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Publisher: Elsevier   (Total: 3042 journals)

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Showing 1 - 200 of 3042 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 19, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 16, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 81, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 23, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 27, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 328, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription  
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 205, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 9, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 22, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 5, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 4, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 3)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 20)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 124, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 25, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 21, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 25, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 24, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 8, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 4)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 39, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 40, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 45, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 14)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 12)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 20, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 24)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 34, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 4)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 5, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 22)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 21, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 13)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 7, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 19, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 58)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 2, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 339, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
Advances in Surgery     Full-text available via subscription   (Followers: 6, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 29, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 15)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 43, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 308, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 5, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 7, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 422, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 38, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 50, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 5, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 10, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 6)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access  
Algal Research     Partially Free   (Followers: 8, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 5, SJR: 0.776, h-index: 35)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 6, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 46, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 3)
American Heart J.     Hybrid Journal   (Followers: 47, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 44, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 34, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 6, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 15, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 30, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 24, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 32, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 44, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 179, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 54, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 2)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 23, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 23, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 21, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 33, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 53, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 5)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 38, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 160, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 10)
Anesthésie & Réanimation     Full-text available via subscription  
Anesthesiology Clinics     Full-text available via subscription   (Followers: 21, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 153, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

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Journal Cover Alexandria Journal of Medicine
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   ISSN (Print) 2090-5068
   Published by Elsevier Homepage  [3042 journals]
  • Antimicrobial activity of some actinomycetes from Western Ghats of Tamil
           Nadu, India

    • Authors: Pathalam Ganesan; Appadurai Daniel Reegan; Rajendran Host Antony David; Munusamy Rajiv Gandhi; Michael Gabriel Paulraj; Naif Abdullah Al-Dhabi; Savarimuthu Ignacimuthu
      Pages: 101 - 110
      Abstract: Publication date: June 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 2
      Author(s): Pathalam Ganesan, Appadurai Daniel Reegan, Rajendran Host Antony David, Munusamy Rajiv Gandhi, Michael Gabriel Paulraj, Naif Abdullah Al-Dhabi, Savarimuthu Ignacimuthu
      Introduction Microbial diseases are increasing year by year and they are becoming a big threat to public health. There are more than 200 known diseases transmitted by bacteria, fungi, viruses, prions, rickettsia and other microbes to humans. The emergence of drug resistance to chemical drugs is the biggest threat in controlling human pathogens. Hence novel antimicrobial agents from actinomycetes are timely needed for the control of several human pathogens. Aim The aim was to find some actinomycetes with antimicrobial metabolites. Methods Soil samples were collected from Nilgiris district in Western Ghats of Tamil Nadu, India. Actinomycetes were isolated using serial dilution and plating techniques on actinomycetes isolation agar. Streptomycin and ketoconazole (25μg/disc) were used as reference controls. The active strains were identified by 16S rRNA and phylogenetic tree was constructed; the sequences were submitted in the GenBank. Results Totally 106 actinomycete strains were isolated and cross streaked against various human microbial pathogens. Only 44 (41.50%) exhibited good antimicrobial activity against different pathogenic microbes. Five isolates (FMS-20, TGH-30, TGH-31, TGH-31-1 and IS-4) were chosen for secondary screening using filtrate. Among them FMS-20 filtrate showed good inhibition on the 16th day against all tested microbial pathogens. Further the intracellular methanol extract of FMS-20 showed maximum zone of inhibition against A. brasiliensis (22mm) at 5mg/disc. Similarly the extracellular ethyl acetate extract of FMS-20 showed maximum zone of inhibition against B. subtilis (25mm). Conclusions The present work revealed that, among 106 actinomycetes screened, Streptomyces rimosus (FMS-20) (Accession No-KT827106) showed promising antimicrobial activity against all the tested human microbial pathogens.

      PubDate: 2017-06-08T02:22:05Z
      DOI: 10.1016/j.ajme.2016.03.004
       
  • Prevalence of intestinal parasites in newly diagnosed HIV/AIDS patients in
           Ilorin, Nigeria

    • Authors: O.A. Obateru; B.J. Bojuwoye; A.B. Olokoba; A. Fadeyi; A. Fowotade; L.B. Olokoba
      Pages: 111 - 116
      Abstract: Publication date: June 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 2
      Author(s): O.A. Obateru, B.J. Bojuwoye, A.B. Olokoba, A. Fadeyi, A. Fowotade, L.B. Olokoba
      Background Human immune-deficiency virus/acquired immune-deficiency syndrome predisposes to opportunistic parasitic infestations of the gastrointestinal tract. This study aimed to determine the prevalence of intestinal parasites in newly diagnosed treatment naïve HIV/AIDS patients. Methods This hospital-based cross-sectional study was carried out from December 2010 to June 2011. Questionnaires were administered to 238 HIV/AIDS subjects, and 238 age and sex-matched controls. CD4+ T cell count was carried out on HIV-positive subjects. Stool samples were examined using direct microscopic and modified Ziehl-Neelsen methods. Positivity of intestinal parasites was taken as the presence of worms, oocyst, cyst, ova or larvae in the stool samples. Results Ninety males and 148 females were studied for the HIV-positive and HIV-negative controls respectively. Intestinal parasitic infestation in HIV-positive subjects was 68.5%, and was significantly higher than in the HIV-negative controls 49.2% (P <0.05). In HIV-positive subjects, Cryptosporidium spp. was the commonest (55.0%) parasite isolated. Others were Cyclospora cayetanensis (41.2%), Isospora belli (3.0%), Entamoeba histolytica (8.4%), Giardia lamblia (3.7%), Ascaris lumbricoides (2.5%), Strongyloides stercoralis (1.7%), Trichuris trichiura (0.8%) and Schistosoma mansoni (0.4%). HIV-positive patients with CD4+ T cell count of less than 200 cells/ul were more at risk of opportunistic parasites compared to the HIV-negative controls. Conclusion The prevalence of intestinal parasites in newly diagnosed HIV/AIDS individuals was high, and its association with CD4+ T cell count was demonstrated. Routine screening for parasitic infestations at diagnosis is indicated to reduce the burden of the disease.

      PubDate: 2017-06-08T02:22:05Z
      DOI: 10.1016/j.ajme.2016.04.001
       
  • Self-reported medical care seeking behaviour of doctors in Nigeria

    • Authors: A.E. Fawibe; L.O. Odeigah; T.M. Akande; A.G. Salaudeen; I. Olanrewaju
      Pages: 117 - 122
      Abstract: Publication date: June 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 2
      Author(s): A.E. Fawibe, L.O. Odeigah, T.M. Akande, A.G. Salaudeen, I. Olanrewaju
      Background There is need for information on the medical care seeking behaviour of Nigerian doctors. Purpose This work was therefore designed to study the medical care seeking behaviour of Nigerian doctors in Nigeria. Methods It was a cross-sectional survey among doctors in Nigeria. Results Data from 522 doctors were included in the analysis. Majority of them (80.5%) had one form of illness or the other in the year preceding the survey. Only 35% of them reportedly consulted another doctor during their illness. Most of the consultations (61.2%) were informal in the form of over the phone (45.6%), Corridor (33.3%) and home visit (21.1%) and just 18.4% of the consultations occurred within 24h of onset of illness. A low 19.5% of them had a regular source of medical care. Screening for illnesses was generally below expectation. Just 6 out of the 436 (1.4%) male doctors had screened for prostate cancer while 39 out of 86 (45.3%) females had screened for cervical cancer. A significantly higher proportion of general practitioners (p =0.01) and doctors above 45 years of age (P =0.004) consulted informally. Higher proportion of general practitioners and resident doctors based their consultations on their familiarity with the doctors consulted (p =0.001) and privacy during consultation (p =0.001). Delay in consultation for more than 24h after onset of illness was more likely in those above below the age of 45 years (p =0.001). Conclusion This study has shown that Nigerian doctors are often reluctant patients who frequently tend to delay medical care. The teaching of appropriate medical care seeking behaviour should be incorporated into medical curriculum in Nigeria.

      PubDate: 2017-06-08T02:22:05Z
      DOI: 10.1016/j.ajme.2016.04.003
       
  • Histological changes of the adult albino rats entorhinal cortex under the
           effect of tramadol administration: Histological and morphometric study

    • Authors: Ibrahim K. Ragab; Hala Z.E. Mohamed
      Pages: 123 - 133
      Abstract: Publication date: June 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 2
      Author(s): Ibrahim K. Ragab, Hala Z.E. Mohamed
      Background Tramadol is a centrally acting synthetic analgesic agent with opioid activity. Tramadol is used to treat moderate to severe pain. The entorhinal cortex has initially attracted attention because of its strong reciprocal connections with the hippocampal formation and its involvement in certain brain disorders. Aim of work The present study was designed to assess the deleterious effects of tramadol on the entorhinal cortex of the adult male albino rats. Materials and methods The study was carried out on 40 adult male rats. The rats were divided equally into two groups: control group, received 1ml normal saline 0.9% intraperitoneally for 4weeks. Treated group received 50mg/kg/day of tramadol intraperitoneally for 4weeks. All animals were anaesthetized by ether inhalation and perfused by normal saline. The brains were extracted from the skulls. For light microscopy, the brains of 10 animals in each group were processed for paraffin sections and stained by Gallocyanine stain. For electron microscopy, the entorhinal cortex was dissected in 10 brains of each group and processed. Semithin sections were prepared and stained with toluidine blue. Morphometric and statistical studies were performed. Results By light microscopy, the treated groups showed neuronal cells disorganization. Apoptotic cells were detected. In addition, diffuse chromatolysis of nuclear chromatin, absence of nucleoli, multinuclear cells, intercellular edema and a congested blood capillary were noticed. By electron microscopy, the treated groups of both lateral and medial entorhinal areas showed granular and pyramidal apoptotic cells. The morphometric and statistical studies showed significant increase of apoptotic index % in treated group as compared with control group. Conclusion Tramadol had degenerative effects on both lateral and medial entorhinal areas. Light as well as electron microscopic examination of entorhinal areas came to prove these effects. Tramadol abuse should be avoided without medical description due to its toxic effects.

