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  Subjects -> MEDICAL SCIENCES (Total: 7268 journals)
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MEDICAL SCIENCES (1810 journals)                  1 2 3 4 5 6 7 8 | Last

Showing 1 - 200 of 3562 Journals sorted alphabetically
16 de Abril     Open Access  
AADE in Practice     Hybrid Journal   (Followers: 4)
ABCS Health Sciences     Open Access   (Followers: 1)
Abia State University Medical Students' Association Journal     Full-text available via subscription  
ACIMED     Open Access   (Followers: 1)
ACS Medicinal Chemistry Letters     Full-text available via subscription   (Followers: 39)
Acta Bio Medica     Full-text available via subscription   (Followers: 2)
Acta Bioethica     Open Access   (Followers: 1)
Acta Bioquimica Clinica Latinoamericana     Open Access   (Followers: 1)
Acta Facultatis Medicae Naissensis     Open Access  
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Medica Bulgarica     Open Access  
Acta Medica Colombiana     Open Access   (Followers: 1)
Acta Médica Costarricense     Open Access   (Followers: 2)
Acta Medica Indonesiana     Open Access  
Acta medica Lituanica     Open Access  
Acta Medica Marisiensis     Open Access  
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Acta Medica Nagasakiensia     Open Access  
Acta Medica Peruana     Open Access   (Followers: 2)
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Acta Scientiarum. Health Sciences     Open Access  
Acupuncture & Electro-Therapeutics Research     Full-text available via subscription   (Followers: 2)
Addiction Science & Clinical Practice     Open Access   (Followers: 7)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Advanced Health Care Technologies     Open Access   (Followers: 4)
Advanced Science, Engineering and Medicine     Partially Free   (Followers: 8)
Advances in Bioscience and Clinical Medicine     Open Access   (Followers: 5)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 29)
Advances in Life Course Research     Hybrid Journal   (Followers: 8)
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Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20)
Advances in Therapy     Hybrid Journal   (Followers: 5)
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)
Advances in Wound Care     Hybrid Journal   (Followers: 10)
African Health Sciences     Open Access   (Followers: 2)
African Journal of Biomedical Research     Open Access  
African Journal of Clinical and Experimental Microbiology     Open Access   (Followers: 1)
African Journal of Laboratory Medicine     Open Access   (Followers: 2)
African Journal of Medical and Health Sciences     Open Access   (Followers: 1)
African Journal of Trauma     Open Access  
Afrimedic Journal     Open Access   (Followers: 2)
Aggiornamenti CIO     Hybrid Journal   (Followers: 1)
AIDS Research and Human Retroviruses     Hybrid Journal   (Followers: 8)
AJOB Primary Research     Partially Free   (Followers: 3)
Aktuelle Ernährungsmedizin     Hybrid Journal   (Followers: 4)
Al-Azhar Assiut Medical Journal     Open Access  
Alexandria Journal of Medicine     Open Access  
Allgemeine Homöopathische Zeitung     Hybrid Journal   (Followers: 2)
Alpha Omegan     Full-text available via subscription  
ALTEX : Alternatives to Animal Experimentation     Open Access   (Followers: 3)
American Journal of Biomedical Engineering     Open Access   (Followers: 11)
American Journal of Biomedical Research     Open Access   (Followers: 2)
American Journal of Biomedicine     Full-text available via subscription   (Followers: 6)
American Journal of Chinese Medicine, The     Hybrid Journal   (Followers: 5)
American Journal of Clinical Medicine Research     Open Access   (Followers: 6)
American Journal of Family Therapy     Hybrid Journal   (Followers: 11)
American Journal of Law & Medicine     Full-text available via subscription   (Followers: 13)
American Journal of Lifestyle Medicine     Hybrid Journal   (Followers: 5)
American Journal of Managed Care     Full-text available via subscription   (Followers: 11)
American Journal of Medical Case Reports     Open Access   (Followers: 1)
American Journal of Medical Sciences and Medicine     Open Access   (Followers: 1)
American Journal of Medicine     Hybrid Journal   (Followers: 45)
American Journal of Medicine and Medical Sciences     Open Access   (Followers: 1)
American Journal of Medicine Studies     Open Access  
American Journal of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American Journal of the Medical Sciences     Hybrid Journal   (Followers: 12)
American Journal on Addictions     Hybrid Journal   (Followers: 9)
American Medical Journal     Open Access   (Followers: 4)
American medical news     Free   (Followers: 3)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 2)
Amyloid: The Journal of Protein Folding Disorders     Hybrid Journal   (Followers: 4)
Anales de la Facultad de Medicina     Open Access  
Anales de la Facultad de Medicina, Universidad de la República, Uruguay     Open Access  
Anales del Sistema Sanitario de Navarra     Open Access   (Followers: 1)
Analgesia & Resuscitation : Current Research     Hybrid Journal   (Followers: 2)
Anatomical Science International     Hybrid Journal   (Followers: 2)
Anatomical Sciences Education     Hybrid Journal   (Followers: 1)
Anatomy Research International     Open Access   (Followers: 2)
Angewandte Schmerztherapie und Palliativmedizin     Hybrid Journal  
Angiogenesis     Hybrid Journal   (Followers: 3)
Annales de Pathologie     Full-text available via subscription  
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale     Full-text available via subscription   (Followers: 3)
Annals of African Medicine     Open Access   (Followers: 1)
Annals of Anatomy - Anatomischer Anzeiger     Hybrid Journal   (Followers: 2)
Annals of Bioanthropology     Open Access   (Followers: 3)
Annals of Biomedical Engineering     Hybrid Journal   (Followers: 18)
Annals of Biomedical Sciences     Full-text available via subscription   (Followers: 3)
Annals of Clinical Microbiology and Antimicrobials     Open Access   (Followers: 8)
Annals of Family Medicine     Open Access   (Followers: 13)
Annals of Fundeni Hospital     Open Access   (Followers: 1)
Annals of Ibadan Postgraduate Medicine     Open Access  
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Medicine     Hybrid Journal   (Followers: 11)
Annals of Medicine and Surgery     Open Access   (Followers: 5)
Annals of Microbiology     Hybrid Journal   (Followers: 10)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Saudi Medicine     Open Access  
Annals of the New York Academy of Sciences     Hybrid Journal   (Followers: 5)
Annals of The Royal College of Surgeons of England     Full-text available via subscription   (Followers: 3)
Annual Reports in Medicinal Chemistry     Full-text available via subscription   (Followers: 7)
Annual Reports on NMR Spectroscopy     Full-text available via subscription   (Followers: 4)
Annual Review of Medicine     Full-text available via subscription   (Followers: 18)
Anthropological Review     Open Access   (Followers: 24)
Anthropologie et santé     Open Access   (Followers: 5)
Antibiotics     Open Access   (Followers: 9)
Antibodies     Open Access   (Followers: 2)
Antibody Technology Journal     Open Access   (Followers: 1)
Anuradhapura Medical Journal     Open Access  
Anwer Khan Modern Medical College Journal     Open Access   (Followers: 2)
Apmis     Hybrid Journal   (Followers: 1)
Apparence(s)     Open Access   (Followers: 1)
Applied Clinical Informatics     Hybrid Journal   (Followers: 2)
Applied Medical Informatics     Open Access   (Followers: 11)
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 1)
Arak Medical University Journal     Open Access  
Archive of Clinical Medicine     Open Access   (Followers: 1)
Archive of Community Health     Open Access  
Archives of Biomedical Sciences     Open Access   (Followers: 7)
Archives of Medical and Biomedical Research     Open Access   (Followers: 3)
Archives of Medical Laboratory Sciences     Open Access   (Followers: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Archives of Trauma Research     Open Access   (Followers: 2)
Archivos de Medicina (Manizales)     Open Access  
ArgoSpine News & Journal     Hybrid Journal  
Arquivos Brasileiros de Oftalmologia     Open Access  
Arquivos de Ciências da Saúde     Open Access  
Arquivos de Medicina     Open Access  
ARS Medica Tomitana     Open Access   (Followers: 1)
Art Therapy: Journal of the American Art Therapy Association     Full-text available via subscription   (Followers: 10)
Arterial Hypertension     Open Access  
Artificial Intelligence in Medicine     Hybrid Journal   (Followers: 12)
Artificial Organs     Hybrid Journal   (Followers: 1)
Asia Pacific Family Medicine     Open Access  
Asia Pacific Journal of Clinical Nutrition     Full-text available via subscription   (Followers: 10)
Asia Pacific Journal of Clinical Trials : Nervous System Diseases     Open Access  
Asian Bioethics Review     Full-text available via subscription   (Followers: 1)
Asian Journal of Cell Biology     Open Access   (Followers: 6)
Asian Journal of Health     Open Access   (Followers: 3)
Asian Journal of Medical and Biological Research     Open Access   (Followers: 2)
Asian Journal of Medical and Pharmaceutical Researches     Open Access   (Followers: 1)
Asian Journal of Medical Sciences     Open Access   (Followers: 1)
Asian Journal of Scientific Research     Open Access   (Followers: 1)
Asian Journal of Transfusion Science     Open Access   (Followers: 2)
Asian Medicine     Hybrid Journal   (Followers: 4)
ASPIRATOR : Journal of Vector-borne Disease Studies     Open Access  
Astrocyte     Open Access  
Atención Familiar     Open Access  
Atención Primaria     Open Access   (Followers: 1)
Audiology - Communication Research     Open Access   (Followers: 8)
Auris Nasus Larynx     Full-text available via subscription  
Australasian Medical Journal     Open Access   (Followers: 3)
Australian Coeliac     Full-text available via subscription   (Followers: 2)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Journal of Medical Science     Full-text available via subscription   (Followers: 1)
Autopsy and Case Reports     Open Access  
Aviation, Space, and Environmental Medicine     Full-text available via subscription   (Followers: 9)
Avicenna     Open Access   (Followers: 2)
Avicenna Journal of Medicine     Open Access   (Followers: 1)
Bangabandhu Sheikh Mujib Medical University Journal     Open Access   (Followers: 1)
Bangladesh Journal of Anatomy     Open Access   (Followers: 1)
Bangladesh Journal of Bioethics     Open Access  
Bangladesh Journal of Medical Biochemistry     Open Access   (Followers: 3)
Bangladesh Journal of Medical Education     Open Access   (Followers: 2)
Bangladesh Journal of Medical Microbiology     Open Access   (Followers: 2)
Bangladesh Journal of Medical Physics     Open Access  
Bangladesh Journal of Medical Science     Open Access  
Bangladesh Journal of Medicine     Open Access   (Followers: 1)
Bangladesh Journal of Physiology and Pharmacology     Open Access  
Bangladesh Journal of Scientific Research     Open Access   (Followers: 1)
Bangladesh Medical Journal     Open Access  
Bangladesh Medical Journal Khulna     Open Access  
Bangladesh Medical Research Council Bulletin     Open Access  
Basal Ganglia     Hybrid Journal  
Basic Sciences of Medicine     Open Access   (Followers: 2)
BBA Clinical     Open Access  
BC Medical Journal     Free  
Benha Medical Journal     Open Access  
Bijblijven     Hybrid Journal  
Bijzijn     Hybrid Journal   (Followers: 2)
Bijzijn XL     Hybrid Journal   (Followers: 1)
Bio-Algorithms and Med-Systems     Hybrid Journal   (Followers: 1)
Bioelectromagnetics     Hybrid Journal   (Followers: 1)
Bioengineering & Translational Medicine     Open Access  
Bioethics     Hybrid Journal   (Followers: 14)
Bioethics Research Notes     Full-text available via subscription   (Followers: 14)
Biologics in Therapy     Open Access  
Biology of Sex Differences     Open Access   (Followers: 4)
Biomarker Research     Open Access   (Followers: 2)

