International Research Journal of Medicine and Medical Sciences

18-24

Authors: Rania Mohammed Ahmed, Sharifah Alkathiri, Waad Altalhi, Hatun Eid, Manar Alshalwai and Sara Alotaibi

Advances in imaging technology over the past decades have contributed to better characterization of hepatic lesions. This study aims to differentiate focal hepatic lesions from their ultrasound (U/S) features and compared the obtained results with histopathology. A descriptive retrospective study of 100 patients who had focal hepatic lesions were reviewed during the period from 2012 to 2019 at King Abdul-Aziz Specialist Hospital, Taif, KSA. The inclusion criteria were Adults Saudi patients, ages 18 and above. LG-9 and Philips ultrasound machines with 3.5 MHz transducers were used in this study. Age group (55 to 80 years) represented 44%, mean age was 49 years, 92% were married. Regarding shape of the lesions during U/S scan, 47% of irregular outline were malignant (p=0.00), 93% of the rounded lesions were benign (p=0.00),86% of well-defined lesions margins were benign in histopathology, 61% ill-defined margin lesions were malignant and 73% of hyperechoic lesions were hemangioma (p=0.02). Regarding nature of hepatic lesions during U/S, 87% of solid lesions were malignant (p=0.03), while 89% of cystic lesions were benign. 61% of hypoechoic lesions were malignant. 80% from vascular lesions under color Doppler were benign. U/S sensitivity and specificity were 93.5 and 98%, respectively. U/S is a useful tool in differentiation cystic hepatic lesions from solid (p=0.03). Comparable studies with large samples must be done in Taif region to provide data base for hepatic lesions.

30-34

Authors: Oky Aryanthana, I. B. Ngurah Rai and Wira Gotera

Chronic obstructive pulmonary disease patients (COPD) have been linked to systemic inflammation. The presence of a systemic inflammatory response is characterized by increased activation and mobilization of inflammatory cells into the circulation. Systemic inflammation is characterized by an increase in proinflammatory cytokines including IL-6, TNF-, and CRP. Increased IL-6 will cause insulin resistance and IL-6 is considered as a good predictive marker for insulin resistance. This research is an analytic cross sectional study. Affordable population is all COPD patients in the pulmonary policlinic at the Sanglah Hospital and Network Hospitals in the period of May to October 2019 who have met the criteria as a research sample. The association between increased IL-6 and insulin resistance was tested using spearmen analysis. The effect of confounding variables such as age, sex, nutritional status, smoking and steroid use, on the relationship of serum IL-6 and HOMA-IR index values were tested using partial correlation analysis. This study included 47 subjects, 42 male (89.3%) and 5 female (10.7%). Results of study, showed that there was no a significant correlation between IL-6 and HOMA-IR (r = -0.24; p = 0.09). Also, there is no influence of confounding variables on the relationship IL-6 and HOMA-IR. Age variables (r = -0.18; p = 0.21), gender (r = -0.18; p = 0.21), nutritional status (r = -0.14; p = 0.32), smoking (r = -0.17; p = 0.26), and steroid therapy (r = -0.18; p = 0.22). On the other hand, obesity status was strongly related to HOMA-IR (r = 0.64; p = 0.001). This study proves that there was no significant correlation found between the increase in serum IL-6 and the HOMA-IR index value. Nevertheless, obesity status is a factor that is very strongly associated with the HOMA-IR index value.

