International Journal of Medicine and Medical Sciences

International Journal of Medicine and Medical Sciences ISSN: 2167-0447 Vol. 2 (7), pp.148-153, July, 2012. © International Scholars Journals

Full Length Research Paper

An audit of paediatric tracheostomies in Port Harcourt Nigeria

Onotai LO¹*, Etawo US² 

 ¹FWACS, Department of Surgery University of Port Harcourt, Port Harcourt, Nigeria.

²Department of Surgery University of Port Harcourt, Port Harcourt, Nigeria. 

*corresponding authors’ E-mail: [email protected]

Received July 12, 2012; Accepted July 29, 2012

Abstract 

Background: Airway management in the paediatric age group may be challenging to both the anesthetists and otolaryngologists. Clinicians usually consider tracheostomy only in circumstances where no other alternative is available because of its associated complications.

Objective: This study was carried out to establish the pattern of paediatric tracheostomies in our setting. It will also highlight the common indications, complications and outcomes of tracheostomized paediatric patients. Lastly, it will obtain baseline data for future studies.

Patients and methods: A retrospective case series of all paediatric patients, 5 days old to16 years who had tracheostomies in the department of Ear, Nose and Throat (ENT) surgery of University of Port Harcourt Teaching Hospital (UPTH) and Rex Medical centre (RMC) both in Port Harcourt, Nigeria, from January 2002 to December 2011. Patient records were analyzed for demographic data, indications for tracheostomy, types of tracheostomy, operative technique, complications of tracheostomy and outcome.

Results: A total of 152 patients had tracheostomy within the study period. There were 104 males and 48 females with M: F ratio of 2.2:1. The age range was 5 days to 16 years with a mean of 4.64 (SD ± 2.35) years. Age group 3-5 years accounted for majority (n=95, 62.50%) of the cases. Upper airway obstruction was the commonest (n=147, 96.71%) indication for tracheostomy and foreign bodies in the larynx ranked highest (n=125, 82.24%) as an etiological factor of the upper airway obstructions. The commonest post-operative complication was post-decannulation airway obstruction (n=22, 14.47%) and there was no mortality associated with the tracheostomies done in this series.

Conclusion: Paediatric tracheostomy is an important procedure that continues to be a standard surgical technique for paediatric airway management in spite of its associated complications. Upper airway obstruction due to laryngeal foreign bodies was the commonest indication in our setting whereas; post-decannulation airway obstruction was the commonest complication in our series.

Key words: Tracheostomy, Airway obstruction, Complications, Laryngeal foreign bodies, Subglottic stenosis

International Journal of Medicine and Medical Sciences ISSN: 2167-0447 Vol. 2 (6), pp.128-133, April, 2012. © International Scholars Journals

Full Length Research Paper

Analysis of psychological characteristics and criminal history of intravenous drug abusers in Iran

Leyla Sahebi¹, Mohammad Asghari Jafar-Abadi², Seyed Hosein Mousavi³, Kamyar Ghabili⁴, Majid Khalili⁵

¹PhD of Epidemiology, Research Center of Health Service Management., Lung& TB research center. Tabriz University of Medical Science.

²Research Center of Health Service Management and Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran. Corresponding author

³MS. c of Health Administration, Tehran municipality

⁴PhD in History of Medicine, Center of Culture & History of Medicine. Tabriz University of medical science

⁵MD. Lung& TB research center, Tabriz University of Medical Science

Corresponding Author’s E-mail: [email protected] 

Received March 10, 2012; Accepted June 08, 2012

Abstract

Objectives: The  main of this study  was assess the psychological characteristics and criminal history of intravenous drug abusers, emphasizing the effects of various abused drugs and multidrug addiction.

Materials and methods: A comparative study was performed in 2009 on intravenous drug abusers in Drop-In Centers (DIC) and a Hospital which only Distributed Methadone (HDM). The sample consisted of 261 subjects. Logistic Regression analyses in SPSS 16 were used for analyzing.

Results: Psychological disorders were highly prevalent among the drug abusers. However, DIC addicts had better overall psychological health compared to HDM group. Prevalence of criminal activity among drug abusers was 48.2% and about 70% of these subjects had a history of more than one crime. Multiple drug abuse and concomitant with alcohol had no relation with criminal history (OR= .84 and 1.7; 95% CI: (.48, 1.5and.7, 1.95). However, addiction to heroine, Psychological disorders and low education level were highly related with criminal activity.

