O. Olopade, I. Odeniyi, O. Fasanmade, B. Olopade, Oluwatosin O. Kayode, A. Anyanwu, P. Chimah
Background: Medical nutrition therapy is an important aspect of managing diabetes mellitus (DM). Foods with low glycemic index are encouraged in individuals with DM. Despite the good glycemic indices associated with beans, glycemic responses of bean meals in persons with DM is unknown. The aim of this study is to determine whether there are differences in the glycemic responses of local beans (Vigna unguiculata [Linn Walp] varieties) in persons with Type 2 DM (T2DM) and healthy controls. Methods: This was an experimental study done at Lagos University Teaching Hospital over 12 weeks. Twelve consenting T2DM persons and 12 healthy controls participated in this study. Peak plasma glucose (PPG), the maximum increase in plasma glucose (MIPG), 2-h postprandial glucose (2HPPG), and incremental area under glucose curve (IAUGC) of three different varieties (V. unguiculata [Linn Walp] varieties) “oloyin,” “drum” and “sokoto white” were measured. Results: Among healthy participants “Oloyin” bean meal had the lowest values of PPG, MIPG, and IAUGC, while “drum” bean meal had the highest values of MIPG and IAUGC (P = 0.039). Among persons with DM, “Oloyin” bean meal had the highest 2HPPG, PPG but lowest MIPG values when compared with other bean meals while “drum” bean meal had the highest MIPG and IAUGC with the lowest 2HPPG of the three-bean meals. Conclusion: There were differences in the glycaemic responses of V. unguiculata (Linn Walp) varieties studied in persons with T2DM and controls. Glycaemic responses, in addition to glycemic indices of meals, should be considered in the management of persons with DM.
{"title":"Glycemic responses of local beans (Vigna unguiculata [Linn Walp] varieties) in persons with Type 2 diabetes mellitus and healthy controls - An experimental study","authors":"O. Olopade, I. Odeniyi, O. Fasanmade, B. Olopade, Oluwatosin O. Kayode, A. Anyanwu, P. Chimah","doi":"10.4103/jcls.jcls_61_19","DOIUrl":"https://doi.org/10.4103/jcls.jcls_61_19","url":null,"abstract":"Background: Medical nutrition therapy is an important aspect of managing diabetes mellitus (DM). Foods with low glycemic index are encouraged in individuals with DM. Despite the good glycemic indices associated with beans, glycemic responses of bean meals in persons with DM is unknown. The aim of this study is to determine whether there are differences in the glycemic responses of local beans (Vigna unguiculata [Linn Walp] varieties) in persons with Type 2 DM (T2DM) and healthy controls. Methods: This was an experimental study done at Lagos University Teaching Hospital over 12 weeks. Twelve consenting T2DM persons and 12 healthy controls participated in this study. Peak plasma glucose (PPG), the maximum increase in plasma glucose (MIPG), 2-h postprandial glucose (2HPPG), and incremental area under glucose curve (IAUGC) of three different varieties (V. unguiculata [Linn Walp] varieties) “oloyin,” “drum” and “sokoto white” were measured. Results: Among healthy participants “Oloyin” bean meal had the lowest values of PPG, MIPG, and IAUGC, while “drum” bean meal had the highest values of MIPG and IAUGC (P = 0.039). Among persons with DM, “Oloyin” bean meal had the highest 2HPPG, PPG but lowest MIPG values when compared with other bean meals while “drum” bean meal had the highest MIPG and IAUGC with the lowest 2HPPG of the three-bean meals. Conclusion: There were differences in the glycaemic responses of V. unguiculata (Linn Walp) varieties studied in persons with T2DM and controls. Glycaemic responses, in addition to glycemic indices of meals, should be considered in the management of persons with DM.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82046996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Estimation of the serum pH and base excess as determinants of the adequacy of resuscitation may predict the patient outcome in peritonitis. Materials, Patients and Methods: This was a prospective study conducted in University College Hospital, Ibadan, on patients from 18 years and above with diagnosis of secondary peritonitis who had exploratory laparotomy over a 4-month period (January to April 2017). The patients' biodata, pulse rate, blood pressure, and clinical diagnosis were documented. At presentation, the patients were resuscitated with intravenous normal saline and broad-spectrum antibiotics. Each patient had measurements of acid-base status, and pH analyzed at presentation and in the immediate postoperative period (within 1 h) using the I-STAT point of care device. They were followed up for 48 h after the surgery. The changes in base excess and serum pH in survivors and nonsurvivors were described at 48 h after surgery. This was statistically compared using SPSS version 20 (Chicago, IL, USA). Results: A total of 45 patients were recruited comprising 37 males and 8 female patients. The mean age was 40.86 ± 15.45 years. The mean admission base excess was −4.76 ± 5.41. The mean admission pH was 7.41 ± 0.07. There were 28 (62%) survivors and 17 (38%) mortalities. The pH on admission and base excess values and after surgery demonstrated statistical significance in survivors and nonsurvivors. Conclusion: Changes in base excess and serum pH values are plausible outcome markers in patients with peritonitis resuscitated with early goal-directed therapy.