      PubDate: 2017-06-08T02:22:05Z
      DOI: 10.1016/j.ajme.2016.05.001
       
  • Effect of the renal natriuretic peptide, ularitide, alone or combined with
           Vasopeptidase inhibitor, Omapatrilat, on experimental volume
           overload-induced congestive heart failure in rats (Ularitide/Omapatrilat
           in Congestive Heart Failure)

    • Authors: Rehab E. Abo El gheit
      Pages: 135 - 149
      Abstract: Publication date: June 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 2
      Author(s): Rehab E. Abo El gheit
      Introduction Ularitide is a synthetic form of renally derived natriuretic peptide (NP), urodilatin. Omapatrilat (OMA) is a Vasopeptidase inhibitor (VPI), acting by dual inhibition of both angiotensin-converting enzyme (ACE) and neutral endopeptidase 24.11 (NEP), which degrades the NPs. Ularitide and OMA underwent evaluation for the management of hypertension and heart failure (HF). Aim This study aimed to address the effect of ularitide and OMA in aortocaval fistula (ACF) –induced congestive heart failure (CHF) in rats under various conditions of compensation (of clinical severity). Experimental protocol Volume-overload CHF was induced in male albino rats by creating an infrarenal ACF. One week after fistula induction, ACF rats were randomized to compensated (Com) and decompensated (Decom) ACF groups and each further subdivided into ACF, ularitide and OMA/ularitide treated ACF groups. Sham was used as control. All treatment protocols were started one week after infrarenal ACF induction and continued for further two weeks. Three weeks after shunt induction, all animals were underwent assessment of cardiorenal and humoral functions. Renal outcome was measured by glomerular filtration rate (GFR), fractional excretion of sodium (F Na), absolute urinary sodium excretion (UNaV), urine volume, plasma cystin C level and urinary cyclic 3′, 5′-guanosine monophosphate (cGMP). The humoral function was assessed by plasma renin activity (PRA), angiotensin II (Ang II), Aldosterone, and cGMP. Cardiac outcome was assessed by plasma atrial natriuretic peptide (ANP), N-terminal pro–brain natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) while total and relative heart, lung and liver weights were recorded. Results Induction of AC shunt was associated with deteriorated renal and excretory functions, activation of renin angiotensin aldosterone system (RAAS), elevated ANP with renal resistance to ANP, (NT-proBNP) and (cTnT), pulmonary and systemic congestion and marked cardiac hypertrophy. These changes were exacerbated in Decom-ACF. Ularitide treatment of ACF rats was associated with natriuresis, diuresis, enhanced GFR with RAAS inhibition. This effect was evident in Com-ACF, maximized by OMA but attenuated in Decom-ACF, restored by OMA treatment. Ularitide/OMA treatment had antihypertrophic, decongestant effect with preserved renal function, resulted in a marked improvement of animals’ survival. Conclusion OMA potentiates the cardiorenal actions of ularitide in ACF-induced Com CHF and restoring its effect in Decom ACF, by simultaneously inhibiting ACE and NEP. OMA and ularitide could provide an effective therapeutic strategy for CHF.

      PubDate: 2017-06-08T02:22:05Z
      DOI: 10.1016/j.ajme.2016.05.005
       
  • A study on adverse drug reactions in a tertiary care hospital of Northeast
           India

    • Authors: Ratan J. Lihite; Mangala Lahkar; Sukirti Das; Debeeka Hazarika; Murali Kotni; Mudasir Maqbool; Swapna Phukan
      Pages: 151 - 156
      Abstract: Publication date: June 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 2
      Author(s): Ratan J. Lihite, Mangala Lahkar, Sukirti Das, Debeeka Hazarika, Murali Kotni, Mudasir Maqbool, Swapna Phukan
      Objective Purpose of this study was to monitor adverse drug reactions reported from various departments of a tertiary care hospital in Northeast India. Reported adverse drug reactions were analysed for causality and severity assessment. Methods This cross sectional study was conducted in a tertiary care hospital at Guwahati, Northeast India, for 7months. Patients of all age and either sex were included. Adverse drug reactions were reported by the physicians of this hospital and their causality and severity assessments were performed as per Naranjo’s and Hartwig’s assessment criteria respectively. Descriptive statistics were used for data analysis. Results Total 255 adverse drug reactions were reported from various departments of this tertiary care hospital. Most of the adverse drug reactions were observed in the age group of 21–30year. Acne (46) was commonly reported reaction. Topical steroids, betamethasone sodium phosphate and clobetasol were reported to induce maximum number of reactions (59). Skin (227, 66.9%) was commonly affected organ system. Most of the adverse drug reactions were possible (240, 94.1%) and mild (222, 87%) in nature. Conclusions The topical steroid (betamethasone sodium phosphate) was reported to induce adverse drug reactions in majority of the patients. The commonly reported reaction was acne.

      PubDate: 2017-06-08T02:22:05Z
      DOI: 10.1016/j.ajme.2016.05.007
       
  • A detailed in vitro study of naproxen metal complexes in quest of new
           therapeutic possibilities

    • Authors: Md. Sharif Hasan; Narhari Das
      Pages: 157 - 165
      Abstract: Publication date: June 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 2
      Author(s): Md. Sharif Hasan, Narhari Das
      Objective The present study was designed to investigate the in vitro anti-inflammatory, antimicrobial, cytotoxic and antioxidant effects of Naproxen metal complexes. Methodology The anti-inflammatory activity was evaluated by HRBC membrane stabilization method while antimicrobial activity by disk diffusion method. The cytotoxicity was evaluated by brine shrimp lethality bioassay and compared with vincristine sulfate. Antioxidant potential was evaluated in terms of DPPH radical scavenging potential, ABTS scavenging potential, reducing power assay, superoxide dismutase assay and total antioxidant capacity by specific standard procedures. Results The Naproxen metal chelates showed significant anti-inflammatory effects in dose dependent manner. Naproxen standard showed maximum inhibition occurred 73.21% at the dose of 2000μg/ml. Among Naproxen metal chelates, Naproxen silver complex showed potent antimicrobial activity against most of the tested microorganisms while Naproxen zinc complex showed better activity against gram positive strains than gram negative. In brine shrimp lethality bioassay, varying degree of lethality to Naproxen metal chelates was observed showing Naproxen iron complex surprisingly very potent cytotoxic activity compared to vincristine sulfate where other metal complexes displayed reduced cytotoxicity than parent Naproxen while Naproxen exhibited the lowest antioxidant assay among all the metal complexes compared to the standard ascorbic acid. Conclusion The present study demonstrated that Naproxen and its complexes possess in vitro anti-inflammatory activity while silver, zinc and iron complexes possess higher antimicrobial and cytotoxic properties than the parent ligand and possess very mild antioxidant activity.

      PubDate: 2017-06-08T02:22:05Z
      DOI: 10.1016/j.ajme.2016.06.003
       
  • In vitro differentiation of human umbilical cord blood mesenchymal stem
           cells into functioning hepatocytes

    • Authors: May H. Hasan; Kamal G. Botros; Mona A. El-Shahat; Hussein A. Abdallah; Mohamed A. Sobh
      Pages: 167 - 173
      Abstract: Publication date: June 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 2
      Author(s): May H. Hasan, Kamal G. Botros, Mona A. El-Shahat, Hussein A. Abdallah, Mohamed A. Sobh
      Mesenchymal stem cells (MSCs) were isolated by gradient density centrifugation from umbilical cord blood. Spindle-shaped adherent cells were permitted to grow to 70% confluence in primary culture media which was reached by day 12. Induction of differentiation started by culturing cells with differentiation medium containing FGF-4 and HGF. Under hepatogenic conditions few cuboidal cells appeared in culture on day 7. From day 21 to day 28, most of cells became small and round. The control negative cells cultured in serum free media showed fibroblast-like morphology. Urea production and protein secretion by the differentiated hepatocyte-like cells were detected on day 21 and increased on day 28. Protein was significantly increased in comparison with control by day 28. The cells became positive for AFP at day 7 and positive cells could still be detected at days 21 and 28. The cells in the control group were stained negative for AFP. The cells expressed albumin gene at the 14th day that became markedly increased at the 28th day of culture with HGF and FGF-4. No albumin expression was observed in the 7th day sample and the control. This study demonstrated that UCB-derived MSCs had the ability to differentiate into functioning hepatocyte-like cells starting from the 7th day after culturing under hepatogenic conditions and became well functioning at days 21 and 28. These data indicated that UCB-derived MSCs can be a promising source of cell therapy for intractable liver diseases.

      PubDate: 2017-06-08T02:22:05Z
      DOI: 10.1016/j.ajme.2016.05.002
       
  • Effect of immunomodulator, fingolimod, on ischemia reperfusion testicular
           injury in rats: Targeting the role of sphingolipid rheostat (fingolimod on
           I/R induced testicular injury)

    • Authors: Marwa N. Emam; Rania N. Abd El-latif
      Pages: 175 - 182
      Abstract: Publication date: June 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 2
      Author(s): Marwa N. Emam, Rania N. Abd El-latif
      Objective To evaluate the potential role of sphingosine-1-phosphate receptor agonist, fingolimod (FTY-720), in rat I/R induced testicular injury and its possible underlying protective mechanisms. Experimental protocol Thirty male albino rats were categorized into three groups, 10 rats each: sham operated control group, Ischemia/Reperfusion (I/R) group: underwent torsion/detorsion procedures of the left testes and FTY720 treated (I/R+FTY720) group: received single FTY720 injection (at a dose of 4mg/kg i.p) 30min. before detorsion. At the end of the ischemia and reperfusion period (4h) left testes were dissected carefully in all rats for histological and biochemical investigations. Testicular malondialdehyde (MDA), testicular antioxidant enzymes and testicular sphingolipids were assessed. Results FTY720 treatment of I/R group resulted in significant reduction in I/R induced elevation in testicular GSH-Px, SOD, MDA and total ceramide level, along with significant increase in testicular catalase, sphingomyelin and sphingosine-1-phosphate. Also, FTY720 treatment of I/R group improved severe testicular injury changes in I/R group. Conclusion FTY treatment may be used as potential therapeutic treatment for I/R induced testicular injury.

