{"title":"World Health Organization medical product alert N°6/2022: A clarion call for eternal vigilance","authors":"Adesoji O. Ademuyiwa","doi":"10.4103/jcls.jcls_71_22","DOIUrl":"https://doi.org/10.4103/jcls.jcls_71_22","url":null,"abstract":"","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90398569","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}
F. Ntirenganya, J. Twagirumukiza, Georges Bucyibaruta, B. Rugwizangoga, S. Rulisa
Background: Breast cancer (BC) is the most prevalent cancer in women and the leading cause of women's cancer-related deaths and morbidity worldwide. Conventionally considered as a single disease, recent advances suggest that BC is rather a heterogeneous disease with different molecular subtypes exhibiting distinct clinical presentation, anatomo-pathological features, response to treatment and survival outcomes. The purpose of this study was to compare tumor characteristics and epidemiologic risk factors associated with premenopausal versus postmenopausal BC and to assess heterogeneity by menopausal status. Methods: This was a comparative cross-sectional study. A total of 340 patients were included in the study (170 premenopausal vs. 170 postmenopausal BC). Patients' and tumor characteristics were compared in both populations. Percentages and means have been used for descriptive statistics. For categorical variables with comparison groups not exceeding 2, Fischer's exact test was used, otherwise, Chi-square test was used. For continuous variables, Mann–Whitney U-test has been used to compare the numerical ranked variables. A value of P = 0.05 or less was considered statistically significant. Odds ratio (OR) and 95% confidence interval (CI) was estimated using logistic regression analysis. Results: The median age of patients was 49 years (range: 18–89 years), with premenopausal median age of 41 years (range 18–50 years) and postmenopausal median age of 58 years (range 48–89 years). Factors associated more with the occurrence of premenopausal BC than postmenopausal BC were obesity/overweight in adolescence/early adulthood (OR = 0.29 95% CI 0.18–0.49, P < 0.001) and history of benign breast disease (OR 0.34 95% CI 0.14–0.83, P = 0.014), while factors associated more with postmenopausal than premenopausal BC included alcohol intake (OR = 2.47 95% CI 1.54–3.98, P < 0.001), history of breastfeeding (OR = 2.75 1.12–6.78, P = 0.036). However, sports activities (OR = 0.33 95% CI 0.16–0.65, P = 0.0015) and contraceptive use (OR = 0.19 95% CI 0.12–0.32, P < 0.001) seem to be protective for postmenopausal BC. In premenopausal period, patients presented more at advanced stages (Stage III and IV) (51.2% of premenopausal vs. 44.7% for postmenopausal, P = 0.0246), reported more intermediate-to-rapid disease progression (92% in premenopausal vs. 81.1% in postmenopausal (P < 0.001), had more invasive ductal carcinoma (98% in premenopausal vs. 93.5% in postmenopausal (P = 0.053) and had more poorly differentiated tumors (72% compared to 19.4% of postmenopausal BC patients (P < 0.0001). There was no statistically difference in molecular subtypes distribution between premenopausal and postmenopausal women (P = 0.062). However, progesterone receptor (PR) positivity was more associated with postmenopausal BC (P = 0.0165). Conclusion: BC is a heterogeneous disease. Premenopausal BC seems to be more aggressive than postmenopausal BC, with a relatively high prevalence of p
背景:乳腺癌(BC)是女性中最常见的癌症，也是世界范围内女性癌症相关死亡和发病的主要原因。传统上被认为是一种单一疾病，最近的进展表明，BC是一种异质性疾病，具有不同的分子亚型，表现出不同的临床表现、解剖病理特征、对治疗的反应和生存结果。本研究的目的是比较与绝经前和绝经后BC相关的肿瘤特征和流行病学危险因素，并评估绝经状态的异质性。方法:采用比较横断面研究。研究共纳入340例患者(170例绝经前和170例绝经后BC)。比较两组患者和肿瘤特征。描述性统计使用了百分比和平均数。对于比较分组不超过2的分类变量，采用Fischer精确检验，否则采用卡方检验。对于连续变量，采用Mann-Whitney u检验对数值排序变量进行比较。P = 0.05或更小的值被认为具有统计学意义。使用logistic回归分析估计优势比(OR)和95%置信区间(CI)。结果:患者中位年龄49岁(范围18-89岁)，绝经前患者中位年龄41岁(范围18-50岁)，绝经后患者中位年龄58岁(范围48-89岁)。绝经前乳腺癌比绝经后乳腺癌发生的相关因素有青春期/成年早期肥胖/超重(OR = 0.29 95% CI 0.18-0.49, P < 0.001)和乳腺良性疾病史(OR = 0.34 95% CI 0.14-0.83, P = 0.014)，绝经后乳腺癌比绝经前乳腺癌发生的相关因素有饮酒(OR = 2.47 95% CI 1.54-3.98, P < 0.001)、母乳喂养史(OR = 2.75 1.12-6.78, P = 0.036)。然而，体育活动(OR = 0.33 95% CI 0.16-0.65, P = 0.0015)和避孕措施的使用(OR = 0.19 95% CI 0.12-0.32, P < 0.001)似乎对绝经后BC有保护作用。在绝经前，患者更多出现在晚期(III期和IV期)(绝经前的51.2% vs绝经后的44.7%，P = 0.0246)，报告更多的中快速疾病进展(绝经前的92% vs绝经后的81.1% (P < 0.001))，有更多的浸润性导管癌(绝经前的98% vs绝经后的93.5% (P = 0.053))，有更多的低分化肿瘤(72% vs 19.4%)绝经后BC患者(P < 0.0001)。绝经前和绝经后妇女的分子亚型分布无统计学差异(P = 0.062)。然而，孕激素受体(PR)阳性与绝经后BC的相关性更大(P = 0.0165)。结论:BC是一种异质性疾病。绝经前BC似乎比绝经后BC更具侵袭性，低分化和高级别肿瘤的患病率相对较高，进展迅速。然而，绝经前和绝经后的BC具有相似的分子亚型，PR表达不同，但ER和人表皮生长因子受体2/Neu癌基因表达相似。
