Open Journal of Clinical Diagnostics

Journal Information
ISSN / EISSN : 2162-5816 / 2162-5824
Published by: Scientific Research Publishing, Inc. (10.4236)
Total articles ≅ 178
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Xue Chen, Hailong Zhang, Xingmiao Quan, Feng Huo
Open Journal of Clinical Diagnostics, Volume 12, pp 1-10; https://doi.org/10.4236/ojcd.2022.121001

Abstract:
Objective: To observe the curative effects of Yiqing granule and Zhibai Dihuang pill combined with Oralpolin gel on recurrent aphthous ulcer. Methods: 150 patients with mild recurrent aphthous ulcer were classified as excessive internal heat type and deficiency internal heat type by traditional Chinese medicine theory. Then, they were randomly divided into the positive control group (thalidomide group), the trial group (Yiqing granule group/Zhibai Dihuang pill group), and the negative control group (topical medication group). All the patients in every group used Oralpolin gel. Additionally, the patients in the positive control group took thalidomide tablets orally and those in the trial group orally took proprietary Chinese medicine (Yiqing granule/Zhibai Dihuang pill). The treatment lasted for 4 weeks. The curative effects were all evaluated according to the “RAU Efficacy Evaluation Trial Standard” which was formulated by the Professional Committee of Mucosal Diseases of Chinese Stomatological Association. Results: Of all the 150 patients involved in this medical experiment, 146 cases finished it, including 66 ones in the trial group, 36 ones in the positive control group, and 44 ones in the negative control group. The total drop-out rate was 2.7%. For the excessive internal heat type, the effective rates in the thalidomide group, the Yiqing granule group and the local medication group were 91.7%, 52.6% and 52.9% respectively in order. For the deficiency internal heat type, the effective rates in the thalidomide group, the Zhibai Dihuang pill group and the local medication group were 87.5%, 71.4% and 40% respectively in order. The clinical efficacy of the Zhibai Dihuang pill group was better than that of the local medication group and similar to that of the thalidomide group (P < 0.05). Conclusion: Zhibai Dihuang pill is significantly effective in the treatment for mild recurrent aphthous ulcer of deficiency internal heat type without severe adverse reactions.
Micah Matiang’I, Priscilla Ngunju, Aranka Hetye, Lydia Odek, Smet Eefje, Mieke Arnoldus, Yvonne Opanga, Colleta Kiilu
Open Journal of Clinical Diagnostics, Volume 12, pp 39-54; https://doi.org/10.4236/ojcd.2022.123005

