International Research Journal of Medicine and Medical Sciences

94-102

Authors: Rohit Mody, Debabrata Dash and Bhavya Mody

Hyperkalemia is one of the few potentially lethal electrolyte disturbances. Severe hyperkalemia (Serum potassium concentration > 6.5 mmol/L) occurs most commonly from renal failure or the release of potassium from cells and can cause circulatory shock, cardiac arrhythmias or cardiac arrest. Current BLS (Basic Life Support) and ACLS (Advanced Cardiovascular Life Support) protocol should be used to manage cardiac arrest associated with hyperkalemia. But early consideration should be given to using the selective method of therapeutic management in addition to standard ACLS protocols that can be provided rapidly, effectively in patients with cardiovascular instability. We describe here a case of chronic kidney disease and congestive heart failure who developed circulatory shock and eventually cardiac arrest due to hyperkalemia managed with Calcium Gluconate, Sodium Bicarbonate and Insulin along with standard advanced cardiovascular life support protocol.

60-67

Authors: Yoshiaki Endo, Tamaki Hirose, Masahiro Ishizaka, Yohei Sawaya, Akihiro Yakabi and Akira Kubo

This study aimed to reveal the extent of the adverse effects caused by the restrictions on going out due to the COVID-19 pandemic on physical function. The participants were 129 healthy older adults, aged 65 years and older, who lived independently without the need for long-term care. The presence or absence of disuse syndrome was investigated using a partially modified “Disuse Syndrome Inventory.” The address, age, and gender of the participants were also surveyed in a factor analysis of disuse syndrome. The effective response rate was 90.6% (n = 117). Disuse syndrome was observed in 38.5% (n = 45) of the participants, which was significantly higher in women compared to men, and in medium-sized to depopulated cities compared to large cities. It has become clear that a large number of older adults have disuse syndrome because of the travel and commute restrictions due to the COVID-19 pandemic. To return to normal life sooner, it is necessary to consider countermeasures as soon as possible.

9-18

Authors: B. Brankov and A. Zlatareva

The purpose of the study is to examine the opinion of the medical community on the need for further training on matters relating to drug policy (as a dynamic and rapidly changing area of healthcare policy bearing on the work of a number of healthcare specialists) and the attitudes to web-based forms of further training. The study was conducted among healthcare professionals (healthcare professionals means graduates in medicine and/or pharmacy – physicians, dentists, pharmacists and healthcare professionals and managers etc. who practice their occupation applying the set of regulatory standards governing drug policy) from three Balkan countries – Bulgaria, Slovenia and Croatia – who have completed a dedicated survey. Participation in the survey was voluntary and the polling was conducted on the basis of the ‘snowballing’ technique for survey dissemination and recruitment of respondents. The statistical processing of collected data relied on a correlational descriptive and regression analysis. The results reveal that respondents are aware of the need and are willing to pursue possibilities for further training on matters relating to drug policy. The correlational analysis has revealed interesting further data. A statistically significant negative correlation has been established between knowledge assessment and the method of updating and upgrading knowledge on matters relating to drug policy. The data suggests that according to the respondents self-learning and attending courses led by trainers who are subject-matter experts increases the evaluation of knowledge in the area of drug policy (rho = 0.-631, р = 0.002). Furthermore, the greater frequency of additional training events to improve current levels of knowledge is also a factor that increases self-assessment of being up to date on the latest developments in this area (rho = 0.577, р = 0.006). There is a need for further training in the area of drug policy and the preferred form of this type of training are the online and physical training events by guest trainers conducted by medical schools. In order to ensure that training conforms to a high-quality standard, a test should be taken at the end and a certificate attesting to the training should be issued as a quality assurance guarantee.

