Pub Date : 2019-04-25DOI: 10.54730/abm.2020.020402
Dagim Assefa Kassaye, Worku Dugassa Girsha, Godana Jarso Guto, Haji Aman Deybasso
Diabetic Ketoacidosis (DKA) is one of the most serious acute complications of diabetes mellitus. The mortality rate remains high in developing countries and among misdiagnosed and treated patients. Therefore targeting early diagnosis and effective treatment programs is vital to save the life of patients. The aim of the study is to assess diabetic ketoacidosis treatment outcome and associated factors among adult patients at Adama Hospital Medical College emergency department and medical wards, Oromia region, Ethiopia. Cross sectional study based on record review of 357 adult diabetic ketoacidosis patients was selected using simple random sampling. Data was collected using checklist from medical registrations. The data was entered and analyzed using SPSS version 20 and EPI-info version 7 statistical packages. Majority of the patients (65.30%) had two or more episodes of diabetic ketoacidosis and the main reasons for recurrent diabetic ketoacidosis were infectious illness (69.50%) and insulin discontinuation (14.80%). Regarding treatment outcomes of diabetic ketoacidosis patients, majority of them (84.90%) discharged with improved. Those diabetic ketoacidosis patients treated with more than six liters fluid replacement in the 1st 24 hours had better treatment outcome by two times as compared to less than three liters fluid replacement (AOR=2.41 (1.58-10.02). Similarly, those patients who got more than sixty international unit insulin doses in the 1st 24hrs had better treatment outcome by ten times (AOR=10.68 (3.88- 20.64)) when compared to less than forty international unit insulin administration. In addition, DKA patients who got supplemental potassium showed five times treatment outcome improvement (AOR= 5.30 (2.11-13.32) than for those potassium replacement was not done. Even if majority of diabetic ketoacidosis patients treated at Adama Hospital Medical College emergency room and medical wards were discharged with improvement, early treatment of infection, ample fluid replacement and insulin dose adjustment during illness need to be encouraged.
糖尿病酮症酸中毒(DKA)是糖尿病最严重的急性并发症之一。发展中国家以及误诊和误治患者的死亡率仍然很高。因此，有针对性的早期诊断和有效的治疗方案对于挽救患者的生命至关重要。本研究的目的是评估埃塞俄比亚奥罗米亚地区Adama医院医学院急诊科和病房成年患者的糖尿病酮症酸中毒治疗结果和相关因素。采用简单随机抽样的方法对357例成人糖尿病酮症酸中毒患者进行横断面研究。使用医疗登记清单收集数据。使用SPSS version 20和EPI-info version 7统计软件包进行数据录入和分析。65.30%的患者曾发生2次及2次以上糖尿病酮症酸中毒，复发的主要原因为感染性疾病(69.50%)和胰岛素停用(14.80%)。从糖尿病酮症酸中毒患者的治疗结果来看，大多数患者(84.90%)出院后病情好转。糖尿病酮症酸中毒患者在24小时内补液6升以上的治疗效果比补液不足3升的治疗效果好2倍(AOR=2.41(1.58 ~ 10.02))。同样，前24小时胰岛素剂量大于60国际单位的患者治疗效果比小于40国际单位的患者好10倍(AOR=10.68(3.88- 20.64))。此外，补充钾的DKA患者的治疗结果改善是未补充钾患者的5倍(AOR= 5.30(2.11-13.32))。即使在安道玛医院医学院急诊室和病房治疗的糖尿病酮症酸中毒患者多数出院情况有所好转，但仍需鼓励早期治疗感染、补充充足液体和在患病期间调整胰岛素剂量。
{"title":"Diabetic Ketoacidosis Treatment Outcome and Associated Factors Among Adult Patients Admitted to Medical Wards of Adama Hospital Medical College, Oromia, Ethiopia","authors":"Dagim Assefa Kassaye, Worku Dugassa Girsha, Godana Jarso Guto, Haji Aman Deybasso","doi":"10.54730/abm.2020.020402","DOIUrl":"https://doi.org/10.54730/abm.2020.020402","url":null,"abstract":"Diabetic Ketoacidosis (DKA) is one of the most serious acute complications of diabetes mellitus. The mortality rate remains high in developing countries and among misdiagnosed and treated patients. Therefore targeting early diagnosis and effective treatment programs is vital to save the life of patients. The aim of the study is to assess diabetic ketoacidosis treatment outcome and associated factors among adult patients at Adama Hospital Medical College emergency department and medical wards, Oromia region, Ethiopia. Cross sectional study based on record review of 357 adult diabetic ketoacidosis patients was selected using simple random sampling. Data was collected using checklist from medical registrations. The data was entered and analyzed using SPSS version 20 and EPI-info version 7 statistical packages. Majority of the patients (65.30%) had two or more episodes of diabetic ketoacidosis and the main reasons for recurrent diabetic ketoacidosis were infectious illness (69.50%) and insulin discontinuation (14.80%). Regarding treatment outcomes of diabetic ketoacidosis patients, majority of them (84.90%) discharged with improved. Those diabetic ketoacidosis patients treated with more than six liters fluid replacement in the 1st 24 hours had better treatment outcome by two times as compared to less than three liters fluid replacement (AOR=2.41 (1.58-10.02). Similarly, those patients who got more than sixty international unit insulin doses in the 1st 24hrs had better treatment outcome by ten times (AOR=10.68 (3.88- 20.64)) when compared to less than forty international unit insulin administration. In addition, DKA patients who got supplemental potassium showed five times treatment outcome improvement (AOR= 5.30 (2.11-13.32) than for those potassium replacement was not done. Even if majority of diabetic ketoacidosis patients treated at Adama Hospital Medical College emergency room and medical wards were discharged with improvement, early treatment of infection, ample fluid replacement and insulin dose adjustment during illness need to be encouraged.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"3 5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76996151","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}