Conclusion: Higher scores in mental health questionnaire of DIC addicts in comparison to HDM addicts, suggest the positive effects of psychological interventions for this Population.  There is the possibility of the involvement of psychopharmacological factors of heroin in occurrence of psychological disorders and criminal activity. This needs more rigorous investigation by large cohort studies.

Key word: addiction, crime, DIC (Drop in center),Psychological disorders, General Health Questionnaire-28

International Journal of Medicine and Medical Sciences ISSN: 2167-0447 Vol. 2 (6), pp.123-127, June, 2012. © International Scholars Journals

Full Length Research Paper

Scholarly publishing in Muslim countries with special reference to research in neuroscience by Turkish Scholars

Fatima Mary Sylvia R¹, Karthic  Rajan M.², Manoharan A.³ and Kumaravel JPS.⁴,

¹Librarian, Jayraraj Annapackiam College for women, Periakulam – 625 601, Tamilnadu.  India.

²Assistant Librarian, Thiagarajar College, Madurai.

³Associate Professor, Dept. of Library & Information Science, Bishop Heber College, Trichy – 620017.Tamilnadu.  India.

⁴Deputy Librarian, Dr.T.P.M.Library, Madurai Kamaraj Univesity, Madurai – 625 021.  India.

*Corresponding Author’s E-mail:[email protected]

Received March 24, 2012; Accepted June 03, 2012

Abstract

Research potential of Turkish scholars in Neuroscience and their Social Networks are highlighted in this paper.  Turkey‘s contribution to the world‘s scientific literature during the period 2000 to 2010, has been taken for this study. The analysis has been done on research potential of Turkish Scholars, publication pattern in neuroscience and existence of social net works.  The findings show that there is a gradual growth in the research productivity by Turkish Scholars and they prefer to publish their research findings in journals from United Kingdom, Netherland and United States.  Also the Turkish Scholars have the international level social network linking many countries, of which USA, Germany and France have the major share.

Key words: Turkish Research Productivity, Neuroscience, Scholarly publishing, Bibliometrics.

International Journal of Medicine and Medical Sciences Vol. 2 (5), pp.117-122, May, 2012. ISSN: 2167-0404 © International Scholars Journals

Review

A Review on Molecular Basis of the Role of Psychological Stress in the Development and Progression of Type 1 and Type 2 Diabetes Mellitus

Mahbub-E-Sobhani¹, *Abul Kalam Azad, Md. Abdul Wadud Molla²

¹Biotechnology and Genetic Engineering Discipline, Khulna University, Khulna-9208, Bangladesh

²Biotechnology and Genetic Engineering Discipline, Khulna University, Khulna-9208, Bangladesh

*Corresponding Author’s E-mail: [email protected]

Received February 04, 2012; Accepted May 17, 2012

 Abstract

Prolonged stress has long been shown to have major effects on the development of both type of diabetes mellitus, type 1 and type 2. This paper reviews the interrelationship between stress and diabetes. Chronic physical or emotional stress can activate the Hypothalamus-pituitary-adrenal (HPA) axis to induce production of the stress hormone glucocorticoids. Glucocorticoids cause abrupt thymus involution and result in a failure or breakdown in immunological tolerance. As a result of breakdown in immunological tolerance autoreactive T-cells are escaped from thymus microenvironment which ensures self/non-self education and selection of mature T-cells before being exported to the periphery. Though regulatory T-cells (Treg) are present in the circulation, they are unable to suppress the autoreative T-cells from initiating the destruction of β-cells and the subsequent development of autoimmune type 1 diabetes. The destruction of β-cells can be mediated by various mechanisms including Fas-FasL, perforin/granzymes, reactive oxygen species, and cytokines (e.g., IL- 1β, IFN-γ). Oxidative stress leads to development of type 2 diabetes either by the activation of multiple stress-sensitive serine/threonine (Ser/Thr) kinase signaling cascades such as c-Jun NH_2-terminal kinase (JNK) pathway resulting in insulin resistance and/or by causing defect in insulin gene expression due to the loss of at least two critical proteins {pancreatic and duodenal homeobox factor-1 (PDX-1) and musculoaponeurotic fibrosarcoma oncogene homolog A (MafA)} that activate the insulin promoter.

Key words: Psychological Stress, Reactive Oxygen Species, β-cells, pancreatic and duodenal homeobox factor-1, musculoaponeurotic fibrosarcoma oncogene homolog A, Diabetes.