42-56

Authors: Mohammed Alimul Islam, Sumaiya Islam, Md. Enamul Haque, Md. Muklesur Rahman, Md. Asir Uddin, A.K.M. Khasruzzaman, Md. Mohiuddin Sharif, Md. Rajibur Rahman, Mohammad Robed Amin and Md. Mortuza Ali

Present study has been designed to clarify the mechanism of inactivation of the RNA enveloped viruses in-vitro. For that, avian Coronavirus (Avian Infectious Bronchitis Virus, AIBV) and Bird flu virus (Low Pathogenic Avian Influenza Virus, LPAIV, H9N2) were selected for this study. Both the viruses were subjected to heat (25 to 70°C and pH (1.0 to 14.0) treatment for 1 to 120 min and 30 s to 5 min respectively and their infectivity was checked by measuring virus titre through hemagglutination (HA) test, chicken embryo inoculation and RT-iiPCR. The results clearly indicates that both the viruses required 55°C for 90 min, 60°C for 60 min, 65°C for 15 min and 70°C for 2 and 3 min respectively to inactivate. Results of pH sensitivity using various detergents and chemicals exposure indicates that the agents having moderate acidic pH (5.0 to 6.0), neutral to moderate alkaline pH (7.0 to 10.0) and extreme alkaline pH (13.0 to 14.0) could inactivate AIBV within 20 to 30 s and the H9N2 virus was inactivated in pH range <3.0 and 13.0 to 14.0 within 5 min. The 70% ethanol or isopropanol was found highly effective to inactivate both the viruses in a minute. More interestingly, juice of various citrus fruits also exhibited antiviral activities in-vitro. Results of the present study indicated that the enveloped RNA viruses of any families could easily be inactivated using very cheap and available chemicals and detergents. Chicken embryos propagation and molecular detection by RT-iiPCR also indicated that ultra-acidic and extreme alkaline pH and higher temperature treatment successfully inactivated both the viruses. Finding of the present study also indicated that any viruses of the family coronaviridae including SARS-CoV-2 and other respiratory viruses of human and animal can be inactivated easily by exposure at high temperature and extremely low and high pH treatment.

61-66

Authors: Hiba A. Awooda and Lojun Aljazoly

Low-level laser therapy (LLLT) has become an increasingly mainstream modality, especially in the areas of physical medicine and rehabilitation. This study aimed to determine the functional and histological changes that occur at the lower thoracic - upper lumber segments associated with the irradiation with LLLT in compression-induced injuries in Wistar rat’s spinal cord. Eighteen rats were randomized into three groups; six rats in each. Group A (sham) with laminectomy only, group B laminectomy plus cord compression injury and finally group C had laminectomy plus cord compression injury plus irradiated with LLLT two times, one after 2 hours from the injury and another after 24 hours from the first dose, each of these doses lasted for 42 minutes. The lesion site for group C directly was irradiated to the spinal direction with a 905 nm diode laser with an output power of 25 mW. The functional recovery was measured by locomotor test (BBB scale) and the histopathological changes were assessed in all groups after two weeks. Rats treated with laser showed a significant improvement in the locomotor functions compared to spinally injured rats. While histopathological evaluations in group C showed mild changes in comparison with group B that suggested significant recovery of the spinal cord compression injury. These findings demonstrated that the 905 nm wavelength laser is a promising neuroprotective non-invasive treatment for improving functional recovery after spinal cord injury.

1-7

Authors: Surinrat Baurangtheinthong, Suparb Aree-Ue and Sirirat Leelacharas

Social networking may help older adults to decrease emotional distress and depression. However, over using or addiction to social networking may lead to sedentary behavior. This descriptive research aimed to examine the relationship between social networking behavior, depressive symptom, and sedentary behavior in older adults. A total of 152 community-dwelling older adults who were living in Bang Bua Thong District, Nonthaburi Province, Thailand, and met inclusion criteria were randomly selected with multi-stage sampling to participate in this study. The data were collected by using The Demographic Questionnaire, Social Network Behavioral Questionnaire, Thai Geriatric Depression Scale-15, and Physical Activity Record Form. Data were analyzed by using descriptive statistics and Spearman’s Rank Correlation Coefficient. A significant level was set at .05. Results revealed that the majority of participants had a high level of social networking behavior (48.0%), but mostly had no depression (92.8%). There was only 3.3% of them had sedentary behavior. Regarding the correlation among study variables, social networking behavior had a mild negatively significant relationship with depressive symptoms, but it was not significant relationship to sedentary behavior. Depressive symptoms had a mild negatively significant relationship with sedentary behavior. The result of this study provides healthcare providers to understand social networking health behavior, depressive symptom, and sedentary behavior, and to help the healthcare providers to plan any intervention to promote healthy behavior in older adults.