Pub Date : 2018-10-12DOI: 10.11648/J.AJIM.20180606.12
N. Jaoua, A. Woodman, M. Amini
Over the past two decades, the Kingdom of Bahrain has seen an increase in weight in a growing number of people. Experts in the field determined that it is due to a lack of exercise and poor dietary habits. The problem has reached extremely high records of obesity; 37% for females and 30% for males. The statistics were based on a cross-sectional study of 414 volunteers at a local shopping mall. The goal of this primary data analysis was to determine the current prevalence of weight abnormalities. The findings were used to predict the trend of such abnormalities among the sub-population of university students in the Kingdom of Bahrain. The analysis, done in 2018, was based on 1,100 surveys collected from subjects in the central universities in the Kingdom of Bahrain including the University of Bahrain, Ahlia University, University of Bahrain, Arabian Gulf University, Applied Science University, AMM International University, Arab Open University, and Bahrain Polytechnic. The research was conducted over a period of several months. The authors developed surveys in both Arabic and English and randomly selected participants aged between eighteen and twenty-five among full-time students from major universities in the Kingdom of Bahrain. The standards of these weight issues, including obesity, overweight and underweight issues were determined with the use of the International Classification Index, a diagnostic tool used for health management. It is managed and prescribed by the World Health Organization. Based on the Chi-square test, the results strongly depended on the gender, age, and the extent of exercise performed on a weekly basis. As a result, a multinomial logistic regression involving these factors was used to compare the trends and predict the highest and lowest probabilities of each abnormal weight. For example, the male students, aged twenty-two or older who exercise less than one hour a week, were the most likely to be obese and overweight; about 20% and 42% chance, respectively. However, the students most probable to be underweight (about 11%) were those females; aged eighteen or nineteen who exercise less than one hour a week.
{"title":"Abnormal Weight Among University Students in the Kingdom of Bahrain (2018): Prevalence, Factors, Predictions, and Recommendations","authors":"N. Jaoua, A. Woodman, M. Amini","doi":"10.11648/J.AJIM.20180606.12","DOIUrl":"https://doi.org/10.11648/J.AJIM.20180606.12","url":null,"abstract":"Over the past two decades, the Kingdom of Bahrain has seen an increase in weight in a growing number of people. Experts in the field determined that it is due to a lack of exercise and poor dietary habits. The problem has reached extremely high records of obesity; 37% for females and 30% for males. The statistics were based on a cross-sectional study of 414 volunteers at a local shopping mall. The goal of this primary data analysis was to determine the current prevalence of weight abnormalities. The findings were used to predict the trend of such abnormalities among the sub-population of university students in the Kingdom of Bahrain. The analysis, done in 2018, was based on 1,100 surveys collected from subjects in the central universities in the Kingdom of Bahrain including the University of Bahrain, Ahlia University, University of Bahrain, Arabian Gulf University, Applied Science University, AMM International University, Arab Open University, and Bahrain Polytechnic. The research was conducted over a period of several months. The authors developed surveys in both Arabic and English and randomly selected participants aged between eighteen and twenty-five among full-time students from major universities in the Kingdom of Bahrain. The standards of these weight issues, including obesity, overweight and underweight issues were determined with the use of the International Classification Index, a diagnostic tool used for health management. It is managed and prescribed by the World Health Organization. Based on the Chi-square test, the results strongly depended on the gender, age, and the extent of exercise performed on a weekly basis. As a result, a multinomial logistic regression involving these factors was used to compare the trends and predict the highest and lowest probabilities of each abnormal weight. For example, the male students, aged twenty-two or older who exercise less than one hour a week, were the most likely to be obese and overweight; about 20% and 42% chance, respectively. However, the students most probable to be underweight (about 11%) were those females; aged eighteen or nineteen who exercise less than one hour a week.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78229699","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}
