African Journal of Medical Case Reports

African Journal of Medical Case Reports Vol. 8 (5), pp. 001-007, May, 2020. © International Scholars Journals

Full Length Research Paper

Vagiprost in management of second and third trimester intrauterine fetal death

EL-Gharib M. N.* and Elebyary M. T.

Department of Obstetrics and Gynaecology, Faculty of Medicine, Tanta University, Tanta, Egypt.

Accepted 15 January, 2020

Abstract

The objective of this study is to assess the effectiveness and side effects of vaginal Misoprostol (Vagiprost® tablet) in the termination of second and third trimester pregnancy complicated with intrauterine fetal death. The study design is a prospective observational cohort study in Tanta University Hospital. The study was carried out on 324 women with fetal demise in the second and third trimesters, from January 2008 to December 2009. All patients were subjected to history taking, physical examination, and the Bishop Scoring. 25 µg Misoprostol was applied in the posterior fornix of the vagina and this was repeated every 4 h over 24 h. We assessed the adverse effects, progress, and outcomes. The success rate was 90 and 45% in women in the third and second trimesters respectively. The mean induction-termination interval was 8.95 ± 2.63 and 15.3 ± 5.37 h for women in the third and second trimesters respectively. The induction termination interval correlated negatively with the duration of gestation. Approximately, 90% of second trimester and 55% of third trimester women required oxytocin augmentation. The mean value of total required dose of Misoprostol was 166.3 ± 7.5 and 120 ± 28.79 µg for women in the second and third trimesters respectively. Vagiprost appears to be a safe, effective, practical, and inexpensive method for termination of third trimester pregnancy complicated with intrauterine fetal death (IUFD).

Key words: Misoprostol, vagiprost, induction of labour, intrauterine fetal death, medical management, fetal demise, second and third trimester.

African Journal of Medical Case Reports Vol. 8 (5), pp. 001-009, May, 2020. © International Scholars Journals

Full Length Research paper

Epidemiological and immunological findings on human hydatidosis

Ihsan E. Al-Saimary¹*, Maani N. Al-Shemari² and Mohammed M. A. Al-Fayadh²

¹Department of Microbiology, College of Medicine, University of Basrah, Iraq.

²University of Al-Qadysia, Iraq.

Accepted 10 April, 2020

Abstract

Thirty patients infected with hydatidosis from different hospitals in Baghdad were included in this study. All these patients were diagnosed by imaging techniques and surgically proven. Immunological study was performed on blood samples. The study showed that the incidence of hydatidosis in females was higher than that of the males. The highest age distribution of hydatidosis patients was between 12 and 40 years. The percentage of liver hydatidosis was higher (64.66%) than any other organs. The results of IgG, IgM, C3 and C4 determination were significantly increased for IgG concentration in males compared with females and highly increased in males at age group 10 - 20 years. There was significant difference in IgM concentration which was significantly increased in females especially at fourth age group comparative with significant decrease in IgM concentration in males at different ages. Also, there was significant increase in C3 and C4 concentrations in females compared with males.

Key words: Patients, hydatidosis, concentrations, infected.

African Journal of Medical Case Reports Vol. 8 (5), pp. 001-005, May, 2020. © International Scholars Journals

Full Length Research paper

Association of serum vitamin D level with diabetic polyneuropathy

Leila Chaychi*, Todd Mackenzie, Diane Bilotta, Matthew Lynch, Jeffrey Cohen and Richard Comi

Dartmouth-Hitchcock Medical Center, Lebanon.

Accepted 21 February, 2020

Abstract 

There is an association between serum vitamin D level and diabetic polyneuropathy. Topical vitamin D has been proposed for treatment of neuropathic pain in diabetics. The relationship between the serum 25-hydroxyvitamin D level and diabetic neuropathy has never been evaluated. The objective of the study was to evaluate a quantitative and qualitative relationship between the serum 25-hydroxyvitamin D level and diabetic polyneuropathy. This was a case - control study and the study was conducted on an outpatient basis. Twenty two subjects were recruited from the Diabetes Clinic at Dartmouth Hitchcock Medical Center. All subjects had type-2 diabetes (male and female, 50-80 years old). The Michigan Neuropathy Screening Instrument (15 point questionnaire) was used to identify patients with neuropathy (score > 7/15). 11 patients did not have neuropathy and were designated the control group. 11 patients did have neuropathy (“study group”) and these patients underwent a detailed quantitative neuropathy evaluation by a neurologist using the 46-point Michigan Diabetic Neuropathy Scale (MDNS) and nerve conduction studies. We measured the serum 25-hydroxyvitamin D concentrations with liquid chromatography-tandem mass spectrometry (LC/MS) chromatography in all patients. These values were compared between the control and study group, and were correlated with the detailed neuropathy score in the study group. Patients with diabetic polyneuropathy had a lower mean serum 25-hydroxyvitamin D level (21. 36 ng/ml with the SD of: 8.56) in comparison to the controls (36.18 ng/ml with the SD of 7.53). However, there was no correlation between the vitamin D level and the detailed quantitative neuropathy score in the study group. There is an association between serum 25-hydroxyvitamin D level and diabetic polyneuropathy. The quantitative association of serum vitamin D level with the severity of diabetic polyneuropathy requires further investigation and possible larger number of patients.