        1 2 3 4 5 6 7 8 | Last

Journal Cover Alexandria Journal of Medicine
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   ISSN (Print) 2090-5068
   Published by Elsevier Homepage  [3043 journals]
  • Ionotropic glutamate receptors (iGluRs) of the delta family (GluD1 and
           GluD2) and synaptogenesis

    • Authors: Muhammad Zahid Khan
      Pages: 201 - 206
      Abstract: Publication date: August 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 3
      Author(s): Muhammad Zahid Khan
      Glutamate delta-1 (GluD1) and glutamate delta-2 (GluD2) form the delta family of ionotropic glutamate receptors (iGluRs) and are distinct from other (iGluRs) in that they do not exhibit typical agonist-induced ion channel currents. Recent studies have demonstrated a crucial role of the delta receptors in synapse formation by interacting with presynaptic proteins such as Neurexin1. This review presents current knowledge regarding the expression, structure and function of Glu delta receptors (GluD1, GluD2) in brain, focusing on synapse formation, function and dysfunction.

      PubDate: 2017-09-08T11:24:09Z
      DOI: 10.1016/j.ajme.2016.09.003
       
  • Antioxidant, anti-inflammatory and antinociceptive activities of
           methanolic extract of Justicia secunda Vahl leaf

    • Authors: Samuel O. Onoja; Maxwell I. Ezeja; Yusuf N. Omeh; Beatrice C. Onwukwe
      Pages: 207 - 213
      Abstract: Publication date: August 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 3
      Author(s): Samuel O. Onoja, Maxwell I. Ezeja, Yusuf N. Omeh, Beatrice C. Onwukwe
      Background of study Plants used for traditional medicine contain a wide range of substances which can be used to treat various infectious diseases. Aim The study evaluated the in vitro antioxidant, antinociceptive, and anti-inflammatory activities of the methanolic extract of Justicia secunda Vahl leaf. Methods The acute toxicity was performed with up and down method and the highest dose used was 2g/kg. The anti-inflammatory activity was evaluated using the carrageenan and formalin-induced paw edema models, and antinociceptive activity was evaluated using acetic acid-induced writhing reflex and tail flick test models while the antioxidant activity was evaluated using 2,2-diphenyl-2-picryl hydrazyl (DPPH) and ferric reducing antioxidant power (FRAP) photometric assay. Results The extract was well tolerated as no signs of toxicity or death were noticed during the period of observation. The extract produced a concentration dependent increase in antioxidant activities in both DPPH and FRAP models. The extract produced its optimum activity at 400μg/ml in both DPPH (54.07%) assay and FRAP (1.58μM) assay. The extract produced significant (P <0.05) dose-dependent increase in both anti-inflammatory and antinociceptive activities. The antinociceptive and anti-inflammatory activities of the extract (0.4g/kg) were comparable with the reference drugs (aspirin and pentazocine) used in the study. Conclusion This study suggests that J. secunda possesses anti-inflammatory, antinociceptive and antioxidant activities and also provide the pharmacological basis for its uses in traditional medicine for these purposes.

