International Journal of Medicine and Medical Sciences ISSN: 2167-0404 Vol. 3 (5), pp. 434-440, May, 2013. © International Scholars Journals

Full Length Research Paper

Evaluation of a malaria rapid diagnostic test among febrile children in Sokoto, Nigeria

*Sani UM, Jiya NM, Ahmed H

Department of Pediatrics, Usmanu Danfodiyo University Teaching Hospital, (uduth) Sokoto, Nigeria.

*Corresponding   author. Email: [email protected]

Accepted 01 May, 2013

Abstract

Malaria rapid diagnostic test (RDT) is an antigen capture assay that enables rapid diagnosis of malaria without the need for electricity or highly skilled technicians. Though potentially useful, its adoption needs to be guided by local test sensitivity. This study evaluated the diagnostic performance of a commercially available RDT (Malaria Pf rapid device, Biotec Laboratories Limited, United Kingdom) among 400 febrile children(aged 6months to 12 years) in Sokoto, Nigeria. It was a prospective observational study conducted at the Paediatric Outpatient Department (POPD) of UDUTH, Sokoto between March and October, 2009. Finger prick blood samples were collected from each of the patients (day 0) and immediately tested for falciparum malaria by both Giemsa microscopy and rapid diagnostic test (RDT). Patients with both positive RDT and positive microscopy results on day 0 were retested on day 7 (after antimalarial therapy) by both diagnostic methods. The prevalence of malaria among the study cohort was 40.8% by microscopy and 39.5% by RDT.  The RDT had a sensitivity of 90.2% and specificity of 95.4%; with positive and negative predictive values of 93.0% and 93.4% respectively. Test accuracy was 93.3%, whereas reliability was 85.3%. Test sensitivity is reduced by low parasite density (100% at > 1600/µl Vs 69.2% at <800/µl). Of the 69 patients who were retested on day 7 after antimalarial treatment, 18 (26.1%) still had positive RDT test even though negative by microscopy and afebrile at the time of follow up.  The diagnostic performance of the RDT in this study was good. Hence, it is recommended as an alternative method for diagnosis of malaria, especially when microscopy is not feasible.

Key words: Malaria, rapid diagnostic test, children, Sokoto, Nigeria.

International Journal of Medicine and Medical Sciences ISSN: 2167-0404 Vol. 3 (4), pp. 419-427, April, 2013. © International Scholars Journals

Perspective

Personal medical record: Dominica’s low-tech, low-cost solution for a high-tech, high-cost problem

Kamal Malaker

Department of ICM, Ross University School of Medicine, Portsmouth, Commonwealth of Dominica. Email:

[email protected] / [email protected].

Accepted 22 March, 2013

Abstract

The advantages of personal medical records in health maintenance and cost reduction have been well studied, and they are recommended as an integral part of health care management. Several Electronic Personal Medical Record (ePMR) systems have been developed, but their popularity and utility falls far short of expectations. Cost, confidentiality, and logistics are all problematic in implementing an acceptable ePMR system. Out of necessity, Dominica, an island nation in the eastern Caribbean, developed a manual Personal Health Record (mPMR), which effectively overcame all of the above problems. Some refinement of its current state will make it the most useful and cost effective system in certain places and an initial step while moving into an electronic phase. Dominica’s system may be adopted by smaller nations or small communities (as a unit) in larger countries at a fraction of the high-tech cost and administrative hassle.

Key words: ePMR, mPMR, cost, confidentiality, universal adoptability.

International Journal of Medicine and Medical Sciences ISSN: 2167-0404 Vol. 3 (4), pp. 428-433, April, 2013. © International Scholars Journals

Full Length Research Paper

Factors associated with co-use of Chinese medicine and Western medicine among outpatients: A survey in a medical center of Chinese Medical University hospital of Central-Taiwan

Fei-Na Chen¹, Yu-Chi Hou², Pei-Dawn Lee Chao²,   Bao-Lien Houng ³

¹School of Medicine, ²School of Pharmacy, ³School of Sports Medicine,  China Medical University, Taichung 40402, Taiwan, R.O.C.

*Corresponding author. E-mail: [email protected]

Accepted 01 April, 2013

Abstract

The purpose of this study is to investigate the factors which are related to the behaviors of patients who visited both Chinese Medicine (CM) clinics and Western Medicine (WM) clinics, as well as using medications of CM and WM in the same day. The questionnaire was developed according to a series of discussions from an expertise group. Two thousand patients who visited outpatient clinics at China Medical University Hospital were randomly selected and recruited voluntarily by interviewers who had been trained in interview skills. The descriptive analysis and stepwise logistic regressions were used. The survey response rate was 78.4% and the average age of participants was 47.3 (SD=16.3) years. Among those who visited WM or CM clinics within past three years (n=1799), 58.6% visited both WM and CM clinics. Females with higher education who were younger than 40 years old and who used more health-related supplements have a significantly higher tendency to visit both kinds of clinics. Those patients with chronic bronchitis, chronic hepatitis, gynecological diseases, allergies and exercise injuries were more likely to visit both clinics. Moreover, among those who visited both clinics (n=1054), 61.5% (n=648) were likely to co-medicate with WM and CM in the same day. Despite having some limitations, this study did demonstrate the high prevalence of co-use and co-medication of CM and WM in Taiwan. Patients with chronic diseases or long-term intake of medicines and young educated women are at a high risk of developing drug toxicity. 

Key words: Chinese medicine (CM), Western Medicine (WM), co-medication of CM and WM, co-use of CM and WM,  socio-demographic factor.