Key words: Serumvitamin D, diabetic polyneuropathy, neuropathy, 25-hydroxyvitamin D.

African Journal of Medical Case Reports Vol. 8 (4), pp. 001-010, April, 2020. © International Scholars Journals

Full Length Research paper

An attempt to develop a novel systemic technique for the evaluation of cardiovascular system

Sameh El-Sharo

Department of Medical Engineering, Faculty of Engineering, Al-Ahliyya Amman University, Jordan. E-mail: [email protected].

Accepted 14 March, 2020

Abstract

A limited number of noninvasive techniques are available for the study of the state of the circulatory system. In this paper, we introduce, for the first time, a systemic method that can be used to assess the function of the cardiovascular system as a whole by building templates (patterns) that characterize its different states. This novel method makes use of the information embedded in both, the ECG, which characterizes mainly the function of the heart, and the pulse waveform, which reflects the function of the blood vessels. The main idea here is to combine the two signals simultaneously in a way to get a two-dimensional plot or a vectorgram, which is called a vectorcardiovasculargram (VCVG), while the technique for obtaining it is the vectorcardiovasculargraphy. Since there is a lack in factual data in clinical situation, we have used Matlab techniques to simulate the ECG and pulse wave signals of normal and some pathologic cases and then to construct the vectorgram for them. In order to test this method, we have created additional vectorgrams by using some ECG signals and pulse waveforms taken from the directory of the BioBench software. The shapes of the vectorcardiovasculargrams obtained varied according to the structural and functional performance of the circulation system. This is why they can be used clinically for diagnosis of the pathological states and diseases of the cardiovascular system.

Key words: Cardiovascular system, cardiovascular diseases, diagnostic methods, vectorgram, vectorcardiovasculargraphy.

African Journal of Medical Case Reports Vol. 8 (4), pp. 001-003, April, 2020. © International Scholars Journals

Short Communication

Anti-depressant drug prescription pattern for depression at a tertiary health care center of Northern India

J. K. Trivedi*, Mohan Dhyani, Himanshu Sareen, V. S. Yadav and S. B. Rai

Department of Psychiatry, Chhatrapati Shahujee Maharaj Medical University, U. P. Lucknow 226003, India.

Accepted 16 April, 2020

Abstract

This study was carried out to observe prescription pattern of anti depressants as well as other psychotropic medications for the treatment of depression. A sample of 100 adult patients was selected to participate in the study. First five patients of depression (with or without psychotic symptoms) from twenty out patient departments (OPDs) of various consultant psychiatrists of Department of Psychiatry, C.S.M. Medical University, Lucknow, were included with the sample. It was found that a large number of patients (84%) were co-prescribed Clonazepam. It was observed that 16% of the patients were prescribed a combination of two antidepressants. 19% of the patients were co-prescribed antipsychotics for the treatment of their psychotic symptoms. Duloxetine was found to be the most frequently prescribed anti depressant while Paroxetine was the least frequently prescribed antidepressant.

Key words: Antidepressants, depression, prescription pattern.

African Journal of Medical Case Reports Vol. 8 (3), pp. 001-004, March, 2020. © International Scholars Journals

Full Length Research paper

Bacterial wound infections in diabetic patients and their therapeutic implications

Ihsan Edan Abdulkareem Alsaimary

Department of Microbiology, College of Medicine, University of Basrah, P. O. Box 696, Ashar, Basrah, Iraq. E-mail: [email protected].

Accepted 24 November, 2018

Abstract

In order to identify the bacterial pathogens associated with diabetic wounds and testing the antibiotic susceptibility of main antibiotics against predominant anaerobic bacterial types in comparison with some plant extracts, a total of 27 diabetic patients in each types; Insulin dependent (IDDM) and non-insulin dependent NIDDM and 30 non-diabetic patients with wound infection were introduced in the present study that was conducted between October - December 2007. It has been found that wounds are highly infected by aerobic and anaerobic bacterial types; Propionibacterium granulosum - as anaerobic bacteria- was a predominant pathogen in diabetic wound infections, in comparison with Pseudomonas aeruginosa which is predominant in non-diabetic wounds. Amoxycillin/ calvulanic acid was the best effective antibiotic which gave 20 mm inhibition zone in comparison with other standard antibiotics, and aqueous extracts of Myrtus communis and Nerium oleander gave II and 10 mm inhibition zone, respectively.

Key words: Bacterial infections, diabetics, antibiotics.