{"title":"Breast cancer heterogeneity: Comparing pre- and postmenopausal breast cancer in an African population","authors":"F. Ntirenganya, J. Twagirumukiza, Georges Bucyibaruta, B. Rugwizangoga, S. Rulisa","doi":"10.4103/jcls.jcls_47_22","DOIUrl":"https://doi.org/10.4103/jcls.jcls_47_22","url":null,"abstract":"Background: Breast cancer (BC) is the most prevalent cancer in women and the leading cause of women's cancer-related deaths and morbidity worldwide. Conventionally considered as a single disease, recent advances suggest that BC is rather a heterogeneous disease with different molecular subtypes exhibiting distinct clinical presentation, anatomo-pathological features, response to treatment and survival outcomes. The purpose of this study was to compare tumor characteristics and epidemiologic risk factors associated with premenopausal versus postmenopausal BC and to assess heterogeneity by menopausal status. Methods: This was a comparative cross-sectional study. A total of 340 patients were included in the study (170 premenopausal vs. 170 postmenopausal BC). Patients' and tumor characteristics were compared in both populations. Percentages and means have been used for descriptive statistics. For categorical variables with comparison groups not exceeding 2, Fischer's exact test was used, otherwise, Chi-square test was used. For continuous variables, Mann–Whitney U-test has been used to compare the numerical ranked variables. A value of P = 0.05 or less was considered statistically significant. Odds ratio (OR) and 95% confidence interval (CI) was estimated using logistic regression analysis. Results: The median age of patients was 49 years (range: 18–89 years), with premenopausal median age of 41 years (range 18–50 years) and postmenopausal median age of 58 years (range 48–89 years). Factors associated more with the occurrence of premenopausal BC than postmenopausal BC were obesity/overweight in adolescence/early adulthood (OR = 0.29 95% CI 0.18–0.49, P < 0.001) and history of benign breast disease (OR 0.34 95% CI 0.14–0.83, P = 0.014), while factors associated more with postmenopausal than premenopausal BC included alcohol intake (OR = 2.47 95% CI 1.54–3.98, P < 0.001), history of breastfeeding (OR = 2.75 1.12–6.78, P = 0.036). However, sports activities (OR = 0.33 95% CI 0.16–0.65, P = 0.0015) and contraceptive use (OR = 0.19 95% CI 0.12–0.32, P < 0.001) seem to be protective for postmenopausal BC. In premenopausal period, patients presented more at advanced stages (Stage III and IV) (51.2% of premenopausal vs. 44.7% for postmenopausal, P = 0.0246), reported more intermediate-to-rapid disease progression (92% in premenopausal vs. 81.1% in postmenopausal (P < 0.001), had more invasive ductal carcinoma (98% in premenopausal vs. 93.5% in postmenopausal (P = 0.053) and had more poorly differentiated tumors (72% compared to 19.4% of postmenopausal BC patients (P < 0.0001). There was no statistically difference in molecular subtypes distribution between premenopausal and postmenopausal women (P = 0.062). However, progesterone receptor (PR) positivity was more associated with postmenopausal BC (P = 0.0165). Conclusion: BC is a heterogeneous disease. Premenopausal BC seems to be more aggressive than postmenopausal BC, with a relatively high prevalence of p","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74917106","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: Despite concerted global efforts to reduce the burden of maternal anemia, it remains a major public health issue. Over 40% of pregnant women worldwide are anemic; low- and middle-income countries (especially those in sub-Saharan Africa) make a disproportionately higher contribution to the global burden. The condition can lead to undesirable outcomes for the mother and child. This study was conducted to determine the prevalence of anemia in pregnancy among women attending antenatal clinics in Chikun LGA, Kaduna. Methods: This study was conducted among 145 women attending antenatal clinics in Chikun LGA. Data were collected using a pretested, semi-structured interviewer-administered questionnaire. Hemoglobin (Hb) level was determined and anemia was defined using the World Health Organization-recommended cutoff of <11 g/dl. The results were presented in frequency tables. Data were analyzed using IBM SPSS Statistics version 26. Statistical significance was set at P < 0.05. Results: Fifty-five (37.9%) of the respondents were between the ages of 25 and 29 years. The mean age of the respondents was 28.61 ± 5.5 years. The majority, 107 (73.8%), had a household size of 2–4. Only 16 (11.0%) respondents were aware of anemia. Pregnant women were identified by half (50.0%) of the respondents as being more at risk of anemia. Only a quarter (25.0%) of respondents had good knowledge of anemia. Over two-fifth (42.8%) of the respondents were anemic. There was a statistically significant relationship between household size and anemia in respondents. Conclusion: A large proportion of the respondents were anemic; this underscores the need to strengthen the nutritional counseling and routine hematinics given during the antenatal period. Social drivers should also be addressed in terms of favorable public policies.
