International Journal of Medicine and Medical Sciences

International Journal of Medicine and Medical Sciences ISSN: 2167-0404 Vol. 2 (12), pp. 301-306, December, 2012. © International Scholars Journals 

Full Length Research Paper

The burden of maternal mortality in a semi urban Nigerian town: Five year experience

Ibrahim Isa A.¹*, Owoeye Gani I. O.² and Obilahi Abhulimen¹

¹Department of Obstetrics and Gynaecology, College of Health Sciences, Niger Delta University,    Amassoma,

Bayelsa State, Nigeria.

²Department of Community Medicine, College of Health Sciences, Niger Delta University, Amassoma,

Bayelsa State, Nigeria.

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

Received 15 July, 2012; Accepted 23 December, 2012

Abstract

Pregnancy is one of the most important periods in the life of a woman, but it can unpredictably at times be affected by obstetrics complications thereby leading to the death of women either directly or indirectly during antenatal period, labour or in the puerperium. This study aims to determine the magnitude and causes of maternal deaths in a tertiary hospital. This is a five-year retrospective descriptive analysis of all cases of pregnancy related maternal deaths at the Niger Delta University Teaching Hospital Okolobiri, Bayelsa State, in the Niger Delta of Nigeria. There were 13 maternal deaths and a total of 1812 live births during the study period giving a maternal mortality ratio of 717.4 per 100,000 live births. Major causes of deaths were sepsis 6 (50.0%) and pre-eclampsia/ eclampsia 4 (33.3%). Maternal death was more likely to  occur  in the unbooked (p ; 0.001; 95% CI ; 0.02 to 0.51), between ages 19 to 23 years (p; 0.035; 95% CI ,0.918 to 11.615), in women of high parity (p ; 0.000; 95% CI ; 0.00 to 0.08)and in the unemployed(x² = 28.198; df = 5; p = 0.000). There is an urgent need to address and improve on the quality of care given to unbooked emergencies in our institution. In addition other preventable social causes need to be tackled.

Key words: Maternal mortality, causes, Niger Delta, Nigeria.

International Journal of Medicine and Medical Sciences ISSN: 2167-0404 Vol. 2 (12), pp. 278-283, December, 2012. © International Scholars Journals 

Case report

Complete response of liver metastatic gastric cancer after FOLFOX-4 chemotherapy regimen followed by salvage gastrectomy: A case report

Bandhuphat Chakrabandhu¹*, Sirikan Yamada¹, ShunJi Kato², Nobutoshi Hagiwara² and Thiraphat Chakrabandhu¹

¹Chiang Mai University, Chiang Mai, Thailand

²Nippon Medical School, Tokyo, Japan

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

Received 05 August, 2012; Accepted 12 December, 2012

Abstract

A 48-year-old Thai male with metastatic liver gastric adenocarcinoma achieved a complete pathological response after neoadjuvant chemotherapy. The patient underwent a esophagogastroduodenoscopy in October, 2008, which revealed a ten centimeter ulcerated tumor mass at his antrum with complete gastric outlet obstruction. The biopsy of his gastric ulcer showed high grade necrotic adenocarcinoma. Further workups with computed tomography staged his cancer as cT4bN1M1 P0 CYX H1. He received 12 cycles of neoadjuvant chemotherapy consisting of oxaliplatin and fluoropyrimidine. The follow up computerized tomography CT scan, showed a complete regression of liver metastasis. Afterwards, he underwent a subtotal gastrectomy with D2 lymph node dissection showing a complete pathological response (grade 3 according to Japanese Classification of Gastric Carcinoma 3rd English edition). Postoperatively, he received eight cycles of capecitabine. After a 43 month follow up period, there is no recurrent disease.

Key words: Gastric cancer, salvage operation, chemotherapy, metastasis, FOLFOX-4, capecitabine.