Pub Date : 2018-10-10DOI: 10.11648/J.AJIM.20180605.17
G. Acherjya, K. Tarafder, R. Ghose, D. Islam, M. Ali, N. Akhtar, R. Chakrabortty, S. R. Sutradhar
Urinary Tract Infection (UTI) is very common in our day-to-day clinical practice. Among all the organisms Escherichia coli (E coli) is the most common but antimicrobial resistance becomes an alarming issue for UTI management now a days. Aim of this study is to assess the pattern of antimicrobial resistance to E coli among the UTI patients in Jashore, Bangladesh. This observational study was conducted from February, 2017 to January, 2018 in the district of Jashore, Bangladesh. We recruited 696 patients of both sex with UTI only infected by E coli. We had excluded the patients with UTI caused by other than E coli, female during menstruation, pregnancy, history of taking antibiotics within last 21 days, catheterization within 1 month and pelvic organ & genito urinary tract surgery within 6 months. Evaluation of antimicrobial resistance was done according to the standard bacteriological methods. Mean age of our study cases was 41.46±17.21 years with the range from 15 to 91 years. More than 85% participants were female with a sex ratio was 8:1.5. Reproductive age group ranged from 21 to 50 years was affected most commonly which constituted approximately two-third of our study. Our study revealed that the maximum antimicrobial resistance to E coli was Cotrimoxazole (95.0%), followed by Ceftazidime (75.7%), Gentamicin (70.3%), Amikacin (69.0%), Imipenam (58.9 %,), Cefixime (58.0%), Ciprofloxacin (57.3%), Azithromycin (56.0%), Cefuroxime (46.6%), Cefotaxime (37.4%), Ceftriaxone (35.2%), Meropenem (32.2%), Nitrofurantion (4.7%). With the high magnitude of antimicrobial resistance to E coli among the UTI patients even with extended generation of Cephalosporins, Carbapenams, Ciprofloxacin, Cotrimoxazole, Azithromycin and Aminoglycosides, our recommendation as first line empirical treatment option in UTI should be Nitrofurantoin due to low resistance pattern.
{"title":"Pattern of Antimicrobial Resistance to Escherichia Coli Among the Urinary Tract Infection Patients in Bangladesh","authors":"G. Acherjya, K. Tarafder, R. Ghose, D. Islam, M. Ali, N. Akhtar, R. Chakrabortty, S. R. Sutradhar","doi":"10.11648/J.AJIM.20180605.17","DOIUrl":"https://doi.org/10.11648/J.AJIM.20180605.17","url":null,"abstract":"Urinary Tract Infection (UTI) is very common in our day-to-day clinical practice. Among all the organisms Escherichia coli (E coli) is the most common but antimicrobial resistance becomes an alarming issue for UTI management now a days. Aim of this study is to assess the pattern of antimicrobial resistance to E coli among the UTI patients in Jashore, Bangladesh. This observational study was conducted from February, 2017 to January, 2018 in the district of Jashore, Bangladesh. We recruited 696 patients of both sex with UTI only infected by E coli. We had excluded the patients with UTI caused by other than E coli, female during menstruation, pregnancy, history of taking antibiotics within last 21 days, catheterization within 1 month and pelvic organ & genito urinary tract surgery within 6 months. Evaluation of antimicrobial resistance was done according to the standard bacteriological methods. Mean age of our study cases was 41.46±17.21 years with the range from 15 to 91 years. More than 85% participants were female with a sex ratio was 8:1.5. Reproductive age group ranged from 21 to 50 years was affected most commonly which constituted approximately two-third of our study. Our study revealed that the maximum antimicrobial resistance to E coli was Cotrimoxazole (95.0%), followed by Ceftazidime (75.7%), Gentamicin (70.3%), Amikacin (69.0%), Imipenam (58.9 %,), Cefixime (58.0%), Ciprofloxacin (57.3%), Azithromycin (56.0%), Cefuroxime (46.6%), Cefotaxime (37.4%), Ceftriaxone (35.2%), Meropenem (32.2%), Nitrofurantion (4.7%). With the high magnitude of antimicrobial resistance to E coli among the UTI patients even with extended generation of Cephalosporins, Carbapenams, Ciprofloxacin, Cotrimoxazole, Azithromycin and Aminoglycosides, our recommendation as first line empirical treatment option in UTI should be Nitrofurantoin due to low resistance pattern.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84070944","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}