      PubDate: 2017-06-08T02:22:05Z
      DOI: 10.1016/j.ajme.2016.06.005
       
  • Breast cancer risk assessment by Gail Model in women of Baghdad

    • Authors: Salam Hussein Ewaid; Luma Hussein Ali Al-Azzawi
      Pages: 183 - 186
      Abstract: Publication date: June 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 2
      Author(s): Salam Hussein Ewaid, Luma Hussein Ali Al-Azzawi
      Objectives To assess the high incidence of breast cancer (BC) and the effect of its early diagnosis on decreasing morbidity and mortality among Iraqi women. Methods A descriptive cross-sectional study was conducted and data were collected from 250 women in Baghdad by a questionnaire consisted of demographic and breast cancer risk (BCR) factors questions. Brest cancer risk was calculated using the BCR Assessment Tool (BCRAT) of the National Cancer Institute’s online version (Gail Model). Results The average age of women was 45.46±9.2years. Twenty-six (10.4%) women have first degree relatives who had BC and three of them have more than one. More than half of the women 136 (54.4%) had their menarche at 12–13yearsof age. Half of them 126 (50.4%) had their first birth at <30yearof age. The mean five year BCR for all women was 0.95±1.4%, and 19 (7.6%) of them had a five year BCR ⩾1.7%. Mean lifetime BCR up to age 90yearswas 11.13±4.7% and 6 (2.4%) women had high risk. Based on these findings, it can be suggested that employing Gail Model for BCR assessment can help healthcare providers in Iraq to estimate an individual’s probability of developing BC for screening and prevention.

      PubDate: 2017-06-08T02:22:05Z
      DOI: 10.1016/j.ajme.2016.09.001
       
  • Nutritional risk factors for postmenopausal osteoporosis

    • Authors: Olfa Berriche; Amrouche Chiraz; Rym Ben Othman; Hamdi Souheila; Ines Lahmer; Chaabani Wafa; Imen Sebai; Haifa Sfar; Feten Mahjoub; Henda Jamoussi
      Pages: 187 - 192
      Abstract: Publication date: June 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 2
      Author(s): Olfa Berriche, Amrouche Chiraz, Rym Ben Othman, Hamdi Souheila, Ines Lahmer, Chaabani Wafa, Imen Sebai, Haifa Sfar, Feten Mahjoub, Henda Jamoussi
      Background Osteoporosis is a bone disease that combines both a decrease in bone density and its internal architecture changes. Nutrition is one of the major determinants of osteoporosis. Aim The purpose of our study was to identify nutritional risk factors of osteoporosis of two groups of osteoporotic women and witnesses. Methods We conducted a comparative cross-sectional study including 60 postmenopausal women and screening for osteoporosis by a bone densitometry, recruited the outpatient service of Rheumatology of the Institute KASSAB. Results We have identified excessive supply of saturated fatty acids (SFA) in the osteoporotic compared with controls (13.27% vs 10.23%, p =0.002) and an inadequate intake of monounsaturated fatty acids (MUFA) (12.6% vs 16.16%, p =0.012). A low calcium intake is another factor of risk of osteoporosis (574.27±336.9mg/day vs 782.45±340.54mg/day; p =0.021). This is explained by the low consumption of milk and milk products objectified in the osteoporotic group (p =0.001). We also found a negative relationship between inadequate intakes of potassium and osteoporosis (2241.55±1049.85mg/day vs 2988.17±1146.52mg/day; p =0.011). This may be due to the low consumption in fruit and vegetables, sources of potassium, found in the osteoporotic group (p =0.003). We found a significant increase in the consumption of the VVPO group in the osteoporotic toward women witness (2.23±0.99 number of times/day vs 1.67±0.76 number of times/day; p =0.019). A high consumption of coffee appears also as a risk factor since the osteoporotic group consume almost twice than controls (p =0.002). Conclusion Nutritional risk factors of osteoporosis are all the most important that they are editable and can take their place in a prevention of public health policy.

      PubDate: 2017-06-08T02:22:05Z
      DOI: 10.1016/j.ajme.2016.03.007
       
  • Gorham–Stout disease or new entity on the basis of vasculopathy

    • Authors: H. Hasan Yeter
      Pages: 193 - 196
      Abstract: Publication date: June 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 2
      Author(s): H. Hasan Yeter
      Gorham–Stout disease (GSD) is a rare osteolytic bone disease also known as vanishing bone disease. The pathogenesis of GSD is not well understood. Studies showed that lymphatic and blood endothelial cells in addition to macrophages secrete TNFα and IL-6 that stimulate osteoclast formation with osteolysis. Also TNFα secretion inhibits osteoblast differentiation and new bone formation. It is known that cytokines such as TNFα, IL-1 and complement system activation are responsible for inflammation and necrosis in the vessel wall at vasculitis. Both diseases have similar pathogenesis. Here, we presented a case of Gorham’s disease with involvement of bilateral humerus, systemic arterial thrombosis and mesenteric vasculitis.

      PubDate: 2017-06-08T02:22:05Z
      DOI: 10.1016/j.ajme.2016.03.006
       
  • Swyer syndrome: The gender swayer?

    • Authors: Jaideep Khare; Prasun Deb; Prachi Srivastava; Babul H. Reddy
      Pages: 197 - 200
      Abstract: Publication date: June 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 2
      Author(s): Jaideep Khare, Prasun Deb, Prachi Srivastava, Babul H. Reddy
      46XY complete gonadal dysgenesis (SWYER SYNDROME) is a rare type of Disorder of Sex Development. Herein we report a 15years-old child, reared as female, presented with complaints of primary amenorrhoea, without short stature or Turner’s stigmata. Secondary sexual development was normal. Biochemically, luteinizing hormone (LH) was 23.29mIU/ml and follicle stimulating hormone (FSH) was 54.94mIU/ml. Serum estradiol level was 15.33pg/ml (21–51), and Testosterone was 14.04ng/dl. USG abdomen revealed a small uterus with thinned endometrium. MRI Abdomen showed hypoplastic uterus with non-visualized B/L ovaries (? Complete/pure gonadal dysgenesis). Patient had withdrawal bleeding with estrogen progesterone challenge test. Karyotype analysis revealed 46XY with no evidence of mosaicism. Based on these results a diagnosis of Swyer Syndrome (complete gonadal dysgenesis: Disorder of Sexual Development) was suspected. Patient was managed with a multidisciplinary approach and various issues were discussed.

      PubDate: 2017-06-08T02:22:05Z
      DOI: 10.1016/j.ajme.2016.05.006
       
  • Can mesenchymal stem cells be used as a future weapon against breast
           cancer?

    • Authors: Hend AbdelGawad Shakshouk; Hayssam Rashwan
      Pages: 1 - 5
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Hend AbdelGawad Shakshouk, Hayssam Rashwan
      Background Mesenchymal stem cells (MSCs) are recruited to the stroma of cancers. They interact with cancer cells to promote invasion and metastasis or to suppress tumor growth. The unique tumor-homing capacity of MSCs makes them a promising vehicle to deliver various anticancer agents. Aim The aim of this study was to detect the possibility of using mesenchymal stem cells as a future weapon against breast cancer. Methods PubMed, PubMed central, Springer and Cochrane databases were searched using specified terms. Results Literature search yielded 17 manuscripts: seven of which suggested the use of MSCs in breast cancer therapy, while six studies raised the possibility that MSCs may promote tumor growth and four other studies assumed a dual role for MSCs. Conclusions The role of MSCs in breast cancer therapy is still debatable. We recommend future research in the field of MSCs in Alexandria University as it is our hope in the fight against breast cancer.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.01.003
       
  • Current status of multi-detector row helical CT in imaging of adult
           acquired pancreatic diseases and assessing surgical neoplastic
           resectability

    • Authors: Mary Y. Tadros; Remon Zaher Elia
      Pages: 7 - 14
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Mary Y. Tadros, Remon Zaher Elia
      Background It is usually hard to detect pancreatic lesions early as the pancreas lays retro peritoneum so it cannot be assessed during a routine physical exam. By the time a person has symptoms, the disease has already established morphological imaging CT changes. Objective The objective of our study was to clarify the role of multidetector computerized tomography (MDCT) in different adult acquired pancreatic diseases and assess the efficacy of surgical pancreatic tumors resectability preoperative. Materials & methods The study included thirty adult patients suspected to have pancreatic diseases (18 males and 12 females); their age range was 45–90years with a mean age of 68years. All patients underwent triple-phase multi-detector row CT using a 16-slice machine. The presence of inflammation, masses, and vascular invasion was evaluated and interpreted images were obtained during each phase. Results were compared with surgery, histopathology or follow-up. Results Of 30 patients, 15 had pancreatic malignancies (14 adenocarcinoma of which 6 were resectable and 8 were irresectable, 1 distant metastasis) proven at biopsy and/or surgery, 11 patients had pancreatitis (acute and chronic), three patients had cystic benign tumors (2 mucinous cystadenoma, 1 serous cystadenoma), and one patient had neuroendocrine tumor (insulinoma). Conclusion Contrast enhanced multiphase pancreatic imaging by MDCT with its post processing techniques represents the imaging modality of choice for the diagnosis of different adult acquired pancreatic diseases.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.01.004
       
  • Clinical outcome of ovarian vein embolization in pelvic congestion
           syndrome