24-33

Authors: W. S. Ahmed, R. M. Gharib, H. M. Salah El-Din and H. A. El-Talawy

The aim of this research was to examine the impact of pelvic girdle stability training in children with hypotonic cerebral palsy on functional sitting control. Thirty children with hypotonic cerebral palsy in both sexes, with their ages ranging from two to four years were used in the study. There were fifteen children in the experimental group and fifteen children in the control group. The study group received pelvic girdle stability training program in addition to a selected program for upper limbs and trunk muscles strengthening exercises, while the control group received only the selected program for upper limbs and trunk muscles strengthening exercises. Results revealed significant difference of GMFM88 (sitting domain) (P < 0.01), stationary raw scores and stationary standard scores of PDMS-2 (P < 0.05) but no significant difference of age equivalent of PDMS-2 (P > 0.05). GMFM88, on the other hand, had a significant difference (sitting domain) (P < 0.05) but no significant difference of stationary raw scores, stationary standard scores and age equivalent of PDMS-2 (P > 0.05) in the control group. Paired t-test were conducted for comparison between pre and post treatment mean values of sitting domain and stationary scores in each group. From the obtained results of the present study, we conclude that pelvic girdle stability training program was more effective in generating core muscle activity for functional sitting control compared to traditional physical therapy of upper limbs and trunk muscles strengthening exercises in children with hypotonic cerebral palsy.

43-51

Authors: Parichehr Tootoonchi

Angiolipoma is the most common soft tissue tumor in human trunk and extremities, mostly affecting young male patients; however, in children, it occurs rarely and the most involved area has not been determined. A 9 year old girl was admitted to the pediatrics ward because of a newly arousal of pain associated with suddenly rapid increasing of the size of an old mass on the right side of her chest wall for almost one month without any history of trauma to the area; she had the lesion since her birthday. Otherwise, her physical examination and laboratory tests were unremarkable. Findings of different types of imaging of the mass were in favor of a benign chest wall lesion. A surgical excision was performed and histopathologic report of the lesion was consistent with typical features of a non-infiltrating angiolipoma. The patient recovered uneventfully with complete resolution of lesion. No recurrence of the tumor was observed in the patient in the following 30 months. This report seems to be the first documented case of congenital non-infiltrating angiolipoma of the chest wall in a child. Review of literature has shown that in children, angiolipoma is mostly a single, benign lesion commonly appears in the face or the spinal region, with complete recovery after a simple surgical excision and no recurrence.

116-118

Authors: Deepa Anbazhagan, Mak Jia Hui, Nurul Aisyah, Arina Syazwani, Teh Pei Keong, Lai Jie Shuen, Manjulah Samugam Sundram, Heymala Subramaniam and Vinoth Kumarasamy

Staphylococcus aureus is a common component of skin flora of healthy adults. However, it can cause serious infections such as bloodstream infections, pneumonia, or bone and joint infections. Methicillin-resistant Staphylococcus aureus (MRSA) is known to cause hospital- (HA-MRSA) and community-acquired (CA-MRSA) infections worldwide. Asia is reported to have highest prevalence rates of HA-MRSA and CA-MRSA. As there were very less number of epidemiological studies being done in Malaysia, this study aimed to determine the prevalence of MRSA infection among the healthcare undergraduates who will be engaging with patients soon. We analyzed nasal swabs of students from a private medical institution in Klang Valley, Malaysia. Methicillin-resistance was accessed by sensitivity to the Oxacillin and Cefoxitin disks. In a total of 151 healthcare undergraduates, 117 of them were found positive for Staphylococcus aureus. Among the latter, 21 samples (13.9%) were resistant to Oxacillin and Cefoxitin. Our data shows significant high percentage of MRSA infection and therefore prevention strategies for MRSA need to be developed for the healthcare students before they engage with patients in clinic setting.

