African Journal of Medical Case Reports

African Journal of Medical Case Reports Vol. 4 (5), pp. 001-006, May, 2016. © International Scholars Journals

Full Length Research Paper

Clinicoepidemiological study in Sudanese patients: Prevalence and effect of eradicative triple therapy on extra digestive Helicobacter pylori skin manifestations, EdHpSm

Bashir A. H. H.^1,2*, Yousif S. M.² and Mahmoud M. O. A.²

¹Department of Dermatology and Venereology, Al Jawda Medical Centre, University of Juba, P. O. Box 1347, Khartoum, Sudan.

²Khartoum College of Medical Science, Jabir AbuEliz Diabetic Centre, Sudan.

Accepted 10 March, 2016

Abstract

Helicobacter pylori are gram-negative; microaerophilic spiral rod-shaped bacteria and they lead to gastritis, duodenal or gastric ulcer and even in rare cases to gastric carcinoma or Mucosa Associated Lymphoid Tissue (MALT) lymphoma. Based on a number of reports, a possible relationship of H. pylori infection to a variety of different dermatosis has been suggested, including urticaria, rosacea, acne-rosacea, atopic dermatitis, alopecia areata, Sjögren’s syndrome, Schönlein-Henoch purpura, and Sweet’s syndrome. This study is intended to identify the prevalence of extra digestive (extra gastric) H. pylori skin manifestations, and to observe the influence of H. pylori eradication through triple therapy on the clinical evolution of patients' skin conditions. A clinical descriptive study of 149 patients with skin manifestations and immunologically detected H. pylori by rapid test, in association with gastric, chest, joints and nasal symptoms were considered as study population. H. pylori (Hp) triple therapy have been given to all positive cases as first, second and relapse modality in 12 weeks duration treatment, 4 weeks interval each with no any added other type of treatment allowed. The study revealed that: 20.5% of the skin cases examined (3723) were considered extradigestive H. pylori skin manifestation (746). Most of the skin manifestations cases were females (67.1%), and approximately 60.4% of EdHpSm were at the age group 14 to 45 yr- old. Most of the patients with EdHpSm are of Northern Sudanese origin (87.2%), the Southerners, the Easterners and the Westerners showed lower percentages, that is, 1.3, 3.4 and 8.1%, respectively. EdHpSm is common among professional. Hay fever and gingival disease were among the most commonly associated diseases where they represented ca. 27.7 and 12.2%, respectively. Chronic Idiopathic Urticaria, CIU represent a higher prevalence (20.6%), where: Polymorphous Light Eruption (PLE) alone represented 12.7%, and Polycystic Ovary Syndrome, PCO was 11.6%. Vitiligo 2.6% among the least presented cases. Consequently, it was concluded that: all cases of EdHpSm responded to triple therapy; 60.0% are of good response and 37.0% are dramatically responded to triple therapy, while 2.0% poorly responded to therapy. H. pylori infection found to have an important role in the etiology of chronic idiopathic urticaria, Urticarial vasculitis, and Atopic dermatitis and other skin diseases. Patients received antimicrobial triple therapy, found to respond dramatically in (37%).

Key words: Immunologically, lymphoma, lymphoid, Helicobacter pylori.

Key words: Giant cell granulomas, fibrous stroma.

African Journal of Medical Case Reports Vol. 4 (4), pp. 001-006, April, 2016. © International Scholars Journals

Full Length Research Paper

The relationship between plasma omentin-1 levels and insulin resistance in newly diagnosed type 2 diabetıc women

G. Gürsoy*, N. G. Kırnap, O. E bah, Y. Acar, B. Demirba , S. Akçayöz and A. Öztürk

Department of Internal Medicine, Ankara Education and Research Hospital, Ankara, Turkey.

Accepted 11 October, 2015

Abstract

In addition to its role in energy storage, adipose tissue produces several hormones and cytokines termed adipokines that have widespread effects on carbohydrate and lipid metabolism. Omentin-1 is a newly identified adipokine that is highly and selectively expressed in visceral adipose tissue relative to subcutaneous adipose tissue. In some recent studies, it was shown to be decreased in obese and in insulin resistant female patients. In this study, intending to increase their knowledge about omentin-1 and its relation with type 2 diabetes mellitus, insulin resistance and obesity, they planned to point out the relationship between serum omentin-1 levels and insulin resistance in newly diagnosed type 2 diabetic patients. The study included 80 newly diagnosed female type 2 diabetic patients and 40 age matched female control subjects. Diabetic group had significantly lower plasma omentin-1 levels than the control group (p < 0.01). Both the diabetic and control groups who were insulin resistant had significantly lower omentin-1 levels (p < 0.009 and p < 0.05 respectively) than the groups who were not insulin resistant. Positive weak correlations were obtained between age, high density lipoprotein cholesterol and omentin-1 levels, and negative weak correlations between body mass index, fasting blood glucose, post prandial blood glucose, HbA1c, fasting insulin, model assessment insulin resistance index and omentin-1 levels. In conclusion, omentin-1 levels were significantly low in diabetic patients and as insulin resistance worsened omentin-1 decreased. The data may point toward a role of omentin-1 in insulin resistance and type 2 diabetes mellitus.

Key words: Omentin-1, diabetes mellitus, insulin resistance.