    • Authors: Hassan Abdelsalam
      Pages: 15 - 20
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Hassan Abdelsalam
      Introduction Pelvic congestion syndrome (PCS), is a condition associated with ovarian vein (OV) incompetence among other causes. It is manifested by chronic pelvic pain with associated dyspareunia and dysmenorrhea. The diagnosis of PCS is often overlooked and the management can be difficult. Traditional therapy for PCS has included both medical and surgical approaches and more recently endovascular therapy. The aim of this work The aim of this work was to assess the clinical efficacy of ovarian vein embolization in treatment of PCS associated with OV incompetence and in the management of pelvic varices via catheter directed coil embolization. Conclusion From our and previous results, we can conclude that catheter directed OV coil embolization is a feasible procedure for treatment of pelvic congestion syndrome associated with OV incompetence. Presence of bilateral OV incompetence should always be investigated prior this therapy. Further prospective trials are required to assess the full benefits and efficacy of this technique, and to assess which may be the best embolic agent.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.01.006
       
  • Diagnostic accuracy of the combined use of conventional sonography and
           sonoelastography in differentiating benign and malignant solitary thyroid
           nodules

    • Authors: Ahmad Hafez Afifi; Walid Abdel Halim Abo Alwafa; Wael Mohamad Aly; Habashy Abdel Baset Alhammadi
      Pages: 21 - 30
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Ahmad Hafez Afifi, Walid Abdel Halim Abo Alwafa, Wael Mohamad Aly, Habashy Abdel Baset Alhammadi
      Objective To assess the diagnostic accuracy of combined use of conventional grayscale US and sono-elastography in differentiating benign and malignant solitary thyroid nodules. Materials and methods This prospective study included 50 patients with solitary thyroid nodules being evaluated using grayscale US followed with sono-elastography (USE). Suspicious conventional sonographic data for malignancy then evaluated using USE were classified according to Rago criteria with calculation of strain ratio. The diagnostic performances of grayscale US, elastography with Rago criteria, for predicting thyroid malignancy were compared and cutoff value for strain ration was statistically analyzed. Finally all patients with solitary nodule were subjected to US-guided FNAC and 35 patients recommended for surgery in the form of 12 patients underwent total thyroidectomy and 23 patients underwent thyroidectomy with neck dissection. Results 30 females (60%), and 20 males (40%) were included (Mean age 38) with final diagnosis comprised 29 (58%) pathologically proved benign thyroid nodules and 21 (42%) pathologically proved malignant nodules. US showed significant relation between markedly hypo-echogenicity, oval than tall, margin irregularity, presence of micro-calcification with diagnosis of thyroid malignancies with p value <0.001. Regarding sonoelastography, there was significant relation between elastography scores 4 and 5 and thyroid malignancies showing sensitivity of 80%, a specificity of 100%, and p value <0.001. The most accurate strain ratio cutoff value among studied cases was 2.52. Combination of grayscale US and sono-elastography yielded better results with sensitivity of 92%, specificity of 95%, PPV of 89%, NPV of 92% and diagnostic accuracy or efficacy of 96%. Conclusion Combined use of USE and grayscale US, showed superior performance in the differentiation of malignant and benign thyroid nodules compared with each technique alone. Suspicious US criteria with elasticity Rago scores 4 and 5 and strain ratio more than 2.52 are the most predictive signs of malignancy.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.02.007
       
  • Gold in semen: Level in seminal plasma and spermatozoa of normal and
           infertile patients

    • Authors: K.P. Skandhan; J. Valsa; B. Sumangala; V. Jaya
      Pages: 31 - 33
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): K.P. Skandhan, J. Valsa, B. Sumangala, V. Jaya
      The study was conducted to understand the amount of gold in semen of normal and different infertile conditions. Gold was estimated in normal (n38) and pathological conditions (n86) by employing Atomic Absorption Spectrophotometer. Gold level observed in seminal plasma was as follows: in normozoospermia (n38) – 17.0μg%±9.63; oligozoospermia (n23) – 13.0μg%±0.73; oligoasthenozoospermia (n44) – 20.5μg%5±.58 and in azoospermia (n19) 21.5μg%±7.52. Gold level in sediment (spermatozoa) of normal was almost same as observed in its seminal plasma whereas in oligozoospermia and oligoasthenozoospermia the level was low.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.02.003
       
  • Serum IL 6 and umbilical artery Doppler indices in pre-eclamptic patients

    • Authors: Medhat Y. Anwer; Tark A. Karkor; Sally S. El-Tawab; Akram A. Deghady; Ihab M. El Tayeb
      Pages: 35 - 40
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Medhat Y. Anwer, Tark A. Karkor, Sally S. El-Tawab, Akram A. Deghady, Ihab M. El Tayeb
      Objectives To study the changes in serum IL 6 levels in pre-eclamptic patients and to detect any correlation between these changes and changes in the umbilical artery Doppler velocimetry. Methods In Shatby Hospital, 100 pregnant women, at or beyond 32weeks were selected and divided into three groups: group A with severe pre-eclampsia, group B with mild pre-eclampsia, and group C with normal pregnancy as control. Measurement of maternal serum IL 6 using ELISA and umbilical artery Doppler velocimetry was done. Kruskal–Wallis, Mann–Whitney U tests, and Spearman’s rank correlation tests were used. Results A statistical significant difference (p <0.001) was found regarding serum IL-6 level. Using ROC curve for IL 6 levels, it is suggested that IL 6 of 0.82ng/dl is a cutoff level to early diagnose mild pre-eclampsia (with sensitivity 87.5% and specificity 100%). A statistical significant correlation was found between maternal serum IL 6 levels and S/D ratio and RI in severe pre-eclamptic group (p <0.05). Conclusion Maternal serum IL 6>0.82ng/dl can be implicated as an early laboratory diagnosis of mild pre-eclampsia. The significant correlation between maternal serum IL 6 levels and Doppler velocimetry supports both the immunologic and the systemic endothelial dysfunction theories of pre-eclampsia.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.02.004
       
  • Serum CYFRA 21-1 in Egyptian women with breast cancer

    • Authors: Samia A. Ebied; Wafaa M.E. Abdel-Rehim; Sanaa A. El-Benhawy; Mona A. El-Gawish; Mohamed A.A. Hassan; Islam I. El-Settawy
      Pages: 41 - 47
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Samia A. Ebied, Wafaa M.E. Abdel-Rehim, Sanaa A. El-Benhawy, Mona A. El-Gawish, Mohamed A.A. Hassan, Islam I. El-Settawy
      Introduction: Cytokeratin fragment 21.1 (CYFRA 21.1) assay detects a serum fragment of cytokeratin 19 (CK19) and is employed in the diagnosis and management of lung cancer, particularly of squamous cell histotype. Breast carcinoma has been demonstrated to express CK19 fragments in the primary and metastatic lesions and CK19 mRNA is detectable in peripheral blood from patients affected by breast cancer. Aim of the work: The aim of the present study was to evaluate the clinical significance of serum CYFRA21-1 in patients with breast cancer by analyzing the correlation between serum CYFRA21-1 titers, clinicopathological factors and prognosis in comparison with serum CA15.3 and CEA tested in the same samples. Subjects and methods: This study included 60 breast cancer patients and 25 healthy females as control group. Three blood samples were drawn from each patient, before surgery, two weeks after surgery and after 6 cycles of chemotherapy. One blood sample was drawn from each subject of control group. Serum was separated and kept frozen till used for estimation of CYFRA21-1 by enzyme linked immunosorbent assay (ELISA) and serum CA15.3 and CEA by immunoradiometric assay (IRMA). Results: Serum CYFRA21-1 was highly elevated in breast cancer patients than in controls and was significantly associated with tumor size, clinical stage and axillary lymph node involvement. Serum CYFRA21-1 was superior to CA15.3 and CEA as a diagnostic marker for breast cancer using ROC curve analysis. Higher levels of serum CYFRA21-1 and CA15.3 were significantly associated with poor prognosis in primary breast cancer patients. Conclusions: The measurement of serum CYFRA 21-1 in breast cancer patients may be useful for detecting disease relapse and for assessing surgical and chemotherapeutic efficacy. Further prospective studies using greater number of patients are required to confirm our findings.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.02.006
       
  • Effects of l-carnitine on oxidative stress parameters in oophorectomized
           rats

    • Authors: Emel Peri Canbolat; Nevin Sağsöz; Volkan Noyan; Aykan Yücel; Üçler Kısa
      Pages: 55 - 60
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Emel Peri Canbolat, Nevin Sağsöz, Volkan Noyan, Aykan Yücel, Üçler Kısa
      Aims The aim of this study was to investigate the antioxidant effects of l-carnitine on the oxidative stress parameters in oophorectomized rats. Methods Twenty-four female albino Wistar rats were used. Rats were divided into four groups: laparotomy-only (LOSALINE) group, oophorectomy plus l-carnitine 100mg/kg/day (OXL100) group, oophorectomy plus l-carnitine 500mg/kg/day (OXL500) group, and oophorectomy-only (OXSALINE) group. Experimental protocol was started on day 21 post-castration. Various dosage forms of l-carnitine or isotonic saline were administered intraperitoneally for 14 consecutive days. Nitric oxide (NO), malondialdehyde (MDA), total antioxidant status (TAS), total oxidative stress (TOS) and oxidative stress index (OSI) were evaluated in the tissues including kidney, liver and heart, and sera. Result(s) In the heart tissue samples, there was no difference in the levels of NO, OSI and TOS between the groups. However, MDA levels in OXSALINE group were significantly higher than OXL500 group. On the other hand, there was no statistically significant differences between the groups in terms of levels of NO, MDA, TAS, TOS and OSI in liver, kidney and sera samples. Conclusion(s) Levels of MDA in the heart tissue were significantly higher in OXSALINE group compared to OXL500 group. Thus, it may be suggested that l-carnitine reduces oxidative stress at least in the heart of oophorectomized rats.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.02.002
       
  • Ultrastructural alterations of renal tissue in a male patient with
           Fabry’s disease

    • Authors: Farahnaz Noroozinia; Khadijah Makhdoomi; Amir Abbas Farshid
      Abstract: Publication date: Available online 23 June 2017
      Source:Alexandria Journal of Medicine
      Author(s): Farahnaz Noroozinia, Khadijah Makhdoomi, Amir Abbas Farshid
      Background Fabry’s disease is an X-linked lipid storage disorder due to deficient lysosomal alpha galactosidase A. Case Presentation Kidney biopsy was done on a 19year old male patient with complaint of acroparesthesia, maculopapular skin lesions and cornea verticillata. Kidney biopsy tissue was processed and examined by electron microscopy. Changes were inclusion bodies in the cytoplasm of the renal cells. These inclusions were osmophilic with concentric lamellation of clear and dark layers, showing onion skin appearance. The podocytes were mostly affected and some of the foot processes were fused. Cross-sections of collagen fibers were also evident, indicating fibrosis. Conclusion The ultra-structure of the kidney clearly showed the intra-cytoplasmic glycosphingolipid accumulation in renal cells, responsible for progressive decline in renal function which could lead to kidney failure. The final diagnosis of Fabry’s disease was confirmed. In the present case-study, electron microscopy proved to be a valuable diagnostic aid.