{"title":"Anemia in pregnancy: Prevalence among clients attending antenatal clinics in Chikun LGA, Kaduna, Nigeria","authors":"B. Nwankwo, Sarah Joseph, N. Usman, A. Oyefabi","doi":"10.4103/jcls.jcls_42_22","DOIUrl":"https://doi.org/10.4103/jcls.jcls_42_22","url":null,"abstract":"Background: Despite concerted global efforts to reduce the burden of maternal anemia, it remains a major public health issue. Over 40% of pregnant women worldwide are anemic; low- and middle-income countries (especially those in sub-Saharan Africa) make a disproportionately higher contribution to the global burden. The condition can lead to undesirable outcomes for the mother and child. This study was conducted to determine the prevalence of anemia in pregnancy among women attending antenatal clinics in Chikun LGA, Kaduna. Methods: This study was conducted among 145 women attending antenatal clinics in Chikun LGA. Data were collected using a pretested, semi-structured interviewer-administered questionnaire. Hemoglobin (Hb) level was determined and anemia was defined using the World Health Organization-recommended cutoff of <11 g/dl. The results were presented in frequency tables. Data were analyzed using IBM SPSS Statistics version 26. Statistical significance was set at P < 0.05. Results: Fifty-five (37.9%) of the respondents were between the ages of 25 and 29 years. The mean age of the respondents was 28.61 ± 5.5 years. The majority, 107 (73.8%), had a household size of 2–4. Only 16 (11.0%) respondents were aware of anemia. Pregnant women were identified by half (50.0%) of the respondents as being more at risk of anemia. Only a quarter (25.0%) of respondents had good knowledge of anemia. Over two-fifth (42.8%) of the respondents were anemic. There was a statistically significant relationship between household size and anemia in respondents. Conclusion: A large proportion of the respondents were anemic; this underscores the need to strengthen the nutritional counseling and routine hematinics given during the antenatal period. Social drivers should also be addressed in terms of favorable public policies.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73452224","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}
Adedeji Fatuga, A. Oliyide, Oyedele Hassan, E. Jeje
Difficult urethral catheterization (DUC) is a commonly encountered emergency by urologists. A review of literature describes many techniques which are not readily accessible in resource-limited settings. We present our recent experience with the use of Terumo hydrophilic guidewire in the management of DUCs and planned elective management of urethral strictures presenting this as a viable option in reducing the frequency of emergency suprapubic catheterization with its attendant risks and costs.
