International Research Journal of Medicine and Medical Sciences

22-25

Authors: Entisar Abd-Al-Farag, Marwan S. M. Al-Nimer and Khalid S. Al-Dulaimi

The objective of this pilot study was to investigate the status of oxidized lipid in Iraqi stroke patients. Blood samples were collected from subjects diagnosed with stroke and blood lipids and oxidized lipoprotein were analyzed using enzymatic and colorimetric methods. We found a significant (p < 0.001) increase in total lipids, and total lipid oxidation as measured by serum aldehyde malondialdehyde. We also found a significant increase in level of oxidized low density lipoproteins in patient with stroke in comparison with healthy individuals. In conclusion, our finding supports the use of oxidized LDL as a marker of stroke. Keywords: Blood, colorimetric methods, malondialdehyde, ischemic stroke, cholesterol.

30-34

Authors: Dalia A. El Aal, Marianne F. Morgan, Heba N. Baz, Mona H. Hafez and Hazem E. Abo Youssef

PTPN22 gene encodes lymphoid protein tyrosine phosphates (Lyp), which is a critical negative regulator of TCR signal transduction. A variant of PTPN22 (1858T) has been reportedly associated with the development and progress of T1DM. Since auto-reactive cytotoxic lymphocytes appear to be the main effector cells in T1DM, this might explain the reason of the aforementioned association. This study was conducted on 150 subjects; 100 T1DM patients and 50 controls; all were subjected to DNA analysis of PTPN22 C1858T polymorphism using PCR-RFLP technique, along with HbA1c%, Glutamic acid decarboxylase (GAD65) autoantibodies determinations. This study showed that 83 patients (83%) were homozygous for PTPN22 (CC), 15 patients (15%) were heterozygous for (CT) and 2 patients (2%) were homozygous for (TT). Statistical comparisons for the distribution of genotypes and allele frequency for the PTPN22 C1858T polymorphism between T1DM patients and controls showed that 17% of T1DM patients were TT/CT compared to 0% of controls (P = 0.002) and odds ratio [1.602 (1.404 to 1.828)]. Also, 181 alleles of T1DM patients were C (90.5%) compared to 100 alleles (100%) of controls with P value = 0.001. No significant associations between PTPN22 genotypes and other factors such as age, gender, age at onset of T1DM, duration of T1DM, DKA, hypoglycemia, nephropathy, neuropathy, retinopathy, macro-vascular complications, arthropathy, consanguinity, HbA1C or GAD65 autoantibodies. In conclusion, PTPN22 C1858T gene polymorphism is associated with development of T1DM in Egyptian pediatric population. Keywords: Protein tyrosine phosphatase non-receptor type 22, T1DM, Lyp protein, Egyptian population.

40-43

Authors: Afolabi A. Y., Oladipo E. K. and Fagbami A. H.

Hepatitis B virus (HBV) is one of the agents of transmissible transfusion infection (TTI) and causes threat to blood safety for recipients. Blood transfusion is one of the pathway in which HBV is being transmitted. This study aimed to determine the prevalence rate of HBV among potential blood donors at Blood Bank of University College Hospital (UCH) Ibadan, Nigeria. Over a period of 6 months (February to July, 2010), 507 consenting potential blood donors, were tested for Hepatitis B virus surface antigen (HBsAg) using a convenient sampling technique. Pre-test counselling sessions was done, before validated questionnaire was administered, for data collection and laboratory serological test was done. The mean age of the study participants was 32.7 ± 9.2 years. A total of 30(5.9%) were positive for HBsAg. HBsAg rate was highest among age group of 26 to 35 which is 14 (7.2%), males 26 (6.1%), others among occupational group 2 (9.5%), level of education {illiterate} 01 (11.1%) and unmarried, 13 (6.8%). The rate of HbsAg in this study were lower than previous studies in Nigeria perhaps this is due to effective prevention control programme, through provision of vaccines and immunization in accordance with Nigeria Federal ministry of health guidelines on Hepatitis B, and other vaccine preventable diseases, and the public enlightment on transmissible transfusion infections. Keywords: Hepatitis B, blood donors, Ibadan, TTI, surface antigen.