Abstract:
Background: Adequate and quality Maternal and Child Health (MNCH) care is considered essential in reduction of maternal and child mortality. More than half of the global maternal deaths (66%) are in sub-Saharan Africa with infant mortality of 51/1000 live births in the WHO Africa region [1]. There is potential to improve access and utilization of health services through investing in Primary Health Care (PHC) digital innovations [2] especially in underserved settings [3]. In the last quarter of the year 2021 after lifting of the COVID-19 restrictions, Tekeleza project, aims to integrate digital health innovations into MNCH care within PHC settings in Kenya. The project team undertook a baseline survey in three rural counties (Kisii, Kajiado and Migori) characterized with low social-economic status to identify opportunities to leverage on the use of evidence-based digital innovations to reverse the adverse trends in Maternal and Child Health. Methods: A cross-sectional and descriptive study was conducted in 15 Community Health Units (CHUs) in Kenya that were linked to selected Primary Health Care (PHC) facilities from three rural counties. Mixed methods were used to collect data from 404 Households (HHs) selected across the sampled CHUs on Probability Proportionate to Size (PPS). The selected households were assigned unique household or respondent identifiers. The sampling frame for household surveys consisted of all women 18 - 49 years of age, who were either pregnant or in their 18 months post-delivery. From the constructed sampling frame, a simple random sampling procedure was used to select the study sample. An audit was also carried out at the selected PHC facilities and sixty-two (62) Primary Health Workers (PHCWs) including facility managers were interviewed to establish challenges affecting ICT infrastructure and sustainable financing of MNCH services. Findings: The majority of the sampled women (64.9%) were lactating at the time of the study, with 34.4% being pregnant and 0.7% both pregnant and lactating. Despite the high proportions of mothers who received Skilled Birth Attendance, discontinuity in seeking antenatal and postnatal care services was observed in all three counties. The proportion of mothers (n = 404) who reported to have attended at least one ANC was 46.8%. This was attributed to limited access to health facilities, poor staff attitude, and negative cultural practices that got exacerbated by the COVID-19 pandemic. An average of 53.2% of the respondents started attending ANC clinics much later after 12 weeks of gestation to minimize the costs and time they will spend on attending ANC clinics. It also emerged that 68.7% of the respondents had low knowledge levels of selected perinatal and infant care practices. On the making of Sexual and Reproductive Health (SRH) health-seeking decisions, 54.7% of the respondents said, it is their husbands who decide. The PHCWs expressed limited access to Continuing Professional Development (CPDs), a situation that worsened with the COVID-19 Pandemic. Notably, only 54.9% of the PHCWs reported having access to either a Smartphone or desktop at the point of service delivery. Nearly the same proportion (54.8%) has access to the internet at their workstations. Facilities reported delayed reimbursement of National Hospital Insurance Fund (NHIF) and only 54% of the women interviewed had registered in Linda mama NHIF package meant to enable them to access free maternity care. Only one county (Migori) had significant utilization of CHVs. Conclusion: There is increasing access to Skilled Birth Attendance (SBA) in rural Kenya but discontinuous pregnancy care is still a problem and it got worse during the COVID-19 pandemic. Rural PHC facilities have poor ICT infrastructure and despite the 98% rural access to a phone by women, there is limited bankable usage of handheld technology to improve health information literacy on self and infant care among women of reproductive age. Recommendations: Feasibility studies to be conducted on how to sustainably deploy Primary Health Care digital solutions to improve the quality of, access to, and Utilization of Maternal and Child Health (MNCH) services.
Emecheta G. Okwudire, Ugonna M. Ezenwugo, Johnpatrick U. Ugwoegbu, Ifeanyi Isiozor, Victor E. Ofeimun, Uchechukwu U. Obiagwu
Open Journal of Clinical Diagnostics, Volume 12, pp 11-18; https://doi.org/10.4236/ojcd.2022.121002

Abstract:
Pulmonary infarction (PI), defined as localized destruction (necrosis) of lung tissue due to obstruction of the arterial blood supply by an embolus, is a rare condition because of the dual blood supply of the lungs. It occurs more in elderly patients who typically have associated co-morbidities, such as chronic heart and lung disease, which affect blood circulation. Pulmonary infarction may present with chest pain, fast breathing, blood tinged cough and fever, resembling more common conditions such as bacterial pneumonia and tuberculosis. High index of suspicion is required for early diagnosis of this condition as mortality from this condition can be as high as 70%. We present a case of cavitary pulmonary infarction in a middle-aged female with no major risk factors for pulmonary embolism who was initially managed as a case of pulmonary tuberculosis. The clinical presentation, pathogenesis, imaging findings and management of PI have also been discussed. The purpose of this report is to increase the awareness of this less common condition among clinicians and highlight the radiologic differences between PI and the more common inflammatory diseases of the lung.
Yeling Yuan, Feng Zhang, Tuanmei Wang
Open Journal of Clinical Diagnostics, Volume 12, pp 19-26; https://doi.org/10.4236/ojcd.2022.122003