      PubDate: 2017-09-08T11:24:09Z
      DOI: 10.1016/j.ajme.2016.06.001
       
  • Evaluation of Interleukin 8 gene polymorphism for predicting inflammation
           in Indian chronic kidney disease and peritoneal dialysis patients

    • Authors: Rajasree Shanmuganathan; Kumaresan Ramanathan; Giri Padmanabhan; Bhooma Vijayaraghavan
      Pages: 215 - 220
      Abstract: Publication date: August 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 3
      Author(s): Rajasree Shanmuganathan, Kumaresan Ramanathan, Giri Padmanabhan, Bhooma Vijayaraghavan
      Background and aim Previous studies have observed the association between inflammation and chronic kidney disease (CKD). The role played by Interleukin 8 (IL8) gene polymorphism has not been studied yet. Hence, the present study has been designed as the first attempt to identify the possible associations between polymorphism of the IL-8 gene and patients with diabetic CKD and on continuous ambulatory peritoneal dialysis (CAPD). Materials and methods A total of 150 participants were selected from a private nephrology outpatient clinic. The subjects were divided into three groups: healthy individuals without any renal complications (group 1, control, n =50), patients with diabetic chronic kidney disease of stages 3 and 4 (group 2, n =50) and CAPD (group 3, n =50). Blood deoxyribo nucleic acid (DNA) isolated from the members of the study group, was confirmed by agarose gel electrophoresis and primers specific for IL8 gene were designed, using primer3 software tool. Results Restriction digestion of the amplicons with Escherichia coli restriction enzyme I (EcoRI) ended up in 203 base pairs (bp) band in control and 108bp band in all diabetic and non-diabetic CKD. This indicated the presence of polymorphism in +781 Cytosine/Thymine (C/T) of IL-8 gene in diabetic CKD and CAPD patients. Statistical analysis of the distribution of frequencies of alleles C and T by chi square test confirmed the presence of polymorphism at +781 C/T of IL-8 gene in patient groups compared to control. Conclusion The polymorphism in +781 C/T of IL-8 gene studied in this work suggests its possible role as an inflammatory marker for both chronic kidney disease and CAPD.

      PubDate: 2017-09-08T11:24:09Z
      DOI: 10.1016/j.ajme.2016.06.004
       
  • Reduced glomerular filtration rate as a predictor of coronary artery
           disease events in elderly patients

    • Authors: Tarek A. Ghonemy; Ebrahim M. Salim; Sameh A. Soliman; Hala M. Allam
      Pages: 221 - 225
      Abstract: Publication date: August 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 3
      Author(s): Tarek A. Ghonemy, Ebrahim M. Salim, Sameh A. Soliman, Hala M. Allam
      Background Chronic kidney disease is independently associated with cardiovascular disease (CVD) events in high-risk populations according to several studies. However, findings from community-based population studies are insufficient. We studied the relationship between estimated glomerular filtration rate (eGFR) and risk of coronary artery disease (CAD) events in patients attending Zagazig University Hospital, Sharqiya governorate, Egypt. Methods A total of 800 subjects aged ⩾60years admitted to Internal Medicine Department or attended medicine outpatient clinic were included in this study. Careful history and full clinical examinations were done to assess the risk factors of CAD. Serum creatinine, lipid profile and serum glucose were measured. Estimated eGFR was evaluated by creatinine based MDRD formula. According to eGFR, patients were divided into 2 groups: group 1 with eGFR⩾60mL/min/1.73m2 and Group 2 with eGFR<60mL/min/1.73m (between 40 and 60mL/min/1.73m). Results 410 patients were found to have eGFR⩾60mL/min/1.73m2, while 390 patients were found to have eGFR<60mL/min/1.73m2. eGFR was lower in patients with CAD (62±13mL/min/1.73m2) in comparison with patients without CAD (76±11mL/min/1.73m2) (P ⩽0.001). Older age, hypertension, Diabetes and Low HDL are highly significant risk factors for CAD in those patients (P 0.001). Conclusions Reduced eGFR is a significant risk factor for CAD events in older patients. Monitoring of eGFR may have a pivotal role in early detection and management of CAD in those types of patients.

      PubDate: 2017-09-08T11:24:09Z
      DOI: 10.1016/j.ajme.2016.06.006
       
  • New treatment paradigm of combined raloxifene and conjugated estrogen for
           postmenopausal symptoms in VCD-induced menopausal rats

    • Authors: Marwa N. Emam; Rehab E. Abo El Gheit
      Pages: 227 - 236
      Abstract: Publication date: August 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 3
      Author(s): Marwa N. Emam, Rehab E. Abo El Gheit
      Introduction The decreased ovarian estrogen production that occurs at menopause, results in osteoporosis and climacteric manifestations, and decreases women’s quality of life. The hormone replacement therapy (HRT) is the primary treatment options but has been associated with increased oncogenic potential. The tissue selective estrogen complex (TSEC) is a novel therapy, partnering a selective estrogen receptor modulator (SERM) with one or more estrogens. Aim Our study was done to evaluate the potential relative estrogenic agonist activities of a SERM, raloxifene (RLX), when dosed alone and its antagonist activities when paired with conjugated estrogen (CE), as a TSEC and its potential use for the postmenopausal osteoporosis, vulvar/vaginal atrophy (VVA) in VCD induced menopausal rat model. Material and methods Female rats were dosed daily with 4-vinylcyclohexene diepoxide (VCD) (80mg/kg/d, IP) for 15days to induce ovarian failure, followed by one month free drug. VCD injected rats received 12weeks of RLX, CE, or combined RLX/CE with 17β-estradiol (E2), vehicle treated groups used as positive and negative controls, respectively. The bone turnover markers (BTM) were measured. The uterotropic activity was assessed by the uterine index and peroxidase assay. Vaginal wet weight (wt.) and glycogen were measured to evaluate the vaginotropic effects. Uterine and vaginal (ER) protein levels were assayed. Results Our findings showed that the appropriate RLX/CE dose combination exhibits significant bone sparing with minimal vaginal stimulation and neutral uterine effect. Conclusion We can conclude that appropriate RLX/CE combination could effectively be a promising alternative for the prevention of postmenopausal osteoporosis and VVA with no oncogenic risk.