International Journal of Medicine and Medical Sciences ISSN: 2167-0404 Vol. 3 (4), pp. 407-410, April, 2013.© International Scholars  Journals

Case Report

Dentigerous cyst associated with ectopic tooth at the roof of maxillary sinus

*Onotai, L.O., da Lilly-Tariah O.B

FWACS, Department of E.N.T Surgery UPTH, Port Harcourt, Nigeria.

Accepted 02 April, 2013

Abstract 

Dentigerous cyst is the most common developmental odontogenic cyst of the jaws. They are frequently associated with impacted mandibular third molars and the maxillary canines. Association of ectopic tooth in the maxillary sinus with dentigerous cyst is quite uncommon. We report a case of dentigerous cyst associated with ectopic tooth at the roof of the maxillary sinus manifesting as a unilateral facial swelling with encroachment into the nose and orbit. This article addresses its unusual location, the important aspect of its etiopathologenesis, its clinical characteristics, differential diagnosis and management.

Key words: Dentigerous cyst, ectopic tooth, maxillary sinus, unilateral facial swelling, benign tumors.

International Journal of Medicine and Medical Sciences ISSN: 2167-0404 Vol. 3 (4), pp. 411-418, April, 2013. © International Scholars Journals

Full Length Research Paper

Selective antiseizure activity of synthetic morpholine in experimental animals

Azikiwe C. C. A.¹*_, Siminialayi I. M.¹, Brambaifa N.², Ifezulike C.C.², and Nwankwo M. J.³, ⁴Amazu LU.

¹Department of Pharmacology, College of Health Sciences, University of Port Harcourt, Nigeria.

²Department of Paediatrics, Anambra State University, Uli, Nigeria.

³Department of Medical Rehabilitation, Nnamdi Azikiwe University. Nnewi, Nigeria.

⁴Department of pharmacology, Imo State University, Orlu. Imo State. Nigeria.

*Corresponding auhor. E-mail: [email protected].

Accepted 04 October, 2012

Abstract

More than two third of epileptic patients have inadequate control of seizure as no drug has been found to be truly antiepiletogenic, a process through which a normal neuron becomes epileptic. Morpholine is an alkaloid and an active constituent of Crinum jagus, a medicinal plant used in the treatment of all forms of convulsive seizures in traditional medicine. Antiseizure activity of morpholine was investigated. Convulsion was induced using maximum electric shock (MEST), pentylenetetrazole(PTZ), strychnine and picrotoxin in the appropriate animal models. Seizures onset time and death time were used as standard convulsive signs while prolongations of these features were taken as anticonvulsant activity of standard drugs/morpholine. Results were analyzed using SPSS-16.0 version. Acute toxicity (LD₅₀) of morpholine was found to be 2.21 mg/kg (IP in mice) based on the arithmetic method of Karbar. Morpholine exhibited a dose dependent antiseizure activity against PTZ induced seizure (P<0.001). The antizeizure activity of morpholine was higher than that of valproic acid (P<0.001), a standard drug used in absence seizure. Morpholine showed no statistically significant antiseizure activity against MEST, strychnine and picrotoxin induced seizures. Synthetic Morpholine is though very toxic but, has potent selective antiseizure as well as antiepileptogenic activity which if well controlled could be used in the treatment of absence seizure and its complications in man. It is highly recommended that a further characterization of the extracts of C. jagus being carried out as well as clinical trial of a less toxic form of morpholine be carried out in man.

Key words: Morpholine, Crinum jagus, medicinal plants, seizure, epilepsy, epileptogenesis, antiepileptogenesis.

International Journal of Medicine and Medical Sciences ISSN: 2167-0404 Vol. 3 (3), pp. 390-396, March, 2013 © International Scholars Journals
 

Full Length Research Paper

Value of serum and bile levels of IGF-1 in discriminating cholangiocarcinoma from other causes of extrahepatic biliary obstruction

¹Hany M. Elsadek,  ²Ahmed M.Hassaneen

Gastroenterology Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University, Egypt.

*corresponding Author.E-mail: [email protected]

Accepted 23 January, 2013

 Absract

Cholangiocarcinoma (CCA) is a highly fatal malignant tumor with increasing incidence rates worldwide.  Many biomarkers were suggested for diagnosis of CCA. Insulin-like growth factor 1 (IGF-1) stimulates mitosis, inhibits apoptosis and plays an important role in molecular pathogenesis of CCA. The aim of this study was to evaluate the performance of IGF-1 level in serum and bile as a diagnostic marker for extrahepatic CCA. The study was conducted on 127 patients with extrahepatic obstructive jaundice diagnosed as extrahepatic CCA (group 1, 45 cases), other malignant causes of extrahepatic obstructive jaundice (group 2, 37 cases) and benign causes of extrahepatic biliary obstruction (group 3, 45 cases). Level of IGF-1 was measured for all patients in collected serum samples as well as in bile samples collected during endoscopic retrograde cholangio-pancreatography (ERCP)  or through percutaneous transhepatic cholangio-drainage (PTCD). Results: Bile level of IGF-1 was significantly elevated in extrahepatic CCA patients in comparison to other groups (P<0.001). On the other hand, no significant difference in serum level of IGF-1 was noticed among different groups. Conclusion: Measurement of IGF-1 level in bile (but not in serum) can distinguish CCA from other causes of extrahepatic biliary obstruction.

Key words: IGF-1, Cholangiocarcinoma, extrahepatic, obstructive jaundice.