      PubDate: 2017-06-23T06:24:10Z
      DOI: 10.1016/j.ajme.2017.06.002
       
  • Socio-demographic and clinical factors predicting time to presentation for
           children with pneumonia in Ilorin, Nigeria

    • Authors: Rasheedat M. Ibraheem; Mohammed B. Abdulkadir; Aishat A. Gobir; Wahab B.R. Johnson
      Abstract: Publication date: Available online 16 June 2017
      Source:Alexandria Journal of Medicine
      Author(s): Rasheedat M. Ibraheem, Mohammed B. Abdulkadir, Aishat A. Gobir, Wahab B.R. Johnson
      Background Pneumonia is a major contributor to morbidity and mortality in children, and the time to presentation is a recognized contributor towards disease severity and outcome. Objectives The current study aimed to explore the influence of some socio-demographic and clinical factors in children with pneumonia on the time to presentation at a health facility in Ilorin, North Central Nigeria. Materials and method A prospective cross-sectional study of 167 children with pneumonia was done. The duration of the various symptoms and first presentation to a health facility was obtained. Time to presentation was categorized as 0–2days (early), 3–5days (intermediate) and greater than five days (late). Multinomial logistic regression analysis was used to identify significant predictors of either early or intermediate presentation compared with late presentation. A p-value of less than 0.05 was considered significant. Results Fifty-one (30.5%) children with pneumonia had an early presentation, 73 (43.7%) had intermediate presentation and 43 (25.7%) were late in presentation. Predictors of early presentation were younger age (OR 0.96, 95%CI 0.93–0.99), higher respiratory rates (OR 1.03, 95%CI 1.01–1.06) and bronchopneumonia (OR 6.93, 95%CI 1.52–31.63). Predictors of intermediate presentation were families with few number of children (OR 0.73, 95%CI 0.57–0.92) and bronchopneumonia (OR 3.41, 95%C.I. 1.02–11.38). Conclusion Infancy and families with few children are socio-demographic features that are likely to determine early-to-intermediate presentation of children with pneumonia while high respiratory rates and bronchopneumonia are disease related factors that predict early presentation.

      PubDate: 2017-06-17T03:47:33Z
      DOI: 10.1016/j.ajme.2017.05.013
       
  • Role of static fluid MR urography in detecting post urinary diversion
           complications

    • Authors: Amr Farouk Ibrahim Moustafa; Tamer M. Abd el Rahman; Amr Abd Elfattah Hassan Gadalla; Karam Gaber Mohamed; Ahmed Morsi Moustafa Fahmy; Sameh Abd AlAziz Zaki Hanna
      Abstract: Publication date: Available online 16 June 2017
      Source:Alexandria Journal of Medicine
      Author(s): Amr Farouk Ibrahim Moustafa, Tamer M. Abd el Rahman, Amr Abd Elfattah Hassan Gadalla, Karam Gaber Mohamed, Ahmed Morsi Moustafa Fahmy, Sameh Abd AlAziz Zaki Hanna
      Aim of work The aim of the study was to assess the diagnostic performance of static MR urography in detection of post cystectomy complications & the ability of static fluid MR urography in visualization of urinary tract segments. Material & methods We prospectively reviewed 21 MR urograms with urinary diversion. The most common surgical procedures included Ileal conduit & Ileocecal neobladder diversion. Magnetic resonance urography examinations were performed with 1.5-T MR scanners. T2 weighted (static fluid) MR urography techniques were done, in addition to conventional T1- and T2-weighted axial and coronal sequences. Urinary tract was divided in different parts: pelvicalyceal systems, upper, mid and lower ureteric segments & the reservoir or conduit Imaging features of the urinary collecting systems were evaluated for their visualization and complications detection. Results T2-weighted MR urography could demonstrate 95% of urinary tract segments & together with conventional MR sequences all urinary tract segments can be visualized. Urinary diversion related complications were encountered included in 15 patients (71.4%) & no urological complications were seen in 6 patients (28.6%). Conclusion Comprehensive T2-weighted MR urography is an effective imaging method for the visualization of the urinary system and detection of early and late postoperative complications in patients with urinary diversion.

      PubDate: 2017-06-17T03:47:33Z
      DOI: 10.1016/j.ajme.2017.04.001
       
  • Attitudes towards menopause and depression, body image of women during
           menopause

    • Authors: Erbil
      Abstract: Publication date: Available online 13 June 2017
      Source:Alexandria Journal of Medicine
      Author(s): Nülüfer Erbil


      PubDate: 2017-06-17T03:47:33Z
       
  • Superimposed effect of ovariectomy on type 2 diabetes mellitus in Wistar
           rats

    • Authors: Minerva K. Fahmy; Hayam G. Sayyed; Eman A. Abd Elrahim; Rana T.A. Farag
      Abstract: Publication date: Available online 12 June 2017
      Source:Alexandria Journal of Medicine
      Author(s): Minerva K. Fahmy, Hayam G. Sayyed, Eman A. Abd Elrahim, Rana T.A. Farag
      Background Estrogen deprivation in the postmenopausal women plays a critical role in progression of type 2 diabetes mellitus (T2DM). Aim The present study investigated the overlaid effect of ovariectomy on T2DM and the possible underlying mechanism. Materials Forty female Wistar rats were divided into four groups (10 rats each): sham control, ovariectomized control, sham diabetic and diabetic ovariectomized groups. At the end of experiment, estimation of body weight gain percentage, food intake, fasting blood glucose concentration, and insulin tolerance test were done. Then, rats were euthanized and blood samples were taken for measurement of serum concentration of insulin, HOMA-IR, lipid parameters, tumor necrosis factor-α, interleukin 1 beta, interleukin 4, interleukin 10, malondialdehyde and total thiol. Also, histopathological and immunohistochemical examination of the pancreas were done. Results The present study revealed that ovariectomy aggravated the diabetic induced glucose metabolic disturbance as implied by impaired insulin tolerance test, increased insulin resistance alongside lipid dyshomeostasis. These metabolic disturbances might claim to exacerbation of oxidative stress and inflammatory response along with apparent histopathological and immunohistochemical changes on the pancreas. Conclusion We concluded that metabolic disturbances induced by diabetes might be getting worse after ovariectomy via intensification of oxidative stress and inflammatory state.

      PubDate: 2017-06-13T03:06:06Z
      DOI: 10.1016/j.ajme.2017.05.011
       
  • Ameliorative effect of apelin on streptozotocin-induced diabetes and its
           associated cardiac hypertrophy

    • Authors: Islam Ibrahim Hegab
      Abstract: Publication date: Available online 9 June 2017
      Source:Alexandria Journal of Medicine
      Author(s): Islam Ibrahim Hegab
      Aim Apelin, an adipocyte-derived factor, exhibited a number of cardioprotective properties; however, its effect in diabetes which is a major risk factor for cardiovascular disease (CVD) needs to be further studied. So this work was designed to evaluate the effect of apelin on diabetes and its associated cardiac hypertrophy with its possible underlying protective mechanisms. Experimental protocol Thirty male adult Wistar rats were categorized into three groups, 10 rats each, normal control group: received standard food and water regime. Diabetic control group: received streptozotocin (STZ) at a dose of (55mg/kg, i.p., once) dissolved in citrate buffer (pH 4.5). Apelin-13 treated diabetic group: STZ diabetic rats received an intra peritoneal injection of apelin-13 at a dose of (100nmol/kg/day), and given daily for 8weeks. at the end of the experiment, oral glucose tolerance test (OGTT) was assayed, then rats were sacrificed and serum glucose, insulin, triglyceride (TG), total cholesterol, high density lipoprotein (HDL) cholesterol, serum lactate dehydrogenase (LDH) and serum creatine kinase – MB (CK-MB) were measured, together with cardiac hypertrophy index (CHI), left ventricular hypertrophy index (LVHI) and left ventricular protein and collagen content levels. Myocardial superoxide dismutase (SOD), catalase, reduced glutathione (GSH) and malondialdehyde (MDA) were determined in the myocardial tissue of experimental rats. Results Treatment with apelin-13 improved hyperglycemia and hyperlipidemia, and significantly protected against STZ-induced structural alterations in cardiac tissue, it also produced a significant reduction in MDA while it elevated the level of antioxidant enzymes in hearts of diabetic rats. Conclusion This study suggested that apelin can ameliorate diabetes and its associated myocardial hypertrophy through mainly its anti diabetic, anti hyperlipidemic and anti oxidative stress properities.

      PubDate: 2017-06-13T03:06:06Z
      DOI: 10.1016/j.ajme.2017.05.006
       
  • Sharp foreign body ingestion by a young girl

    • Authors: Riyadh Mohamad Hasan
      Abstract: Publication date: Available online 9 June 2017
      Source:Alexandria Journal of Medicine
      Author(s): Riyadh Mohamad Hasan
      A 16year old patient had ingested two sewing needles about 4.5cm long accidentally that eventually resided in extra intestinal tract position, and being asymptomatic, she ignored the problem for a long period about 2years. She only consulted the hospital after having symptoms. The needles were located by X-ray imaging and retrieved with the aid of C-arm fluoroscope at a laparotomy. Her postoperative period was uneventful.