1-8

Authors: Salima Alburke, Bashir Ashur and Muktar Assadi

Infant and under-5 childhood mortality rates in developing countries have declined significantly in the past 2 to 3 decades. World leaders agreed on a critical goal to reduce deaths of children <5 years by two thirds, but this may be unattainable without halving newborn deaths, which now comprise 40% of all under-5 deaths. Approximately 99% of neonatal deaths take place in developing countries, but review of the impact of interventions on neonatal health and survival in developing countries has not been reported. This study aimed to: (1) measure the perinatal mortality rate (PNMR) in Misurata; (2) identify risk factors of perinatal death; and (3) compare the estimated perinatal mortality rate with previous results in Misurata hospital before application of new facilities. A descriptive, retrospective study based on hospital files records. From January 2012 to December 2012, information was collected from admitted newborn in neonatal unit and the registration book at labour room including operating theatre. The information collected include, history, clinical examination, investigation, treatment and outcome. Also data from 2005 were collected to be compared with. The total number of delivery in Misurata hospital were 6520 births, include 36 stillbirth (1.16%) and 6474 were live births. 850 babies out of the total live birth were admitted to neonatal ICU after delivery. 48 babies (0.74%) died in the first week of life and 70% (34) of the first week death died in the first 24 h. The main reasons of admission to neonatal unit were preterm delivery, sepsis, meconium delivery, birth asphyxia and congenital malformation. Perinatal mortality rate was 13/1000 total births (57% death in the first week of life and 43% still birth). The main causes of early neonatal deaths were RDS 45%, congenital malformation 18%, birth asphyxia 12.5%, CHD 10% and sepsis 6%. About 12 (25%) of death were full term and 36 (75%) were PT, 35% of these PT between 32 and 36 weeks gestation, 20% between 24 and 28 weeks and 18% between 28 and 32 weeks gestation. Regarding birth weights, 27% of death their weight between 1 and 1.5 kg, 25% more than 3 kg, 18% between 1.5 and 2 kg, 12% between 2 and 2.5 kg and 8% were less than 1 kg. While, perinatal mortality rate was 28/1000 total births in 2005 before application of new facilities. In conclusion, although our PNMR still high in comparison with developed countries but it is better in comparison with previous result in same unit, in 2005 was 28/1000 and this is due to availability of facilities e.g. nasal bubble CPAP and surfactant. The vast majority of perinatal mortality is secondary to preterm delivery, birth asphyxia and sepsis which usually increased in presence of maternal risk factor. Prevention, early recognition and management of birth asphyxia, infection and LBW infants with development of indicators and simple management tools (guidelines) for assessing and monitoring health system performance for perinatal and newborn care at national level, are recommended. Keywords: Perinatal mortality, stillbirth, neonate, infant death.

17-21

Authors: Dilorom Alimovna Rakhimova, Sabirjanova Zulfiya Talgatovna and Ahmadreza Abedi

The objective of this study is the assessment of interrelations of the structurally-functional condition of cardio-pulmonary system with medical aspects of quality of life and effects of ozonotherapy in patients suffered from cor pulmonale secondary to bronchial asthma. This randomized, quasi-experimental interventional study was conducted on 55 participants. 22 patients suffered from corpulmonale secondary to bronchial asthma and 30 healthy persons (HP) were studied. Depending on methods of intervention, participants were divided into the 2 groups: 1st group (12) and 2nd group (10) received routine basic therapy (BТ) combined with ozonotherapy as intravenous introduction Ozonized saline, 1000 mg/L. In cor pulmonale patients secondary to bronchial asthma with Right Ventricular Enlargement is more expressed in the reduction of quality of life on a physical condition and satisfaction by the intervention, in CP patients secondary to BA with pulmonary hypertension on an emotional condition and occupational suitability that is necessary to note during the adequate treatment. Infringements of respiratory system and quality of life are positively correlate pulmonary ventilation ability, average of pulmonary arterial pressure condition and remodeling of the right ventricle of hearts; ozonotherapy on the combined with the routine standard therapy can improve the above stated pathogenicity interconnected infringements. It seems that combination of ozonotherapy along with routine modality can lead to improve pulmonary function of CP secondary to BА, reduction of preload of right heart as well as improvement of RV structure. Also application of this combined method of therapy can lead to efficacy of treatment and better quality of life and reduced the use of urgent healthcare in CP secondary to BА patient. Keywords: Pulmonary rehabilitation, pulmonary hypertension, chronic obstructive pulmonary disease, pulmonary function test, combination therapy, complex therapy.

