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  Citation statistics : Table of Contents
   2012| July  | Volume 4 | Issue 7  
    Online since July 17, 2012

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Diagnosis and management of gallbladder cancer
Ĺke Andrén-Sandberg
July 2012, 4(7):293-299
DOI:10.4103/1947-2714.98586  PMID:22866265
Gallbladder cancer (GBC) is a rather uncommon disease, but at the time when it gives symptoms it has usually reached no longer curable stage. Therefore, all attempts must be made to make the diagnosis earlier to have better opportunity for cure. The author searched PubMed, and reviewed literatures on diagnoses and treatment of GBC.
  32 2,948 353
Blood glucose control and medication adherence among adult type 2 diabetic Nigerians attending a primary care clinic in under-resourced environment of eastern Nigeria
Iloh GU Pascal, John N Ofoedu, Njoku P Uchenna, Amadi A Nkwa, Godswill-Uko E Uchamma
July 2012, 4(7):310-315
DOI:10.4103/1947-2714.98590  PMID:22866268
Background: Despite the evidence that goal blood glucose control reduces preventable emergency hospitalizations, the control of blood glucose has been variable in Nigeria. Aim: The study was designed to determine the blood glucose control and medication adherence among adult type 2 diabetic Nigerians attending a primary care clinic in under-resourced environment of Eastern Nigeria. Materials and Methods: A cross-sectional study was carried out on 120 adult type 2 diabetic patients who were on treatment for at least 3 months at the primary care clinic of Federal Medical Centre, Umuahia. A patient was said to have a goal blood glucose control if the fasting blood glucose was 70-130 mg/dL. Adherence was assessed in the previous 30 days using pretested, interviewer-administered questionnaire on self-reported therapy. Operationally, an adherent patient was one who scored 4 points in the previous 30 days. The reasons for non-adherence were documented. Results: The blood glucose control and medication adherence rates were 61.7% and 72.5%, respectively. Blood glucose control was significantly associated with adherence to treatment (P=0.025) and medication duration ≥3 years (P=0.045). The most common reason for non-adherence was financial constraints (P=0.033). Conclusion: Glycaemic control and medication adherence among the study population were good and should constitute logical targets for intervention.
  22 4,634 645
Antibiotic susceptibility patterns of uropathogens in obstetric patients
Ekadashi R Sabharwal
July 2012, 4(7):316-319
DOI:10.4103/1947-2714.98591  PMID:22866269
Background: Urinary tract infections (UTI) are the most commonly encountered infections in obstetric patients. Although a variety of etiology is involved, Escherichia coli and other coliforms account for a large majority of these naturally acquired infections. The estimation of local etiology and susceptibility profile could support the most effective empirical treatment. Aim: The current study was undertaken to find the spectrum of micro-organisms responsible for causing UTI in obstetric patients and to find out the most appropriate antibiotic. Materials and Methods: Consecutive patients in different stages of pregnancy with or without symptoms of UTI attending the antenatal clinic during November 2011 to March 2012 were screened for significant bacteriuria. The bacterial uropathogens isolated were then subjected to antimicrobial susceptibility testing and screened for ESBL production and methicillin resistance. Results: During the 5-month study period, out of the 250 samples screened, a total of 60 (24%) samples of urine from pregnant females, in different stages of pregnancy were found to be positive on culture. The Enterobacteriaceae accounted for nearly two-thirds of the isolates and E. coli alone accounted for 63% of the urinary isolates followed by Klebsiella pneumonia 8%. Among the Gram-positive cocci, coagulase-negative Staphylococcus (15%) were more frequently isolated than Staphylococcus aureus (8.3%). A significantly high resistance was noted to the beta-lactam group of antimicrobials, fluoroquinolones and cotrimoxazole, both by the Gram-negative bacilli as well as Gram-positive cocci. Resistance was quite low against the aminoglycosides and nitrofurantoin and virtually absent against imipenem. Conclusion: The susceptibility patterns seen in our study seem to suggest that it is absolutely necessary to obtain sensitivity reports before initiation of antibiotic therapy in cases of suspected UTI.
  18 3,835 651
The Glu727 allele of thyroid stimulating hormone receptor gene is associated with osteoporosis
Ren-De Liu, Rui-Xiong Chen, Wen-Rui Li, Yu-Liang Huang, Wen-Hu Li, Guang-Rong Cai, Heng Zhang
July 2012, 4(7):300-304
DOI:10.4103/1947-2714.98588  PMID:22866266
Background: Published data indicate that thyroid stimulating hormone receptor (TSHR) activities are associated with osteoporosis in some patients. Aim: This study aimed to elucidate whether a given polymorphism of the TSHR gene is associated with osteoporosis. Materials and Methods: One hundred and fifty subjects with osteoporosis were recruited in this study. The diagnosis of osteoporosis was performed with quantitative ultrasound system. The TSHR gene polymorphism was examined by polymerase chain reaction-restriction fragment length polymorphism. Results: The results showed a nucleotide substitution in the first position of codon 36 of the TSHR gene. The nucleotide substitution was from G to C, leading to a 36 D → 36 H change (D36H) in the predicted amino acid sequence of the receptor. The change did not show significance between healthy subjects and patients with osteoporosis (P > 0.05). On the other hand, we identified another single nucleotide polymorphism that is a C-to-G substitution at codon 727 (GAC to GAG); its frequency was significantly higher in patients with osteoporosis than that in healthy subjects. Using logistic regression analysis, significant correlation was revealed between the genotype D727E and the serum levels of TSH, or the quantitative ultrasound value of the calcaneal bone. Conclusions: The present study suggests that the genotype D727E of the TSHR, but not the genotype D36H, may be a genetic risk factor for osteoporosis.