      PubDate: 2017-06-13T03:06:06Z
      DOI: 10.1016/j.ajme.2017.05.009
       
  • Health-related quality of life and associated factors among patients with
           diabetes mellitus in Botswana

    • Authors: Godfrey Mutashambara Rwegerera; Thato Moshomo; Marea Gaenamong; Taibat Aderonke Oyewo; Sivasomnath Gollakota; Yordanka Piña Rivera; Anthony Masaka; Brian Godman; Meshack Shimwela; Dereje Habte
      Abstract: Publication date: Available online 9 June 2017
      Source:Alexandria Journal of Medicine
      Author(s): Godfrey Mutashambara Rwegerera, Thato Moshomo, Marea Gaenamong, Taibat Aderonke Oyewo, Sivasomnath Gollakota, Yordanka Piña Rivera, Anthony Masaka, Brian Godman, Meshack Shimwela, Dereje Habte
      Background: Health-related quality of life (HRQOL) is an important aspect of diabetes mellitus care. The objective of the study was to determine theHRQOL of diabetes mellitus (DM) patients in Botswana as little known in Africa. Materials and methods: A cross-sectional study of 380 randomly selected DM patients in a tertiary clinic in Gaborone, Botswana was conducted to obtain Data on HRQOL and structured questionnaire was used to collect information on sociodemographic and clinical characteristics. Multivariate logistic regression to determine sociodemographic and clinical characteristics associated. Results: Majority of patients were female with no formal education or primary level of education. Mean HbA1c was 7.97% (SD: 2.02) and most patients had poor glycemic control. The majority had both worse physical composite score (PCS-12) and mental composite score (MCS-12), with worse proportions of the two. Female gender, older age ≥65years, and the presence of three or more documented diabetic complications were associated with significant worse PCS-12. Presence of two diabetic complications, three or more diabetic complications, and musculoskeletal disease were associated with significant MCS-12. Conclusions: Diabetic patients in Botswana have relatively poor HRQOL. The fact that most patients present late with complications calls for policy attention to diagnose diabetes mellitus early and prevent associated complications, ultimately improving health-related quality of life among diabetes mellitus patients.

      PubDate: 2017-06-13T03:06:06Z
      DOI: 10.1016/j.ajme.2017.05.010
       
  • Tracheotomy as a surgical access for removal of bullet in the trachea: A
           case report

    • Authors: Shankar Ramasundram; Baharudin Abdullah; Sivakumar Kumarasamy; Nurul Syamiza Shamsudin
      Abstract: Publication date: Available online 7 June 2017
      Source:Alexandria Journal of Medicine
      Author(s): Shankar Ramasundram, Baharudin Abdullah, Sivakumar Kumarasamy, Nurul Syamiza Shamsudin
      Gunshot tracheal injury with retained bullet fragment inside the trachea presents a challenge for removal. The treatment of the tracheal injury depends on the magnitude of the tracheal wound and the presence of injury to adjacent organs. The surgical removal may require both bronchoscopy and an open trachea exploration. We report a case of a gunshot injury to the trachea which requires a tracheotomy for a successful bullet removal.

      PubDate: 2017-06-08T02:22:05Z
      DOI: 10.1016/j.ajme.2017.05.007
       
  • Screening for psychological distress among High School Graduates Accepted
           

    • Authors: Iman Hassan Diab; Heba Mahmoud Taha Elweshahi; Hesham Adel Sheshtawy; Ayat Nabil Youssef Salem Eltayar; Abd Elrahman Mohammed Sharaf
      Abstract: Publication date: Available online 3 June 2017
      Source:Alexandria Journal of Medicine
      Author(s): Iman Hassan Diab, Heba Mahmoud Taha Elweshahi, Hesham Adel Sheshtawy, Ayat Nabil Youssef Salem Eltayar, Abd Elrahman Mohammed Sharaf
      Background Mental and psychological health of adolescents in general and prospective medical students in particular is a priority area to investigate as it affects wellbeing of the future doctors. Objectives The current research was conducted to screen first year medical students accepted for enrollment at Alexandria Faculty of Medicine to identify those with a high probability of having psychological distress before the start of academic courses as well as explore the sources of stress among them. Methods. A cross sectional survey of 779 high school graduates accepted for admission to Alexandria Faculty of medicine was conducted. Participants were approached on the days of obligatory pre-enrollment medical examination. The translated Arabic version of DASS 21 questionnaire was used to screen students for three negative emotional symptoms namely depression, anxiety and stress. Inquiry about age, sex, residency and type of high school was added. Results More than a tenth of studied medical students (12.6%) suffered from severe or profound stress and 29.1% of them had mild to moderate stress. Moreover, one fifth (20%) of studied students were severely anxious and less than one third (29.3%) had mild to moderate anxiety. Severe and profound depression was diagnosed among 14.3% of students whereas, 18.7% them were moderately depressed. No association was found between any of studied negative emotional symptoms and the students' educational background or their residency. Conclusion Nearly half of the prospective medical students might have some sort of psychological distress before starting their study in the Faculty of Medicine. They should be investigated to verify diagnosis and start intervention to minimize its adverse effects on academic performance and advancement at the faculty. Stress management courses should be considered for all medical students.

      PubDate: 2017-06-08T02:22:05Z
      DOI: 10.1016/j.ajme.2017.05.005
       
  • Spontaneous de novo vaginal adenosis resembling Bartholin’s cyst: A
           case report

    • Authors: Adebayo Alade Adewole; Osadolor Augustine Ugiagbe; Temitope Gabriel Onile; Olatunji Oluwaseyi Fadahunsi; Daniel Ike Awelimobor; Toba Ajagun; Obioma Jude Nnorom
      Abstract: Publication date: Available online 2 June 2017
      Source:Alexandria Journal of Medicine
      Author(s): Adebayo Alade Adewole, Osadolor Augustine Ugiagbe, Temitope Gabriel Onile, Olatunji Oluwaseyi Fadahunsi, Daniel Ike Awelimobor, Toba Ajagun, Obioma Jude Nnorom
      Background Vaginal adenosis is a rare benign condition with a small percentage of patients at risk of vaginal adenocarcinoma. Case A 34year old woman presented with paravaginal swelling resembling Bartholin’s cyst. Vaginal examination revealed a cystic, fluctuant and non-tender mass on the right lateral vaginal wall measuring 6 by 5 cm. The cervix, uterus, adnexa and Pouch of Douglas (POD) were normal. She had paravaginal cyst excision and histology showed stratified cuboidal epithelial cells with proliferation of numerous glands of small caliber within its wall that are separated by scanty stroma and consistent with vaginal adenosis. No other lesion was found on the genital tract. Conclusion Excision and histology is required in suspicious cases of paravaginal cyst to rule out vaginal adenosis, a potential precursor of vaginal adenocarcinoma. Counseling and follow up will help detect early occurrence of adenocarcinoma.

      PubDate: 2017-06-08T02:22:05Z
      DOI: 10.1016/j.ajme.2017.05.002
       
  • Sleep restriction progress to cardiac autonomic imbalance

    • Authors: Arbind Kumar Choudhary; Tanwir Alam; Anup Kumar Dadarao Dhanvijay; Sadawarte Sahebrao Kishanrao
      Abstract: Publication date: Available online 31 May 2017
      Source:Alexandria Journal of Medicine
      Author(s): Arbind Kumar Choudhary, Tanwir Alam, Anup Kumar Dadarao Dhanvijay, Sadawarte Sahebrao Kishanrao
      Previous studies have shown that night shift work is thought to be a risk factor for cardiovascular disease and inadequate sleep is a common feature of night shift work. Since it’s more difficult to maintain adequate sleep duration among night watchmen during their working schedule, hence the purpose of our present study was to investigate whether mental stress or fatigue over restricted sleep period in night shift, affects HRV, in order to elucidate on cardiac autonomic modulation among nigh watchmen. With the purpose of this, autonomic activity determined from the levels of the heart rate variability (HRV), and also measured, body mass index (BMI), body fat percentage from skin fold thickness (biceps, triceps, and sub-scapular, supra-iliac) among normal sleep watchmen) (n=28) and restricted sleep watchmen (n=28) at first (1st) day, fourth (4th) day and seventh (7th) day of restricted sleep period. We observed that among restricted sleep individuals, sleepiness was significant increase at 4th day and 7th day when compare to normal sleep individuals, and, there was significant increase in, mean NN, VLF, LF, LF(nu), LF/HF AND significant decrease in SDNN, RMSSD, TSP, HF, and HF(nu) at 4th and 7th day of restricted sleep period. In addition to, this variable was more significant increase on 7th day, when compare with 4th day. As well as there was significant negative correlation between LF(nu) and HF(nu) at subsequent 4th day [r (48)=−0.84; P=0.01] and 7th day[r (48)=−0.95; P=0.01] of restricted sleep period. However we didn’t observe any significant variation in BMI, and body fat percentage among restricted sleep individuals when compare to normal sleep individuals with in this restricted sleep periods. Hence we concluded that partial sleep loss may cause autonomic imbalance represented by increased sympathetic and decreased parasympathetic activity; as revealed by altered HRV indices observed in this study.

      PubDate: 2017-06-03T00:46:07Z
      DOI: 10.1016/j.ajme.2017.05.003
       
  • The effect of the essential oils of lavender and rosemary on the human
           short-term memory

    • Authors: O.V. Filiptsova; L.V. Gazzavi-Rogozina; I.A. Timoshyna; O.I. Naboka; Ye.V. Dyomina; A.V. Ochkur
      Abstract: Publication date: Available online 27 May 2017
      Source:Alexandria Journal of Medicine
      Author(s): O.V. Filiptsova, L.V. Gazzavi-Rogozina, I.A. Timoshyna, O.I. Naboka, Ye.V. Dyomina, A.V. Ochkur
      The research results of the effect of essential oils on the human short-term image and numerical memory have been described. The study involved 79 secondary school students (34 boys and 45 girls) aged 13 to 17years, residents of the Ukrainian metropolis. Participants were divided into three groups: the control group, “Lavender” group, in which the lavender essential oil was sprayed, and “Rosemary” group, in which the rosemary essential oil was sprayed. The statistically significant differences in productivity of the short-term memory of the participants of different groups have been found. Therefore, the essential oils of rosemary and lavender have significantly increased the image memory compared to the control. Inhalation of the rosemary essential oil increased the memorization of numbers, and inhalation of the lavender essential oil weakened this process.