73-78

Authors: Henrique Meirelles Boldori, Wendel Mombaque dos Santos, Izabel Cristina Hoffmann, Caroline Mombaque dos Santos, Francisco Maximiliano Pancich Gallarreta, Stela Maris de Mello Padoin and Sonia Maria Oliveira de Barros

The purpose of this study was to evaluate risk factors associated with miscarriage (defined as the interruption of pregnancy before the 20th week of gestation) and perinatal mortality (defined as fetal death from the 21st week of pregnancy until neonatal stage, occurring until the first week of life) in HIV-infected pregnant women. This retrospective, cross-sectional study included HIV-infected pregnant women from Brazil aged between 18 and 47 years, who had miscarriage, vaginal delivery, or delivery by cesarean section. Data on miscarriage or perinatal mortality, sociodemographic characteristics, clinical conditions, and treatment were obtained. Statistical analyses included the use of binary logistic regression. In this cohort, the prevalence of miscarriage was 6.1% and the perinatal mortality rate was 4.0%. Risk factors for miscarriage included drug use (OR = 6.23; CI = 0.5 to 73.1), multiple gestation (OR = 3.06; CI = 0.9 to 10.9), and lack of prenatal care (OR = 18.42; IC = 3.9 to 87.6). Moreover, risk factors for perinatal mortality included drug use (OR = 1.03; IC = 0.9 to 1.1), vaginal delivery (OR = 5.56; CI = 1.2 to 26.1), and the absence of antiretroviral use during labor (OR = 17.77; CI = 3.9 to 81.8). In order to reduce the rates of miscarriage and perinatal mortality in HIV-infected pregnant women, actions aimed at eliminating drug use during pregnancy, ensuring adequate prenatal care, performing elective cesarean section delivery, and using antiretroviral medications during labor should be prioritized. Keywords: Pregnant women, abortion, miscarriage, perinatal mortality, risk factors.

84-90

Authors: Hanan A. Madani, Hafez M. Bazaraa and Hanaa Rady

The pathogenesis of idiopathic nephrotic syndrome (INS) is associated with Th1 and Th2 cytokines imbalance. Cytokines act as mediators of inflammation in childhood NS. The objectives are to investigate the role of cytokine genes polymorphisms (IL6-G174C, IL4-C590T, and TNFα-G308A and the response to corticosteroid therapy in children with INS in Egypt. 90 children were included in this study, they divided into 3 groups: 30 children with steroid sensitive nephrotic syndrome (SSNS), 30 children with steroid resistant nephrotic syndrome (SRNS) and 30 age and sex matched healthy control children. Polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) were used to assess IL6-G174C, IL4-C590T, and TNFα-G308A polymorphisms. A significant association was found between the CC genotype and the C allele in IL6-G174C and INS group when compared to the control group (P = 0.003 and 0.009, OR = 4.3 and 2.67 respectively), also, they were significantly associated with SRNS compared to SSNS groups (P = 0.008 and 0.000, OR = 4.93 and 5.82 respectively). Also, TNF-α G308A AA genotype A allele were significantly associated with INS group compared to the control group (P = 0.045 and 0.014, OR = 3.5 and 3.51 respectively) and on comparing SRNS to SSNS groups TNF-α G308A A allele was only significantly associated with SSNS group (p = 0.032, OR = 2.83). IL4-C590T showed no significant difference in the genotypes or the allele distribution between the studied groups. In conclusion, IL6-G174C and TNFα-G308A polymorphisms may affect response to steroid therapy in childhood INS. Keywords: Idiopathic nephrotic syndromes, IL-4, IL-6, TNF-α gene polymorphism, steroid response.

56-62

Authors: Muhammad Akbar Malik and Hamza Malik

Children with epilepsy are known to be prone to educational underachievement as a result of learning and behavioural problems. Identification of these comorbidities and their early intervention will go a long way in improving quality of life of children with epilepsy. The objective of this paper is to study the incidence of behavioural disorders (BD) and school underachievement (SU) in newly diagnosed generalized idiopathic epileptic children, and to determine association of behavioural disorders and school underachievement with different antiepileptic drugs. The design is prospective observational cohort study. Settings and duration is private multidisciplinary neuropaediatric clinics, from 1st September 2010 to 31st August 2013. 305 school going (7 to 16 years) children, 205 children with newly diagnosed idiopathic generalized epilepsy (study group) and 100 non-epileptic peers (50 siblings of epileptic children and 50 healthy children without family history of seizures or other chronic neurological illness (control group) were evaluated for BD and SU for over a period of four years. Chi Square Test was used for statistical analysis. The prevalence of BD and SU were present simultaneously in most of the patients. BD and SU were 11% in the study group, 10% in siblings of epileptic children, while in the control group without family history of epilepsy was 6% and this was statistically significant (p < 0.05). All epileptic children and their siblings have higher incidence of BD and SU as compared to their normal counterparts. These are associated with all currently used antiepileptic drugs (AEDs) in children. A holistic approach, comprising medical, educational and psychosocial counselling of families and placement of the child both in society and school should form integral part of management of idiopathic generalized childhood epilepsy (IGCE). Keywords: Antiepileptic drugs, cognition, epilepsy, medication, neuropsychology, behavioural disorders, school underachievement.