{"title":"Use of guidewire in assisted urethral catheterization and urethral dilatation with Cook's S dilators: A viable option in resource limited setting","authors":"Adedeji Fatuga, A. Oliyide, Oyedele Hassan, E. Jeje","doi":"10.4103/jcls.jcls_35_22","DOIUrl":"https://doi.org/10.4103/jcls.jcls_35_22","url":null,"abstract":"Difficult urethral catheterization (DUC) is a commonly encountered emergency by urologists. A review of literature describes many techniques which are not readily accessible in resource-limited settings. We present our recent experience with the use of Terumo hydrophilic guidewire in the management of DUCs and planned elective management of urethral strictures presenting this as a viable option in reducing the frequency of emergency suprapubic catheterization with its attendant risks and costs.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90666214","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: Fracture remains a common cause of morbidity, mortality, and disability in childhood. The etiology of fractures varies between and within countries and depends on the socioeconomic and environmental conditions. Etiology of fractures from the elite and high socioeconomic class community has not been documented and this study aimed to document such, including the radiographic features. Methods: A prospective, descriptive, cross-sectional study conducted on 38 children below 17 years that presented with injured limb between July 1, 2018, and June 30, 2020, to a private facility located within a highbrow location in Lagos, Nigeria. Ethical approval was obtained from the Health Research and Ethics Committee, Lagos University Teaching Hospital, Idi-Araba. Data were collected with pro forma. Data analysis was done using the Microsoft excel and Statistical Package for the Social Sciences software (SPSS) for Windows version 21. Results: Thirty-eight children were recruited. The mean age was 8.78 ± 4.35 years. The male-to-female ratio was 3.2–1. Fall was the most common cause of the fracture. Injury occurred most within the school environment followed by the home environment. All the injured presented with pain and swelling of the affected parts. The upper limbs were more injured. Transverse fractures were the most common radiographic findings. Moderate-to-severe displacement of fracture edges was seen in 55.3%, with severe angulations of fracture edges in 23.4%. Majority of the fractures were managed conservatively. Conclusion: Majority of the fractures were due to falls. Most are complete and transverse fractures. A higher percentage was displaced. The management was mostly conservative.
{"title":"Epidemiological and radiological patterns of paediatric fractures in an elite community in South West Nigeria","authors":"O. Omidiji, O. Akinmokun, O. Olowoyeye","doi":"10.4103/jcls.jcls_55_22","DOIUrl":"https://doi.org/10.4103/jcls.jcls_55_22","url":null,"abstract":"Background: Fracture remains a common cause of morbidity, mortality, and disability in childhood. The etiology of fractures varies between and within countries and depends on the socioeconomic and environmental conditions. Etiology of fractures from the elite and high socioeconomic class community has not been documented and this study aimed to document such, including the radiographic features. Methods: A prospective, descriptive, cross-sectional study conducted on 38 children below 17 years that presented with injured limb between July 1, 2018, and June 30, 2020, to a private facility located within a highbrow location in Lagos, Nigeria. Ethical approval was obtained from the Health Research and Ethics Committee, Lagos University Teaching Hospital, Idi-Araba. Data were collected with pro forma. Data analysis was done using the Microsoft excel and Statistical Package for the Social Sciences software (SPSS) for Windows version 21. Results: Thirty-eight children were recruited. The mean age was 8.78 ± 4.35 years. The male-to-female ratio was 3.2–1. Fall was the most common cause of the fracture. Injury occurred most within the school environment followed by the home environment. All the injured presented with pain and swelling of the affected parts. The upper limbs were more injured. Transverse fractures were the most common radiographic findings. Moderate-to-severe displacement of fracture edges was seen in 55.3%, with severe angulations of fracture edges in 23.4%. Majority of the fractures were managed conservatively. Conclusion: Majority of the fractures were due to falls. Most are complete and transverse fractures. A higher percentage was displaced. The management was mostly conservative.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84305893","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}
R. Braimah, Dawood Ali-Alsuliman, B. Alyami, Abdurrazaq Taiwo, A. Ibikunle, Abdullah Al-walah
Objective: Worldwide, the increase in chronic comorbid medical conditions in the young and elderly is of a major concern, especially in Saudi Arabia. Therefore, the objective of the present study was to investigate the prevalence and clinico-odontological management of medically compromised during intra-alveolar exodontia in Saudi Arabia. Methods: This 5-year retrospective study was conducted on patients who had intra-alveolar extraction of teeth at the department of oral and maxillofacial surgery of a government referral hospital, between January 2016 and December 2020. Data on the age, gender, comorbid medical conditions, and management protocols which include general, specific, and special consultations with relevant specialties were also recorded and analyzed. Results: The prevalence of comorbidities in 8065 patients seen during the study period was 19.6%. There were 1578 (748 [47.4%] males and 830 [52.6%] females) patients with age range of 10–102 years. The mean (±standard deviation) of 36 (16.6) was observed. The most frequent spectrum of medical conditions discovered included endocrine (458 [29.0%]), cardiac (259 [16.4%]), respiratory (79 [5.0%]), central nervous system (83 [5.2%]), and autoimmune (54 [3.4%]). Five hundred and sixteen (32.7%) patients had combined medical conditions. Out of the 1578 patients with medical conditions, 1554 (98.5%) were on routine prescription medications. Conclusions: The current study observed that 19.6% of patients presenting for intra-alveolar tooth extractions were medically compromised. Majority were in middle age and were female. Endocrine and cardiac abnormalities were most prevalent medical conditions. Prescription medications were observed in 98.2%.
