|
|
|
Volume-18 (2019);
No. 1 (January-March)
Published on Apr 30, 2019
|
|
|
|
|
|
2019;1:1
Original Article |
Parmar VB, Rupani MP, Trivedi AV.
Social Determinants of Diabetes and Hypertension in an Urban Slum of Gujarat, Western India: a Cross-Sectional Study. |
|
Abstract: This study attempts to explore the social determinants of patients with diabetes and hypertension. This was a cross-sectional study conducted in an urban slum on a random sample of 251 patients. The participants were interviewed at their home, where their anthropometry was performed. The social determinants significantly associated with both diabetes and hypertension were being literate, currently married, having an active occupation, belonging to Hindu religion, being in higher socio-economic group, having financial crunch, having social conflicts at home and inability to perform daily work, except, having professional stress and regular consumption of junk food, which were significantly associated with hypertension. The risk factors significantly associated with both diabetes and hypertension were obesity by body mass index, abdominal obesity by waist circumference as well as by waist-hip ratio, sedentary lifestyle and lack of physical activity. Among the diabetics, 15.7% smoked tobacco, 19.6% consumed oral tobacco and 9.8% were alcoholic; while among the hypertensive, 13.5% smoked tobacco, 25% consumed oral tobacco and 5% were alcoholic. Social determinants of health have significant ramifications on diabetes and hypertension. While assessing the patients with hypertension and diabetes in their clinics, clinicians are advised to address the social determinants of health as well.
Key words: Social determinants of health, Addictive behavior, Diabetes, Hypertension, Socioeconomic factors, Less-developed countries, Low-income population |
|
|
This Article |
|
 |
 |
|
|
|
|
|
|
2019;1:2
Original Article |
Rai L, Hebbar S, Vengetesh PM, Kumar R.
Association of Insulin Indices and Glucose Tolerance Test During Pregnancy in South Indian Women. |
|
Abstract: Background: Gestational diabetes (GDM) is on the rise in Asia. High Insulin resistance (IR), low insulin sensitivity (IS) and pancreatic cell dysfunction are said to be responsible. This can be detected by estimating insulin indices along with oral glucose tolerance test (OGTT). Objective: The aim was to correlate the various Insulin indices and OGTT values in pregnant women. Material and Methods: This cross sectional study included 69 pregnant women between 24 to 28 weeks of gestation who underwent 3 hour 100-g OGTT along with insulin levels. They were stratified into: Normal glucose tolerance (NGT), gestational impaired glucose tolerance (GIGT) and GDM based on Carpenter and Coustan criteria. The insulin indices studied were Matsuda Index, quantitative insulin sensitivity check index (QUICKI), homeostasis model assessment for IS (HOMA-1S, HOMA2-S), HOMA-1IR, HOMA2-IR for resistance & (HOMA1-B, HOMA2-B) for Insulin secretion. Results: The prevalence of GDM in this study was 13% and that of GIGT was 11%. Lower IS indices (Matsudo Index, QUICKI, HOMA1-S, HOMA2-S) and higher IR (HOMA1-IR, HOMA2-IR) were seen in the GDM & GIGT groups. Matsuda Index at the cut off value of =2.2 showed superior diagnostic ability (sensitivity 88.24%, specificity 80.77%), and had the maximum AUC (area under curve). No statistically significant differences in ß-cell secretion were noted in the three groups.Conclusions: Low IS and high IR rather than defective insulin secretion seemed to be responsible for altered OGTT in this study group. The Matsuda index for IS and HOMA1 IR for resistance seemed better than other insulin indices.
Key words: Insulin resistance, Insulin secretion, Homeostasis model assessment (HOMA), Gestational diabetes mellitus (GDM); Gestational impaired glucose tolerance (GIGT), Matsuda Index |
|
|
This Article |
|
|
|
|
|
|
|
|
|
2019;1:3
Original Article |
Talwar P, Mohamad FS, Mustaffa MS, Othman MK, Bee OY, Hian CC.