      PubDate: 2017-05-28T20:33:31Z
      DOI: 10.1016/j.ejbas.2017.04.002
       
  • Verification of brain ring enhancing lesions by advanced MR techniques

    • Authors: Momena Essam Elsadway; Heba Ibrahim Ali
      Abstract: Publication date: Available online 25 May 2017
      Source:Alexandria Journal of Medicine
      Author(s): Momena Essam Elsadway, Heba Ibrahim Ali
      Purpose To evaluate the role of MR Spectroscopy in verification and differentiation of different brain ring enhancing lesions, for better diagnostic purpose and management outcome. Patients and methods 25 patients were included in this study, 15 of them were males and 10 were females, with age ranging between 21 and 75 (mean 46±14). All patients were presented with variable symptoms, some of them have known primary disease entity and others presented with headache, visual disorders or disturbed level of consciousness. MRI was done to all the patients including conventional and contrast sequences, as well as MR Spectroscopy. Some did MR perfusion and DTI in order to further characterize their nature. Histopathological findings and results of clinical follow up were our reference standard. Results Among the 25 patients, MR Spectroscopy was able to specify 22 lesions (88%), DTI was performed in 13 out of 25 lesions and MR perfusion was performed in 8 out of 25 lesions. Conclusions Characterization of ring enhancing lesions of the brain has increased accuracy by applying advanced MRI techniques. In this study, MR Spectroscopy combined with DTI and MR perfusion sequences in some cases improved verification of different ring enhancing brain lesions.

      PubDate: 2017-05-28T20:33:31Z
      DOI: 10.1016/j.ajme.2017.05.001
       
  • Unmet need for postpartum family planning in Alexandria, Egypt

    • Authors: Heba Mahmoud Taha Elweshahi; Gihan Ismail Gewaifel; Sameh Saad EL-Din Sadek; Omnia Galal El-Sharkawy
      Abstract: Publication date: Available online 8 May 2017
      Source:Alexandria Journal of Medicine
      Author(s): Heba Mahmoud Taha Elweshahi, Gihan Ismail Gewaifel, Sameh Saad EL-Din Sadek, Omnia Galal El-Sharkawy
      Background Postpartum women are a priority group to target on trying to solve the problem of closely spaced pregnancies as well as population explosion. Aim To estimate the level of unmet need for postpartum family planning one year after birth as well as identify factors associated with having unmet need in Alexandria, Egypt. Methods A cross sectional survey was adopted. A sample of 1500 women one year post-partum was selected. A predesigned interviewing questionnaire was used to collect data. Data include their socio-demographic characteristics and current use of family planning method. Those with unmet need for postpartum family planning (PPFP) were asked about the reasons for non-use, their intention to use in the future and their knowledge about contraceptives. Setting Public settings delivering routine immunization for infants in Alexandria. Results Out of 1500 postpartum women, 1370 (91.33%) have a real demand for family planning. Out of those with a real demand for family planning (n=1370), 1106 (80.72%) were using a modern contraceptive method and only 41 (3%) were using a traditional method for birth control while the remaining 223 (16.28%) were having unmet need for postpartum family planning. Amenorrhea, breast feeding, fear of side effects, discontinuation due to health concerns and pressure from the surroundings were the most common cited reasons for non-use. Conclusion Integration of family planning education during antenatal, natal and postnatal care services in Egypt should be actively initiated. Women with unmet need for PPFP in general and those with intention to use a contraceptive in particular should be targeted for recruitment efforts and services in any program tackle the problem of family planning and rising fertility in Egypt.

      PubDate: 2017-05-08T22:30:08Z
      DOI: 10.1016/j.ajme.2017.03.003
       
  • The effects of valproic acid on the mRNA expression of Natriuretic Peptide
           Receptor A and KQT-like subfamily Q-1 in human colon cancer cell lines

    • Authors: Mona Hajikazemi; Hoda Sohrabi; Ahad Yamchi; Mohsen Saeedi
      Abstract: Publication date: Available online 28 April 2017
      Source:Alexandria Journal of Medicine
      Author(s): Mona Hajikazemi, Hoda Sohrabi, Ahad Yamchi, Mohsen Saeedi
      Aim and objectives The histone deacetylase (HDAC) inhibitor, Valproic Acid (VPA), causes growth inhibition and apoptosis in colorectal cancer cells. HDAC inhibition is associated with the transcriptional regulation of Natriuretic Peptide Receptor-A (NPR-A). NPR-A regulates voltage-gated potassium channel, KQT-like subfamily Q, member 1 (KCNQ1). NPR-A and KCNQ1 are also involved in the initiation and propagation of cancer cells. In this study, we investigated the simultaneous expressional changes of NPR-A and KCNQ1 among VPA-treated colon cancer cells. Materials and methods Human colorectal cancer cells were cultured and treated with increasing concentrations of VPA at different time points. MTT viability test was conducted to evaluate the growth inhibition. Real Time RT-PCR was used to quantify differential mRNA expression of NPR-A and KCNQ1 genes. Two-way ANOVA and bonferroni post-tests were used to analyze data statistically. Results We showed that VPA treatment inhibits the growth of SW-480 cells more efficiently compared to HT-29. NPR-A and KCNQ1 genes were significantly upregulated upon VPA treatment in both cell lines (P<0.0001). Conclusion The alteration of NPR-A and KCNQ1 genes were more ordered among SW-480 cancer cells. The expressional changes of KCNQ1 and NPR-A among VPA treated human colon cancer cells follow the same pattern in similar combinations. VPA could regulate the expression of KCNQ1 through altering the mRNA expression of NPR-A.

      PubDate: 2017-05-03T20:23:29Z
      DOI: 10.1016/j.ajme.2017.04.002
       
  • Assessing prescriber’s awareness of essential medicine list, hospital
           drug formulary and utilization of standard treatment guidelines in a
           tertiary healthcare facility in North-Central Nigeria

    • Authors: Abdullahi Hassan; Gobir Abdulrazaq Abdullahi; Abubakar Aisha Ahmed; Adamu Sabiu; Uwaya John; Gwamna Ezekeil; Yahaya Aliyu Ibrahim
      Abstract: Publication date: Available online 26 April 2017
      Source:Alexandria Journal of Medicine
      Author(s): Abdullahi Hassan, Gobir Abdulrazaq Abdullahi, Abubakar Aisha Ahmed, Adamu Sabiu, Uwaya John, Gwamna Ezekeil, Yahaya Aliyu Ibrahim


      PubDate: 2017-04-26T18:50:27Z
      DOI: 10.1016/j.ajme.2017.03.006
       
  • Liver enzyme elevations in a cohort of HIV/AIDS patients on first-line
           antiretroviral therapy in Namibia: Findings and implications

    • Authors: P.A. Mataranyika; D. Kibuule; F. Kalemeera; H. Kaura; B. Godman; W.T. Rennie
      Abstract: Publication date: Available online 13 April 2017
      Source:Alexandria Journal of Medicine
      Author(s): P.A. Mataranyika, D. Kibuule, F. Kalemeera, H. Kaura, B. Godman, W.T. Rennie
      Introduction All antiretroviral therapies (ARTs) are potentially toxic to the liver. In sub-Saharan Africa, the rising incidence of ART induced adverse events has complicated treatment leading to recent revisions of Namibian ART guidelines. Unfortunately there have been limited studies to date evaluating ART induced liver injury in Namibia to guide further revisions if needed. Objective Determine the current patterns and grades of ALT elevation in Namibia’s HIV/AIDS. Methods Retrospective cohort analysis. Patterns of alanine amino transferase (ALT) liver enzyme elevation were determined in a cohort of ART naïve HIV patients on firstline ART regimen in a referral hospital in Namibia over a 1year treatment period. Patterns of ALT changes at baseline, 3months and 6months were analyzed using ANOVA and Bonferroni test for pairwise comparisons. Results Of 79 eligible patients, 72 developed significant ALT elevation within 3months of ART initiation (F (3, 76)=6.4, p =0.002, η2 =0.193). Four 4 (5.6%) and 1 (1.38%) patient respectively developed grade 2 and grade 3 ALT elevation by month 3. There was no significant difference between mean ALT levels at baseline and month 6. A CD4 count of <350cells/mm3; female gender and age over 40years were the main factors associated with moderate or severe ALT elevation. Conclusions First line ART commonly induces mild self-limiting liver enzyme elevation in Namibian HIV patients especially in the first 3months. Consequently, there is a need to monitor ALT levels for at least 3months after initiation mainly in high risk patients to reduce side-effect concerns. This is already happening.