背景:估计血清pH值和碱性过剩作为复苏充分性的决定因素，可以预测腹膜炎患者的预后。材料、患者和方法:这是一项在伊巴丹大学学院医院进行的前瞻性研究，研究对象为18岁及以上诊断为继发性腹膜炎的患者，他们在4个月的时间内(2017年1月至4月)进行了剖腹探查。记录患者的生物资料、脉搏率、血压和临床诊断。入院时，给予静脉生理盐水和广谱抗生素复苏。使用I-STAT护理点装置测量每位患者在就诊时和术后1小时内的酸碱状态和pH值。术后随访48小时。在手术后48小时描述幸存者和非幸存者的碱基过量和血清pH的变化。使用SPSS version 20 (Chicago, IL, USA)进行统计比较。结果:共纳入45例患者，其中男37例，女8例。平均年龄40.86±15.45岁。平均入院基准超额为- 4.76±5.41。平均入院pH为7.41±0.07。幸存者28例(62%)，死亡17例(38%)。入院时和手术后的pH值在幸存者和非幸存者中具有统计学意义。结论:碱过量和血清pH值的变化可能是腹膜炎患者早期目标导向治疗复苏的预后指标。
{"title":"Base excess and pH as predictors of outcomes in secondary peritonitis in a resource limited setting - A prospective study","authors":"O. Afuwape, O. Ayandipo, Samuel Aroso","doi":"10.4103/jcls.jcls_18_20","DOIUrl":"https://doi.org/10.4103/jcls.jcls_18_20","url":null,"abstract":"Background: Estimation of the serum pH and base excess as determinants of the adequacy of resuscitation may predict the patient outcome in peritonitis. Materials, Patients and Methods: This was a prospective study conducted in University College Hospital, Ibadan, on patients from 18 years and above with diagnosis of secondary peritonitis who had exploratory laparotomy over a 4-month period (January to April 2017). The patients' biodata, pulse rate, blood pressure, and clinical diagnosis were documented. At presentation, the patients were resuscitated with intravenous normal saline and broad-spectrum antibiotics. Each patient had measurements of acid-base status, and pH analyzed at presentation and in the immediate postoperative period (within 1 h) using the I-STAT point of care device. They were followed up for 48 h after the surgery. The changes in base excess and serum pH in survivors and nonsurvivors were described at 48 h after surgery. This was statistically compared using SPSS version 20 (Chicago, IL, USA). Results: A total of 45 patients were recruited comprising 37 males and 8 female patients. The mean age was 40.86 ± 15.45 years. The mean admission base excess was −4.76 ± 5.41. The mean admission pH was 7.41 ± 0.07. There were 28 (62%) survivors and 17 (38%) mortalities. The pH on admission and base excess values and after surgery demonstrated statistical significance in survivors and nonsurvivors. Conclusion: Changes in base excess and serum pH values are plausible outcome markers in patients with peritonitis resuscitated with early goal-directed therapy.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82319785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"COVID-19 pandemic in Nigeria: A case study of Kano State – Challenges and lessons learned","authors":"O. Odukoya, U. Omeje","doi":"10.4103/jcls.jcls_73_20","DOIUrl":"https://doi.org/10.4103/jcls.jcls_73_20","url":null,"abstract":"","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75754648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The objective was to examine the oral hygiene, gingival, and periodontal status among smokers and to relate them with nicotine dependence. Methods: The cross-sectional study was carried out among smokers and nonsmokers in Benin-City, Edo State. Data collection was done through questionnaire and oral examination. The indices applied were Fagerstrom test, Simplified Oral Hygiene Index (OHI-S), Gingival Index (GI), Community Periodontal Index, and tooth mobility index. Results: A