International Journal of Medicine and Medical Sciences

International Journal of Medicine and Medical Sciences Vol. 1(2), pp. 031- 034, 27 December, 2011, ISSN: 2167-0404 © International Scholars Journals

Full Length Research Paper

Risk of Depression and Subjective Quality of Life among Attendees of a West African Glaucoma Clinic

Taiwo .O. Akindipe¹, Olatunji .F. Aina²_, and Adeola .O. Onakoya³

¹ MBBS, FMCPsych, FWACP (Specialist Senior Registrar, Psychiatry). Groote Schuur Hospital, Cape Town, South Africa {formerly with Dept of Psychiatry, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos}.

² MBBS, FWACP (Associate Professor/ Consultant Psychiatrist). Dept. of Psychiatry, College of Medicine, University of Lagos (CMUL), Lagos

³ MBBS, FWACS (Senior Lecturer/ Consultant Ophthalmologist). Dept of Ophthalmology (Guiness Eye Centre), CMUL/ LUTH, Lagos.

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

Received November 28, 2011; Accepted December 23, 2011

Abstract

Background: Glaucoma is a common cause of blindness. Particularly in West Africa where most affected patients present late in the clinic, glaucoma is often associated with psychological complications with possible effect on quality of life.

Methods: The study was carried out in the glaucoma clinic of Lagos University Teaching Hospital on consenting attendees aged ≥18 years. Equal number of age and sex-matched controls with the diagnosis of cataract were also recruited into the study from the general ophthalmology clinic. The subjects and controls were assessed with Zung Self-Rating Depression Scale (SDS) and World Health Organization Quality of Life-bref (WHOQoL-bref). 

Results:  A total of one hundred subjects with glaucoma and equal number of controls were studied. The median age of the subjects was 59.0 years with near equal sex distribution, that is 51 (51%) males and 49 (49%) females. Nearly half, 49 (49%) had severe glaucoma. Forty seven (47%) had visual impairment; with 21 (21%) having blindness in one eye and 3 (3%) with blindness in both eyes. On assessment with SDS, 22 (22%) subjects and 11 (11%) controls scored ≥40, indicating positive screen for depression. The difference was statistically significant (X²=4.391, df=1, p=0.036). From assessment with WHOQoL-bref, the overall quality of life was poor in 27 (27%) of subjects compared with 8 (8%) controls. Fifty six (56%) of subjects and eighty (80%) of controls had fair overall quality of life; and the difference was statistically significant (X²=15.412, df=2, p=0.0001).  

Conclusion: The study showed risk of depression with overall poor quality of life in relatively greater number of subjects compared to controls. It is also noted that nearly half of the subjects presented late with severe glaucoma in the study centre. It is recommended for routine screening for early detection of glaucoma among at risk subjects; and health education for affected patients to present early for necessary management.

Key Words: Glaucoma; Depression; Quality of Life; West Africa. 

International Journal of Medicine and Medical Sciences ISSN: 2167-0404, Vol. 2 (1), pp. 047-049, 27 January, 2012, © International Scholars Journals

Short Communication 

Commentary: Long-Term Opioid Therapy vs. Serial Intraspinal Injections for Low Back Pain

Devi E. Nampiaparampil, ^1,2,3 Yan Y. Chen RN,¹ Megan Li,¹ and Robert G. Nampiaparampil²

¹Department of Veterans Affairs, New York Harbor Healthcare System, New York, NY

²Department of Anesthesiology, NYU School of Medicine, New York, NY

³Department of Rehabilitation Medicine, NYU School of Medicine, New York, NY

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

Received December 28, 2011; Accepted January 7, 2011

^Abstract

Low back pain (LBP) is a highly prevalent condition with significant health-related morbidity and a detrimental impact on society.  There are several non-pharmacologic treatments for chronic LBP including physical therapy, aerobic exercise, and alternative treatments such as acupuncture. There are no studies that directly compare percutaneous spinal interventions to opioid therapy for LBP. It is unclear whether safe and high-quality healthcare will be achieved if the population of patients with chronic pain is steered towards chronic opioid therapy vs. procedural alternatives. More research is needed to elucidate the mechanism of action both of opioids and intraspinal steroid injections in chronic LBP. We argue that the safest and most patient-centered strategy to treat LBP is to maintain the current clinical guidelines until there are evidence-based guidelines to support an alternative treatment algorithm.