      PubDate: 2017-04-19T17:17:02Z
      DOI: 10.1016/j.ajme.2017.03.002
       
  • Sexual function of pregnant women in the third trimester

    • Authors: Erbil
      Abstract: Publication date: Available online 7 April 2017
      Source:Alexandria Journal of Medicine
      Author(s): Nülüfer Erbil
      Introduction Physical, hormonal and psychological changes during pregnancy can affect a woman’s sexuality as well as a couple’s sexual relationship. The aim of this study was to examine sexual function of pregnant women in the third trimester of pregnancy. Methods The data of descriptive and cross-sectional study was collected via a questionnaire form and Female Sexual Function Index. A score≤26.55 is classified as female sexual dysfunction. A total of 125 volunteer healthy and married pregnant women in third trimester of pregnancy who admitted to the antenatal policlinics were included in this study. Results The determined that 92% of participants had sexual dysfunction. The Female Sexual Function Index and domains scores in the 28th-31st, 32nd-35th and 36th and higher gestational weeks of pregnancy were as follows: sexual desire scores, 2.50, 2.77 and 2.40; sexual arousal scores, 2.26, 2.72 and 1.69; lubrication scores, 2.61, 3.42 and 1.97; orgasm scores, 2.51, 2.85 and 1.78; sexual satisfaction scores, 3.17, 3.77 and 2.66; pain scores, 2.44, 2.72 and 1.66, and total Female Sexual Function Index scores were 15.51, 18.29, 12.26, respectively. Sexual arousal (p=0.008), lubrication (p=0.001), orgasm (p=0.031), sexual satisfaction (p=0.005), pain (p=0.049) and total Female Sexual Function Index score (p=0.004) were the lowest in 36th and higher gestational weeks, and only sexual desire did not differ (p=0.191). Conclusions Sexual function of pregnant women in the third trimester were negatively effected. Health professionals should be trained to evaluate sexual difficulties in pregnant women and to recommend possible solutions.

      PubDate: 2017-04-11T19:41:53Z
       
  • Natural pomegranate juice reduces inflammation, muscle damage and increase
           platelets blood levels in active healthy Tunisian aged men

    • Authors: Ammar Achraf; Chtourou Hamdi; Mouna Turki; Osama Abdelkarim; Fatma Ayadi; Anita Hoekelmann; Sourou Yaich; Nizar Souissi
      Abstract: Publication date: Available online 7 April 2017
      Source:Alexandria Journal of Medicine
      Author(s): Ammar Achraf, Chtourou Hamdi, Mouna Turki, Osama Abdelkarim, Fatma Ayadi, Anita Hoekelmann, Sourou Yaich, Nizar Souissi
      Currently, it’s well established that aging is associated with various health problems that may interfere with the maintenance of a good nutritional status. Otherwise, pomegranate (POM) was shown to prevent or treat various disease risk factors in adults. However, its efficacy is still not well widespread in elderly population. Therefore, the purpose of the present study is to investigate the effect of natural pomegranate juice (POMj) rich in polyphenols on the blood levels of selected biochemical parameters using older adults. Twelve active healthy aged men (age: 60±5years) volunteered to participate in this randomized study. Before and after the supplementation period fasting blood samples were collected, heart rate (HR) and systolic arterial pressure (SAP) were recorded. Supplements of placebo (PLA) or POMj were taken twice daily (250ml×2) for 15days. Paired simple t-test showed a significant difference between PLA and POMj supplementation effects on systolic blood pressure (SAP), creatinine (CRE), hematological and muscle damage parameters and C-reactive protein (CRP) (p<0.01) with lower values using POMj. Similarly, a significant differences were shown for platelets PLT (p<0.01) with higher values using POMj supplementation. POMj rich in polyphenols seems to have a power anti-inflammatory effect and to be an effective treatment for patients who suffer from the thrombocyto-penia disease. Therefore, aged populations are advised to add natural POMj to their daily nutrition behavior.

      PubDate: 2017-04-11T19:41:53Z
      DOI: 10.1016/j.ajme.2017.03.005
       
  • Protective role of Spondias mombin leaf and Cola acuminata seed extracts
           against scopolamine-induced cognitive dysfunction

    • Authors: Ismail O. Ishola; Bukola O. Ikuomola; Olufunmilayo O. Adeyemi
      Abstract: Publication date: Available online 6 April 2017
      Source:Alexandria Journal of Medicine
      Author(s): Ismail O. Ishola, Bukola O. Ikuomola, Olufunmilayo O. Adeyemi
      The leaves of Spondias mombin L. (Anacardiaceae) when chewed with Cola acuminata (P. Beauv.) Schott & Endl. (Sterculiaceae) seeds have memory enhancing and anti-ageing properties. This study sought to investigate the protective effect of hydroethanolic leaf extract of Spondias mombin (SM) and Cola acuminata seed extract (CA) against scopolamine-induced cognitive dysfunction. SM or CA (50, 100 or 200mg/kg, p.o.) or SM+CA (50mg/kg, p.o.) was administered to rats for 3 consecutive days. One hour post-treatment on day 3, scopolamine (3mg/kg i.p) was administered and 5min later, the Y-maze test or Morris water maze test (MWM; days 3–7) was conducted. The rat’s brains were isolated for the estimation of oxidative-nitritive stress status following the MWM task. The antioxidant capacity of SM and CA was also evaluated in vitro using the 1,1-diphenyl-2-picrylhydrazyl (DPPH), nitric oxide (NO) and ferric ion reducing power (FRAP) assays. Pretreatment of rats with SM, CA or SM+CA significantly ameliorated the learning and memory impairment induced with scopolamine as evidenced in Y-maze and MWM paradigms. Moreover, SM, CA or SM+CA significantly attenuated the oxidative-nitritive stress induced by scopolamine, evidenced in the decrease in malondialdehyde and nitrite levels and restoration of glutathione, catalase and superoxide dismutase levels. Furthermore, SM and CA showed promising free radical scavenging effect against DPPH and moderate antioxidant activity in NO and FRAP tests. This study showed that Spondias mombin and Cola acuminata have significant protective effect against scopolamine-induced memory deficit that could be attributed to their antioxidant properties.

      PubDate: 2017-04-11T19:41:53Z
      DOI: 10.1016/j.ajme.2016.08.001
       
  • Broken Heart Syndrome – An intra operative complication

    • Authors: Zara Wani; Meenaxi Sharma
      Abstract: Publication date: Available online 9 March 2017
      Source:Alexandria Journal of Medicine
      Author(s): Zara Wani, Meenaxi Sharma
      We report a case of Broken Heart Syndrome in a 56year old Postmenopausal woman suffered while undergoing simple biopsy procedure for vocal cord polyp that lead to physical, mental and financial burden both for the patient as well as the doctors. A team of cardiologists based on clinical and echocardiographic findings made the diagnosis of this case.

      PubDate: 2017-03-13T03:33:09Z
      DOI: 10.1016/j.ajme.2017.02.003
       
  • IGF-I and IGFBP-3 levels and their correlations with carcinoembryonic
           antigen in colorectal cancer patients

    • Authors: Çiğdem Yağcıoğlu Yücel; Gönül Erden; Fatma Meriç Yılmaz; Sevilay Sezer; Esin Çalcı
      Abstract: Publication date: Available online 7 March 2017
      Source:Alexandria Journal of Medicine
      Author(s): Çiğdem Yağcıoğlu Yücel, Gönül Erden, Fatma Meriç Yılmaz, Sevilay Sezer, Esin Çalcı
      Background Colorectal cancer is one of the most frequently seen cancers worldwide. Currently, CEA is the most commonly used tumor marker in colorectal cancer. The changes in IGF/IGFBP equilibrium is also known to cause carcinogenesis. In this study, we aimed to monitor IGF-I/IGFBP-3 levels, the changes in IGF-I/IGFBP-3 ratio and correlations of these peptides with the common tumor marker CEA. Materials and methods 55 colorectal cancer patients and 35 control group patients were included in this study. Serum CEA, IGF-I and IGFBP-3 levels of all specimens were measured with chemiluminescence method. Results In colorectal cancer patients, IGF-I levels was found to be increased, IGFBP-3 levels decreased and IGF-I/IGFBP-3 ratio was increased; when compared to control group (p<0.05). A moderately significant correlation was found between the conventional tumor marker CEA and IGF-I and IGF-BP3 (p=0.001, r=0.533 and p=0.001, r=−0.573 respectively). Conclusions IGF-I/IGFBP-3 ratio seems to be increased in the colorectal cancer patients. When considered with the moderate correlation levels of these peptides with CEA, this increase in IGF-I/IGF-BP3 ratio may be useful in monitoring carcinogenesis in colorectal cancer patients among with CEA but more detailed and extensive studies in larger study groups needed to be carried out.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2017.02.001
       
  • Antidiabetic medication adherence and associated factors among patients in
           Botswana; implications for the future

    • Authors: Godfrey Mutashambara Rwegerera; Thato Moshomo; Marea Gaenamong; Taibat Aderonke Oyewo; Sivasomnath Gollakota; Francis Apolinary Mhimbira; Joseph Fadare; Brian Godman; Johanna C. Meyer; Yordanka Piña Rivera
      Abstract: Publication date: Available online 6 March 2017
      Source:Alexandria Journal of Medicine
      Author(s): Godfrey Mutashambara Rwegerera, Thato Moshomo, Marea Gaenamong, Taibat Aderonke Oyewo, Sivasomnath Gollakota, Francis Apolinary Mhimbira, Joseph Fadare, Brian Godman, Johanna C. Meyer, Yordanka Piña Rivera
      Background Diabetes mellitus (DM) is a major global public health problem. Lack of adherence to medication causes suboptimal glycemic control increasing complication rates, costs and mortality. The objective of the study was to determine current antidiabetic medication adherence in Botswana and assess associated factors so as to direct potential future interventions. Materials and methods A cross-sectional study among 376 randomly selected diabetic patients attending a leading clinic in Gaborone, Botswana. Eight item Morisky Medication adherence questionnaire was used to assess antidiabetic medication adherence. A structured questionnaire was also used to collect information on factors influencing adherence including age, gender, education, type and duration of diabetes, treatment, complications and HIV status. Data were entered and analyzed using STATA Version 14, and logistic regression performed. Results Over forty percent (41.8%) of patients were non-adherent to antidiabetic medications. Studied sociodemographic characteristics and clinical variables did not affect adherence. HIV positive status was associated with a statistically significant better adherence at multivariate analysis. Conclusion Adherence to antidiabetic medication was found to be suboptimal in a setting where medicines are provided free of charge. Only HIV positivity was found to be significantly associated with better adherence, probably due to effect of greater psychosocial support and counselling as part of HIV treatment. There is a need to carry out studies to further improve understanding of factors associated with medication adherence that are pertinent to Botswana and similar settings given the growing prevalence of diabetes.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2017.01.005
       
 
 
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