Abstract:
Objective: As a rare cause of fever and lymphadenopathy (especially in the neck) in children, the purpose of this study is to explore the clinical characteristics of histiocytic necrotizing lymphadenitis (HNL) in children and improve the diagnosis and treatment of this disease. Methods: We retrospectively collected the data of 6 pediatric patients with HNL diagnosed by lymph node biopsy from 2012 to 2021 in department of pediatric, the affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, including the clinical characteristics, laboratory examinations, imaging findings and histopathological examinations, treatment and follow-up of the patients and reviewed relevant literature. Results: All the patients were Han girls, with no kinship with each other, and four cases were from rural areas. The age of onset was from 7 to 14 years old, with durations ranged from 1 week to 3 months. All children had cervical lymphadenopathy with tenderness, five cases of fever, two cases of cough, one case of weight loss, four cases of leukopenia, one case of liver impairment, one case of combined bacterial infection of leukocytosis. All children underwent lymph node biopsy and were diagnosed with HNL, four children were treated with anti-infection before diagnosis, two children were treated with steroid therapy after diagnosis, and 1 case of weakened immune function was used immunoglobulin for modulating immunity. All children improved and discharged, and no recurrence was observed until October 2021. Conclusion: In our study, the children with swollen lymph nodes in the neck were accompanied by tenderness and fever as the main clinical manifestations, without specificity. Histopathology and immunohistochemical examination by removing the affected lymph nodes could confirm HNL. Most children had a good prognosis and long-term follow-up were required.
Mark W. Morningstar, Megan Strauchman
Open Journal of Clinical Diagnostics, Volume 12, pp 27-37; https://doi.org/10.4236/ojcd.2022.122004

Abstract:
Purpose: Adolescent idiopathic scoliosis is a condition characterized by a three-dimensional curvature of the spine. However, in addition to the spinal curvature, it has also been reported that patients with idiopathic scoliosis can display other abnormal physiologic parameters, such as hormone imbalances, genetic variants, and micronutrient deficiencies. The present study evaluated the salivary progesterone levels, as well as the results of brain-derived neu-rotrophic factor (BDNF) genomic testing, from a historical cohort of patients seeking treatment at a single integrative medicine clinic. Method: A group of female patients with a history of adolescent idiopathic scoliosis was compared to a group of non-scoliosis female patients. Results: Salivary progesterone lev-els were 41% higher in non-scoliosis patients compared to the scoliosis group (P < 0.05), and while 71% of the scoliosis group was positive for the BDNF func-tional genomic group compared to 19% of the non-scoliosis group (P < 0.05). These results were unchanged regardless of menstrual status. Conclusion: These results suggest a potential relationship between salivary progesterone, BDNF, and adolescent idiopathic scoliosis among female patients. Prospective studies are needed for data extrapolation. The current data warrants further investigation.
Charity Gikunda, Lucy Gitonga, Paul Kamweru
Open Journal of Clinical Diagnostics, Volume 11, pp 19-46; https://doi.org/10.4236/ojcd.2021.112002

Abstract:
Background: Non-adherence to hypertensive medication continues to become a contributing factor to hypertensive complications like stroke, heart attacks, kidney disease heart failure. Associated factors to non-adherence are complex, are both internal and external to the patient and are difficult to extrapolate. Reports from Chuka referral hospital records showed that in 2016 there were 140 patients with hypertensive complications from 560 patients who attended the medical clinic that year. Objective: This study sought to explore the patient’s related factors that are associated with non-adherence to hypertension medication. Methods: This is a descriptive study design of (N = 575) people among them doctors, pharmacists, nurses, record officers and hypertension patients. Simple random sampling for patients (n = 81) and census sampling for health care workers was done and data collected using questionnaires and interview schedules between April 4th-May 30th 2019. Inferential and descriptive statistics were used for data analysis, aided by SPSS version 25. Results: 64% of the patients stated that they had missed medication. A significant negative correlation (rpb = -0.23, p rpb = 0.24, p rpb = -0.13, p = 0.25) and patients’ level of education (rpb = -0.06, p = 0.57). The overall model of health system related factors were found to be significant (p p = 0.012). Conclusion: Lacks of funds, unavailability of drugs are the leading factors to regimen completion. This could be easily be addressed by the government.
Jialiang Chen, Louis Chebli
Open Journal of Clinical Diagnostics, Volume 11, pp 47-51; https://doi.org/10.4236/ojcd.2021.112003