      PubDate: 2017-09-08T11:24:09Z
      DOI: 10.1016/j.ajme.2016.06.002
       
  • In vitro antioxidant, hypoglycemic and oral glucose tolerance test of
           banana peels

    • Authors: V.V. Navghare; S.C. Dhawale
      Pages: 237 - 243
      Abstract: Publication date: August 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 3
      Author(s): V.V. Navghare, S.C. Dhawale
      Banana fruit is claimed to have antidiabetic effects despite its high calorie content, and its peels also contain vital phytoconstituents including gallocatechin. Previously banana pulp has been studied for antihyperglycemic effects, and in the present investigation antihyperglycemic effect of ethanolic extract of inner peels of Musa sapientum (EMS), Musa paradisiaca (EMP), Musa cavendish (EMC) and Musa acuminata (EMA) fruit was evaluated using oral glucose tolerance test in normoglycemic rats. In vitro antioxidant study was conducted using DPPH, H2O2 radical scavenging assay and ferric reducing power assay. Wistar rats were divided into fourteen groups and twelve groups received different doses of aforementioned extracts, while control group received gum acacia solution and remaining group received standard drug, glimepiride. All the rats received glucose load at a dose of 2g/kg body weight. Groups treated with EMC and EMA showed significant decrease in glucose level (p <0.01) at 150min as compared to control group. In hypoglycemic study, only EMP 500mg/kg, p.o. treated group revealed a significant decrease (p <0.05) in glucose level at 120min, while other groups did not show any sign of hypoglycemia. In glucose tolerance test, animals treated with EMC and EMA depicted dose dependent antihyperglycemic effect at 150min while EMS and EMP showed significant reduction in plasma glucose at higher doses. In a similar fashion, EMA i.e. M. acuminata demonstrated highest antioxidant activity followed by EMC against DPPH radical. In ferric reducing power and H2O2 scavenging assay, EMA demonstrated maximal antioxidant activity when compared with other extracts.

      PubDate: 2017-09-08T11:24:09Z
      DOI: 10.1016/j.ajme.2016.05.003
       
  • Mathematical models for drug diffusion through the compartments of blood
           and tissue medium

    • Authors: M.A. Khanday; Aasma Rafiq; Khalid Nazir
      Pages: 245 - 249
      Abstract: Publication date: August 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 3
      Author(s): M.A. Khanday, Aasma Rafiq, Khalid Nazir
      This paper is an attempt to establish the mathematical models to understand the distribution of drug administration in human body through oral and intravenous routes. Three models were formulated based on diffusion process using Fick’s principle and law of mass action. The rate constants governing the law of mass action were used on the basis of the drug efficacy at different interfaces. The Laplace transform and eigenvalue methods were used to obtain the solution of the ordinary differential equations concerning the rate of change of concentration in different compartments viz. blood and tissue medium. The drug concentration in the different compartments has been computed using numerical parameters. The graphs plotted illustrate the variation of drug concentration with respect to time using MATLAB software. It has been observed from the graphs that the drug concentration decreases in the first compartment and gradually increases in other compartments.

      PubDate: 2017-09-08T11:24:09Z
      DOI: 10.1016/j.ajme.2016.03.005
       
  • Role of MRP-1 and GST-Pi in MDR and their inhibition by indomethacin in
           AML

    • Authors: Samia A. Ebeed; Nadia A. Sadek; Ebtsam R. Zaher; Mervat M. Mahmoud; Gihan Nabil; Sanaa A. Elbenhawy
      Pages: 251 - 259
      Abstract: Publication date: August 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 3
      Author(s): Samia A. Ebeed, Nadia A. Sadek, Ebtsam R. Zaher, Mervat M. Mahmoud, Gihan Nabil, Sanaa A. Elbenhawy
      Background MDR continues to be a major challenge to effective chemotherapeutic interventions against cancer. Defining major factor contributing to MDR and inhibiting their action may thus be used for reversing MDR. Aim This work aimed to evaluate the role played by MRP-1 and GST-Pi in MDR, and to explore the possible role of indomethacin as an inhibitor of chemotherapy resistance in patients with AML. Subjects and methods The study included 2 groups, one included 20 healthy volunteers and the second included 50 AML patients. All patients received one cycle of standard induction chemotherapy, then regrouped according to their response to either CR group or unremitted group. Unremitted patients received a second cycle of chemotherapy combined with indomethacin. From each subject a blood sample was drawn before and after the 1st cycle of chemotherapy and after the 2nd cycle. From blood, mononuclear cells were separated, mRNA was extracted, and RT-PCR was carried out to detect GST-Pi and MRP-1 gene expression. Results GST-Pi expression in CR group was 60% before therapy that significantly decreased to 30% after therapy. While in unremitted group, its expression significantly increased from 30% before to 80% after therapy. GST-Pi positive patients had a significantly lower overall and disease free survival time than GST-Pi negative patients (P =0.000 and 0.039, respectively). While MRP-1 expression was so low (20%) and remained unchanged after therapy in both groups. MRP-1 expression did not affect overall or disease free survival. Taking indomethacin with 2nd cycle of chemotherapy in unremitted patients resulted in a significant inhibition of GST-Pi expression and a significantly longer overall survival time than those taking 2nd cycle chemotherapy alone (P =0.034). Conclusion MRP-1 is not likely to contribute to MDR, while GST-Pi might have a role in MDR phenotype in AML patients. Furthermore, GST-Pi inhibition significantly reduced MDR in AML patients.

      PubDate: 2017-09-08T11:24:09Z
      DOI: 10.1016/j.ajme.2016.04.002
       
  • Sub therapeutic drug levels among HIV/TB co-infected patients receiving
           

    • Authors: Daniel W. Gunda; Samuel E. Kalluvya; Christa Kasang; Benson R. Kidenya; Bonaventura C. Mpondo; Hartwig Klinker
      Pages: 271 - 279
      Abstract: Publication date: August 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 3
      Author(s): Daniel W. Gunda, Samuel E. Kalluvya, Christa Kasang, Benson R. Kidenya, Bonaventura C. Mpondo, Hartwig Klinker
      Background Tuberculosis/Human Immunodeficiency Virus (TB/HIV) is a very common co-infection which carries a high mortality rate. Though World Health Organization recommends co-treatment of TB/HIV to improve its outcome, Rifampicin potentially induces metabolism and sub-therapeutic antiretroviral plasma levels of non nucleoside reverse transcriptase inhibitors and protease inhibitors which may cause inadequate virological suppression if corrections are not timely done. In Tanzania Therapeutic drug monitoring is not done; so the proportion of sub-therapeutic ARV plasma levels among TB/HIV patients co-treated with anti-tuberculous drugs is not known. The aim of this study was therefore to determine the magnitude and risk factors of sub-therapeutic ARV plasma levels among adult HIV patients co-treated with anti tuberculous Medications. Materials and methods A cross sectional hospital based study was conducted among adult HIV patients on ARV and TB co-treatment for at least one month. Patients were serially enrolled through routine HIV care and treatment services until the sample size was reached. The information about demographic, clinical and adherence level, Anti-TB duration, viral load, baseline and enrollment CD4 counts, Hepatitis B co-infection and ARV plasma levels was collected and analyzed using STATA 12 software. Results In total 118 patients were included in this study; of whom 26 (22%) had sub-therapeutic ARV plasma levels. The sub-therapeutic ARV levels were independently associated with adherence <95% (OR=6.8, p =0.001), female gender (OR=3.4, p =0.028) and virological failure (OR=3.8, p =0.016). NVP based regimen was associated with sub-therapeutic drug levels on univariate model (OR=2.1, p =0.010). Conclusion The magnitude of sub-therapeutic ARV plasma levels is high among adult HIV/TB co-infected patients on anti-TB co-treatment in Tanzania. These patients stand a high risk of inadequate virological suppression with a potential resistance development and a long term poor clinical outcome. Identifying at risk patients and adherence enhancement could potentially improve the overall outcome of this subgroup of patients in resource restricted setting like ours where TDM is not available.