Incomplete removal of micro- organisms from infected root canals is a common cause of failed endodontic treatment. The difficulty in eradication of Enterococcus faecalis from root canals plays an essential role in pathogenesis of persistent pulpal and periradicular infections. The aim of the present study was to compare the reduction of Enterococcus faecalis in root canals by mechanical instrumentation using two rotary systems (One Shape and ProTaper Next) and Hand K-file instrumentation by using microbiological and Scanning Electron Microscopy (SEM) evaluation. Fifty one freshly extracted mandibular premolars with a single root were collected. After pre-instrumentation sampling, they were divided into three groups, Group A, Group B and Group C in which biomechanical preparation was done using Hand K-File, OneShape and Protaper Next respectively. Reduction in pre- instrumentation and post- instrumentation values of Enterococcus faecalis were analysed using microbiological and SEM evaluation. Statistical analysis by paired ‘t’ test and p value showed that there was highly statistical significant difference in CFU count reduction between the pre-instrumentation and post-instrumentation values in all the groups (p<0.001). Statistical analysis by Kruskal-Wallis Test and Mann-Whitney Test showed that at 1mm and 3mm level, Group A (Hand K-File) scored significantly higher value followed by Group B (OneShape Apical) and Group C (ProTaper Next). The most effective instrumentation technique in eliminating Enterococcus faecalis from the root canal was ProTaper Next system in comparison to OneShape Apical and Hand K-File.
{"title":"A Comparison of One Shape and ProTaper Next Rotary Systems for Elimination of Enterococcus Faecalis from Root Canal: Microbiological and SEM Evaluation","authors":"Renu B. Sroa, Baljeet Sidhu, Sangeeta Aggarwal, Aakanksha Chopra, Amna Bedi","doi":"10.11648/j.ajim.20180605.16","DOIUrl":"https://doi.org/10.11648/j.ajim.20180605.16","url":null,"abstract":"Incomplete removal of micro- organisms from infected root canals is a common cause of failed endodontic treatment. The difficulty in eradication of Enterococcus faecalis from root canals plays an essential role in pathogenesis of persistent pulpal and periradicular infections. The aim of the present study was to compare the reduction of Enterococcus faecalis in root canals by mechanical instrumentation using two rotary systems (One Shape and ProTaper Next) and Hand K-file instrumentation by using microbiological and Scanning Electron Microscopy (SEM) evaluation. Fifty one freshly extracted mandibular premolars with a single root were collected. After pre-instrumentation sampling, they were divided into three groups, Group A, Group B and Group C in which biomechanical preparation was done using Hand K-File, OneShape and Protaper Next respectively. Reduction in pre- instrumentation and post- instrumentation values of Enterococcus faecalis were analysed using microbiological and SEM evaluation. Statistical analysis by paired ‘t’ test and p value showed that there was highly statistical significant difference in CFU count reduction between the pre-instrumentation and post-instrumentation values in all the groups (p<0.001). Statistical analysis by Kruskal-Wallis Test and Mann-Whitney Test showed that at 1mm and 3mm level, Group A (Hand K-File) scored significantly higher value followed by Group B (OneShape Apical) and Group C (ProTaper Next). The most effective instrumentation technique in eliminating Enterococcus faecalis from the root canal was ProTaper Next system in comparison to OneShape Apical and Hand K-File.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83848501","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}
Pub Date : 2018-09-03DOI: 10.11648/J.AJIM.20180605.15
Nagib Abuasba, Khalid Alwadee, M. Al-Hamadi
Although acute kidney injury (AKI) in our setting is growing rapidly, the available data on the magnitude of this lethal problem are very limited. The objective of this study was to determine the incidence, epidemiology and outcome of AKI. A total of 143 hospitalized patients with AKI in Al Thawra General Hospital, nephrology department between July 2015 and December 2016 were enrolled. The mean age of the study population was 37.7 ± 8.4 years, and 68.5% of these patients were males. Almost 81.8% of cases were medically referred and malarial infection was the commonest cause of AKI (23%). Pre renal AKI was present in 65 patients (45.4%) and renal AKI in 78 patients (54.5%). Most cases were presented with clinical manifestation of volume overload (65%), oliguria (51.7%), anuria (16.7%), and high serum creatinine level. The majority of cases (58.7%) had recovered without dialysis. In-hospital mortality was observed in 11 patients (7.7%). Hepatic failure and malarial infection were the common causes of death. This study demonstrates low frequency of AKI in our setting. The etiologies of this lethal health problem are preventable and treatable in approximately half of cases. Late referral to hospital may contribute both to the progression of renal disease and also to high mortality.