{"title":"Clinico-odontological management of medically compromised patients during intra-alveolar exodontia in Saudi Arabia: A retrospective study","authors":"R. Braimah, Dawood Ali-Alsuliman, B. Alyami, Abdurrazaq Taiwo, A. Ibikunle, Abdullah Al-walah","doi":"10.4103/jcls.jcls_31_22","DOIUrl":"https://doi.org/10.4103/jcls.jcls_31_22","url":null,"abstract":"Objective: Worldwide, the increase in chronic comorbid medical conditions in the young and elderly is of a major concern, especially in Saudi Arabia. Therefore, the objective of the present study was to investigate the prevalence and clinico-odontological management of medically compromised during intra-alveolar exodontia in Saudi Arabia. Methods: This 5-year retrospective study was conducted on patients who had intra-alveolar extraction of teeth at the department of oral and maxillofacial surgery of a government referral hospital, between January 2016 and December 2020. Data on the age, gender, comorbid medical conditions, and management protocols which include general, specific, and special consultations with relevant specialties were also recorded and analyzed. Results: The prevalence of comorbidities in 8065 patients seen during the study period was 19.6%. There were 1578 (748 [47.4%] males and 830 [52.6%] females) patients with age range of 10–102 years. The mean (±standard deviation) of 36 (16.6) was observed. The most frequent spectrum of medical conditions discovered included endocrine (458 [29.0%]), cardiac (259 [16.4%]), respiratory (79 [5.0%]), central nervous system (83 [5.2%]), and autoimmune (54 [3.4%]). Five hundred and sixteen (32.7%) patients had combined medical conditions. Out of the 1578 patients with medical conditions, 1554 (98.5%) were on routine prescription medications. Conclusions: The current study observed that 19.6% of patients presenting for intra-alveolar tooth extractions were medically compromised. Majority were in middle age and were female. Endocrine and cardiac abnormalities were most prevalent medical conditions. Prescription medications were observed in 98.2%.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87989124","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: High plasma concentration of homocysteine (Hcy) is a well-established risk factor for several disorders, including cardiovascular disease, stroke, venous thrombosis, and arteriosclerosis. Folic acid deficiency leads to an increase in homocysteine. This study aimed to test whether elevated serum homocysteine, diminished folate, and B12 levels correlate with the frequency of crisis in sickle cell disease (SCD). Methods: This was a comparative cross-sectional study conducted on 110 adults consisting of participants with SCD in vaso-occlusive crises (VOC), SCD in hyperhemolytic crises (HHC), SCD in steady-state (SS), and healthy controls. Serum homocysteine, folate, and B12 levels were determined using the Enzyme-linked immunosorbent assay method. The level of statistical significance was defined as P < 0.05, at a 95% confidence interval. Results: The mean age of all participants was 25.5 ± 5.8 years. There was a statistically significant difference in mean serum homocysteine levels with mean levels of (11.9 ± 4.5, 13.1 ± 5.4, 10.3 ± 2.3, 9.9 ± 2.5 μmol/L) in participants in VOC, HHC, SS, and controls, respectively (P = 0.016). With a cut-off of <15 μmol/L, hyperhomocysteinemia was seen in 31.% and 26.7% of participants in HHC and VOC, respectively. Conversely, no participant in the SS or the control group had hyperhomocysteinemia. Serum folate (nmol/L) level was lower, though not significantly, in the HHC group than in the other groups, with 9.9 ± 5.5 versus 12.7 ± 6.8, 11.8 ± 4.1 and 12.7 ± 2.2 nmol/L for the VOC, SS, and control group, respectively (P = 0.121). A significant inverse correlation was found between homocysteine and folate (correlation coefficient − 0.589 and P < 0.001) in all study participants. Conclusion: This study reveals significantly higher homocysteine levels in participants with sickle anemia in vaso-occlusive and hyperhemolytic crises (HHCs), highlighting homocysteine and folate role in the pathogenesis of these events.