total of 40 (20 smokers and 20 nonsmokers) persons participated in the study. The mean OHI-S for smokers was 2.87 ± 0.92 while that of nonsmoker was 2.20 ± 0.73 and this was statistically significant (P = 0.015). The mean GI for smokers was 1.04 ± 0.36 while that of nonsmoker was 0.80 ± 0.22 and this was statistically significant (P = 0.018). The mean number of mobile teeth for smokers was 0.15 ± 0.49 while that of nonsmoker was. 00 ± 0.00 and this was not statistically significant (P = 0.178). One-quarter (25%) of smokers had score 3 and 4 while only 5% of nonsmokers had were found Shallow and deep pockets were found score 3 and 4. About half (45.0%) of the smokers had low-moderate nicotine dependency among the smokers revealed that. Participants with higher nicotine dependence had nonsignificantly poorer oral hygiene, gingival, and periodontal status than their counterparts. Conclusion: Smokers generally had poorer oral hygiene, gingival, and periodontal status as compared to the nonsmokers. Smokers with higher nicotine dependence did not have poorer oral hygiene, gingival, and periodontal status than their counterparts.
{"title":"Relating oral hygiene, gingival, and periodontal status with nicotine dependence among smokers - A cross-sectional study","authors":"Chibuzor Boi-Ukeme, C. Azodo","doi":"10.4103/jcls.jcls_35_19","DOIUrl":"https://doi.org/10.4103/jcls.jcls_35_19","url":null,"abstract":"Background: The objective was to examine the oral hygiene, gingival, and periodontal status among smokers and to relate them with nicotine dependence. Methods: The cross-sectional study was carried out among smokers and nonsmokers in Benin-City, Edo State. Data collection was done through questionnaire and oral examination. The indices applied were Fagerstrom test, Simplified Oral Hygiene Index (OHI-S), Gingival Index (GI), Community Periodontal Index, and tooth mobility index. Results: A total of 40 (20 smokers and 20 nonsmokers) persons participated in the study. The mean OHI-S for smokers was 2.87 ± 0.92 while that of nonsmoker was 2.20 ± 0.73 and this was statistically significant (P = 0.015). The mean GI for smokers was 1.04 ± 0.36 while that of nonsmoker was 0.80 ± 0.22 and this was statistically significant (P = 0.018). The mean number of mobile teeth for smokers was 0.15 ± 0.49 while that of nonsmoker was. 00 ± 0.00 and this was not statistically significant (P = 0.178). One-quarter (25%) of smokers had score 3 and 4 while only 5% of nonsmokers had were found Shallow and deep pockets were found score 3 and 4. About half (45.0%) of the smokers had low-moderate nicotine dependency among the smokers revealed that. Participants with higher nicotine dependence had nonsignificantly poorer oral hygiene, gingival, and periodontal status than their counterparts. Conclusion: Smokers generally had poorer oral hygiene, gingival, and periodontal status as compared to the nonsmokers. Smokers with higher nicotine dependence did not have poorer oral hygiene, gingival, and periodontal status than their counterparts.