      PubDate: 2017-09-08T11:24:09Z
      DOI: 10.1016/j.ajme.2016.10.001
       
  • Proliferaton index in pituitary adenomas from a black African population

    • Authors: Ayodeji Salami; Mustapha Ajani; Augustine Adeolu; Olufunmi Ogun; Amos Adeleye; Olabiyi Ogun; Clement Okolo; Adefolarin Malomo; Effiong Akang
      Pages: 281 - 284
      Abstract: Publication date: August 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 3
      Author(s): Ayodeji Salami, Mustapha Ajani, Augustine Adeolu, Olufunmi Ogun, Amos Adeleye, Olabiyi Ogun, Clement Okolo, Adefolarin Malomo, Effiong Akang
      Background The WHO has recognized a variant of pituitary adenomas with potential aggressive behaviour which have been termed atypical pituitary adenomas. This group of tumours are recognized by their mitotic rate of more than >3%, p53 expression and invasion of surrounding structures. There has however been no study of the occurrence of these tumours in a black African population. This study is a preliminary attempt to examine this group of tumours in blacks. Methods This study retrospectively reviewed fifty-seven histologically diagnosed and immunohistochemically characterized pituitary adenomas received in our department over a twenty-one year period. Specimens were stained with ki67, a nuclear marker of cell proliferation which has been identified as the single best predictor of atypical pituitary adenoma. Results Twelve of the tumours showed atypical features with eight (67%) of these tumours being prolactinomas. Two of the tumours were gonadotrophs and two were null cell adenomas. There was no correlation with age or gender. Two of the tumours required neurosurgical re-exploration with one of these showing a higher mitotic index in the second biopsy. Conclusion The study suggests similarity in the rate of occurrence of pituitary adenomas with atypical features in a black African population with what is seen in Caucasians. Prolactinomas constitute a significant percentage of the tumours with this feature.

      PubDate: 2017-09-08T11:24:09Z
      DOI: 10.1016/j.ajme.2016.11.003
       
  • Subclinical hypothyroidism ups the risk of vascular complications in type
           2 diabetes

    • Authors: Ghada A. Mohamed; Amira M Elsayed
      Pages: 285 - 288
      Abstract: Publication date: August 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 3
      Author(s): Ghada A. Mohamed, Amira M Elsayed
      The incidence of thyroid dysfunction in diabetic patients is higher than that of the general population. Undiagnosed thyroid dysfunction may affect the metabolic control and enhance cardiovascular, and other chronic complication risks in diabetic patients. Few studies have examined the relationship between subclinical hypothyroidism (SCH) and vascular complications of type 2 diabetes. Objectives: To find out the relationship between SCH and vascular complications in patients with Type 2 diabetes. Subjects and Methods: Our cross sectional study included 110 patients with type 2DM (45 males and 65 females) who were followed at the Diabetes outpatient Clinics in the state of Kuwait during 6months period. All patients subjected to complete clinical and laboratory data, including thyroid function tests, total cholesterol (TC), triglyceride (TG), HDL-C, LDL-C, urinary albumin, fundus examination, ECG, and Glycosylated hemoglobin. Results: Among 110 patients, 21 (19.1%) Patients had SCH. Patients with SCH were more significantly older, with longer duration of diabetes, higher HbA1c, total cholesterol and LDL-C than euthyroid group. However, gender (p=0.076), BMI (p=0.092), and smoking (P=0.715) were not significantly different between the SCH and euthyroid groups. The SCH group had a higher prevalence of dyslipidemia (p=0.017), diabetic nephropathy (p=0.003) diabetic retinopathy (p=0.004) and IHD (p=0.011) than the euthyroid group while no significant difference in the prevalence of diabetic neuropathy (p=0.420). Conclusions: SCH is a common endocrine disorder in patients with Type 2 diabetes. It could be associated with a higher prevalence of vascular complications in type 2 diabetes. We could not prove a relation between SCH and diabetic neuropathy.

      PubDate: 2017-09-08T11:24:09Z
      DOI: 10.1016/j.ajme.2016.10.003
       
  • Caudal Regression Syndrome/neurogenic bladder presented as recurrent
           urinary tract infection

    • Authors: Burhan M. Edrees
      Pages: 289 - 297
      Abstract: Publication date: August 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 3
      Author(s): Burhan M. Edrees


      PubDate: 2017-09-08T11:24:09Z
      DOI: 10.1016/j.ajme.2016.11.001
       
  • 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
       
  • Traditional practices and childhood cryptosporidiosis in Nigeria: A review

    • Authors: Adekunle B. Ayinmode; Oluwasola O. Obebe
      Abstract: Publication date: Available online 16 October 2017
      Source:Alexandria Journal of Medicine
      Author(s): Adekunle B. Ayinmode, Oluwasola O. Obebe
      Cryptosporidium infection is known worldwide as an important aetiology of chronic diarrhoea that can become fatal in children (below 5years of age) and immunocompromised individuals. This review was aimed at identifying some traditional practices that may be risk factors for childhood diseases like cryptosporidiosis in a country like Nigeria with different tribes and cultures. Information gathered from literature search and informal sources identified some indigenous practices like birth rituals, special childhood menus, traditional nanny practice, local management of childhood diarrhoea and some myths among others, as factors that may negatively impact childhood health in a multi-cultural population like Nigeria. A proper understanding of these traditional practices will enable the prevention and control of childhood disease like cryptosporidiosis in a multi-ethnic setting.