{"title":"Frequency, Epidemiology and Outcome of Acute Kidney Injury Among Patients Admitted to Nephrology Center, Sana’a: Observational Study","authors":"Nagib Abuasba, Khalid Alwadee, M. Al-Hamadi","doi":"10.11648/J.AJIM.20180605.15","DOIUrl":"https://doi.org/10.11648/J.AJIM.20180605.15","url":null,"abstract":"Although acute kidney injury (AKI) in our setting is growing rapidly, the available data on the magnitude of this lethal problem are very limited. The objective of this study was to determine the incidence, epidemiology and outcome of AKI. A total of 143 hospitalized patients with AKI in Al Thawra General Hospital, nephrology department between July 2015 and December 2016 were enrolled. The mean age of the study population was 37.7 ± 8.4 years, and 68.5% of these patients were males. Almost 81.8% of cases were medically referred and malarial infection was the commonest cause of AKI (23%). Pre renal AKI was present in 65 patients (45.4%) and renal AKI in 78 patients (54.5%). Most cases were presented with clinical manifestation of volume overload (65%), oliguria (51.7%), anuria (16.7%), and high serum creatinine level. The majority of cases (58.7%) had recovered without dialysis. In-hospital mortality was observed in 11 patients (7.7%). Hepatic failure and malarial infection were the common causes of death. This study demonstrates low frequency of AKI in our setting. The etiologies of this lethal health problem are preventable and treatable in approximately half of cases. Late referral to hospital may contribute both to the progression of renal disease and also to high mortality.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85157732","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}
Pub Date : 2018-08-24DOI: 10.11648/J.AJIM.20180605.13
R. Bhikha, J. Glynn
Acceptance of the clinical efficacy and tolerance of herbal remedies by practitioners of conventional, Western medicine is strongly dependent on unambiguous and reproducible evidence, particularly their pharmacological action. A single conventional drug generally has one dominant pharmacological mode of action which accounts for its therapeutic efficacy, whereas a herbal remedy because of the various active agents it contains, generally influences several biochemical and/or physiological systems present in the body. Identifying this therefore poses several challenges. They are much more complex, and the active components of a herbal remedy may act synergistically or interact in other ways. Although the need to determine modes of action has not been a primary concern of complementary healthcare practitioners, there is increasing pressure to elaborate objectively on their pharmacological action. In response, there has been an encouraging, and escalating, release of scientific data documenting the mode of action of many herbal remedies. Some we know about in considerable detail; of others we have an inkling; but for the vast majority the’ modes of action remain to be elucidated. This brief review, based on a survey of the available scientific and clinical literature, examines the modes of action of several therapeutic herbs which are being increasingly used, whether informally or as part of complementary or integrative medical practice. It examines a major category of sub stances, the adaptogens, and the various chemical forms it embraces, such as the saponins and triterpenes. The herbs with modulate the immune system, for instance garlic, turmeric and St John’s Wort, are likewise surveyed, as are the alkaloids and botanical anti-inflammatory agents. Herbs which exert pharmacological action via their nitric oxide regulatory properties are listed, as are those which provide essential micro-nutrients, such as vitamins and certain minerals. The review concludes with comment on the importance of understanding herbal remedy modes of action as a positive step to their wider adoption in the modern-day therapeutic armamentarium.
{"title":"The Pharmacological Action of Common Herbal Remedies","authors":"R. Bhikha, J. Glynn","doi":"10.11648/J.AJIM.20180605.13","DOIUrl":"https://doi.org/10.11648/J.AJIM.20180605.13","url":null,"abstract":"Acceptance of the clinical efficacy and tolerance of herbal remedies by practitioners of conventional, Western medicine is strongly dependent on unambiguous and reproducible evidence, particularly their pharmacological action. A single conventional drug generally has one dominant pharmacological mode of action which accounts for its therapeutic efficacy, whereas a herbal remedy because of the various active agents it contains, generally influences several biochemical and/or physiological systems present in the body. Identifying this therefore poses several challenges. They are much more complex, and the active components of a herbal remedy may act synergistically or interact in other ways. Although the need to determine modes of action has not been a primary concern of complementary healthcare practitioners, there is increasing pressure to elaborate objectively on their pharmacological action. In response, there has been an encouraging, and escalating, release of scientific data documenting the mode of action of many herbal remedies. Some we know about in considerable detail; of others we have an inkling; but for the vast majority the’ modes of action remain to be elucidated. This brief review, based on a survey of the available scientific and clinical literature, examines the modes of action of several therapeutic herbs which are being increasingly used, whether informally or as part of complementary or integrative medical practice. It examines a major category of sub stances, the adaptogens, and the various chemical forms it embraces, such as the saponins and triterpenes. The herbs with modulate the immune system, for instance garlic, turmeric and St John’s Wort, are likewise surveyed, as are the alkaloids and botanical anti-inflammatory agents. Herbs which exert pharmacological action via their nitric oxide regulatory properties are listed, as are those which provide essential micro-nutrients, such as vitamins and certain minerals. The review concludes with comment on the importance of understanding herbal remedy modes of action as a positive step to their wider adoption in the modern-day therapeutic armamentarium.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90984983","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}