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73418249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Return to work during the epidemic – Implications for surgical care: Caution is the word","authors":"A. Ademuyiwa","doi":"10.4103/jcls.jcls_53_20","DOIUrl":"https://doi.org/10.4103/jcls.jcls_53_20","url":null,"abstract":"","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79237240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Our aim was to study the clinical characteristics and predictors of mortality in heart failure (HF) with diuretic resistance. Methods: We conducted a 5-year retrospective study on 119 HF patients with diuretic resistance at Tikur Anbessa Specialized Teaching Hospital. The primary endpoint was mortality. We compared baseline characteristics and assessed association in patients who received high-dose (≥120 mg) versus low-dose (<120 mg) furosemide. Bivariate and multivariate logistic regression analyses were done. Results: Patients receiving high-dose diuretic had significantly higher mean values for age and in New York Heart Association Class IV HF and received a larger dose of hydrochlorothiazide than low-dose patients. They also had significantly higher mean values for systolic blood pressure (SBP), hemoglobin, and serum creatinine. There was no significant difference in mortality between the two groups. On multivariate analysis, association with the high-dose diuretic group remained significant for the higher mean value for SBP and serum creatinine. Independent predictors of mortality were anemia (adjusted odds ratio [AOR]: 4.1, 95% confidence interval [CI]: 1.1–15.2, P = 0.04), infective endocarditis (AOR: 4.9, 95% CI: 2.1–25.7, P = 0.01), and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) (AOR: 3.1, 95% CI: 1.1–9.9, P = 0.04). The use of digoxin was associated with lower mortality (AOR: 0.21, 95% CI: 0.06–0.78, P = 0.01). Conclusions: In HF patients with diuretic resistance, anemia, infective endocarditis, and the use of NSAIDs were independently associated with increased mortality, whereas the use of digoxin was associated with reduced mortality. Early identification and treatment of the risk factors could play a role in reducing mortality.
背景:我们的目的是研究伴有利尿剂抵抗的心力衰竭(HF)的临床特征和死亡率预测因素。方法:对在提库尔安贝萨专科教学医院就诊的119例心衰利尿剂耐药患者进行5年回顾性研究。主要终点是死亡率。我们比较了高剂量(≥120mg)和低剂量(< 120mg)呋塞米患者的基线特征和相关性。进行了双变量和多变量logistic回归分析。结果:接受高剂量利尿剂治疗的患者年龄和纽约心脏协会IV级HF的平均值明显高于接受低剂量氢氯噻嗪治疗的患者。他们的收缩压(SBP)、血红蛋白和血清肌酐的平均值也明显较高。两组患者的死亡率无显著差异。在多变量分析中，与高剂量利尿剂组相关的收缩压和血清肌酐的平均值较高。死亡率的独立预测因素为贫血(校正优势比[AOR]: 4.1, 95%可信区间[CI]: 1.1-15.2, P = 0.04)、感染性心内膜炎(AOR: 4.9, 95% CI: 2.1-25.7, P = 0.01)和使用非甾体类抗炎药(AOR: 3.1, 95% CI: 1.1-9.9, P = 0.04)。地高辛的使用与较低的死亡率相关(AOR: 0.21, 95% CI: 0.06-0.78, P = 0.01)。结论:伴有利尿剂抵抗、贫血、感染性心内膜炎和使用非甾体抗炎药的心衰患者与死亡率增加独立相关，而地高辛的使用与死亡率降低相关。早期发现和治疗危险因素可以在降低死亡率方面发挥作用。
{"title":"Diuretic resistance in patients with heart failure: Clinical characteristics and predictors of outcome","authors":"Mesfin Tasew, T. Aklilu, S. Abdissa","doi":"10.4103/jcls.jcls_1_20","DOIUrl":"https://doi.org/10.4103/jcls.jcls_1_20","url":null,"abstract":"Background: Our aim was to study the clinical characteristics and predictors of mortality in heart failure (HF) with diuretic resistance. Methods: We conducted a 5-year retrospective study on 119 HF patients with diuretic resistance at Tikur Anbessa Specialized Teaching Hospital. The primary endpoint was mortality. We compared baseline characteristics and assessed association in patients who received high-dose (≥120 mg) versus