{"title":"Elevated homocysteine and crises state in patients with sickle cell anemia: A comparative study","authors":"A. Orolu, T. Adeyemo, Alani S Akanmu","doi":"10.4103/jcls.jcls_33_22","DOIUrl":"https://doi.org/10.4103/jcls.jcls_33_22","url":null,"abstract":"Background: High plasma concentration of homocysteine (Hcy) is a well-established risk factor for several disorders, including cardiovascular disease, stroke, venous thrombosis, and arteriosclerosis. Folic acid deficiency leads to an increase in homocysteine. This study aimed to test whether elevated serum homocysteine, diminished folate, and B12 levels correlate with the frequency of crisis in sickle cell disease (SCD). Methods: This was a comparative cross-sectional study conducted on 110 adults consisting of participants with SCD in vaso-occlusive crises (VOC), SCD in hyperhemolytic crises (HHC), SCD in steady-state (SS), and healthy controls. Serum homocysteine, folate, and B12 levels were determined using the Enzyme-linked immunosorbent assay method. The level of statistical significance was defined as P < 0.05, at a 95% confidence interval. Results: The mean age of all participants was 25.5 ± 5.8 years. There was a statistically significant difference in mean serum homocysteine levels with mean levels of (11.9 ± 4.5, 13.1 ± 5.4, 10.3 ± 2.3, 9.9 ± 2.5 μmol/L) in participants in VOC, HHC, SS, and controls, respectively (P = 0.016). With a cut-off of <15 μmol/L, hyperhomocysteinemia was seen in 31.% and 26.7% of participants in HHC and VOC, respectively. Conversely, no participant in the SS or the control group had hyperhomocysteinemia. Serum folate (nmol/L) level was lower, though not significantly, in the HHC group than in the other groups, with 9.9 ± 5.5 versus 12.7 ± 6.8, 11.8 ± 4.1 and 12.7 ± 2.2 nmol/L for the VOC, SS, and control group, respectively (P = 0.121). A significant inverse correlation was found between homocysteine and folate (correlation coefficient − 0.589 and P < 0.001) in all study participants. Conclusion: This study reveals significantly higher homocysteine levels in participants with sickle anemia in vaso-occlusive and hyperhemolytic crises (HHCs), highlighting homocysteine and folate role in the pathogenesis of these events.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91286906","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}
Sananda Kumar, Barathy Chandrasegaran, Devi Kittu, R. Jayavani, S. Ananthakrishnan
Introduction: Exclusive breastfeeding (EBF) for the first 6 months of life and timely introduction of complementary feeds (CFs) with continuation of breastfeeding up to 2 years or beyond are optimum infant and toddler nutrition practices. Mother's employment status influences the feeding practice which in turn can have a negative impact on the growth and development of the infant. The objectives of the study were to determine and compare breastfeeding and CF practices in working and stay-at-home mothers attending our health facility and its effect on the growth of their children. Methods: This observational comparative study was done on 200 mothers, 100 working mothers and 100 stay-at-home mothers of children aged 1–24 months after obtaining written consent. Data were recorded in a pretested semi-structured questionnaire using interview method. Details were elicited regarding feeding practices and illnesses in the child. Each infant's growth and development were assessed using the World Health Organization growth chart and Trivandrum development chart. Statistical tests used were descriptive statistics for frequencies, means and standard deviation, Chi-square for proportions, and Student's t-test for means. A P < 0.05 was considered statistically significant. Results: EBF for 6 months was given by 37% (37/100) of stay-at-home and 45% (45/100) of working mothers (P = 0.251). Breastfeeding beyond 6 months was given by 94.7% (n = 71/75) of stay-at-home and 93.8% of working mothers (n = 90/96, P = 0.800), and beyond 12 months by 61.1% n = 33/54) and 54.8%, respectively, (n = 40/73, P = 0.477). CF was initiated by 180 days by 44% of stay-at-home (44/100) and 55% of working mothers (55/100, P = 0.120). Underweight, wasting, and stunting were seen in 12%, 10%, and 13% (12/100, 10/100, 13/100), respectively, of stay-at-home and 14%, 15%, and 13% (14/100, 15/100, 13/100), respectively, of working mothers and there was no statistical difference between the two groups. A higher frequency of diarrheal episodes was observed in babies of working mothers (6/100, 6% vs. 18/100, 18%, P = 0.009). Conclusion: There was no statistical difference between stay-at-home and working mothers in time of initiation of first feed, giving colostrum, EBF rate, continued breastfeeding beyond 12 months, and age of initiation of CF. Thus, the nutrition and health status of children in both groups were comparable except acute diarrheal illness which was more in babies of working mothers.