African Journal of Medical Case Reports Vol. 4 (3), pp. 001-008, March, 2016. © International Scholars Journals

Full Length Research Paper

Effect of drug sample availability on physician prescribing behavior: A systematic review

Rugmini Warrier¹*, Michael S. Monaghan², Anna Maio¹, Kathryn Huggett³ and Eugene Rich¹

¹Department of Internal Medicine, Creighton University Medical Center, Omaha, Nebraska.

²Department of Pharmacy Practice, School of Pharmacy and Health Professions, Creighton University Medical Center, Omaha, Nebraska.

³Office of Medical Education, Creighton University Medical Center, Omaha, Nebraska.

Accepted 11 October, 2015

Abstract

The purpose of this investigation was to systematically review and assess the influence of the pharmaceutical industry on physician prescribing. MEDLINE, PubMed and WebSPIRS were searched using the following terms: sample closet, drug samples, sample medications, sample medication utilization, sample dispensing, drug sample availability, drug industry, legislation drug samples, drug promotion, prescribing behavior and advertising. Two researchers independently evaluated and abstracted each article and compiled descriptive data. Of the 334 potentially relevant articles screened using the key words, 96 studies were considered for evaluation by reviewers. Of these, 40 studies addressed effects of sample availability on physician prescribing behavior. Access to drug samples influenced prescribing decisions in most of the studies. Physicians were more likely to prescribe heavily advertised drugs when they had access to samples. At the same time, there was a decrease in the prescribing of over-the-counter, generic, and inexpensive drugs. Availability of samples promoted prescribing habits inconsistent with practice guidelines and in conflict with teaching and formulary policies. The reliance on samples tended to prompt the question, “What samples do we have?” rather than, “Which drug is best for the patient?”

Key words: Drug samples, pharmaceutical industry, prescribing behavior, systematic review.

African Journal of Medical Case Reports Vol. 4 (3), pp. 001-006, March, 2016. © International Scholars Journals

Full Length Research Paper

Osteopontin a new probable marker for atherosclerosis in obese women?

G. Gürsoy*, S. Alagöz, Y. Acar, B. Demirba , H. Çetiner and Z. Kiliç

Department of Internal Medicine, Ankara Education and Research Hospital, Ankara, Turkey.

Accepted 21 October, 2015

Abstract

Obesity is associated with a state of chronic, low-grade inflammation characterized by abnormal cytokine production and macrophage infiltration into adipose tissue, which may contribute to the development of insulin resistance and type 2 diabetes. It was emphasized that inflamation takes part in all stages and complications of atherosclerosis. Osteopontin (OPN) is a multifunctional protein involved in various inflammatory processes, cell migration, and tissue remodeling. This study evaluated the role of OPN in female patients who have at least one risk factor for atherosclerosis such as obesity. The study included 45 morbidly obese normotensive female patients and 22 age and sex-matched control subjects. As well as making physical and antropometric examinations, fasting plasma glucose and insulin, post prandial plasma glucose and insulin, lipid profile, C-reactive protein, lipoprotein a, OPN levels were obtained in all female person. In this study we investigated atherosclerosis indirectly. Our obese group had significantly higher levels in glucose and lipid parameters as well as antropometric measures. Obese group also had significantly higher plasma OPN and C -reactive protein levels than the control group (p < 0.05). We also performed the correlation analysis of the groups and found positive correlations in OPN levels and body mass index, C-reactive protein, fasting insulin. In conclusion, our data may point toward a role of OPN in atherosclerosis and obesity.

Key words: Osteopontin, atherosclerosis, obesity.

African Journal of Medical Case Reports Vol. 4 (2), pp. 001-004, February, 2016. © International Scholars Journals

Review

Retrospective analysis of leptospirosis among children–clinico-microbiological and therapeutic aspects for the cases

Nagarajan Prabhu¹*, Danialas Joseph Pushpa Innocent² and Chinnaswamy Periyasamy³

¹Postgraduate and Research Department of Microbiology, Dr. N.G.P. Arts and Science College, An Institution of Kovai Medical Center and Hospital, Coimbatore-641048, India.

²Division of Microbiology, Rajah Muthaiah Medical College and Hospital, Annamalai University, Chidambaram, India.

³Institute of Laboratory Medicine, Kovai Medical Center and Hospital, Coimbatore-641048, India.

Accepted 21 July, 2015

Abstract

These case capsules provide a nice record of the identification of leptospirosis in Coimbatore among children in isolation, sensitive serological analysis and complete haematogram. Eight cases that were clinically suspected showing general body signs (jaundice, decreased urine output and arthralgia) were well studied in this investigation. As per this study, the cases had fever, puffiness, respiratory anguish and hemorrhagic diathesis as leading manifestations. Leptospirosis was suspected in view of the epidemic situation prevailing in the city by conducting a hospital based study on the presence of leptospiral infection among patients with signs/symptoms suggestive of leptospirosis during June 2007 to July 2008. As per this survey, we reported six positive cases among eight clinically suspected cases, of which five survived and one died. It is important to anticipate and recognize the suspected cases early in the course of leptospirosis so that the appropriate steps can be taken to prevent it and to treat it with appropriate antibiotics when it develops.

Key words: Leptospirosis, children, microscopic agglutination test.