  8 3,242 378
Cyanoacrylate glue dressing for hypospadias surgery
Seyed Mohammad Vahid Hosseini, Ahmad Reza Rasekhi, Mohammad Zarenezhad, Arya Hedjazi
July 2012, 4(7):320-322
DOI:10.4103/1947-2714.98593  PMID:22866270
Background: Hypospadias repair is a common pediatric operation. Several kinds of dressings are currently available, with their benefits and side effects. Aim: The aim of our study was to introduce a new method of dressing, by pouring several layers of cyanoacrylate (CA) glue as the dressing, in hypospadias surgery. Materials and Methods: Twenty out of the 61 patients with hypospadias, with a mean age of 13.5 months, were enrolled in this study. Forty-one had conventional dressing (pressure wrap dressing), while CA glue was used in 20 patients. CA glue was applied around the penis and its base four times and each time it took one minute to dry. All patients were followed postoperatively for two weeks and six to twelve months, for early and late complications, respectively. Results: One out of 20 developed wound hematoma, one had skin necrosis with infection, and edema was present in all. All these were easily diagnosed and managed rapidly. In the group treated with conventional methods, there were five infections, seven hematomas, all the patients in the group had edema and painful removal of the dressing, and 10 needed repeat dressing. Conclusions: CA glue is impermeable to urine and stool, and prevents edema and hematoma. Used in several layers, it is a good alternative dressing in hypospadias surgery.
  7 4,783 398
Hidden diagnosis in the subglottic larynx: Schwannoma mimicking as bronchial asthma
Fayaz A Sofi, Mohmad Hussain Mir, Farhana S Bagdadi, Khalid Mehmood
July 2012, 4(7):325-327
DOI:10.4103/1947-2714.98596  PMID:22866272
Schwannomas are rare neurogenic tumors derived from the schwann cells. Their laryngeal location is uncommon and the diagnosis is difficult. We report a case of a 17-year-old female who presented with symptoms of intermittent breathlessness mimicking acute attacks of bronchial asthma and resulted in delayed diagnosis, which lead to upper airway obstruction and an emergency tracheostomy. Computed tomography (CT) of neck revealed a soft-tissue mass within the subglottic region. Surgical excision of the growth was done by laryngofissure technique. Histopathological examination of the tumor revealed it to be a schawanoma. The subglottic occurrence of schwannoma is very rare. Case history and detailed clinical examination are important and will guide for relevant investigations and help to reach at a definitive diagnosis.
  4 2,693 289
Prevalence of malnutrition among the mising children of Northeast India: A comparison between four different sets of criteria
Mithun Sikdar
July 2012, 4(7):305-309
DOI:10.4103/1947-2714.98589  PMID:22866267
Background: Prevalence of malnutrition among the children from developing countries has reached unprecedented level which can be evaluated by body mass index. Aim: This study was designed to determine the prevalence of malnutrition among the Mising children of Northeast India using four different sets of Body Mass Index references. Materials and Methods: A cross-sectional study was performed on a population representative sample of 511 Mising children. Four different sets of Body Mass Index reference were used to define thinness as well as overweight cases. Results: With the use of different references the prevalence of thinness varies from 17.18% to 27.73% among the boys and from 19.21% to 28.23% among the girls. On the other hand the prevalence of overweight varies from 1.95% to 7.81% among the boys and 1.96% to 9.41% among the girls. Reference based on United States (1971-74) survey detects sex difference in overweight. The calculated kappa values indicated a fair to almost perfect agreement between various references. Conclusion: Considerable prevalence of overweight despite a persistently high burden of thinness suggests existence of nutrition transition among the Mising population. Prevalence of malnutrition differs with the application of different references which warrants application of international references carefully for any potential misclassification of children.
  4 3,124 399
Type 3B malrotation presented with acute appendicitis as left renal colic
Fuat Ozkan, Nursel Yurttutan, Mehmet Fatih Inci, Erhan Akpinar
July 2012, 4(7):328-330
DOI:10.4103/1947-2714.98597  PMID:22866273
Midgut malrotation is a rare anatomic anomaly that complicates the diagnosis and managemant of acute abdominal pain. It is a congenital anomaly that arises from incomplete rotation or abnormal position of the midgut during embryonic development. We report a case of a patient who have very rare form (Nonrotation of the proximal loop associated with partial rotation of the distal loop) of malrotation with ruptured appendicitis. Left-sided acute appendicitis should be considered in the differential diagnosis of patients with pain with localized in the left lower quadrant.
  3 3,434 276
Applications of cyanoacrylate glue in pediatric urology
Mirko Bertozzi, Antonino Appignani
July 2012, 4(7):323-324
  - 2,005 198