111-117

Authors: Kaiomakx Renato Assunção Ribeiro, André Rodrigues dos Santos, Rachel Iglesias Teodoro dos Santos, Lorena Suquyama Lelis, Thales Antônio Martins Soares, Widney de Castro Baião, Daniella Valença Daher, Edivalda Pereira de Abreu and Fernanda Alves Ferreira Gonçalves

The objective of this study is to analyze the difference between the male and female genders regarding the number of cases of acute coronary syndrome (ACS)/acute myocardial infarction (AMI). This is an integrative literature review study, in which articles were searched in the following databases: MEDLINE, LILACS, SCIELO, BDENF. The articles were published between the years 2006 and 2018. Initially, 502 studies were found, 17 of which were selected to compose this research. Studies in general have pointed to a high incidence of ACS/AMI in males, however, a linear increase in the incidence of cardiovascular diseases in females has been observed in recent years. And that the factors associated with the appearance are hypertension, smoking, alcoholism, sedentary lifestyle and obesity, among others. In conclusion, the incidence of patients with ACS/AMI every year has been a major challenge for health institutions and health professionals. The gender most affected by these diseases is the male gender; however, the increase in new cases in women has increased linearly in recent years.

68-74

Authors: L. A. Lar, O. G. Ogbeyi and Z. W. Wudiri

Absenteeism occurs when an employee (individual) does not come to work for one or more days (or shifts) when assigned. It is a common global occurrence having negative effects on work productivity. This study aimed to determine the level of absenteeism and contributory factors among staff of Plateau State Specialist Hospital, Jos, Plateau State. This was a facility based, cross sectional study, involving 181 hospital staff, consecutively selected. A structured, pre tested, self-administered questionnaire was used to assess absenteeism within the previous one year. Data was collected and analysed using Epi info statistical software (and a p value of ≤ 0.05 was considered statistically significant). Annual prevalence of absenteeism was 38.7%, crude absence rate; 1.6% and sickness absenteeism; 28.7%. Other factors included attending burials, weddings, study, examinations, family responsibilities, inadequate salary, working additional jobs, lack of promotion, and transportation problems. There was a statistically significant relationship (p = 0.0026) between poor remuneration and absenteeism. In conclusion, majority of the workers at the hospital had not been absent in the preceding year. It is therefore recommended that hospital management should improve staff remuneration.

84-90

Authors: Mahmoud S. Babiker, Rana A. Eisa, Fahad B. Albadr, Abdullah H. Abujamea, Awatef M. Omer, Mohammed Gamaleldin Mohammed, Arwa M. Asiri, Zeena H. Abdulhamid and Rawan Saif

The clinical significance of knowing the status of thyroid nodules is the need to exclude thyroid cancer. The purpose of this study is to evaluate ultrasound (U/S) features of thyroid nodules and correlate them with fine-needle aspiration cytology (FNAC). A descriptive prospective study was conducted at the Radiology Department, King Khalid University Hospital, King Saud University (KSU), Riyadh, KSA. The inclusion criteria were adult patients with neck swelling, palpable neck lesion, and/or abnormal thyroid-stimulating hormone (TSH) laboratory test result. Philips IU22, epic, sonosite, and Toshiba-Xerio ultrasound (U/S) systems with 7-MHz transducers were used in this study. All participants underwent a thyroid U/S scan according to standard protocol. FNAC-U/S was conducted for 159 nodules (according to suspicious U/S features) using a 10-ml plastic syringe with conventional (23 to 25) gauge needle. There were 246 participants included in this study (165 females [67%] and 61 males [33%], age range 13 to 88 years). There were 303 types of thyroid nodules noted, as follows: 47.8% were solid nodules, 42.5% were complex, and 9.6% were cystic nodules. Among 159 FNAC samples, 8.2% (n = 13) were positive results for malignancy. Females predominantly had malignant results (P = 0.001). U/S showed a sensitivity of 89.1 and 78.0% and a specificity of 43.0 and 57% for the right and left lobes, respectively. FNAC showed a sensitivity of 10.0% and 21% and a specificity of 56.9% and 42% for the right and left lobes, respectively. In conclusion, nodule malignancy and gender were significantly associated. Mixed and hypoechoic nodules were common features of malignancy. Both U/S and FNAC confirmation were important in thyroid nodule evaluation.