low-dose (<120 mg) furosemide. Bivariate and multivariate logistic regression analyses were done. Results: Patients receiving high-dose diuretic had significantly higher mean values for age and in New York Heart Association Class IV HF and received a larger dose of hydrochlorothiazide than low-dose patients. They also had significantly higher mean values for systolic blood pressure (SBP), hemoglobin, and serum creatinine. There was no significant difference in mortality between the two groups. On multivariate analysis, association with the high-dose diuretic group remained significant for the higher mean value for SBP and serum creatinine. Independent predictors of mortality were anemia (adjusted odds ratio [AOR]: 4.1, 95% confidence interval [CI]: 1.1–15.2, P = 0.04), infective endocarditis (AOR: 4.9, 95% CI: 2.1–25.7, P = 0.01), and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) (AOR: 3.1, 95% CI: 1.1–9.9, P = 0.04). The use of digoxin was associated with lower mortality (AOR: 0.21, 95% CI: 0.06–0.78, P = 0.01). Conclusions: In HF patients with diuretic resistance, anemia, infective endocarditis, and the use of NSAIDs were independently associated with increased mortality, whereas the use of digoxin was associated with reduced mortality. Early identification and treatment of the risk factors could play a role in reducing mortality.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85760523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: Laryngopharyngeal reflux (LPR) is the retrograde flow of gastric content to the larynx and pharynx where these materials come in contact to the upper aerodigestive tract. This clinical entity is less studied among the pediatric population. The objective of this study is to evaluate the impact of LPR in the pediatric population. Materials and Methods: This retrospective study was done in between December 2016 and January 2019. Clinical data such as associated symptoms, endoscopic findings, laboratory testing, therapeutic interventions, and outcome were analyzed. Endoscopic findings were considered to be consistent with LPR in the pediatric age included: Lingual tonsil hypertrophy, postglottic edema, true vocal fold edema and congested and swollen arytenoids, congested inter-arytenoids area. Results: There were 212 children evaluated for dysphonia. There were 38 girls (52.77) and 34 boys (47.22%), and mean age at presentation was 9.32 years with a male-to-female ratio of 0.89:1. Out of 212 children who underwent endoscopy, 72 had shown LPR disease. Five children (6.94%) showed vocal nodules, 3 (4.16%) showed vocal fold cyst, and 2 (2.77%) children showed subglottic edema along with LPR. All the children were treated with anti-reflux measures. By second follow-up visit on 1 month, 68 children (94.44%) had improved symptomatically. Conclusion: LPR appears to cause laryngeal manifestations more commonly in children. In this study, all the children were presenting dysphonia, intermittent cough, foreign-body sensation in throat, and throat-clearing habit. All of them showing congested arytenoids and inter-arytenoid membrane. Early diagnosis and treatment often result in the improvement of hoarseness of voice and prevent complications. LPR in the pediatric population is almost a new diagnosis.