Pub Date : 2018-08-20DOI: 10.11648/J.AJIM.20180605.11
G. Gürbüz, F. Hazan, S. Edizer, Bahar Baysal, Ünsal Yılmaz, A. Ünalp
Many chromosomal anomalies manifest with epilepsy. Only few typical EEG and seizure type have been identified in genetic syndromes. Identification of typical seizure and EEG findings of certain genetic syndromes may serve as a guide for genetic analysis. This study aims to find typical EEG paterns of spesific genetic syndromes. The study enrolled 50 patients aged 0-16 years with a diagnosis of epilepsy and genetic syndrome in between 2014-2017 at the Dr. Behçet UZ Children’s Hospital Pediatric Neurology and Medical Genetics departments. Patients' characteristics and dysmorphic features were retrieved from Medical Genetic outpatient clinic patient files, while seizure type, epileptic syndromic classification, EEG and brain MRI findings, age at onset and frequency of seizure were determined from pediatric neurology follow-ups. Fifty patients (29 girls) with a mean age of 6.52 ±3.67 years (max=16, min=1) were enrolled. Twenty-two patients had microdeletion-duplication (44%), 12 had chromosomal anomalies (24%) and 16 had monogenic syndrome (32%). Pathology was present in the EEGs of 40 patients (80%). Focal epileptic disorder was determined in 28 subjects (56%), epileptic encephalopathy in 7 (14%), and generalized epileptic disorder in 5 (10%) Identification of seizure type and EEG pattern specific to each genetic dysmorphic syndrome may give clues to clinicians in recognizing these syndromes. However, in order to detect other specific EEG patterns, there is a need for multicentre studies with more patients.
{"title":"Evaluation of Eeg Pattern and Seizure Types of Genetic Dysmorphic Syndromes: Report of 50 Patients and Review of the Literature","authors":"G. Gürbüz, F. Hazan, S. Edizer, Bahar Baysal, Ünsal Yılmaz, A. Ünalp","doi":"10.11648/J.AJIM.20180605.11","DOIUrl":"https://doi.org/10.11648/J.AJIM.20180605.11","url":null,"abstract":"Many chromosomal anomalies manifest with epilepsy. Only few typical EEG and seizure type have been identified in genetic syndromes. Identification of typical seizure and EEG findings of certain genetic syndromes may serve as a guide for genetic analysis. This study aims to find typical EEG paterns of spesific genetic syndromes. The study enrolled 50 patients aged 0-16 years with a diagnosis of epilepsy and genetic syndrome in between 2014-2017 at the Dr. Behçet UZ Children’s Hospital Pediatric Neurology and Medical Genetics departments. Patients' characteristics and dysmorphic features were retrieved from Medical Genetic outpatient clinic patient files, while seizure type, epileptic syndromic classification, EEG and brain MRI findings, age at onset and frequency of seizure were determined from pediatric neurology follow-ups. Fifty patients (29 girls) with a mean age of 6.52 ±3.67 years (max=16, min=1) were enrolled. Twenty-two patients had microdeletion-duplication (44%), 12 had chromosomal anomalies (24%) and 16 had monogenic syndrome (32%). Pathology was present in the EEGs of 40 patients (80%). Focal epileptic disorder was determined in 28 subjects (56%), epileptic encephalopathy in 7 (14%), and generalized epileptic disorder in 5 (10%) Identification of seizure type and EEG pattern specific to each genetic dysmorphic syndrome may give clues to clinicians in recognizing these syndromes. However, in order to detect other specific EEG patterns, there is a need for multicentre studies with more patients.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90909431","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}
Pub Date : 2018-08-14DOI: 10.11648/J.AJIM.20180604.16
A. Uppe, Padmaraj Ankale, Arti Sharma, R. Shah, Girija Nair
Objective: The aim of our study was to study the COPD phenotypes, comorbidities and factors predicting treatment outcomes in patients with acute exacerbations of COPD admitted in hospital. Methodology: A retrospective study of fifty patients with acute exacerbation of COPD admitted in a tertiary care hospital during July 2015 to August 2016 was done. Results: It was observed that the mean duration of hospital stay was 8 ± 7 days with 44% of the patient discharged in less than 7 days (short stay) and 56% of patients in more than 7 days (long stay). The factors favouring longer stay in hospital include history of current smoking, hypoxia and CO2 retention while patients on active COPD treatment and cessation of smoking leads to shorter hospital stay. Conclusion: For patients with acute exacerbations of COPD requiring hospitalization, history of current smoking with hypoxia and CO2 retention are associated with longer stay in hospital while patients on active COPD treatment and cessation of smoking leads to shorter hospital stay.
