Modern Clinical Medicine Research

7

Authors: Ieong Chon Man, Liang Gang Zhu, Tam Man Pan, Kong Soi Chau, Kuok Cheong U

Objective: To investigate the feasibility and clinical efficacy of stent implantation and balloon angioplasty in the treatment of severe lower extremity arterial ischemia. Methods: Twenty- two patients with severe lower extremity ischemia were enrolled from January 2016 to December 2016. According to the scope of the patient's lesions, we choose the appropriate length of the balloon, according to different degrees of balloon dilation lesion stenosis or occlusion of the adjacent multiple short part of the lesion, as far as possible the formation of long balloon. Metallic stents were implanted in the dilated vessels to prevent restenosis. The incidence of postoperative complications, the rate of technical success and the clinical efficacy were observed, and the primary patency rate was evaluated through follow-up. Results: The total of 22 patients had 42 vessels with varying degrees of stenosis and occlusion, with an operative success rate of 100%. The primary patency rate was 90.9% and 81.8% at 6 and 12 months respectively. The ankle brachial index was significantly higher than that before the operation, and the Rutherford classification of most patients was significantly improved after the operation (P<0.05). No serious complications or death cases were found in this study. The average postoperative hospital stay was 4.3 days. Conclusion: For the severe ischemic disease of the lower extremities, interventional therapy is more effective than surgical treatment, with fewer complications and faster recovery. Stent implantation combined with balloon therapy does not affect the postoperative blood supply of the affected limb. The initial technical and clinical success rate is very high. It is a safe and effective method for the treatment of severe arterial ischemia disease of the lower extremities.

7

Authors: Mustapha W. Shehu, Nafi’u Abdulkadir, Idris Bello, Abdulaziz Shehu, Sadiya A. Waziri

Infectious diseases such as skin infection, chronic cough, stomach infection, tuberculosis, diarrhoea, warts, herpes zoster and others were claimed to be treated using medicinal plants. The study was aimed at determining the antibacterial activity and determination of bioactive compound of some medicinal plants used in management of HIV/AIDS opportunistic infections. A total of six plants were subjected to phytochemical and three out of six were tested against bacterial pathogens. The aqueous extracts of plants leaves of Pseudospondias microcarpa (PM), Callistemon citrinus (CC) and Spathodea campanulata (SC) were tested against two bacterial pathogens namely: Staphylococcus aureus and Pseudomonas aeruginosa. The result revealed the presence of Saponins, Tannins, Anthracenosides and Steroid glycosides. Alkaloids, flavonoids and reducing sugars had narrow distribution among the species. The highest clear zones were found in PM against Staphylococcus aureus (21.18mm) followed by 20.07mm for CC and 19.03mm for PM against the same bacterium. For Pseudomonas aeruginosa 20.36mm, was recorded for PM, 21.3mm for CC and 20.16mm for Sc at different concentration. The antibiotic used as control revealed highest against all the tested bacteria. There was no significant difference between the bacterial activities of the extracts of the three plant species but it varied significantly across the different serial dilutions. Further studies should be conducted on phytochemical analysis to establish more active ingredients that may be used in the development of drugs by pharmaceutical companies.

16

Authors: Daniel Sop, Wally Smith, Abdulkhaliq Alsalman, Jennifer Li Wong, Ding-Yu Fei, Donna McClish, Azhar Rafiq, Patrick Coyne, Shirley Johnson, Thokozeni Lipato

Sickle cell disease (SCD) pain is often acute-on-chronic, likening it to other chronic acuteon-chronic pain conditions. Pain treatment of SCD was already reported as inadequate prior to the current opioid epidemic, but attitudes underlying treatment were understudied. Understanding these attitudes prior to the current epidemic would be revealing. Therefore in 1997, before the current opioid epidemic, we surveyed physicians’ attitudes toward pain management and treatment preferences for acute pain exacerbations in the Emergency Department in SCD versus those of chronic pancreatitis and chronic low back pain, two other acute-on-chronic pain diseases. Thirty-nine residency trainees were surveyed in a level one triage hospital. Resident estimates of the rate of opioid addiction in SCD were higher than estimates in both chronic pancreatitis and chronic low back pain. Most residents relied on their personal clinical experience rather than external sources of data or knowledge as the most important driver when they managed chronic pain. This survey research shows that, predating the current opioid epidemic, there was both a backdrop of opioidphobia and a bias against treating SCD pain compared to other chronic pain conditions among our sample. Repeating this survey research among current training physicians, along with surveys of other attitudes, would provide useful comparisons.