      PubDate: 2017-10-17T20:20:15Z
      DOI: 10.1016/j.ajme.2017.09.004
       
  • Factors affecting seeking health-related information through the internet
           among patients in Kuwait

    • Authors: Haya M. Alkhatlan; Khan F. Rahman; Badriyah H. Aljazzaf
      Abstract: Publication date: Available online 14 October 2017
      Source:Alexandria Journal of Medicine
      Author(s): Haya M. Alkhatlan, Khan F. Rahman, Badriyah H. Aljazzaf
      Background The internet is a powerful worldwide communication medium that provides its users with immediate information irrespective of their location, culture, language and time. E-health service will have a great impact in reducing the costs of health care, increasing satisfaction of patients and health professionals, and minimizing the burden on health facilities. Objective This study aims to determine the proportion of patients who obtain health-related information through the internet as well as factors that could affect using the internet for seeking health information. Subjects and methods This study was conducted in six general hospitals in Kuwait. A cross-sectional study was adopted to determine the proportion of patients who obtain health-related information through the internet. It was followed by a case-control study to determine factors that could be associated with on-line search of health information. A questionnaire was used which included data related to socio-demographic characteristics, clinical history and computer experience. The final analysis included 220 participants. Results The majority of participants (93.2%) mentioned that they have used the internet for one or more purposes. Only 129 participants (62.9%) used the internet for obtaining health related information. All studied socio-demographic factors, except age and marital state, and computer skills variables had significant effect on on-line search for health information. After adjustment for confounding, only gender, nationality, level of education, and using computer at work were proved to be significant determinants of the outcome of interest. Conclusion It is important to close the gap in health literacy and increase the use of health information technology to support patient self-management. The creation of an eHealth-literate population should be a priority in Kuwaiti public health policy.

      PubDate: 2017-10-17T20:20:15Z
      DOI: 10.1016/j.ajme.2017.05.008
       
  • Adjustment disorder after botulinum toxin injection in an adolescent
           palatal myoclonus case: The importance of informed consent in the
           treatment of neuropsychiatric disorders in children and adolescents

    • Authors: Yusuf Öztürk; Zehra Topal; Nuran Demir; Ali Evren Tufan
      Abstract: Publication date: Available online 12 October 2017
      Source:Alexandria Journal of Medicine
      Author(s): Yusuf Öztürk, Zehra Topal, Nuran Demir, Ali Evren Tufan


      PubDate: 2017-10-17T20:20:15Z
      DOI: 10.1016/j.ajme.2017.08.008
       
  • Utility of diffusion weighted imaging (DWI) in assessment of liver
           fibrosis

    • Authors: Doaa Emara; Marwa Reda Doaa Elwazzan
      Abstract: Publication date: Available online 9 October 2017
      Source:Alexandria Journal of Medicine
      Author(s): Doaa M. Emara, Marwa M. Reda, Doaa A. Elwazzan
      Objectives: hepatic fibrosis occurs due to chronic liver injury. Early fibrosis can be reversed by treatment with specific antifibrotic therapy in addition to removal of the cause if possible, that is why, identification of the early liver fibrosis is important. MRI DWI is a non-invasive non-contrast imaging technique which help in diagnosis of different stages of hepatic fibrosis. Aim of the work: was to study the predictive value of diffusion weighted MRI for assessing liver fibrosis in comparison to liver biopsy in chronic hepatitis C virus patients. Methods: all the studied cases were subjected to the followings: (1) History and laboratory examination (PCR for HCV and liver function tests). (2) MRI DWI and post processing ADC map. (3) Percutaneous liver biopsy in cases with HCV for histopathological examination to assess the stage of fibrosis. Results: this study was carried out on 75 subjects, divided into two group, 50 cases and 25 controls, the mean age in the two studied groups was 36.5±9.32 and 35.8±6.75 respectively in patients and control. ADC of both liver and spleen showed a highly significant increase in the control than in the cases with mean liver ADC in the control group=2.3±0.25. There was a significant negative correlation between the mean ADC of the liver, spleen and the stage of liver fibrosis.

      PubDate: 2017-10-10T19:35:59Z
       
  • Additive manufacturing applications in medical cases: A literature based
           review

    • Authors: Mohd. Javaid; Abid Haleem
      Abstract: Publication date: Available online 6 October 2017
      Source:Alexandria Journal of Medicine
      Author(s): Mohd. Javaid, Abid Haleem
      Background A significant number of the research paper on Medical cases using Additive manufacturing studied. Different applications of additive manufacturing technologies in the medical area analysed for providing the state of the art and direction of the development. The aim of work To illustrate the Additive Manufacturing technology as being used in medical and its benefits along-with contemporary and future applications. Materials and methods Literature Review based study on Additive Manufacturing that are helpful in various ways to address medical problems along with bibliometric analysis been done. Result Briefly described the review of forty primary applications of AM as used for medical purposes along with their significant achievement. Process chain development in the application of AM is identified and tabulated for every process chain member, its achievement and limitations for various references. There are five criteria which one can achieve through medical model when made through AM technology. To support the achievements and limitations of every criterion proper references are provided. The ongoing research is also classified according to the application of AM in medical with criteria, achievement and references. Eight major medical areas where AM is implemented have been identified along with primary references, objectives and advantages. Conclusion Paper deals with the literature review of the Medical application of Additive Manufacturing and its future. Medical models which are customised and sourced from data of an individual patient, which vary from patient to patient can well be modified and printed. Medical AM involves resources of human from the field of reverse engineering, medicine and biomaterial, design and manufacturing of bones, implants, etc. Additive Manufacturing can help solve medical problems with extensive benefit to humanity.

      PubDate: 2017-10-10T19:35:59Z
       
  • Role of magnetic resonance imaging in the evaluation of the popliteus
           musclotendinous injuries as a part of the posterolateral corner injuries
           of the knee

    • Authors: Aly A. Abdel-Kerim Farahat; Abd ElAziz Elnekeidy; Mohamed Abdel Motaleb Abdelgelil
      Abstract: Publication date: Available online 30 September 2017
      Source:Alexandria Journal of Medicine
      Author(s): Aly A. Abdel-Kerim Farahat, Abd ElAziz Elnekeidy, Mohamed Abdel Motaleb Abdelgelil
      Introduction The popliteus musclotendinous complex is considered to be one of the main stabilizers of the posterolateral corner of the knee having different attachments and variable sites of injuries, the use of MRI helps the radiologists to depict such injuries consistently. Purpose of the study To study the role of MRI in evaluating the popliteus musclotendinous injuries as a part of the PLCof the knee. Patients and methods Our study included 15 patients with trauma to the knee undergoing MRI using 1.5T magnet using the following sequence: Axial, Coronal, sagittal proton density fat sat, T1, T2 and T2 gradient and conventional X-ray/CT [All patients did conventional X-ray Knee (AP and Lateral views), two patients did CT study of the knee]. Results Out of 15 studied patients with PLC injuries, eight (53.33%) patients had popliteus complex injuries, 7 (87.5%) patients showed combined injuries with other posterolateral structures while one (12.5) patient had isolated popliteus musclotendinous complex injury. Conclusion MRI imaging is crucial in the evaluation of the different sites and patterns of injuries of the popliteus musclotendinous complex when suspecting PLC injury.