Internet Addiction Among University Students: Psychometric Properties of Three Factor Model Internet Addiction Test. |
|
Abstract: Incursion of the Internet into daily life has become problematic for an increasing number of people, particularly for individuals with the affliction which is often referred as Internet Addiction (IA). Burgeoning global research has demonstrated the perceptible adverse consequences of IA, especially among students. Of the available scales that assess IA, thus far the most extensively used has been the Internet Addiction Test (IAT). However, several prior psychometric analyses have portrayed ambiguous factor structures. The main aim of the present study was to provide data on its factorial structure and ascertain its reliability in a sample comprising 307 university students. Convenience sampling technique was employed in this cross-sectional study wherein a bilingual version of IAT was administered to participants. Findings revealed that nearly 32% students could be considered as moderately addicted, and 3% as severely addicted. Examination of the latent structure of the IAT scale using both exploratory and confirmatory factor analysis revealed a 3-factor solution (lack of control, excessive use and compulsion) which explained 48% total variance. Also, low factor loadings on Item 8 prompted its exclusion. Subsequent multi-group CFA showed that the scores for this model were invariant in terms of gender. The resulting 19-item IAT with a three-factor structure appears to be a valid and reliable instrument for measuring IA. Though initial indications of construct validity were promising, additional research may still be required to elucidate the stability of factor solutions in a variety of settings and demographic backgrounds in Malaysia.
Key words: Internet addiction, University students, Psychometric properties, Reliability |
|
|
This Article |
|
|
|
|
|
|
|
|
|
2019;1:4
Original Article |
Oluboyo OA, Iwuchukwu T, Oluboyo OB, Olayanju OA.
Impact of Malaria Severity on Serum Levels of Hepcidin and Iron Status in Children. |
|
Abstract: Malaria is a life threatening disease and one of the leading causes of death in Africa especially in children. This study aimed to assess the impact of malaria on levels of hepcidin and iron status (haemoglobin, serum iron and total iron binding capacity) based on the severity of malaria infection. A total of ninety three subjects between the ages of 6 months-15 years were investigated for malaria infection using microscopic method. Thirty three subjects had severe malaria; thirty subjects had unsevere malaria and thirty apparently healthy subjects served as control. Hepcidin was estimated using enzyme linked immunosorbent assay (ELISA), serum iron and haemoglobin were estimated spectrophotometrically. The results obtained showed that there were increased levels of hepcidin and decreased levels of haemoglobin, serum iron and total iron binding capacity in severe and unsevere malaria compared with apparently healthy subjects (P<0.05). Hepicidin also showed inverse correlation with serum iron, TIBC and haemoglobin in both severe and unsevere malaria. The study concluded that severe malaria may cause the upregulation of hepcidin and the increased hepcidin could put the subject at risk of iron deficiency anemia. The study suggests that hepcidin could help in the evaluation of severe and unsevere malaria and also be used to monitor the progression of malaria infection.
Key words: Hepcidin, Malaria, Children |
|
|
This Article |
|
|
|
|
|
|
|
|
|
2019;1:5
Original Article |
Pai SG, Mounika V.
Ocular Manifestations of HIV: A Hospital Based Study. |
|
Abstract: Background: HIV is a global health issue of unparalleled proportions and unprecedented emergency, with diverse health and economic implications. As per 2017 global HIV statistics, 36.9 million people globally were living with HIV. It is estimated that 70% of adult HIV population will experience an ocular complication at some stage of life. Revelation of ocular complications can be the presenting sign of a systemic infection in an otherwise asymptomatic person. The clinical presentation may be modified by HAART, which dramatically improves prognosis. This study intended to outline the magnitude of the problem of HIV in our community and to determine the spectrum of ocular manifestations of HIV, and their clinical outcomes at our tertiary care centre. Materials and Methods: An observational cross-sectional study was done on 30 HIV-positive patients presented to ophthalmology clinic in a tertiary care centre. Data were collected using face-to-face interview, clinical examination with slit lamp biomicroscopy, direct and indirect ophthalmoscopy and laboratory investigations, and analyzed in terms of ocular manifestations and associated immune status. Conclusion: Dry eyes were the most common anterior segment manifestation encountered in our study. HIV retinopathy remained the most common posterior segment manifestation. CMV retinitis was the next common lesion and most common opportunistic infection in the study with poor immune status. In our study the most common coexistent systemic disease was Systemic tuberculosis.