{"title":"Experience with the management of pediatric laryngopharyngeal reflux in an Indian teaching hospital","authors":"S. Swain, Jasashree Choudhury","doi":"10.4103/jcls.jcls_38_19","DOIUrl":"https://doi.org/10.4103/jcls.jcls_38_19","url":null,"abstract":"Aim: Laryngopharyngeal reflux (LPR) is the retrograde flow of gastric content to the larynx and pharynx where these materials come in contact to the upper aerodigestive tract. This clinical entity is less studied among the pediatric population. The objective of this study is to evaluate the impact of LPR in the pediatric population. Materials and Methods: This retrospective study was done in between December 2016 and January 2019. Clinical data such as associated symptoms, endoscopic findings, laboratory testing, therapeutic interventions, and outcome were analyzed. Endoscopic findings were considered to be consistent with LPR in the pediatric age included: Lingual tonsil hypertrophy, postglottic edema, true vocal fold edema and congested and swollen arytenoids, congested inter-arytenoids area. Results: There were 212 children evaluated for dysphonia. There were 38 girls (52.77) and 34 boys (47.22%), and mean age at presentation was 9.32 years with a male-to-female ratio of 0.89:1. Out of 212 children who underwent endoscopy, 72 had shown LPR disease. Five children (6.94%) showed vocal nodules, 3 (4.16%) showed vocal fold cyst, and 2 (2.77%) children showed subglottic edema along with LPR. All the children were treated with anti-reflux measures. By second follow-up visit on 1 month, 68 children (94.44%) had improved symptomatically. Conclusion: LPR appears to cause laryngeal manifestations more commonly in children. In this study, all the children were presenting dysphonia, intermittent cough, foreign-body sensation in throat, and throat-clearing habit. All of them showing congested arytenoids and inter-arytenoid membrane. Early diagnosis and treatment often result in the improvement of hoarseness of voice and prevent complications. LPR in the pediatric population is almost a new diagnosis.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73750318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The appendix is a vestigial tube-like organ. Its exact physiological function is unknown. Appendectomies are done usually following a clinical diagnosis of acute appendicitis. Neoplasms can arise from this organ as well. Carcinoids are the most common neoplasms arising commonly at the tips. This retrospective review of neoplasms of the appendix was aimed at identifying the incidence and describing the histological variants of neoplasms of the appendix in our environment. Materials and Methods: This study was a 10-year retrospective review of all appendectomy specimens submitted to the Department of Pathology, University College Hospital, Ibadan, Nigeria, from January 1, 2009, to December 31, 2018. Microscopy was done examining the longitudinal sections from the tip to the base of the appendix. The histological diagnosis was extracted from the records in the department and classified using the WHO classification of tumors of the appendix (2019). Patients' biodata such as age and sex were also extracted. The data were analyzed for frequency distribution using SPSS 23. Results: The incidence of neoplasms in the appendix was 0.84% of the 1071 appendectomies received in our department over the study period. Low-grade appendiceal mucinous neoplasm (LAMN) was the most common histological variant accounting for 55.5% of neoplasms, followed by metastatic carcinoma at 22.2% and carcinoids at 11.1%. There was a female preponderance of 77.8%. Conclusion: Neoplasms of the appendix are rare in our environment, and LAMN was the most common neoplasm of the appendix in our institution. There is a female preponderance among patients with appendiceal neoplasms.