{"title":"Feeding practices and nutrition in children of working and stay-At-Home mothers: A comparative study","authors":"Sananda Kumar, Barathy Chandrasegaran, Devi Kittu, R. Jayavani, S. Ananthakrishnan","doi":"10.4103/jcls.jcls_32_22","DOIUrl":"https://doi.org/10.4103/jcls.jcls_32_22","url":null,"abstract":"Introduction: Exclusive breastfeeding (EBF) for the first 6 months of life and timely introduction of complementary feeds (CFs) with continuation of breastfeeding up to 2 years or beyond are optimum infant and toddler nutrition practices. Mother's employment status influences the feeding practice which in turn can have a negative impact on the growth and development of the infant. The objectives of the study were to determine and compare breastfeeding and CF practices in working and stay-at-home mothers attending our health facility and its effect on the growth of their children. Methods: This observational comparative study was done on 200 mothers, 100 working mothers and 100 stay-at-home mothers of children aged 1–24 months after obtaining written consent. Data were recorded in a pretested semi-structured questionnaire using interview method. Details were elicited regarding feeding practices and illnesses in the child. Each infant's growth and development were assessed using the World Health Organization growth chart and Trivandrum development chart. Statistical tests used were descriptive statistics for frequencies, means and standard deviation, Chi-square for proportions, and Student's t-test for means. A P < 0.05 was considered statistically significant. Results: EBF for 6 months was given by 37% (37/100) of stay-at-home and 45% (45/100) of working mothers (P = 0.251). Breastfeeding beyond 6 months was given by 94.7% (n = 71/75) of stay-at-home and 93.8% of working mothers (n = 90/96, P = 0.800), and beyond 12 months by 61.1% n = 33/54) and 54.8%, respectively, (n = 40/73, P = 0.477). CF was initiated by 180 days by 44% of stay-at-home (44/100) and 55% of working mothers (55/100, P = 0.120). Underweight, wasting, and stunting were seen in 12%, 10%, and 13% (12/100, 10/100, 13/100), respectively, of stay-at-home and 14%, 15%, and 13% (14/100, 15/100, 13/100), respectively, of working mothers and there was no statistical difference between the two groups. A higher frequency of diarrheal episodes was observed in babies of working mothers (6/100, 6% vs. 18/100, 18%, P = 0.009). Conclusion: There was no statistical difference between stay-at-home and working mothers in time of initiation of first feed, giving colostrum, EBF rate, continued breastfeeding beyond 12 months, and age of initiation of CF. Thus, the nutrition and health status of children in both groups were comparable except acute diarrheal illness which was more in babies of working mothers.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75188519","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 and Objective: The role of serum uric acid (SUA) as a biomarker in Parkinson's disease (PD) remains exploratory and has not been described in our population. The objective of this study was to explore the profile of SUA and its relationship to nonmotor symptoms (NMS) burden in PD. Methods: This cross-sectional study recruited 70 persons with PD and 140 matched healthy controls in Lagos, Nigeria. PD was diagnosed using the United Kingdom PD Society Brain Bank criteria. NMS were assessed with the NMS Questionnaire (NMS-Quest). SUA was measured using standard methods. Results: The mean ages of PD and controls were 63 ± 9.4 years and 62.9 ± 8.8 years, respectively (P = 0.65), with no difference when compared by sex. The median PD duration (interquartile range [IQR]) was 4 (4.25) years. Median Hoehn and Yahr stage (IQR) was 2.5 (1.0). The mean total unified Parkinson's disease rating scale score was 70.7 ± 23.7. The mean NMS-Quest score was 8.5 ± 3.8. Mean SUA level was significantly lower in PD compared to controls (2.42 ± 0.75 mg/dL vs. 3.73 ± 1.09 mg/dL [P = 0.000]). There was a nonsignificant inverse linear trend of association (r = −0.184; P = 0.126) between the total NMS-Quest score and SUA level in PD. Logistic regression analysis revealed hyposmia and memory impairment were significantly related to lower SUA levels (P = 0.02 and P = 0.04, respectively). Conclusion: Our study corroborates the potential of SUA as a serum biomarker in PD and a possible role in defining non-motor symptom burden. Further exploration to clarify the association and interrogate the impact of interventions is warranted.
{"title":"Association of serum uric acid and non-motor symptoms in Parkinson's disease: A cross-sectional study from a movement disorders clinic in Lagos, Nigeria","authors":"Olanike Odeniyi, O. Ojo, I. Odeniyi, N. Okubadejo","doi":"10.4103/jcls.jcls_29_22","DOIUrl":"https://doi.org/10.4103/jcls.jcls_29_22","url":null,"abstract":"Background and Objective: The role of serum uric acid (SUA) as a biomarker in Parkinson's disease (PD) remains exploratory and has not been described in our population. The objective of this study was to explore the profile of SUA and its relationship to nonmotor symptoms (NMS) burden in PD. Methods: This cross-sectional study recruited 70 persons with PD and 140 matched healthy controls in Lagos, Nigeria. PD was diagnosed using the United Kingdom PD Society Brain Bank criteria. NMS were assessed with the NMS Questionnaire (NMS-Quest). SUA was measured using standard methods. Results: The mean ages of PD and controls were 63 ± 9.4 years and 62.9 ± 8.8 years, respectively (P = 0.65), with no difference when compared by sex. The median PD duration (interquartile range [IQR]) was 4 (4.25) years. Median Hoehn and Yahr stage (IQR) was 2.5 (1.0). The mean total unified Parkinson's disease rating scale score was 70.7 ± 23.7. The mean NMS-Quest score was 8.5 ± 3.8. Mean SUA level was significantly lower in PD compared to controls (2.42 ± 0.75 mg/dL vs. 3.73 ± 1.09 mg/dL [P = 0.000]). There was a nonsignificant inverse linear trend of association (r = −0.184; P = 0.126) between the total NMS-Quest score and SUA level in PD. Logistic regression analysis revealed hyposmia and memory impairment were significantly related to lower SUA levels (P = 0.02 and P = 0.04, respectively). Conclusion: Our study corroborates the potential of SUA as a serum biomarker in PD and a possible role in defining non-motor symptom burden. Further exploration to clarify the association and interrogate the impact of interventions is warranted.