Key words: Low back pain, spine, opioids, epidural steroid injection

International Journal of Medicine and Medical Sciences Vol. 1(1), pp. 014-016, 27 November, 2011, ISSN: 2167-0404 © International Scholars Journals

Full Length Research Paper

The Prevalence of the Metabolic Syndrome among Normal Weight Nigerians

Ogbu, I.S.I     Ph.D. and Chukwukelu , E.E M.Sc

Department of Medical Laboratory Sciences Faculty of Health Sciences and Technology College of Medicine, University of Nigeria ENUGU – NIGERIA.

*Corresponding Author’s Email: [email protected]

Received November 10, 2011; Accepted November 27, 2011

Abstract 

Aims and Objectives. In the past, most notions about the metabolic syndrome emphasized the importance of obesity. This study determined the prevalence of the metabolic syndrome (MS), among normal weight BMI Nigerians.

Materials and Methods. Three hundred and sixty-nine subjects, (369, men 207, women 162), aged above 30 years were randomly recruited for the study. Metabolic syndrome was diagnosed using the National Cholesterol Education Programme/ Adult Treatment Panel 111, (NCEP/ATP111), criteria.

Results.  Thirty six subjects (9 males, 27 females) had three abnormal factors.  Four abnormal factors occurred in 3 female subjects giving a total of 39 subjects that satisfied the criteria for the diagnosis of the MS. These gave the prevalence of MS as 10.6%, 4.3% and 18.5% among all, male and female subjects respectively. MS was distributed evenly in the normal BMI range among the women while among the men more cases were found in the upper range of normal BMI. Elevated waist circumference, (WC), had similar prevalence as MS among the subjects. 

Conclusions. Occurrence of MS among normal weight BMI persons is thought to be due to production and release of pro-inflammatory cytokines by adipose tissues and underscore the need to screen non-obese individuals for the MS to prevent type 2 diabetes and cardiovascular diseases.

Keywords: metabolic syndrome, Normal Weight BMI Nigerians, obesity, abnormal factors,cardiovascular diseases, type 2 diabetes

International Journal of Medicine and Medical Sciences Vol. 1(2), pp. 023-030, 27 December, 2011, ISSN: 2167-0404 © International Scholars Journals

Full Length Research Paper

The role of Plasma Fibrinogen and Uric Acid Levels in relation to Myocardial Infarction risk in patients with the Metabolic Syndrome- Preliminary findings   in the Littoral Region of Cameroon

Gordon Kunbuma Tachang^1.5, Simeon-Pierrre Choukem ^2,3, Jules Djebet  .^3’4, Anastase Dzudie ²³⁴ and Vincent P.K Titanji^1*

^1,5Biotechnology Unit, University of Buea-Cameroon

² Department of Clinical sciences, Faculty of Health Sciences, University of Buea, Cameroon

³ Department of Internal Medicine, Douala Referral Hospital , Douala, Cameroon

⁴ Department of Medicine and Pharmaceutical sciences, University of Douala,      Cameroon,

Corresponding Author’s Email: [email protected]

Received 27 October 2011; Accepted 3, December, 2011

Abstract 

Background: Information on relationship between some biomarkers (uric acid and plasma fibrinogen) to the risk of myocardial infarction in patients with the metabolic syndrome among Africans is inexistent or scanty at best. Moreover there is a burden of myocardial infarction and metabolic syndrome on the population.

Aims: The objective of this study was to establish the correlation: plasma fibrinogen and uric acid to myocardial infarction risks in patients with the metabolic syndrome.

Method— A total 68subjects(34 patients and 34 healthy controls) aged between  18 -80 years    were recruited for this study between November 2010 and  March 2011.Patients for the study as well as the controls were recruited from  Douala  and were matched  for sex ,age and place of residence. Trained nurses, using standard procedures, obtained blood pressure and anthropometric measurements and collected a venous blood sample for assay of plasma fibrinogen and uric acid. Serum uric acid was measured enzymatically after hydrolyzation to glycerol, Plasma glucose concentration was measured using an enzymatic reaction. Plasma fibrinogen was estimated by the Hook’s procedure. Data were analyzed using SPSS version 15 ..

Results:   Negative correlations were record between plasma fibrinogen and FBS, height, pulse, WHR and systolic pressure .Uric acid did not show any negative correlation with any of the indicators. There was no correlation between uric acid and fibrinogen (r=-0.056; p=0.599). As for uric acid, it showed very strong correlation   with weight, height, waist circumference, diastolic pressure and body mass index.)

