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   2012| February  | Volume 4 | Issue 2  
    Online since February 29, 2012

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Pregnant women and non-steroidal anti-inflammatory drugs: Knowledge, perception and drug consumption pattern during pregnancy in Ethiopia
Chalelgn Kassaw, Nasir Tajure Wabe
February 2012, 4(2):72-76
Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are among the widely used drugs and are often used by pregnant women. However, they can have significant teratogenic effects. The aim of the study was to investigate pregnant women's knowledge about NSAIDs use during pregnancy and their perception and consumption pattern. Materials and Methods: The study was a cross sectional study on women waiting for a consultation in the selected maternity hospitals in Addis Ababa, Ethiopia. The pregnant women were selected randomly and then interviewed by using standardized questionnaires. Result : A total of 224 pregnant women were involved in the study. Out of those, 203 (90.6%) of them have taken NSAIDs since the beginning of their pregnancy. About 201 (89.7%), 198 (88.4%) and 189 (84.4%) of the pregnant women considered that ibuprofen, diclofenac and aspirin are not NSAIDs respectively. Regarding analgesic effect of NSAIDs, 97 (43.3%) of the pregnant women believed that NSAIDs are effective for treating pain. Acetaminophen was considered as the most effective treatment for pain by 84 (37.50%) of the patients. Conclusion: Acetaminophen is the most common analgesic that was taken by most pregnant women. The knowledge of pregnant women about NSAIDs is poor.
  6,844 1,046 10
Medication adherence and its determinants among patients on concomitant tuberculosis and antiretroviral therapy in South West Ethiopia
Abebe Kebede, Nasir Tajure Wabe
February 2012, 4(2):67-71
Background: To benefit from therapy and to avoid contracting treatment resistant strains, the individuals must adhere to medications. Aim : The study was designed to assess the degree of drug adherence and its determinants in patients living with HIV/AIDS and TB comorbidity. Materials and Methods: A cross-sectional study was conducted to assess the degree of drug adherence and its determinants with the help of self-administered questionnaires in Tercha District Hospital in South Ethiopia. Result : A total of 24 patients were included in the study. The majority were females (54.2%) and the mean age was 32.4 (SD±9.6) years. Adherence level was 95.8% for Antiretroviral (ARV) medications and 79.2% for anti TB medications. Educational status was associated with anti TB (P=0.021) medication adherence. The reason for the missed doses were mostly lack of money for transport (23.7% for antiretroviral therapy (ART), 26.0% for TB treatment) and forgetting to take medications (18.4% for ART, 17.4% for TB treatment. Conclusion: The adherence level obtained for both ARV and anti-TB where high. Transportation costs for patients could be reduced by bringing the services close to where they live.
  6,132 910 32
Prevalence and desire for body contouring surgery in postbariatric patients in Saudi Arabia
Saleh M Aldaqal, Osama A Samargandi, Basem S El-deek, Basim A Awan, Abdulrahman A Ashy, Ahmed A Kensarah
February 2012, 4(2):94-98
Background: Morbid obesity has become a common problem worldwide and as a result the demand for bariatric surgery has increased as well. Most patients develop skin redundancy and sagging at many body parts after major weight loss procedures which increased the demand for body contouring procedures. Aims : The study was to address the prevalence and patient's desire for body contouring procedures. Materials and Methods: A cross-sectional study targeting the postbariatric patients from April 2011 to October 2011 was conducted at our hospital. Questionnaire was administered in order to measure frequency and patients desire to undergo body contouring surgery after massive weight loss. Results: The total number of patients was 128 patients. The mean age of our patients was 37-year old (range 18-56 year). The percentage of the desire for body contouring surgery after bariatric surgery was 78.1%. There was very pronounced desire to body contouring surgery after those who underwent gastric bypass surgery with P-value 0.001. Only 18 patients (14%) have underwent body contouring surgery, with a total of 29 procedures, in which abdominoplasty considered the most commonly procedure performed (57%). Conclusion : With the increasing number of weight loss surgery, there is higher number of patients that desire a body contouring surgery, which create huge disparity between demand and accessibility.
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Vitamin E supplementation with Rauwolfia vomitoria root bark extract improves hematological indices
Akpanabiatu Monday Isaiah, Otitoju Olawale, Edet Emmanuel Effiong, Ndem Jessie Idongesit, Uwah Anthony Fidelis, Ufot Usenobong Friday
February 2012, 4(2):86-89
Background: Vitamin supplementation in Rauwolfia vomitoria root bark extract administration may interact and impact significantly on hematology of albino Wistar rats. Aim : In this investigation we studied vitamin E supplementation with Rauwolfia vomitoria root bark extract on the hematology of experimental animals. Materials and Methods: Forty two rats weighing 200 - 230 g were randomly selected into six groups of seven animals each. Group 1 animals serve as controls; group 2 received vitamin E (10 IU/kg body weight). Groups 3 and 4 were given the extract (150 and 300 mg/kg body weight) respectively. Groups 5 and 6 were given vitamin E (10 IU/kg body weight), the extract (150 and 300 mg/kg body weight) respectively. The extract and the vitamin were administered daily by oral intubation. Blood samples analyzed for hematological indices. Results : Decrease in white blood cell count (WBC) was observed, indicating improved immunity of animals. Extract at 150 and 300 mg/kg body weight with and without vitamin E affected hemoglobin and packed cell volume. Conclusion : Rauwolfia vomitoria with or without vitamin E improved animal's immunity and enhances their hematology. Interaction of vitamin E with the extract affects medicinal therapeutics of this plant.