International Journal of Medicine and Medical Sciences Vol. 2 (5), pp.114-116, May, 2012. ISSN: 2167-0404 © International Scholars Journals

Full Length Research Paper

Lime Juice (Citrus aurantifolia): Effect on fetal parameters of pregnant Sprague-Dawley rats

Airat Adeola Bakare¹, Rosemary Basiono Bassey², Chika Ann Onyeka³, Francis Ikechukwu Duru¹

¹Department of Anatomy, College of Medicine of the University of Lagos, Nigeria

²Department of Anatomy, Faculty of Basic Medical Sciences, University of Uyo, Nigeria

³Department of Anatomy, Faculty of Basic Medical Sciences, Madonna University, Nigeria

*Corresponding Author’s E-mail: [email protected]

Received February 6, 2012; Accepted May 29, 2012

 Abstract

Objective: The aim of this study was to determine the effect of lime juice on the fetal parameters of Sprague-Dawley rats

Materials and Methods: Forty adult female Sprague-Dawley rats were used. The experiment was divided into 2 groups (I and II) of 10 rats each. The estrous cycles of the rats were studied for the first 16 days to establish cyclicity. The rats were mated with male SD rats of proven fertility on the estrous day (heat period) of estrous cycle. Rats in group I received 1ml of undiluted lime juice while rats in group II received distilled water by gastric gavage. The rats were sacrificed the 20^th day of gestation using chloroform anesthesia and fetal parameters were evaluated.

Results: There was a reduction in the number of fetus of treated pregnant rats when compared to the control which has between eight to eleven litters. There was a significant reduction in the crown-rump length, weight and umbilical cord length of the fetus when compared with the control which was normal.

Conclusion: Lime juice showed abortificient effect but no obvious teratogenic effect was observed.

Key Words: Lime juice, Ovulation, Estrous cycle

International Journal of Medicine and Medical Sciences ISSN: 2167-0447 Vol. 2 (5), pp.108-113, May, 2012. © International Scholars Journals

Full Length Research Paper

The Challenges of Rigid esophagoscopy in the management of esophageal foreign bodies in Port Harcourt

Onotai L.O. and Etawo U.S

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

FWACS, Department of Surgery UPTH, Port Harcourt, Nigeria.

Corresponding Author’s E-mail: [email protected]

Received May 03, 2012; Accepted 29 May, 2012

Abstract

Background: Foreign body (FB) ingestion and impaction in the esophagus constitutes an important cause of morbidity and mortality worldwide. Most of the impacted foreign bodies in the esophagus require endoscopic removal with rigid esophagoscopy.

Objective: This study seeks to highlight the challenges in the management of esophageal FB using rigid esophagoscopy. It will also evaluate the outcome of management.

Patients and Method: This was a retrospective study of 70 patients with confirmed esophageal foreign bodies that were managed in the Ear, Nose and Throat (ENT) department of University of Port Harcourt Teaching Hospital (UPTH) and Rex Medical center Port Harcourt, from January 2006 to December 2011. The records of all patients that presented to both centers with history of FB ingestion were retrieved from admission registers, theatre records and case files. Demographic and clinical data were documented and simple statistical tables were used to illustrate the data. Data analysis was done using SPSS for windows 15.

Results: The records of 70 patients were retrieved out of 2,400 patients that presented with ENT emergencies giving a prevalence of 2.92%. The total ENT cases seen within the study period were 22,200 cases giving a prevalence of 0.32%. Fifty five patients had radiologic confirmation of foreign bodies in their esophagus and 15 were further confirmed during esophagoscopy. There were 44 males and 26 females with Male: female ratio of 1.7:1. The age range was 1- 65 years with a mean of 23.15 ± 14.24 years. Majority of the foreign bodies 60 (85.71%) were impacted in the cricopharyngeal sphincter of the esophagus. Dentures ranked highest among the adult population, 10 (14.29%) cases while, metallic objects excluding coins ranked highest in the pediatric population, 21 (30%) cases. Forty (57.14%) cases presented to the hospitals after 72 hours. Only 66 (94.29%) patients’ foreign bodies could be extracted. There was failed extraction in 4 (5.71%) cases. Complications occurred in 9 (12.86%) cases. Conclusion: The management of impacted esophageal foreign bodies with rigid esophagoscopy was an effective procedure despite its challenges. Public enlightenment campaigns are necessary to help reduce the incidence and encourage early presentation to hospitals.

Key words: Esophageal, Foreign bodies, Management challenges, Perforations, Rigid esophagoscopy.