International Journal of Medicine and Medical Sciences ISSN: 2167-0404 Vol. 2 (12), pp. 284-289, December, 2012. © International Scholars Journals

Full Length Research Paper

Genetic markers for trait anxiety as the risk factors for cardiovascular diseases (WHO-MONICA Program and MONICA-Psychosocial Subprogram)

Valery V. Gafarov,^1,2*, Mikhail I. Voevoda,^2,3, Elena A. Gromova,^1,2, Vladimir N. Maksimov,^2,3,
Igor V. Gagulin,^1,2, Nikolay S. Yudin,³, Almira V. Gafarova,^1,2 and Tatiana M. Mishakova³

¹Federal State Budgetary Institution the Research Institute of Internal Medicine of Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russia.

²Federal State Budgetary Institution the Interdepartmental Laboratory of Cardiovascular Disease Epidemiology of Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russia.

³Cytology and Genetics Institute of Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia.

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

Received 18 September, 2012; Accepted 01 December, 2012

Abstract

Anxiety is considered an independent risk factor for cardiovascular diseases (CVD). The objectives of the study were to determine trait anxiety prevalence; to find associations between trait anxiety and VNTR polymorphisms in the DRD4 and DAT genes; and to calculate relative risks (RR) for developing arterial hypertension (AH), myocardial infarction (MI), and stroke. Representative sample of 25 to 64-year-old males (n = 2149) was examined in three screening studies in a framework of the WHO MONICA program and MONICA-psychosocial subprogram in Novosibirsk in 1984, 1988, and 1994. All first time MI, AH, and stroke events were registered. Genotyping of VNTR polymorphism was performed for DRD4 and DAT genes. Anxiety levels were evaluated by Spielberger’s test. Stratified cox proportional regression model was used for RR estimation. High level of anxiety (HLA) was 50.9%. The DRD4 genotype 4/6 and DAT genotype 9/9 were significantly associated with HLA increasing CVD risk. Stroke and AH risks were maximal during the first five years, whereas maximal MI risk was found for 10-year period. Prevalence of HLA in Novosibirsk was high. Rates of HLA were significantly associated with certain VNTR polymorphisms in the DRD4 and DAT genes. High levels of anxiety were associated with increased CVD risk.

Key words: Trait anxiety, DRD4 gene, DAT gene, cardiovascular disease risk, cardiovascular disease. 

International Journal of Medicine and Medical Sciences ISSN: 2167-0404 Vol. 2 (12) pp. 273-277, December , 2012. © International Scholars Journals

Case report

Enhanced diagnostics of pyelonephritis - A case report

Pesola J.^1,2, Paakkanen H.³ and Hakalehto E.^4,5*

¹Kuopio University Hospital, Clinic of Children and Adolescents, P. O. BOX 1777, FI-70211 Kuopio, Finland.

²University of Eastern Finland, Faculty of Health Sciences, Institute of Clinical Medicine, P. O. Box 1627,

FI-70211 Kuopio, Finland.

³Environics Oy, Sammonkatu 12, FI-50130 Mikkeli, Finland.

⁴Finnoflag Oy, P.O.B. 262, FI-70101 Kuopio, Finland

⁵Institute of Biomedicine, University of Eastern Finland, P.O.B. 1627, FI-70211 Kuopio, Finland.

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

Received 27 August, 2012; Accepted 12 December, 2012

Abstract

A case of 49-year-old man with a pyelonephritis occurring for the second time within a year is described with special emphasis to the urgent verification detection of the urinary pathogen. The patient was treated in Kuopio University Hospital (KUH), Finland. An Uricult dipslide method (Orion Diagnostica Oy, Espoo, Finland; standard method) was compared with a PMEU Scentrion^® enrichment culture method (PMEU method), where the growth of the bacteria was detected by the PMEU Scentrion^® analysis of volatiles emitted from the syringes. By the PMEU method the bacterial growth was detected after 3 h with equal speed from both aerobic and anaerobic enrichment cultures. By the standard method one day after the sampling, when the plates were read for the first time, the pathogen concentration was >10E5/ ml. The enhancement of microbiological analysis of urine samples is warranted for decreasing the numbers of complications. This is especially important for patients prone to urinary tract infections or at risk of disseminating antibiotic resistant strains. According to this study the PMEU method proved out to be a useful means for shortening the delays and in guiding the selection of suitable treatments for urinary tract infections repeatedly threatening a risk patient.