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Unusual case of acute renal failure following multiple wasp stings
Niranjan M Rachaiah, Lokesh A Jayappagowda, Harsha B Siddabyrappa, Venkatesh K Bharath
February 2012, 4(2):104-106
The wasp stings usually cause local reactions and rarely anaphylaxis. However the multiple wasp stings may cause multisystem involvement. We report a case of acute renal failure (ARF) following multiple wasp stings. A middle aged healthy gentleman presented with pain and swelling of the upper part of the body following multiple wasp stings. After 2 days, he developed progressive decrease in urine output with high colored urine. Physical examination revealed the edematous and tender affected part. On investigating, it was found to have sequential elevations in renal function tests. The markers of muscle injury were grossly elevated and liver enzymes were deranged. These findings suggest multisystem involvement predominantly ARF secondary to rhabdomyolysis. With the initiation of the intense hemodialysis, all the above parameters became normal. Timely intervention of multiple wasp stings causing ARF with multiorgan involvement by hemodialysis not only prevents mortality but also other complications.
  3,960 372 5
Minimally invasive total knee arthroplasty: A comparative study to the standard approach
Naji Dabboussi, Mazen Sakr, Julien Girard, Riad Fakih
February 2012, 4(2):81-85
Background: Minimally invasive surgery has gained popularity over the past several years. Early results have shown better functional outcome with early recovery and rapid rehabilitation. Aim : Evaluation of the short-term clinical and functional outcome of minimally invasive surgery total knee arthroplasty (MIS-TKA) compared with the traditional total knee arthroplasty (TKA). Materials and Methods: During 2009, all cases scheduled for primary TKA through the modified mini-mid-vastus approach (MIS group) were studied. This group included 40 knees and was compared to a cohort control group of similar number of patients (40 knees) that underwent the procedure through the standard conventional technique (standard group). Results : Patients in the MIS group showed significant decrease in postoperative pain, blood loss in first 24 hours, and in hospital stay. Furthermore, they achieved motion considerably faster than the standard group with earlier return of quadriceps function and greater early flexion. Conclusion : This study proved that MIS-TPA has the ability to couple the benefits of less invasive surgical approach.
  3,656 536 11
Carotid artery intima media thickness as a surrogate marker of atherosclerosis in patient with chronic renal failure on hemodialysis
Jayanta Paul, Somnath Dasgupta, Mrinal Kanti Ghosh
February 2012, 4(2):77-80
Background: In patients with chronic renal failure (CRF), carotid artery intima media thickness (CAIMT) is increased when the patients are on hemodialysis. Vascular events caused by atherosclerosis are the major cause of death in patients undergoing hemodialysis. Aims: This study was done to find out the relationship between carotid artery intima media thickness and hemodialysis in chronic renal failure patients independent of classical risk factors and also the relationship between CAIMT of hemodialyzed patients and nonhemodialyzed CRF patients. Materials and Methods: In this observational study, CAIMT of 78 CRF patients was examined by B-mode ultrasonography. Glomerular filtration rate (GFR) was calculated by using the "Modification of Diet in Renal Disease" formula. CRF patients, who had been on regular hemodialysis treatment (treated thrice weekly) for at least 6 months, were identified as hemodialyzed patients. Data were analyzed by software Statistical package for the social Sciences (SPSS) (17 th version). Results: There was significant positive correlation between CAIMT and hemodialysis (P=0.045) independent of traditional risk factors. Hemodialyzed patients had higher mean CAIMT (1136.30±21.21 μm, P<0.001) than mean CAIMT of age and sex matched nondialyzed patients (959.30±23.01 μm). Conclusion: Hemodialysis is an independent risk factor for atherosclerosis in CRF patents. Hemodialyzed patients have significantly higher CAIMT than nondialyzed CRF patients.