126-131

Authors: Nain-Feng Chu, Chien-Hsin Lee, Chang-Hsun Shieh, Chieh-Hua Lu and Yi-Jen Hung

This open-label non-controlled study is to evaluate the effects of black vinegar intake for 8 weeks on the anthropometric measures, cardiometabolic profiles, and insulin sensitivity among impaired fasting glucose adults. 32 subjects (14 males and 18 females) were recruited with the mean age of 56.3 (from 25 to 65). Black vinegar 50 ml was diluted to 500 ml with drinking water and was given to all subjects for 8 weeks. At baseline and 8-week, all study subjects received 75 g of oral glucose tolerance test (OGTT) after 10 h of fasting. Venous blood was collected at 0, 30, 60, 90 and 120 min. Plasma glucose and insulin levels were measured using the glucose oxidase method and radioimmunoassay method. Anthropometric variables, blood pressure and blood lipid profiles were measured using standard methods. The Wilcoxon signed-rank test was used to compare the difference between baseline and after eight weeks. After eight weeks, the body weight and BMI decreased from 68.2 ± 14.4 kg to 67.6 ± 14.2 kg and 26.3 ± 4.5 kg/m2 to 26.0 ± 4.4 kg/m2, respectively, with statistical significance (p < 0.05). Triglyceride level decreased from 152.5 ± 134.7 to 140.6 ± 93.8 mg/dl but without statistical significance. The blood glucose levels at 120 min of OGTT decreased from 178.8 ± 57.0 to 173.7 ± 57.5 mg/dl and the insulin levels at 120 min of OGTT increased from 117.5 ± 74.2 to 126.4 ± 95.9 IU/L but not statistically significant (p > 0.05). There is a slight decrease of body weight and BMI, but no significantly change in blood pressure, lipid profiles, and insulin sensitivity after eight weeks of black vinegar intake among impaired fasting glucose adults. However, further large-scale and longer studies are needed to explore the effects of black vinegar on cardiometabolic profiles and insulin sensitivity.

83-96

Authors: R. S. Omotayo, A. L. Akintan, O. Akadiri, A. M. Bade-Adefioye and S. E. Omotayo

It is pertinent for the pregnant woman to understand the concept of what she is embarking on. Antenatal care is a specialized form of health care given to pregnant women in order to have safe delivery for both mother and child. Pregnant women need to be informed of the meaning and importance of Antenatal Care and the need for them to avail themselves of the opportunity in order to benefit from expert monitoring of the progress of pregnancy, prompt identification of anything that may jeopardize the outcome of the pregnancy and access to skilled personnel at delivery. This study assessed the level of awareness of pregnant women about pregnancy and antenatal care at the time of booking in their first pregnancy. This is a descriptive cross-sectional study. Questionnaires were used to obtain information on the level of awareness of primigravid women about pregnancy. A simple structured questionnaire was used to get the consented pregnant women’s awareness or otherwise about basic pregnancy issues and antenatal care. The questionnaire was administered by research assistants already trained with the questionnaire. Data was fed into and analyzed with the Statistical package for Social Sciences (SPSS) version 20.0. Proportions were calculated using percentages and crosstabulation of variables to find out relationship and statistical significance by chi-square. Majority, 110 (34.7%), of the respondents were booked at 8 to 16 weeks gestation. Majority of respondents were aware of doing basic investigations like PCV (98.1%), HIV (94.3%) and Hepatitis B (85.8%) in pregnancy. Majority of the respondents 259 (78.9%) know that high blood pressure of pregnant mother can affect the baby. One hundred and seventy-eight respondents (56.2%) said they do not know that previous caesarean section has effect on subsequent deliveries. Majority of the respondents 278 (87.7%) knew that they will start immunization for their babies at birth. In conclusion, there is fair awareness of basic pregnancy issues and antenatal care among pregnant women. Notable area of inadequate knowledge is the impact of caesarean section on subsequent pregnancies. It is recommended that all efforts must be made to ensure that discussions about pregnancy and antenatal care with women starts at younger age as early as in the secondary school days to prepare them for the eventuality of pregnancy, its care and childbirth. The health education aspect of antenatal care should be well organized to fill all information gaps for the pregnant women.