{"title":"Neoplasms of the appendix: An experience of a tertiary hospital in Southwestern Nigeria","authors":"M. Ajani, S. Omenai, O. Iyapo","doi":"10.4103/jcls.jcls_19_20","DOIUrl":"https://doi.org/10.4103/jcls.jcls_19_20","url":null,"abstract":"Background: The appendix is a vestigial tube-like organ. Its exact physiological function is unknown. Appendectomies are done usually following a clinical diagnosis of acute appendicitis. Neoplasms can arise from this organ as well. Carcinoids are the most common neoplasms arising commonly at the tips. This retrospective review of neoplasms of the appendix was aimed at identifying the incidence and describing the histological variants of neoplasms of the appendix in our environment. Materials and Methods: This study was a 10-year retrospective review of all appendectomy specimens submitted to the Department of Pathology, University College Hospital, Ibadan, Nigeria, from January 1, 2009, to December 31, 2018. Microscopy was done examining the longitudinal sections from the tip to the base of the appendix. The histological diagnosis was extracted from the records in the department and classified using the WHO classification of tumors of the appendix (2019). Patients' biodata such as age and sex were also extracted. The data were analyzed for frequency distribution using SPSS 23. Results: The incidence of neoplasms in the appendix was 0.84% of the 1071 appendectomies received in our department over the study period. Low-grade appendiceal mucinous neoplasm (LAMN) was the most common histological variant accounting for 55.5% of neoplasms, followed by metastatic carcinoma at 22.2% and carcinoids at 11.1%. There was a female preponderance of 77.8%. Conclusion: Neoplasms of the appendix are rare in our environment, and LAMN was the most common neoplasm of the appendix in our institution. There is a female preponderance among patients with appendiceal neoplasms.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78404173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Enteric fever, which is endemic in India, is a significant cause for morbidity, particularly among young children. Enteric fever is associated with high fever, abdominal pain, diarrhea, and splenomegaly. Recently, there have been increasing reports of enteric fever due to Salmonella enterica serovar Paratyphi A and multidrug resistance among Salmonella species. Objectives: The objective of this study was to know the relative occurrence of Salmonella Typhi and Salmonella Paratyphi A from blood cultures of enteric fever cases, to study the sensitivity pattern of Salmonella species isolated, to compare the clinical profiles in typhoid and paratyphoid fever, and to know their treatment outcome. Materials and Methods: It was a prospective hospital-based cross-sectional study. The demographic, clinical, and laboratory data were recorded for all cases included in the study. All clinically suspected cases of enteric fever were confirmed by blood culture and/or the Widal test. Antibiotic sensitivity was tested by the Kirby–Bauer disc diffusion method. Results were analyzed using SPSS version 21. Results: One hundred and nineteen cases were confirmed enteric fever. Their clinical profile is discussed. Out of 119 cases, 24 showed blood culture positivity. Salmonella Paratyphi A and Salmonella Typhi were isolated in the ratio of 3:1. The isolates were sensitive to ampicillin, co-trimoxazole, ceftriaxone, and azithromycin. Ceftriaxone was the most commonly used antibiotic for treatment. All patients recovered, and no mortality was encountered. Complications were seen in 33 children (27.7%), which included subclinical hepatitis, bronchitis, and pneumonia. Conclusion: Considering the blood culture results, enteric fever due to S. Paratyphi A was more common in our study. Multidrug resistance was not seen among Salmonella species. The duration of illness and complications were more with typhoid than paratyphoid cases.
导言:肠热病是印度的一种地方病，是发病的重要原因，特别是在幼儿中。肠热伴有高热、腹痛、腹泻和脾肿大。最近，有越来越多的报告，由于肠炎沙门氏菌血清型副伤寒和多种沙门氏菌耐药引起的肠热。目的:了解伤寒和副伤寒沙门氏菌在肠热患者血培养中的相对发生率，研究分离沙门氏菌的敏感性，比较伤寒和副伤寒的临床特点，了解其治疗效果。材料和方法:这是一项前瞻性的以医院为基础的横断面研究。记录研究中所有病例的人口学、临床和实验室数据。所有临床疑似肠热病例均经血培养和/或维达尔试验证实。采用Kirby-Bauer圆盘扩散法检测抗生素敏感性。使用SPSS version 21对结果进行分析。结果:确诊肠热119例。讨论了他们的临床表现。119例中，24例血培养阳性。甲型副伤寒沙门菌和伤寒沙门菌的分离比例为3:1。该菌株对氨苄西林、复方新诺明、头孢曲松和阿奇霉素敏感。头孢曲松是最常用的抗生素。所有患者均康复，无死亡病例。并发症33例(27.7%)，包括亚临床肝炎、支气管炎和肺炎。结论:从血培养结果来看，副伤寒沙门氏菌引起的肠热在本研究中更为常见。沙门氏菌未见多药耐药。伤寒病例的病程和并发症多于副伤寒病例。
{"title":"Clinical and microbiological profile of enteric fever among pediatric patients in a tertiary care center in South India: A cross-sectional study","authors":"A. Malini, C. Barathy, N. Madhusudan, C. Johnson","doi":"10.4103/jcls.jcls_17_20","DOIUrl":"https://doi.org/10.4103/jcls.jcls_17_20","url":null,"abstract":"Introduction: Enteric fever, which is endemic in India, is a significant cause for morbidity, particularly among young children. Enteric fever is associated with high fever, abdominal pain, diarrhea, and splenomegaly. Recently, there have been increasing reports of enteric fever due to Salmonella enterica serovar Paratyphi A and multidrug resistance among Salmonella species. Objectives: The