Key words: Pyelonephritis, Escherichia coli, enrichment culture, rapid microbial detection, portable microbe enrichment unit (PMEU), urinary tract infections.

International Journal of Medicine and Medical Sciences ISSN: 2167-0404 Vol. 2 (12), pp. 290-295, December, 2012. © International Scholars Journals

Full Length Research Paper

Prevalence and temporal shifts of various diseases in a closed community: A clinical study from a public sector university

Samina Rafique¹* and Waseem Sarwar²

¹Bahauddin Zakariya University Multan Pakistan.

²Department of general surgery Unit 2 Nishtar Medical College and Hospital Multan Pakistan.

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

Received 10 August, 2012; Accepted 15 December, 2012

Abstract

Epidemiological studies are of significant concern in the field of public health. Though an ample account of such studies is available from teaching and non teaching medical institutions (basic health units, rural health centers and hospitals established at district level by local government), no such data is available from any public/private sector university. Therefore, the present study aimed to identify temporal variations in health problems of female students from a public sector university. In this cross sectional study, the data for more than 4000 female students of age 20 to 25 years coming to medical centre of the university during the year 2010 was recorded. The records indicated that the maximum number of patients was encountered during the month of March. Among the females, upper respiratory tract infections were of higher prevalence followed by allergic rhinitis/spasm particularly during winter (December, January and February) and early spring (March). The prevalence of various ailments and temporal variations were found to be highly significant (P< 0.001 for both). The study clearly signified that occurrence of most of the aliments for instance scabies can be attributed to overcrowding and bad personal hygiene. It also became evident that certain ailments were related to mental tensions such as acid peptic disease while others (anemia and gastrointestinal disorders) were due to nutritional imbalance poor hygienic conditions and low quality diet. The findings suggested that living conditions of the community should be improved and awareness among masses regarding personal health and hygiene should be created by involving professionals to conduct lectures and seminars. Moreover, the centre should be well equipped with proper diagnostic facilities for efficient working. Furthermore, an overall increase in health budget is pivotal to raise health care standards of the institution.

Key words: Diseases, prevalence, seasonal variation, female community.

International Journal of Medicine and Medical Sciences ISSN: 2167-0447 Vol. 2 (12), pp. 269-270, December, 2012. © International Scholars Journals

Case Report

Rosuvastatin induced rhabdomyolysis–Rare case reported in Batticaloa

Pirasath S.¹*,  Jasotharan V.², Sundaresan K. T.³

¹ Post Intern Medical Officer, Teaching Hospital, Batticaloa.

²Medical student, Faculty of Health Care Sciences, Eastern University of Sri Lanka.

³Consultant Physician, Teaching Hospital, Batticaloa

*Corresponding author. E-mail: selladuraipirasath81@gmail.com

Received 09 July, 2012; Accepted 12 December, 2012

Abstract

We reported a case of rosuvastatin induced rhabdomyolysis in a patient, who presented with one week history of bilateral thigh, back and shoulder pain and easy fatigability associated with passing dark coloured urine for two days. His systemic examination reveals muscle tenderness. His investigations showed high blood urea (147 mg%), serum creatinine (2.4mol/L), creatine kinase (CK) (21,210 U/L) and with a significant increase in urine myoglobin. Even he has no risk factors; he was diagnosed as rosuvastatin induced rhabdomyolysis associated with acute renal failure. The drug was stopped on the first day of admission and the patient was initiated on intravenous fluid with cautious monitoring of serum electrolytes. On the following days, the level of creatine kinase and serum myoglobin returned towards normal and consequently he was discharged without statins but on dietary therapy. On follow-up evaluation, the patient was symptoms free, his serum creatinine was 0.7mol/L, whereas his LDL cholesterol was 119mg/dL. The rosuvastatin induced rhabdomyolysis is discussed and the danger of its use in low risk patients is emphasized.

Key Words: Cytochrome P450, rhabdomyolysis, rosuvastatin.