99-104

Authors: Solyom Árpád, Gilyén Botond, Fodor Pál, Zuh Sándor and Bățagă Tiberiu

Elbow arthroplasty is very successful in terms of pain relief, motion and function. Indications include posttraumatic osteoarthritis, acute distal humerus or proximal forearm fractures, and many others. With the present article, the authors would like to present the case of a patient who underwent total elbow arthroplasty following a car crash which resulted in the following conditions: IIIC type distal humerus open fracture, IIIC type proximal forearm open fracture, and multiple other lesions. Immediate surgical care consisted of primary wound correction and external fixation of the bones and secondary wound correction was practiced. A few months later the patient underwent total elbow arthroplasty. One year after the accident, following rigorous physical therapy, the patient has regained 45% of nerve function, 70% of muscle function and now can lead a relatively normal life. He can drive a car and use his elbow in daily activity. Although replacement arthroplasty was initially used mainly in patients with inflammatory arthritis, its indications were expanded to other conditions, which place higher demands on the implants and seem to lead to higher failure rates, but an elbow arthroplasty is a good option in complicated open fractures if we have a multidisciplinary team and the time of surgery is opportune despite the high failure risk.

34-39

Authors: Joshi B. and Chaudhary R.

Meniscus extrusion can be considered as a serious and relatively frequent clinical problem and can be also considered as a risk factor for osteoarthritis progression and knee pain symptom. Previous studies have shown a strong association between degenerative radial meniscal tears and extrusion. The aim of this study was to correlate the shape of lateral meniscus and the risk of its extrusion based on MRI examination of the knee joint. A prospective study was done in 75 patients of age group between 18 years and 50 years of age who were referred for MRI of knee joint in a tertiary hospital. The MRI was performed on a Magnetom Amira 1.5 Tesla MRI scanner following TUTH MRI routine protocol of Knee joint. All the cases who met the inclusion criteria were included in the study. After the procedure, images were evaluated. The measurements for the parameters used for this study were done in T1 Coronal image at the level of inter-condylar eminence and Proton density(PD) fat saturated sagittal image at the mid bow tie level where the morphology of the lateral meniscus were clearly delineated. Then the recorded data for each patient was correlated with the extrusion of the lateral meniscus along with body mass index (BMI) of the patient. The study showed a strong positive linear correlation of BMI and lateral meniscus-bone angle [LMBA] with meniscus extrusion, where (r=0.94; p=0.000) and (r=0.857; p=0.000) respectively. However, lateral meniscus-cartilage angle [LMCA] and lateral meniscus-cartilage height [LMCH] showed a moderate positive linear correlation with meniscus extrusion (r=0.564; p=0.000) and (r=0.305; p=0.26) respectively. The height of the anterior and posterior horns of the lateral meniscus showed the mean dimension of about 6.13(SD±0.62) mm and 6.30 (SD±0.58) mm respectively in our study. Similarly, the mean antero-posterior diameter of the anterior and posterior horns of the lateral meniscus were found to be 11.3(SD±1.06) mm and 11.4(SD±1.02) mm, respectively. Finally, the mean meniscus extrusion of the lateral meniscus observed beyond the tibial margin were about 2.57 (SD±0.93) mm whereas, the maximum meniscus extrusion was found to be 4.7 mm. In conclusion, increased BMI and LMBA showed significant increased risk of lateral meniscus extrusion beyond the tibial margin. However, LMCA and LMCH showed statistically moderate relation with the risk of lateral meniscus extrusion.