{"title":"Factors Predicting Treatment Outcome in Hospitalized Patients with Acute Exacerbation of COPD (AECOPD)","authors":"A. Uppe, Padmaraj Ankale, Arti Sharma, R. Shah, Girija Nair","doi":"10.11648/J.AJIM.20180604.16","DOIUrl":"https://doi.org/10.11648/J.AJIM.20180604.16","url":null,"abstract":"Objective: The aim of our study was to study the COPD phenotypes, comorbidities and factors predicting treatment outcomes in patients with acute exacerbations of COPD admitted in hospital. Methodology: A retrospective study of fifty patients with acute exacerbation of COPD admitted in a tertiary care hospital during July 2015 to August 2016 was done. Results: It was observed that the mean duration of hospital stay was 8 ± 7 days with 44% of the patient discharged in less than 7 days (short stay) and 56% of patients in more than 7 days (long stay). The factors favouring longer stay in hospital include history of current smoking, hypoxia and CO2 retention while patients on active COPD treatment and cessation of smoking leads to shorter hospital stay. Conclusion: For patients with acute exacerbations of COPD requiring hospitalization, history of current smoking with hypoxia and CO2 retention are associated with longer stay in hospital while patients on active COPD treatment and cessation of smoking leads to shorter hospital stay.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85912443","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}
Pub Date : 2018-08-07DOI: 10.11648/J.AJIM.20180604.15
A. Woodman, N. Jaoua
The purpose of this primary data analysis is to estimate the prevalence of obesity in a specific workplace in the Kingdom of Saudi Arabia (KSA). The information would then be used to predict the prevalence of obesity among the male workforce of Saudi Aramco, the largest oil company in the world. A total of N=1,000 male employees (883Saudis, 117non-Saudis), aged 19-65, participated. They were randomly selected from several male Saudi Aramco stations and were asked to take a survey. Chi-square test was used to measure the significance effect of some independent variables on the BMI status. The overall prevalence was estimated, with a confidence level of 95%, at 22.5±2.6% for obesity, 36.7±3% for overweight, and 1±0.6% for underweight. The figures highly depended on the region where they spent their childhood, their age, nationality, and amount of exercise performed per week. For instance, 27.4±4.2% of those who grew up in the Eastern Province were estimated to be obese (vs. 16.5±3.5% among those raised elsewhere in KSA), and 28.7±5% of those who rarely exercise (less than 1 hour per week) were considered obese (vs. 17.8±4.1% among those who work out for at least 3 hours per week). As a result, a logistic model, involving these factors, was used for future prediction. For example, non-Saudis would be about 2.3 times more likely to be obese, and those aged 30-39 would be about 1.9 times more likely to be obese compared to “under 30” and “50 or more” age groups and 1.7 times more likely to be so than those aged 40-49. In addition, the lowest and highest conditional probabilities of obesity relative to this model were determined (6.6% and 66.4%). As a result, the likeliest male employees to be obese; the non-Saudi ones, raised in the Easter Province, aged 30-39 and exercise very little (less than 1h/w), would actually have more than two chances in three to be obese. Based on relatively concerning figures about obesity in male employees of Saudi Aramco, this paper recommends workplace wellness program model to improve the health of employees and their productivity, by creating an atmosphere of health and care for their well-being.