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83194846","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 rate of benzathine penicillin G (BPG) injection to prevent rheumatic heart disease (RHD) is insufficient owing to poor knowledge and the negative attitude of health workers. We aim to investigate the gap of knowledge, attitude, and experience of clinical nurses at the primary health-care level who had not received training on rheumatic fever (RF)/RHD prevention to get information on their training need. Methods: A cross-sectional survey was conducted on clinical nurses at randomly selected health centers in Addis Ababa. After interviewing with semi-structured questionnaires, the data were analyzed on SPSS software version 25. Results: A total of 278 nurses (92% response) with a mean age of 28 years were analyzed. The knowledge scores on “organisms causing tonsillopharyngitis (TP),” “the route of administration of penicillin,” and “when to give BPG after preparation” were good (≥75%). Participants' score was poor (<50% score) in the knowledge of “duration of treatment of tonsillopharyngitis, frequency of chemoprophylaxis of RF/RHD, and the relationship between throat infection and RF.” Knowledge on “prevention of pain using lidocaine,” “warming the syringe and allowing alcohol to dry from the swab before injecting” were also good. In contrast, knowledge of “delivering injection very slowly,” “using vibration before/during injection, and “distracting patient using conversation” was poor. Attitude was positive to statements such as “single dose BPG injection given every 3–4 weeks,” “BPG injection is effective in the treatment of streptococcal pharyngitis and the prevention of RF/RHD,” “good patient – health provider relationship enables the success of prophylaxis.” and “educating patients, health-care providers and their caregivers help adherence to BPG prophylaxis. Fear of anaphylactic reaction, pain at the injection site, and blockage of the syringe during injection were the negative experiences reported. Conclusions: The knowledge of clinical nurses on the prevention of RF/RHD was generally good. However, their knowledge of safe injection techniques was partial. On the other hand, most attitude statements were positive. Fear of anaphylactic shock while injecting BPG, pain, and blockade of the syringe was the common barriers experienced.
{"title":"Knowledge, attitude, and experiences of using penicillin G, as a prophylaxis for rheumatic fever and rheumatic heart diseases among nurses in Addis Ababa, Ethiopia: A cross-sectional survey","authors":"Mekuye Ibrahim, T. Aklilu","doi":"10.4103/jcls.jcls_30_21","DOIUrl":"https://doi.org/10.4103/jcls.jcls_30_21","url":null,"abstract":"Background: The rate of benzathine penicillin G (BPG) injection to prevent rheumatic heart disease (RHD) is insufficient owing to poor knowledge and the negative attitude of health workers. We aim to investigate the gap of knowledge, attitude, and experience of clinical nurses at the primary health-care level who had not received training on rheumatic fever (RF)/RHD prevention to get information on their training need. Methods: A cross-sectional survey was conducted on clinical nurses at randomly selected health centers in Addis Ababa. After interviewing with semi-structured questionnaires, the data were analyzed on SPSS software version 25. Results: A total of 278 nurses (92% response) with a mean age of 28 years were analyzed. The knowledge scores on “organisms causing tonsillopharyngitis (TP),” “the route of administration of penicillin,” and “when to give BPG after preparation” were good (≥75%). Participants' score was poor (<50% score) in the knowledge of “duration of treatment of tonsillopharyngitis, frequency of chemoprophylaxis of RF/RHD, and the relationship between throat infection and RF.” Knowledge on “prevention of pain using lidocaine,” “warming the syringe and allowing alcohol to dry from the swab before injecting” were also good. In contrast, knowledge of “delivering injection very slowly,” “using vibration before/during injection, and “distracting patient using conversation” was poor. Attitude was positive to statements such as “single dose BPG injection given every 3–4 weeks,” “BPG injection is effective in the treatment of streptococcal pharyngitis and the prevention of RF/RHD,” “good patient – health provider relationship enables the success of prophylaxis.” and “educating patients, health-care providers and their caregivers help adherence to BPG prophylaxis. Fear of anaphylactic reaction, pain at the injection site, and blockage of the syringe during injection were the negative experiences reported. Conclusions: The knowledge of clinical nurses on the prevention of RF/RHD was generally good. However, their knowledge of safe injection techniques was partial. On the other hand, most attitude statements were positive. Fear of anaphylactic shock while injecting BPG, pain, and blockade of the syringe was the common barriers experienced.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87313956","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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