Key words: Acquired immuno deficiency syndrome, Human immunodeficiency virus, Ocular manifestations |
|
|
This Article |
|
|
|
|
|
|
|
|
|
2019;1:6
Original Article |
Idowu AO, Odusan O, Olawale O, Ajiro T, Adesegun O, Osonuga A, Abiodun O.
Thyroid Function Abnormalities among Patients with HIV/AIDS in South-Western Nigeria. |
|
Abstract: Sub-Saharan Africa accounts for a huge proportion of the global burden of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS). However, there is paucity of local studies assessing thyroid dysfunction among HIV/AIDS patients in Sub-Saharan Africa.The purpose of this study was to determine the prevalence, severity and correlates of thyroid function abnormalities among HIV positive patients. We recruited 300 participants for this study conducted at a tertiary hospital in Nigeria. One Hundred were HIV positive on HAART, another 100 were HIV positive but HAART-naďve and the remaining 100 participants that served as control were apparently healthy HIV negative individuals. Venous blood samples were collected from all the study groups for quantitative determination of Thyrotropin and free thyroid hormones, while thyroid autoantibodies were assayed in the two HIV positive study groups.The prevalence of thyroid function abnormalities among HIV positive subjects from this study was 33%. The mean free triiodothyronine (FT3) and free Thyroxine (FT4) were lowest in the HIV positive HAART naďve group (p<0.05). Correspondingly thyroid autoantibodies and CD4 counts were also significantly lower in HAART naďve group (p<0.05). In conclusion, abnormal thyroid function tests are common findings among HIV positive subjects, which is a more frequent occurrence among HIV positive HAART naďve subjects who usually present at CD4 nadirs with concurrently low thyroid hormone levels.
Key words: Thyroid Function Test, Human Immunodeficiency Virus (HIV), Free T4, Free T3, Thyrotropin, Nigeria |
|
|
This Article |
|
|
|
|
|
|
|
|
|
2019;1:7
Original Article |
Murugesan M, Nair CK, Nayanar SK, Pentapati KC.
Analysis of Flow Cytometric Enumeration of CD34+ cells in Leukapheresis Product from South Indian Cancer Centre. |
|
Abstract: Background: The success of peripheral blood stem cell (PBSC) transplant often relies on CD34+ cells counting. As the assay needs to be repeated in duplicate, this study was conducted to observe the variations between the duplicates with respect to concentration of leukapheresis product. Methods: The assay followed was single platform method - ISHAGE protocol published by the International Society of Haematotherapy and Graft Engineering. New parameter named variation index was used to compare the difference between the duplicates.
Results: We present our data on 111 samples collected from leukapheresis product. 10% of the assay did not meet the criteria and required repeat testing. We observed no significant difference betweenthe duplicate samples with respect to low (CD34+ cells/µl<500; P=0.632), Medium: 500 to 1000 CD34+ cells/µl, P=0.085 and High >1000 CD34+ cells/µl, P=0.864). Conclusion: Testing the CD34 enumeration in duplicate and verifying its repeatability for variation index of less than 10 will help in accurately determining CD34+ dose calculations.
Key words: CD34+ cells Enumeration, Flowcytometry, ISHAGE |
|
|
This Article |
|
|
|
|
|
|
|
|
|
2019;1:8
Original Article |
Samuel S, Safeera A, Ahmed G, Rudrapathy P, Murugesan S, Dinju.