67-72

Authors: Mohammed-Durosinlorun Amina, Akinlusi Fatimat, Adesiyun Adebiyi, Rabiu Kabiru, Ojabo Augustine and Kolawole Abimbola

Physicians with gynaecological training often have correct information about contraceptive technologies, their effects and benefits. Their personal choices may affect their practice. The objectives of this study are to find out what contraceptives Nigerian trainee gynaecologists use, and if this affects the way they counsel their clients. This was a cross-sectional survey. Participation was voluntary and 150 trainees were to fill out a pretested, self-administered questionnaire eliciting general demographic information, academic post and years of training, information on personal contraceptive use and choices, and how it may influence their practices. Analysis was done using the statistical package for social science (SPSS) computer software, version 20. Descriptive analysis was performed, using frequency tables. Chi-square test was used to compare variables and assess significance. P value of <0.05 was considered significant. There was a response rate of 62%. About 25.8% of respondents were not currently using any form of contraception and 53% were currently using modern methods of contraception, most commonly barrier methods and intrauterine devices. There was poor uptake of male sterilization. Twenty four respondents (25.8%) had several objections to contraceptive use. The choice of contraception used was significantly associated with gender. Sixteen respondents (17.2%) felt their personal choices may affect how they counsel patients and prescribe contraceptive agents. The level of respondents and number of children significantly affected counseling practices. In conclusion, trainees prefer to use natural forms of contraception. However, larger studies will be required to verify that personal objections to contraceptives introduce bias to contraceptive counseling practices. Keywords: Contraception, personal choices, gynaecologists, counseling practices.

20-39

Authors: Revocatus Twinomuhangi, Ron N. Buliung, Mable T. Nakitto and Ronald Lett

Injury is a major international public health concern internationally, contributing to population morbidity and mortality and related social and economic costs. While several national injury survey initiatives have been conducted in Uganda in the past, none have explicitly incorporated geographical aspects of injury. Injury surveillance should include location data, with a view to ultimately understanding and explaining the geography of injury risk and prevalence. This paper documents a GIS method developed for a national injury surveillance pilot study in Uganda, Africa. The study’s primary goal was to assess the feasibility of using GIS in injury surveillance in Uganda. A trauma registry form was designed and used to capture spatial and non-spatial (socio-economic status of injured persons, injury type/cause) factors of injury events. The trauma registry was piloted for 30 days at two referral hospitals (Mulago and Mubende) in Central Uganda. Spatial patterns of injury pilot data were studied by injury source, and socio-demographic characteristics. The study demonstrated the utility of GIS for injury surveillance and analysis in the Ugandan context. The addition of GIS-based surveillance and mapping capacity may become an important approach to treating the prevalence of different types of injury in Uganda, over the longer term. Keywords: Geographic information systems, injury surveillance, spatial analysis.

44-50

Authors: Ergie P. Inocian, Edsel P. Inocian and Elsie I. Ysatam

This study compared the dependency needs of the nursing home residents and community-dwelling elderly in the performance of Basic and Instrumental Activities of Daily Living (ADL). It was also correlated to their age, educational attainment, cognitive status, and health-related conditions. It was conducted in one community and in four (4) Geriatric Homes in Cebu, Philippines. There were 120 respondents of the study, aged 65 years old and above. To measure their cognitive status, the standardized Mini Mental Status Examination by Folstein et al. (1975) was used. The dependency needs in performing ADLs were assessed using the Katz Index of Independence (1963) and Lawton Instrumental ADL Scale (1969). The elderly from the home for the age needed assistance in basic ADL and are dependent on the performing instrumental ADL, while the community-dwelling elderly were independent in both basic and instrumental ADL. Age, educational attainment, co-morbidities and cognitive status were found to have significant relationships in the performance of basic and instrumental ADL among the Filipino elderly. Moreover, there was a significant difference in the ADL performance between the nursing home residents and community-dwelling elderly. With functional decline as person ages, it is essential to support the health needs of the elderly. Keywords: Activities of daily living, cognitive status, community-dwelling elderly, dependency needs, Filipino elderly, functional status, health-related conditions, nursing home residents.