48-52

Authors: Beatriz Cepeda De Romero, Diana Carolina Cañon Guarnizo, Lina Marcela Orozco Herrera, Sofìa Cepeda Tarazona and Maria Alexandra Polo Pacheco

The ratio Deoxypyridinoline / Creatinine measured in urine (DPD/Cr) is the most sensitive and specific marker of early metabolic breakdown of collagen I, and therefore, of osteopenia and bone resorption. The normal values change with age and gender; in male adults the normal range is 2.3 to 5.4 nmol/mmol and in women is 3.0 to 7.4 nmol/mmol. It has been shown that osteopenia can lead to osteoporosis and to failure of implant osseointegration. The objective of this study was to associate levels of DPD/Cr in urine with bone height measured by tomography before surgery and three months after oral implant surgery in menopausal women. 20 healthy or systemically controlled postmenopausal women who underwent surgery implants, were selected by convenience for the study. All implants were: Titanium SIS® Implants (CIEO Foundation, Colombia) customized according to the patient requirements indicated in the CBCT. The implant length varied in the range 5 to 15 mm, internal diameter: 3 to 5 mm, internal hexagon: 2.4 mm, and screw: 1.85 × 0.35 mm. DPD values in urine were measured by a Chemical Luminescence Immune test and bone height in mm was measured in a tomography on implant zone before the surgery and 3 months after implant surgery. The average age of the patients was 61.2 ± 17.31 years and the number of implants 1-4/patient. The ratio DPD/ Cr showed a high average of 9.594 ± 0.475 nmol/mmol. Average pre-surgery bone height was 15.23 ± 1.41 mm and post-surgery decreased to 13.78 ± 1.16 mm. This difference was significant (t paired, p = 0.001). The Pearson correlation test showed a high association (p = 1) between the elevation of DPD/Cr and the decrease in bone height. There is a significant association between the change in concentrations of urinary creatinine-corrected deoxypyridinoline and bone resorption in menopausal women, three months after oral implant surgery.

60-67

Authors: R. S. Omotayo, O. Akadiri, A. L. Akintan and S. E. Omotayo

The health sector occupies an enormously important position in ensuring sustainable overall socio-economic advancement in developing countries. Healthy people make a healthy nation and also contribute to economic growth. Satisfaction is the contentment one feels when one has fulfilled a desire, need, or expectation. Poor quality is costly - to clients, to programmes and to the society overall. People's perception about quality of care often determines whether they seek and continue to use services. This study evaluated the level of patient’s satisfaction in gynaecological practice at the state specialist hospital Akure. This study is a descriptive cross-sectional study. Questionnaires of the Likert-like form was used to obtain information from consenting patients on various factors that determines or have effect on their level of satisfaction while accessing gynaecological care services at the gynaecology clinic of State Specialist Hospital, Akure. Systematic sampling method was used to recruit patients by selecting every second patient serially as they present . Three hundred and eight consenting gynaecological patients were recruited into the study. Data was analysed with the Statistical Package for Social sciences (SPSS) 20.0. Majority of the respondents 295 (95.7%) were satisfied with the morning time clinic schedule. More percentage of respondents were very satisfied with attending doctor being male (52.9%) than if the attending doctor was female (26.3%). Most patients (53.3%) were not satisfied with having to go outside the hospital to get some of their investigations done. Most patients (44.6%) were not satisfied with the level of availability of drugs in the hospital as they still go out to buy drugs. Vast majority of the respondents (89.2%) were either satisfied or very satisfied with the behavior and competence of the attending doctors and nurses. In conclusion, client's satisfaction is reflected by their happy expression about the care they receive, where and how they access the care. There is need for health care givers to continue and improve on aspects of care that gives patients satisfaction and discourage those that make the patients dissatisfied.