{"title":"Obesity Among Male Employees at Saudi Aramco: Trends, Factors, and Johns Hopkins Aramco Healthcare Recommendations","authors":"A. Woodman, N. Jaoua","doi":"10.11648/J.AJIM.20180604.15","DOIUrl":"https://doi.org/10.11648/J.AJIM.20180604.15","url":null,"abstract":"The purpose of this primary data analysis is to estimate the prevalence of obesity in a specific workplace in the Kingdom of Saudi Arabia (KSA). The information would then be used to predict the prevalence of obesity among the male workforce of Saudi Aramco, the largest oil company in the world. A total of N=1,000 male employees (883Saudis, 117non-Saudis), aged 19-65, participated. They were randomly selected from several male Saudi Aramco stations and were asked to take a survey. Chi-square test was used to measure the significance effect of some independent variables on the BMI status. The overall prevalence was estimated, with a confidence level of 95%, at 22.5±2.6% for obesity, 36.7±3% for overweight, and 1±0.6% for underweight. The figures highly depended on the region where they spent their childhood, their age, nationality, and amount of exercise performed per week. For instance, 27.4±4.2% of those who grew up in the Eastern Province were estimated to be obese (vs. 16.5±3.5% among those raised elsewhere in KSA), and 28.7±5% of those who rarely exercise (less than 1 hour per week) were considered obese (vs. 17.8±4.1% among those who work out for at least 3 hours per week). As a result, a logistic model, involving these factors, was used for future prediction. For example, non-Saudis would be about 2.3 times more likely to be obese, and those aged 30-39 would be about 1.9 times more likely to be obese compared to “under 30” and “50 or more” age groups and 1.7 times more likely to be so than those aged 40-49. In addition, the lowest and highest conditional probabilities of obesity relative to this model were determined (6.6% and 66.4%). As a result, the likeliest male employees to be obese; the non-Saudi ones, raised in the Easter Province, aged 30-39 and exercise very little (less than 1h/w), would actually have more than two chances in three to be obese. Based on relatively concerning figures about obesity in male employees of Saudi Aramco, this paper recommends workplace wellness program model to improve the health of employees and their productivity, by creating an atmosphere of health and care for their well-being.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"145 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79942742","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}
Pub Date : 2018-07-06DOI: 10.11648/J.AJIM.20180604.11
K. Morris, E. Shmukler, A. Schmit, S. Chaudhry, M. Walsh, A. Ravichandran
PARADIGM-HF compared valsartan/sacubitril (ARNI) with enalapril in symptomatic patients with heart failure with reduced ejection fraction (HFrEF) (1). It was stopped early after the boundary for overwhelming benefit in favor of ARNI had been reached. Patients taking ARNI had decreased symptoms, risk of HF hospitalization and all-cause and cardiovascular mortality. We sought to describe our center’s initial year of experience with this novel agent. A retrospective chart review was completed of all patients in our advanced HF clinic who were prescribed ARNI between August 2015 and October 2016. Outcomes data were collected through August 2017. Consistent with the Food and Drug Administration (FDA) indication, patients treated had NYHA class II, III or IV HF symptoms with LVEF of 35% or less. The majority of those prescribed ARNI were able to initiate the medication. However, a significant proportion of patients (26.4%) had to discontinue ARNI due to a variety of reasons, most commonly symptomatic hypotension (31.0%) and insufficient insurance coverage (31.0%). Only 30.5% of patients successfully treated reached the maximum dose; in 85% of these patients, hypotension limited up titration of therapy. PARADIGM-HF demonstrated benefit of ARNI therapy over enalapril in patients with HFrEF and therapy was well tolerated. In our real world experience, hypotension and lack of insurance coverage limited utilization. Further experience with this therapy in a non-trial setting will inform optimal patient selection and titration strategies. Expanded insurance coverage will be crucial to allow for patient access.
{"title":"Valsartan/Sacubitril for Treatment of Hfref: A Single Center's Paradigm","authors":"K. Morris, E. Shmukler, A. Schmit, S. Chaudhry, M. Walsh, A. Ravichandran","doi":"10.11648/J.AJIM.20180604.11","DOIUrl":"https://doi.org/10.11648/J.AJIM.20180604.11","url":null,"abstract":"PARADIGM-HF compared valsartan/sacubitril (ARNI) with enalapril in symptomatic patients with heart failure with reduced ejection fraction (HFrEF) (1). It was stopped early after the boundary for overwhelming benefit in favor of ARNI had been reached. Patients taking ARNI had decreased symptoms, risk of HF hospitalization and all-cause and cardiovascular mortality. We sought to describe our center’s initial year of experience with this novel agent. A retrospective chart review was completed of all patients in our advanced HF clinic who were prescribed ARNI between August 2015 and October 2016. Outcomes data were collected through August 2017. Consistent with the Food and Drug Administration (FDA) indication, patients treated had NYHA class II, III or IV HF symptoms with LVEF of 35% or less. The majority of those prescribed ARNI were able to initiate the medication. However, a significant proportion of patients (26.4%) had to discontinue ARNI due to a variety of reasons, most commonly symptomatic hypotension (31.0%) and insufficient insurance coverage (31.0%). Only 30.5% of patients successfully treated reached the maximum dose; in 85% of these patients, hypotension limited up titration of therapy. PARADIGM-HF demonstrated benefit of ARNI therapy over enalapril in patients with HFrEF and therapy was well tolerated. In our real world experience, hypotension and lack of insurance coverage limited utilization. Further experience with this therapy in a non-trial setting will inform optimal patient selection and titration strategies. Expanded insurance coverage will be crucial to allow for patient access.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"381 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77372915","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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