Emergence of Non- Diphtheritic Corynebacterium as a Co- Pathogen in Various Clinical Specimens in Cancer Patients. |
|
Abstract: Corynebacterium other than C. diphtheria are referred to as Non-diphtheritic Corynebacteria “diphtheroids”which have garnered medical interest due to an evolving number of publications refered to community-acquired and nosocomial infections. Non-diphtheria Corynebacteria (NDC) species cause disease in risk populations such as immunocompromised patients and those with implanted medical devices. This study was performed, to find out the prevalence of NDC species among cancer patients and to determine their antimicrobial susceptibility. Clinical specimens like sputum, pus exudates, bronco-alveolar aspirates, urine and blood was collected by standard methods with aseptic precautions. Sputum along with other respiratory secretions (54%) and pus (33%) were the most prominent samples presenting diphtheroids as pathogenically significant isolates. Blood (5%), fluids and other exudates (7%) and urine (1%) were other specimens from which diphtheroids were isolated. The incidence of infections caused by bacteria among cancer patients in our study was estimated to be 17.9%. Among the infected individuals, 59% and 41% were male and female patients respectively with overwhelming incidence among elderly patients (>90%). Corynebacterium pseudodiphthereticum was isolated from 47% of the specimens. There was an alarming state of resistance among the isolates. Most of the tested antibiotics showed poor effectiveness except imipenem (100% susceptibility), linezolid (100% susceptibility) and tigecycline (100% susceptibility). The isolates were also found capable of forming biofilms.
Key words: Non- diphtheritic corynebaterium, Biofilm, Cancer patients, Antibiotic resistance. |
|
|
This Article |
|
|
|
|
|
|
|
|
|
2019;1:9
Original Article |
Yaghoubi S, Baseri Z, Rasti A, Erfani Y.
Clinico-Epidemiological Profile of VRE Enterococcus faecium in Shariati Hospital in Tehran. |
|
Abstract: Background: Owing to restricted treatment options, Vancomycin-resistant Enterococci (VRE) was considered a prominent cause of nosocomial infections. This study was undertaken to evaluate the presence of Van-type and virulence determinants in the clinical isolates of E. faecium (Ent. faecium) in Shariati Hospital. Materials and Methods: A total of 150 Enterococcal isolates were surveyed. Antimicrobial susceptibility testing was performed by disc di?usion and E-test as well as the genotypic method. The presence of virulence factors, including hyaluronidase (hyl), gelatinase (gelE), aggregation substance (asa1), and Enterococci surface protein (ESP) were identified by Polymerase chain reaction (PCR). Results: Overall, 66.67 percent (80/120) of VRE Ent. faecium strains were confirmed by the PCR method. The maximum number of isolates was from urine specimens (p < 0.05) and blood samples. Among the 80 VRE Ent. faecium isolates, 76 isolates showed high-level resistance (MICs to Vancomycin 32 > µg/ml) and carried a VanA phenotype (p < 0.05). In all the isolates, asa1, gelE, and ESP genes were identified in 14% (17/5), 26/3% (21/80), and 45% (36/80), respectively. E. Ent. faecium carried ESP at a significantly higher frequency presented in VRE strains (p < 0.001). The prevalence of hly determinants in the E. faecium was 20% (16) (P < 0.001). Conclusion: We, in our hospital, are faced with a high rate of VRE Ent. faecium isolates with a VanA-positive phenotype. With increasing resistance of the VRE strains to linezolid, we will encounter a serious challenge in treating VRE patients in future years. An interesting finding from the present study is that the spreading rates of ESP and hly among Ent. faecium isolates are higher.