objective of this study was to know the relative occurrence of Salmonella Typhi and Salmonella Paratyphi A from blood cultures of enteric fever cases, to study the sensitivity pattern of Salmonella species isolated, to compare the clinical profiles in typhoid and paratyphoid fever, and to know their treatment outcome. Materials and Methods: It was a prospective hospital-based cross-sectional study. The demographic, clinical, and laboratory data were recorded for all cases included in the study. All clinically suspected cases of enteric fever were confirmed by blood culture and/or the Widal test. Antibiotic sensitivity was tested by the Kirby–Bauer disc diffusion method. Results were analyzed using SPSS version 21. Results: One hundred and nineteen cases were confirmed enteric fever. Their clinical profile is discussed. Out of 119 cases, 24 showed blood culture positivity. Salmonella Paratyphi A and Salmonella Typhi were isolated in the ratio of 3:1. The isolates were sensitive to ampicillin, co-trimoxazole, ceftriaxone, and azithromycin. Ceftriaxone was the most commonly used antibiotic for treatment. All patients recovered, and no mortality was encountered. Complications were seen in 33 children (27.7%), which included subclinical hepatitis, bronchitis, and pneumonia. Conclusion: Considering the blood culture results, enteric fever due to S. Paratyphi A was more common in our study. Multidrug resistance was not seen among Salmonella species. The duration of illness and complications were more with typhoid than paratyphoid cases.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79398600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Multiple bee stings are associated with intravascular hemolysis (IVH), rhabdomyolysis, hypotension, renal tubule injury, and all causing acute kidney injury. Evidence in support of hemolysis includes anemia, hyperbilirubinemia, hemoglobinemia, hemoglobinuria, low haptoglobin (Hp) levels, elevated lactate dehydrogenase, and Coomb's test (if antibody mediated). However, under certain circumstances, hemoglobinemia and hemoglobinuria may be the only evidence of IVH depending on the etiological factors in association with the environment inside the body. Bee venom is known to have deleterious actions on different tissue types (neurotoxin, muscle paralytic, hematotoxic, epithelial damage, etc.). Altogether, they determine the outcome and presentation. Apart from this, there are several conditions that determine the binding of oxygen and Hp to hemoglobin (Hb). Arterial blood gases (ABGs) play a very important role in this. Hence, it is important for the pathologists to have an understanding of ABG as well to know how even simple tests (Hb, bilirubin, and Hp) can get affected by them. We describe one such occurrence in a patient with multiple hornet bee stings and formulate the likely causes and pathogenesis.
{"title":"An interesting story of intravascular hemolysis but normal haptoglobin and bilirubin levels","authors":"Kriti Chauhan, N. Shandilya","doi":"10.4103/jcls.jcls_76_19","DOIUrl":"https://doi.org/10.4103/jcls.jcls_76_19","url":null,"abstract":"Multiple bee stings are associated with intravascular hemolysis (IVH), rhabdomyolysis, hypotension, renal tubule injury, and all causing acute kidney injury. Evidence in support of hemolysis includes anemia, hyperbilirubinemia, hemoglobinemia, hemoglobinuria, low haptoglobin (Hp) levels, elevated lactate dehydrogenase, and Coomb's test (if antibody mediated). However, under certain circumstances, hemoglobinemia and hemoglobinuria may be the only evidence of IVH depending on the etiological factors in association with the environment inside the body. Bee venom is known to have deleterious actions on different tissue types (neurotoxin, muscle paralytic, hematotoxic, epithelial damage, etc.). Altogether, they determine the outcome and presentation. Apart from this, there are several conditions that determine the binding of oxygen and Hp to hemoglobin (Hb). Arterial blood gases (ABGs) play a very important role in this. Hence, it is important for the pathologists to have an understanding of ABG as well to know how even simple tests (Hb, bilirubin, and Hp) can get affected by them. We describe one such occurrence in a patient with multiple hornet bee stings and formulate the likely causes and pathogenesis.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76745656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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