Plasma fibrinogen showed the strongest correlation with Hip circumference (r=0.362, p<0.001)) while with the waist circumference showed a relatively weaker though significant correlation (r=0.240, p=0.023) Plasma fibrinogen did not show any significant difference between patients group and control groups and did not show any significant correlation with the determinants of the metabolic syndrome

Conclusions: Uric acid and not plasma fibrinogen may be considered as a component of the metabolic syndrome. Further investigation is necessary to confirm the results of this preliminary study.

Keywords: Plasma Fibrinogen, Uric Acid, Myocardial Infarction risk, Metabolic Syndrome 

International Journal of Medicine and Medical Sciences Vol. 1(1), pp. 001-003, 27 November, 2011, ISSN: 2167-0404 © International Scholars Journals

 Case Report

Sublingual Neurilemmoma: A Case Report

Shashi Prakash*, S.K. Tiwary, Puneet, A.K. Khanna, **Manjaree Mishra

¹Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India 221005

²Department of Anaesthesiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi

³Department of General Surgery Institute of Medical Sciences Banaras Hindu University Varanasi 221005, India

Tel: 91-542-2318418, 2318879, Fax: 91- 542- 2367568, M: 09415201954

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

Received October 31, 2011; Accepted November 27, 2011

Abstract

Neurilemmoma or schwannoma is a benign, slow growing and encapsulated tumour originating from Schwann cells. Neurilemmoma in the oral cavity are rather uncommon and merits to be differentiated from neurofibroma. We here present a case of neurilemmoma in the floor of mouth with typical histopathological appearance.

Key words- Neurilemmoma, floor of mouth, verocay body, case report.

International Journal of Medicine and Medical Sciences Vol. 1(1), pp. 011-013, 27 November, 2011, ISSN: 2167-0404 © International Scholars Journals

Full Length Research Paper 

Demographic pattern and severity of caustic injury in 300 caustic ingestion patients

Esmaeil Haji Nasrollah¹, Hassan Peyvandi², Ali Khoshkar³, Hadi Mirhashemi⁴, Mehdi Ahmadi⁵ and Ghazal Hajinasrollah⁶

¹Professor of General Surgery. Shahid Behshti University Loghman Medical Center.

²Associated Professor of General Surgery. Shahid Behshti University Loghman Medical Center.

³Assistant Professor of General Surgery. Shahid Behshti University Loghman Medical Center.

⁴Assistant Professor of General Surgery. Shahid Behshti University Loghman Medical Center.

⁵Resident of General Surgery. Shahid Behshti University Loghman Medical Center.

⁶Intern of General Surgery. Shahid Behshti University Loghman Medical Center.

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

Received November 27, 2011; Accepted November 20, 2011

Abstract

Objective: The aim of this study was to report frequency and ratio of caustic substance ingestion     cases and their demographic data that admitted in Loghman Medical Center, as a referral center in toxicological problems

Cases and methods: From 2007 to 2010, 300 cases of caustic ingestion were admitted. One hundred and eighty nine men and 109 women ingested caustic ingestion. All demographic data, past medical and past psychiatric history were recorded. Gastresopagheal endoscopy underwent. Caustic injury was defined based on Zargar grading system. Data were analyzed with SPSS 18 software, accordingly.

Results: Three hundred cases with corrosive substance ingestion admitted in Loghman Medical Center during 2007 to 2010. 154 patients (51.3%) were single, 83 cases (27.6%) were married, 34 cases (11.2%) were divorced and 39 cases (13%) were widowed.

Ingestion was associated with suicidal intent in 217cases (72.3%). 134 cases (44.6%) had a previous history of psychiatric 98cases (32.6%) had history of substance abuse. Mean time interval was (8.45±2.11 hours).Amount of caustic substance was between 1 cup (75cc) and 12 cup (900cc). The caustic materials for injuries were in 97cases (32.4%) chemical depilatory agent (Vajebi), 128 cases (42.6%) acids and 75 cases (25%) liquid lye. Based on Zargar system 128cases did not have esophageal and gastric burn, 116 cases had grade I injury, 38cases had grade II injury and 14cases had grade III injury.

Conclusion: More than two third of the cases with caustic ingestion were due to intent ingestion.  Singles, men and cases with psychiatric problems are more prone to suicide, and thus to caustic ingestion.

Keywords: Caustic ingestion, demographic pattern, caustic injury, severity