Key words: Enterococcus faecium, Antibiotic resistance, Vancomycin-resistant enterococci, Virulence factors |
|
|
This Article |
|
|
|
|
|
|
|
|
|
2019;1:10
Original Article |
Samuel S, Noyar T, Ahmed G, Rudrapathy P, Murugesan S.
Prevalence and Resistance Pattern of Moraxella catarrhalis causing Respiratory Tract Infections in Cancer Patients. |
|
Abstract: Background: The emergence of Moraxella catarrhalis as a nosocomial pathogen in the last decade with increasing prevalence of antibiotic resistant strains has gained interest. In immunocompromised hosts, the bacterium can cause a variety of severe infections, including pneumonia, endocarditis, septicemia and meningitis. Aim: The purpose of our current study was to evaluate the prevalence and resistance pattern of M. catarrhalis causing RTI among cancer patients. Methods: Patients suspected to be suffering from respiratory tract infection (RTI) were taken up for the study. All specimens were cultured. Identification was done by standard microbiological methods. Certain criteria were considered for determining the pathogenic significance of Moraxella catarrhalis. Result: Out of the total 355 respiratory samples received, 100 (28.1%) respiratory samples showed meaningful growths. The rest of 255 (71.8%) of the respiratory samples produced no significant respiratory bacterial pathogen or no growth. Out of the 100 meaningful samples 124 respiratory pathogens were isolated. Among 124 isolates 19 (15.3%) were Moraxella catarrhalis. Other bacterial isolates were as follows: Pseudomonas aeruginosa 17 (13.7%), Klebsiella pneumoniae 17 (13.7%), Escherichia coli 14 (11.2%), Acinetobacter baumanii 10(8.0%), Streptococcus spp 10 (8.0%), Staphylococcus spp 9 (7.2%), Candida albicans 8 (6.4%), Staphylococcus aureus 7 (5.6%) and others 13 (10.4%). The finding shows M. catarrhalis as one of the predominant bacterial pathogen causing respiratory tract infection in cancer patients. The susceptibility pattern of M. catarrhalis showed that all the isolates were more susceptible to Amoxycillin-clavulanic acid (57.8%), followed by Chloramphenicol (50.1%). Patients (47.3%) with Lung carcinoma were found to be more prone to get infection by M. catarrhalis. Conclusion: Keeping in mind the increasing prevalence of patients being infected with M. catarrhalis in our region, a larger scale research should be conducted to evaluate resistance pattern of M. catarrhalis. Continued surveillance of antimicrobial susceptibility pattern and application of control measures against further transmission are required to decrease the emergence of the resistant strains.
Key words: Moraxella catarrhalis, Respiratory tract infections, Cancer patients, Antibiotic resistance |
|
|
This Article |
|
|
|
|
|
|
|
|
|
2019;1:11
Original Article |
Chukwu CS, Ojukwu CP, Okemuo AJ, Ikele IT, Igwe SE, Onuchukwu CL, Ikele CN.
Correlation Between the Intensities of Pregnancy - Related Low Back Pain and Urinary Incontinence in Pregnant and Postpartum Women in Enugu, Nigeria. |
|
Abstract: Background: Functional pelvic floor muscles have been associated with increased spinopelvic stability. However, studies are limited on the co-existence of pregnancy-related Low Back Pain (LBP) and pelvic floor muscle dysfunctions. Objectives: This study evaluated correlations between the LBP and Urinary Incontinence (UI) among pregnant and postpartum women in Enugu, Nigeria. Methods: This cross-sectional study involved One hundred and fifty (150) consenting women (103 pregnant and 47 postpartum) attending antenatal and post-natal clinics of three hospitals in Enugu, Nigeria. Information on maternal and obstetric characteristics, LBP and UI symptoms were obtained using a structured questionnaire which consisted three sections, including the International Consultation Incontinence Questionnaire (ICIQ). Data were analyzed with descriptive statistics and Spearman’s rank correlation with at a significant level of 0.05. Results: Pregnant and postpartum women’s mean age ± standard deviations were 28.89±4.80 years and 29.89±5.69 years respectively. Most pregnant and postpartum women had moderate (40.5%) and mild (39.1%) LBP Intensity respectively. Majority (pregnant – 72,5%; postpartum – 71.4%) of the women in both groups experienced stress UI. LBP and UI were co-existent among the respondents (pregnant 35.9% and postpartum 42.6%). There were no significant correlations between intensities of LBP and degree of UI in both pregnant (p = 0.324) and postpartum (p = 0.464) women. However, intensity of LBP was significantly (p = 0.041) associated with the types of UI reported by the pregnant women only. Conclusion: LBP and UI are co-existent in pregnant and postpartum women. Incorporating pelvic floor muscle training into management of LBP is recommended as well as integration of back muscles’ rehabilitation into the management of pelvic floor muscle dysfunctions.