      PubDate: 2017-10-02T18:32:37Z
      DOI: 10.1016/j.ajme.2017.08.006
       
  • Association of IL-23R gene single nucleotide polymorphism; rs 11209026
           with incidence and severity of ankylosing spondylitis in a cohort of
           Egyptian patients

    • Authors: Mohamed I. Sayed; Doaa I. Hashad; Eman A. Soliman; Maha M. Talaaba
      Abstract: Publication date: Available online 15 September 2017
      Source:Alexandria Journal of Medicine
      Author(s): Mohamed I. Sayed, Doaa I. Hashad, Eman A. Soliman, Maha M. Talaaba
      The aim of the present study was to investigate the possible association between incidence and severity of ankylosing spondylitis (AS) in a cohort of Egyptians and Interleukin-23Receptor (IL23R) genesingle nucleotide polymorphism(rs11209026). Methods:The study included thirty-two AS patients and forty volunteers who serves asa control group. The studied polymorphismwas genotyped using 5′ Nuclease assay. Results: A statistically significant difference was detected between both studied groups as regards different IL23R genesingle nucleotide polymorphism(rs11209026) genotypes. Heterozygous genotype was the most prevailing among both cases and controls. At a cutoff level of 110pg/mL, a statically significant difference was observed between cases and controls as regards serum IL23 level. Conclusions:In Egyptians, IL-23R single nucleotide polymorphism (rs11209026) appears to be associated with ankylosing spondylitis occurrence not severity, while higher levels of IL-23 might be associated with disease severity.

      PubDate: 2017-09-19T15:28:02Z
      DOI: 10.1016/j.ajme.2017.08.005
       
  • Serum cobalamin and red cell folate levels of anti-psychotic treatment and
           treatment naïve psychiatic patients in a tertiary hospital in Nigeria

    • Authors: Ao Shittu; Ao Adewoye; Ho Olawumi
      Abstract: Publication date: Available online 14 September 2017
      Source:Alexandria Journal of Medicine
      Author(s): Ao Shittu, Ao Adewoye, Ho Olawumi
      Background Psychiatric disorders contribute significantly to the global burden of diseases. There is an urgent need to curtail the morbidity and mortality associated with psychiatric disorders. Deficiencies of cobalamin and folate have been linked with psychiatric disorders. Materials and method Sixty-six each of antipsychotic treatment, treatment naïve psychiatric patients and control were recruited for the study. Red cell folate and serum cobalamin were determined with Enzyme Linked Immunosorbent Assay kits and the haemogram using Sysmex XT2000i. Result Folate deficiency was present in 13.6% of newly diagnosed anti-psychotic naive psychiatric patients with few of them having neutrophil hypersegmentation (7.6%) and macrocytosis (4.5%). Mean red cell folate levels for anti-psychotic naïve, patients on anti-psychotic and controls were 350.23±0.54nmol/l, 370±0.70nmol/l and 370±0.51nmol/l respectively, with p-values of 0.0001 and 0.3500 respectively when compared with control, while serum cobalamin levels were within the normal reference range in all patients and controls. Reticulocyte count had 8 times and 3 times likelihood of influencing low serum folate and low serum cobalamin respectively. Conclusion All patients had Serum cobalamin levels within the reference interval, the same can be said of the RBC folate levels of the greater percentage (95.5%) of psychiatric patients on psychotropic drugs.

      PubDate: 2017-09-19T15:28:02Z
      DOI: 10.1016/j.ajme.2017.08.009
       
  • Perceptions of caretakers with different socioeconomic status about the
           harmful outcomes of fever in under-five children in Dodoma region, central
           Tanzania: A cross-sectional study

    • Authors: Telemu Kassile; Bruno P. Mmbando; Razack Lokina; Phares Mujinja
      Abstract: Publication date: Available online 30 August 2017
      Source:Alexandria Journal of Medicine
      Author(s): Telemu Kassile, Bruno P. Mmbando, Razack Lokina, Phares Mujinja
      Background Socioeconomic status can affect health in childhood through many different pathways. Evidence on how households differ with regard to socioeconomic status and the degree to which this difference is associated with investment in child health is essential to the design of appropriate intervention strategies. Aim This study examines the impact of caretakers’ socio-economic characteristics on perceptions about the harmful outcomes of fever among under-five children. Material and methods The study used a three-stage cluster sample of households with under-five children in Dodoma region, central Tanzania. Multilevel modelling approach was used to model the relationship between the outcome measure and caretakers’ socioeconomic characteristics while controlling for other variables. Results A total of 329 under-five children with fever were studied of which 74.8% were perceived by their caretakers to have some chances for harmful effects of fever to occur when they experienced fever. Secondary school education or above of caretakers was significantly associated with decreased beliefs about the occurrence of harmful effects of fever. Conclusion Many caretakers are concerned about the occurrence of harmful effects of fever for their under-five children. Study findings suggest that promoting enrolment in secondary education or above and participation in the labour market particularly in non-farm activities of women would be valuable to the health of under-five children in central Tanzania.

      PubDate: 2017-09-02T09:57:42Z
      DOI: 10.1016/j.ajme.2017.08.004
       
  • Forensic dissection of lip print as an investigative tool in a mixed
           Egyptian population

    • Authors: S.A. Ahmed; Hanan E. Salem; Marwa M. Fawzy
      Abstract: Publication date: Available online 16 August 2017
      Source:Alexandria Journal of Medicine
      Author(s): S.A. Ahmed, Hanan E. Salem, Marwa M. Fawzy
      Background: Identification is a major problem facing forensic practitioners, DNA and finger prints are highly useful but sometimes aren't easily collected from the crime scene. Lip print could be useful in this field being unique to each individual. Aim: The current study aimed at detecting the frequency and gender relation of lip print pattern in an Egyptian sample. Methodology: Samples were collected on white copy paper, divided into four quadrants then examined with magnifying lens for pattern distribution. Results: The study showed that pattern IV was the most frequently represented pattern in the study sample, pattern I & II were more prevalent in males and females respectively. Prevalent pattern in Cairo and Lower Egypt was I while it was IV in Upper Egypt. Conclusion: The lip print pattern can differ due to gender and geographical origin in Egyptian subjects.

      PubDate: 2017-08-22T07:56:35Z
      DOI: 10.1016/j.ajme.2017.08.002
       
  • Otosclerosis and complications of stapedectomy: CT and MRI correlation

    • Authors: Heba Ibrahim Ali; Nivan Hany Khater
      Abstract: Publication date: Available online 10 August 2017
      Source:Alexandria Journal of Medicine
      Author(s): Heba Ibrahim Ali, Nivan Hany Khater


      PubDate: 2017-08-11T06:40:57Z
      DOI: 10.1016/j.ajme.2017.07.001
       
  • An overview about mitochondrial DNA mutations in ovarian cancer

    • Authors: Iyer Mahalaxmi; K.S. Santhy
      Abstract: Publication date: Available online 16 June 2017
      Source:Alexandria Journal of Medicine
      Author(s): Iyer Mahalaxmi, K.S. Santhy
      Background Ovarian tumour is the second most common form of cancer affecting female reproductive system and the most lethal of the gynaecological malignancies. Since past decades, tremendous efforts have been made to illuminate the molecular basis for initiation and progression of ovarian carcinoma. A low quantity of dysfunction in mitochondrial DNA (mtDNA) is considered to be a risk factor for variety of cancer types. Mitochondrial dysfunctions have been allied with varied metabolic diseases and for occurrence of cancer. Researches say that mtDNA have pivotal role in development of cancer but future work has to be carried out to know the exact significance of specific mitochondrial mutations linked with cancer and disease progression. Most of mtDNA mutations in gynecological cancers are observed in the D-loop region. Objective This review article provides a detailed summary about the ovarian cancer and mutations observed in mtDNA. Result Furthermore, this review offers some perspective as to the mtDNA origin of these mutations in ovarian cancer, their functional consequences in ovarian cancer development, to check for incidence rate for transmission of the disease through maternal lineages and possible diagnostic marker implication.

