) and mean arterial blood pressure (MAP) decreased significantly compared to pre-block values in both groups with an insignificant difference between the two groups (P >0.05). Moreover, respiratory, and arterial blood gases (ABG) parameters improved significantly in both groups in the form of reduced in respiratory rate (RR), elevated oxygen saturation, and increase in P/F ratio with an insignificant difference between the two groups (P >0.05). Occurrence of complications as hypotension, bradycardia and pneumothorax was less in ESPB group than TPVB group. Conclusions: ESPB is nearly effective as TPVB to relief pain in cases with rib fractures as demonstrated by significant decrease in VAS scores in both groups.
Megha Rao, B. S. Keshava Prasad, H. Murali Rao, Vanamala Narayana
Journal of Advances in Medicine and Medical Research pp 9-15; https://doi.org/10.9734/jammr/2022/v34i1431384

Abstract:
One of the most important steps in endodontic therapy is obtaining an adequate access to the root canal system. This ensures adequate instrumentation, irrigation, visibility, access and disinfection, making endodontic therapy more predictable. However, in the process of gaining a good convenience form, access cavities are being excessively widened, weakening the tooth to masticatory forces and increasing their chance of fracture. Clark and Khademi introduced evidence based new concepts of modern endodontic access designs which primary aims at preservation of tooth structure and increasing fracture resistance of the tooth. Several techniques of modern access designs have been proposed but they all correspond to one fundamental concept, bio-minimalism. This review aims to comprehensively summarize the principles of modern access cavity preparation as well as highlight the various techniques of modern access cavity designs.
Samar Darwish Mostafa Alhelby, Hossam AbdElmohsen Hodeib, Amr Mohamed Gawaly, Ebaa Hussein El-Sheikh
Journal of Advances in Medicine and Medical Research pp 16-30; https://doi.org/10.9734/jammr/2022/v34i1431385

Abstract:
Background: Lupus erythematosus is a diverse autoimmune disorder that is capable of afflicting a variety of organs and has a clinical history that is inconsistent. Despite substantial improvements in systemic lupus erythematosus (SLE) patient survival, the pathophysiology of the disease remains unexplained, despite the fact that genes play a key role in its propensity. Objective: To evaluate the several hematological indicators (neutrophil- to- lymphocyte ratio (NLR), platelet -to- lymphocyte ratio (PLR), platelet distribution width (PDW), red cell distribution width (RDW), mean platelet volume (MPV) in SLE patients and their correlation with disease manifestations. Patients and Methods: In our study, a cross-sectional comparative study that enrolled 100 SLE patients (30 male and 70 female patients) aged from 18-55y who are recruited from the Internal Medicine Department, Rheumatology Unit (inpatient wards and outpatient clinics) the patients were categorized into three groups according to the (SLE disease activity index 2000. (SLEDAI-2K): Group (I): Inactive (SLEDAI-2K, <6) Include thirty-one patients. Group (II): Moderately active (SLEDAI-2K, 6-10) Include twenty-nine patients. Group (III): Highly active (SLEDAI-2k, ≥11) Include forty patients. Results: Our study showed clinical parameters such as vasculitis, nephritis, serositis, CNS involvement are significant and indicate severe activity. Also, our study showed laboratory data as ESR, ANA, anti-dsDNA, and consumption of complement showed a significant correlation with systemic lupus activity. The highly active group had higher PLR, NLR, PDW, and MPV than other groups. However, the highly active group showed a decrease in lymphocyte median. CNS symptoms indicated a negative correlation that is statistically significant with lymphocytes. While it demonstrated a statistically significant positive correlation, with NLR, however, CNS showed a significant positive correlation with PDW. Nephritis had a significant positive correlation with NLR and PLR. Vasculitis had a positive highly significant correlation with lymphocytes and a positive significant correlation with PLR. Conclusion: Patients with SLE in both high and moderate activity of disease exhibited significant renal manifestations, vasculitis, serositis, CNS symptoms, consumed C3 and C4 while ESR and Anti-dsDNA were elevated in all groups. The highly active group had higher NLR, PLR, PDW, and MPV than other groups. However, it showed a decrease in lymphocyte median. Further, CNS symptoms revealed a negative correlation that is statistically significant with lymphocytes, while it showed a positive statistically significant correlation with PDW and NLR. Nephritis had a positive significant correlation with NLR, and PLR and vasculitis had a positive highly significant correlation with lymphocytes and PLR.
Zeenat Sarmadi Imam, Shadan Rabab, Reecha Singh, Bipin Kumar, Manish Mandal, Rakesh Kumar Singh, Zeeshan Haider
Journal of Advances in Medicine and Medical Research pp 31-47; https://doi.org/10.9734/jammr/2022/v34i1431386

Abstract:
Aims and Objectives: To study the demographic distribution and histomorphological variations of Whipple’s pancreaticoduodenectomy specimens in regard to tumour site, size, type, grade, marginal status, lymph node metastasis, perineural invasion (PNI) and lymphovascular invasion (LVI). This study will also highlight the incidental pathological lesions occurring in Whipple’s specimens. Hence it will further facilitate to analyse the prognostic significance of all these parameters in order to co-relate the overall spectrum of these cases. Study Design and Place of Study: An observational retrospective time bound descriptive study conducted at Indira Gandhi Institute of Medical Sciences (IGIMS), Patna after approval of ethical committee. Materials and Methods: A total of 150 Whipple’s resection specimens received in the Department of Pathology, IGIMS, Patna from January 2015 to December 2020 were selected as per inclusion and exclusion criterias. Details were collected from histopathology request forms and hospital record sheets. Gross and microscopic features were analysed and recorded. Slides were reviewed and the parameters were calculated. Results: Statistical analysis showed that out of 150 Whipple’s pancreaticoduodenectomy specimens, 141 (94%) cases were malignant tumours, 6(4%) cases had low malignant potential and 3 (2%) cases were of benign nature. Periampullary carcinomas were the predominant malignant tumours (78.66%), followed by ampullary carcinomas (14%) and pancreatic endocrine tumours (1.33%). Tumours with low malignant potential were constituted by SPN (solid pseudopapillary neoplasm of the pancreas) (2.67%), GIST (gastrointestinal stromal tumours) (0.67%) and mucinous cystic neoplasm of the pancreas (0.67%). Mean age incidence was 49.57 years with a male to female sex ratio of 1.4:1. Most of the malignant tumours (more than 75%) were moderately differentiated and were in stage 2 category. Out of the total 141 malignant tumours, 71 (50.35%) cases showed LVI, 50 (35.46%) cases had PNI and 84 (81.67%) had tumour deposits in the lymph nodes. Conclusions: Our study emphasizes the importance of tumour grade, tumour stage, presence of LVI, PNI, positive margins and lymph node metastasis as strong prognostic factors for patient survival. This is well corroborated by the significant P value in our study. Most of our cases were diagnosed at a locally advanced stage. Hence a more precise assessment and clinical evaluation can lead to early detection of cancer, improving the survival rates.
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