Abstract:
Chronic lower limb wounds are common. They can be of arterial or venous origin. In this article, we will present a clinical case of a 30-year-old patient with a chronic injury to the right medial malleolus. In his history, we can note a gunshot wound to the right leg. Ultrasonography and CT angiography helped in the diagnosis of traumatic arteriovenous fistula. The patient underwent a fistula embolization which allowed the wound to heal. The clinical presentation, additional examinations and the latest treatment recommendations will be discussed in this article.
Daniel Maitethia Memeu, Abdallah Merenga Sallorey, Ciira Maina, Dickson Mwenda Kinyua
Open Journal of Clinical Diagnostics, Volume 11, pp 59-75; https://doi.org/10.4236/ojcd.2021.112005

Abstract:
Malaria is one of the leading causes of mortality and morbidity in developing countries. Accurate and complete diagnosis is key for effective treatment of the disease. However, mainstream malaria diagnostic techniques suffer from a number of shortcomings. There is therefore an urgent need for development of new and more efficient techniques for malaria diagnosis. In vivo Photoacoustic spectroscopy is an emerging technique, which has great potential of delivering a nearly ideal method for early diagnosis of the disease. The technique promises to be highly sensitive and specific. In this paper, a description of photoacoustic malaria sensing is given. This is followed by a review of photoacoustic-based malaria diagnostic techniques and suggestions for future improvements.
Ayoub Maaroufi, Abdellatif Diai, Nouredine Jebbar, Lotfi Bibiche, Kaissi Jaber, Nabil Jbili, Hicham Kechna, Jaouad Laoutid
Open Journal of Clinical Diagnostics, Volume 11, pp 52-58; https://doi.org/10.4236/ojcd.2021.112004

Abstract:
We report the case of an adult patient diagnosed with acute SARS-CoV-2-associated meningoencephalitis based on the detection of its RNA on a nasopharyngeal swab, cerebrospinal fluid analysis. The most destructive type of extrapulmonary tuberculosis is tuberculous meningitis, in which the consequences are severe, resulting in death or disability in almost half of all sufferers despite anti-tuberculosis chemotherapy. The aim of this study was to assess the clinical and paraclinical features and laboratory findings and outcome of a patient with tuberculous meningitis and COVID-19 coinfection. Infection of COVID-19 and lymphopenia promotes the development of the severe form of tuberculosis. On the other hand, TBM increased the risk of infection with coronavirus due to the weakened immune system in addition to other immunosuppressive factors (older age and comorbidities such as low socioeconomic status and malnutrition). The patient had a good recovery even if he required intensive neurorehabilitation for a month due to poor feeding and weakness. Treatment, both anti-mycobacterial and anti-inflammatory, early started, guaranteed good recovery.
Changcen Zhou, Yalin Zhang
Open Journal of Clinical Diagnostics, Volume 11, pp 93-99; https://doi.org/10.4236/ojcd.2021.114007

Abstract:
Introduction: Clear Cell Myomelanocytic Tumor (CCMMT) of ligamentum teres hepatis is a pathological classification of Perivascular Epithelioid Cell tumor (PEComa), which is rare clinically and easy to misdiagnose. Objective: To report a case of a rare type of PEComa located in the ligamentum teres hepatis. Case Report: A 22-year-old Asian female was diagnosed with abdominal mass during physical examination in September 2018, and was admitted to the general surgery department of our hospital that month. She was diagnosed with abdominal mass, the nature of which remains to be determined is: teratoma, pheochromocytoma or ganglioma. At the time of admission, the patient had no symptoms or signs, and no other medical history. The patient was diagnosed with an abdominal mass by abdominal plain scan and enhanced CT, whose nature was to be determined: pheochromocytoma, paragangliomas or other mesenchymal tumors, or giant lymph node hyperplasia. The patient underwent abdominal mass resection and appendectomy without incident, without any complications at discharge, and there was no significant difference in follow-up. Conclusions: The clinical data, imaging features and pathological features of one patient diagnosed with CCMMT in our hospital were retrospectively analyzed, and the literature was reviewed in combination with the research progress of CCMMT, in order to improve the understanding and diagnostic accuracy of this disease.
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