      PubDate: 2017-08-01T11:44:25Z
      DOI: 10.1016/j.ajme.2017.05.014
       
  • Physiological variables and molecular study of KLK2 and KLK3 among patient
           with benign prostatic hyperplasia

    • Authors: Mustafa F. Dawood; Sameer M. Khalaf; Ahmed A. Suleiman
      Abstract: Publication date: Available online 16 June 2017
      Source:Alexandria Journal of Medicine
      Author(s): Mustafa F. Dawood, Sameer M. Khalaf, Ahmed A. Suleiman
      Prostatic hyperplasia is benign tumor occur in prostate. Benign prostatic hyperplasia is common disease in old men. The incidence of disease arises with increase in age. The patient with benign prostatic hyperplasia are estimated 20% of men in 40s old, and 90% in of men in 80s old, and main causes of prostatic hyperplasia are unknown but there is evidence referring to genetic and hormonal disorders that may cause the disease. This study includes 60 patients with prostatic hyperplasia with an average age of 64years old and 30 samples as a control with same age group. The study obtained that there was significant association (P≤0.05) between PSA (KLK3) and prostatic hyperplasia. Result also mentions that there was significant decrease in testosterone level and significant increase in dihydrotestosterone level. The present study for KLK2 and KLK3 genes showed molecular variation in both genes, varied between polymorphism and allele polymorphism. PCR amplification of specific primers of KLK2 gene showed polymorphisms ranged between 14%, 8%, 10%, and 6% in each KLK2a, KLK2b, KLK2c, and KLK2d primers respectively, while the allele polymorphism in KLK2c amplification with primer reaches 18% of patient. PCR amplification of specific primers of KLK3 gene showed polymorphisms ranged between 10%, 6%, 2%, and 4% in each KLK3a, KLK3b, KLK3c, and KLK3d primer respectively, and allele variation was not detected in amplification product of KLK3.

      PubDate: 2017-08-01T11:44:25Z
      DOI: 10.1016/j.ajme.2017.03.001
       
  • Hepatitis-C Virus Infection and Exposure to Blood and Body Fluids among
           Nurses and Paramedical Personnel at the Alexandria University Hospitals,
           Egypt

    • Authors: Yehia Abdelghaffar Moustafa Seida; Maha Mohamed Helmy Moemen; Mona Shawki Ali Moustafa; May Moheb Eldin Mohamed Raouf; Noha Selim Mohamed Elshaer
      Abstract: Publication date: Available online 18 July 2017
      Source:Alexandria Journal of Medicine
      Author(s): Yehia Abdelghaffar Moustafa Seida, Maha Mohamed Helmy Moemen, Mona Shawki Ali Moustafa, May Moheb Eldin Mohamed Raouf, Noha Selim Mohamed Elshaer
      Background Worldwide, prevalence of anti-HCV positivity in health care workers (HCWs) ranges from 0% to 9.7%. The current study was conducted to calculate prevalence of HCV infection, frequency and characteristics of blood and body fluid (BBF) exposure among HCW at the Alexandria University Hospitals. Methods Hospital-based cross-sectional approach was adopted. At the Hospitals, 62.2% of available nurses and paramedical personnel voluntarily participated (n=499), and were interviewed, screened for HCV antibodies. Quantitative estimation of HCV-RNA was done to seropositive cases. Results Prevalence of anti-HCV antibodies and HCV infection was 8.6%, and 4.4% respectively. The frequency of BBF exposures was 66.7%. Blood/blood products were mainly involved (92.1%). More than half of exposed HCWs reported not wearing personal protective devices. Anatomical site of exposure was mainly right hand palm (36.2%). Regarding needle-stick injuries, two thirds of injured HCWs were the original user of sharp item which was contaminated in 79.7% of injuries. In 70.2% of injuries, disposable syringes were involved and occurred during item disposal. About 61% of injuries were superficial. Conclusion Prevalence of HCV infection among HCWs is similar to that among general population in the country. Nurses and housekeepers are frequently exposed to BBF. Adherence to infection control measures according to the National Guidelines is crucial to reduce HCV transmission.

      PubDate: 2017-07-24T12:10:21Z
      DOI: 10.1016/j.ajme.2017.06.005
       
  • Evaluation of selective peripheral neurotomies in the treatment of
           refractory lower limb spasticity in adults

    • Authors: Sherif M. Salem; Waleed Fawzy El-Saadany; Wael Ahmed Fouad; Walid A. Abdel Ghany
      Abstract: Publication date: Available online 8 July 2017
      Source:Alexandria Journal of Medicine
      Author(s): Sherif M. Salem, Waleed Fawzy El-Saadany, Wael Ahmed Fouad, Walid A. Abdel Ghany
      Background “Selective peripheral neurotomies” (SPNs) are indicated for the treatment of refractory focal and multifocal spasticity of lower limbs in adults. Objective To evaluate the surgical results of selective peripheral neurotomies in 20 adult patients who had refractory focal & multifocal spasticity of the lower limbs, follow up period of one year. Patients and Methods Prospective study included 20 adult patients who had refractory spasticity of the lower limbs. Preoperative evaluation for muscle tone using Modified Ashworth Score (MAS), muscle power using Medical Research Council Scale (MRCS), functional assessment using Oswestry Functional Scale (OFS) and Range Of Motion (ROM) using manual goniometry were done for all patients. All cases underwent surgery in the form of SPN of tibial, obturator, sciatic and/or femoral nerves. Follow up of the patients was done at 10th day, 3, 6months and one year postoperatively. Results The mean age of patients was 31.35±12.42years. There were statistically significant improvement of muscle tone, muscle power, functional assessment and range of motion between preoperative and one year postoperative values. Improvement of the muscle tone was from a preoperative Mean±SD of 3.60±0.68 on MAS to a postoperative 2.30±0.86 at one year, improvement of muscle power on MRCS was from preoperative Mean±SD 3.75±1.08 to postoperative 4.08±0.69 at one year, There was a functional improvement from a preoperative Mean±SD of 3.0±0.73 on OFS to 3.60±0.60 at one year postoperatively. Also, there was a significant improvement between preoperative ROM Mean±SD 61.25±15.29 and one year postoperatively 72.25±12.19. Conclusions Selective peripheral neurotomies could effectively improve muscle tone, muscle power, functional performance & range of motion in patients with refractory focal and multifocal spasticity in the lower limbs.

      PubDate: 2017-07-13T10:03:31Z
      DOI: 10.1016/j.ajme.2017.06.006
       
  • 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
       
 
 
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