Key words: Low back pain, Urinary incontinence, Co-existence, Pregnancy, Postpartum |
|
|
This Article |
|
|
|
|
|
|
|
|
|
2019;1:12
Original Article |
Salati SA.
Awareness about Male Breast Cancer in Indian Expatriates in the Middle East – A Pilot Study. |
|
Abstract: Objective: The pilot study was conducted to understand the level of awareness about male breast cancer in Indian expatriates in the Middle East. Methods: A cross-sectional survey was conducted in a random sample of Indian expatriate males in Al-Qassim region of Saudi Arabia. A self-designed questionnaire was used to study the awareness levels related to male breast cancer. Results: Awareness related to male breast cancer was poor in 81% of the participants of the study. Conclusion: Awareness regarding male breast cancer among Indian men working in Saudi Arabia is low. Therefore special attention should be given to educate this community about male breast cancer.
Key words: Male breast cancer, Awareness, Social media, Breast self-examination |
|
|
This Article |
|
|
|
|
|
|
|
|
|
2019;1:13
Original Article |
Andrade LS, Singh I.
Variations of the Brachial Plexus: A Study in Human Fetuses. |
|
Abstract: Objectives: Brachial plexus, is a nerve plexus, that supplies the upper limb. Very few studies have been conducted in the fetus to know its pattern of variations. Therefore, this study aimed to identify the variations in the brachial plexus in human fetuses. Materials and method: Twenty-five formalin-fixed human fetuses were dissected bilaterally and the variations in the roots, trunks, cords and branches were identified.
Results: Out of the fifty brachial plexuses studied, thirty-five plexuses were normal and fifteen showed variations. Among the fifteen variant plexuses, more number of variations were seen in the median nerve branch of the lateral cord of brachial plexus. These variations in the fetuses show that the adult pattern of variations are pre-determined in the embryological life.
Conclusion: Therefore, these variations are of clinical importance for the clinicians and surgeons performing surgeries in the region of the axilla and in the upper limb.
Key words: Brachial plexus, Cords, Fetus, Roots, Median nerve |
|
|
This Article |
|
|
|
|
|
|
|
|
|
2019;1:14
Case Report |
Chandra S, Shukla SK, Barua U, Gupta M.
Ovarian Immature Teratoma Associated with Pregnancy. |
|
Abstract: Ovarian immature teratoma is an uncommon tumor and its association with pregnancy is rarer still. At times it may be asymptomatic and lie undetected till full term pregnancy. The present rare case is being reported because of its unusual presentation where the female presented with immature ovarian teratoma with full term pregnancy and omental metastasis. Histopathological diagnosis with vigilant examination of the sections is essential for the grading of the tumor and determining the prognosis of this aggressive tumor. The management of this malignancy is crucial depending on gestational age, patient decision and associated fetal risks. The case also highlights that it is essential to assess all the pregnancies during antenatal period with ultrasonography and fetal delivery of any unsuspected genital organ tumor.
Key words: Immature teratoma, Ovary, Pregnancy, Prognosis |
|
|
This Article |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