  3,723 405 14
Drug-induced hepatotoxicity in a tertiary care hospital in Rural South India
Heethal Jaiprakash, Sarala Narayana, Jaiprakash Mohanraj
February 2012, 4(2):90-93
Background: Liver is the main organ for metabolism of drugs and hepatotoxicity is a potential adverse effect for most drugs. Aims: This study was to study the frequency of drug-induced hepatotoxicity and to find the common drugs causing hepatotoxicity. Materials and Methods: The study was conducted at a tertiary care hospital in rural India. It is a study based on case series analysis. All patients with an abnormal liver function report, between July 2006 and July 2007, were included in the study. Results : The study included 411 patients. Among them 141 patients were females and 270 males. The common cause for abnormal liver function was alcoholic liver disease (30.4%) followed by drug-induced hepatotoxicity (15.8%) and malaria (15.3%). Drug-induced hepatotoxicity was seen in 65 patients. It was common in males (55%) compared to females (44%). The mean age of the patients with drug-induced hepatotoxicity was 43±15.9. Antitubercular drugs were the commonly encountered drugs (44%) causing hepatotoxicity followed by lipid lowering agents (41%). The others drugs included antiretroviral drugs (6%),steroids (5%) and chlorpromazine (2%). Conclusion : A thorough history of drug intake must be taken in all patients presenting with abnormal hepatic function.
  3,430 407 7
Fashion or science? How can orthodox biomedicine explain the body's function and regulation?
Graham Wilfred Ewing, Igor Gennadyevich Grakov
February 2012, 4(2):57-61
The cost of diagnosing and treating disease continues to rise inexorably. Almost every new test adds to the complexity and cost of healthcare. There is a need for better and less expensive screening, diagnostic and scanning techniques. Medical scanning technologies are based upon the body's response to an external stimulus e.g. heat, ultrasound, X-rays, magnetic resonance, etc. Biomarker and histopathology tests have inherent limitations because diseases are often polygenic and/or influence the function of multiple physiological systems. The results are compared with expected norms. This makes it difficult to diagnose the onset of disease. Such techniques measure only what the clinician wants or expects to see. A technique which can provide more information, regarding the influence of a medical condition upon the body's whole function, may be invaluable to the clinician. There is not yet a clear understanding of how the body regulates its function. A greater understanding of how the body responds to sensory input, in particular to light, has been incorporated into a mathematical model of the physiological systems developed by I.G. Grakov. This has been incorporated into a cognitive technology which improves the understanding of how the body regulates its function and has led to the development of a better method for the diagnosis and treatment of disease(s). This technique, virtual scanning, appears able to diagnose at different levels of physiological significance i.e. as systems, organs, cells (as morphologies) and molecular (as pathologies). It may be a major scientific development, conceivably more advanced than biomarker techniques, with the potential to provide far more information about a patient's health. It may have the potential to significantly reduce the complexity and cost of healthcare. This article reviews the available literature.
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Early determination of human immunodeficiency virus status by routine voluntary counseling and testing in Benin City, Nigeria
Favour Osazuwa, John Osilume Dirisu, Patrick Evbaguehita Okuonghae
February 2012, 4(2):99-103
Background: To reduce the burden of human immunodeficiency virus (HIV), the popularization of voluntary counseling and testing (VCT) for early determination of human immunodeficiency virus status will be of immense benefit. Aim: To evaluate the uptake of voluntary counseling and testing and sero-prevalence of human immunodeficiency virus among status naïve outpatients and self-presenting VCT clients in Benin City, Nigeria. Materials and Methods: This study was carried out in the period of May 2010 to April 2011 at the University of Benin teaching hospital, Benin City. Subjects who consented were included and screened for HIV. Pre and post-test counseling was done following the world health organization guidelines. Results: Out of 10,533 subjects (7783 outpatients and 2750 self-presenting VCT clients) counseled for VCT, a total of 4651(44.2%) subjects; (3971(51.0%) outpatients and 680 (24.7%) self-presenting VCT clients), consented and accepted HIV VCT. Overall HIV prevalence was 6.4%. 270 (6.8%) outpatients and 29 (4.3%) self-presenting VCT clients were HIV positive. HIV was significantly associated with female gender among the outpatients (P<0.001). Conclusion: VCT uptake was low; the sero-prevalence of HIV was high. The need to employ an expanded and more purpose oriented public enlightenment campaign on the usefulness of HIV VCT should be a priority for HIV control agencies in our area.
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HIV and anemia among pregnant
Beuy Joob, Viroj Wiwanitkit
February 2012, 4(2):107-107
  2,244 318 -
Importance of reporting age-adjusted prevalence in epidemiological studies
Palanivel Chinnakali, Kapil Yadav, Arvind Kumar Singh
February 2012, 4(2):107-108
  2,100 274 3
Clinical highlights in the treatment of pancreatic diseases
Ĺke Andrén-Sandberg
February 2012, 4(2):62-66
Despite advances in the treatment of pancreatic diseases, they remain clinical challenges. In this review article, the author summarized the key abstracts presented at 9 th Congress of the European Hepato-Pancreato-Biliary Association, held in Cape Town, South Africa, from April 12 th to 16 th , 2011. These studies include the endoscopy, surgery, complications, and other clinical points of the pancreatic treatment.
  847 184 1