Vol 7 Issue 1 April 2019-September 2019

Abstract: This paper aimed at analyzing the major causes of diabetes among city dwellers in Burco. Diabetes has been cited as a chronic disease that is widespread not only in Burco but the rest of Somaliland. It is thought be caused by poor feeding, increasing lifestyles imported by urbanization resulting into people preferring to eat processed food that is causing over-weight (obesity) among other cases. Mixed methods (involving questionnaires, interviews and participant observation) were used to gather primary data. Some of the research findings were as follows: The study found that there are two types of diabetes existing in Burco which are type 1 and Type 2(TM) of which the latter has claimed more lives but also worried the Burco populace so much. While a good number of people confirmed that they have seen or heard of diabetes disease or diabetic individuals, there are also some who are not even aware of the disease existence and this could mean that some people may be diabetic without knowing; we also found that diabetes is affecting young people that are below 19 years of age in Burco.

Keywords: Analysis, causes, diabetes, Burco, City, Somaliland.

Title: Analysis of the Major Causes of Diabetes in Burao City, Somaliland

Author: Hibaq Ali Ismail, Hafsa Abdirazak Mohamed, Magool Aden Mire, Khadra Mohamud Ayah, Abdifatah Abdillahii Hassan, Mohamed Salah Omer

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Cockayne syndrome is related to defective DNA transcription and/or repair and belongs to the family of Nucleotide Excision Repair. It is an autosomal recessive multisystemic disorder a rare disorder characterized by an abnormally small head size (microcephaly), a failure to gain weight and grow at the expected rate (failure to thrive) leading to very short stature, premature aging (progeria) and delayed development. The signs and symptoms of this condition are usually apparent from infancy, and they worsen over time. Most affected individuals have an increased sensitivity to sunlight (photosensitivity), and in some cases even a small amount of sun exposure can cause a sunburn or blistering of the skin. Other signs and symptoms often include hearing loss, vision loss, severe tooth decay, bone abnormalities, hands and feet that are cold all the time, and changes in the brain that can be seen on brain scans.

People with Cockayne syndrome have a serious reaction to an antibiotic medication called metronidazole. If affected individuals take this medication, it can cause life-threatening liver failure.

Cockayne syndrome is sometimes divided into types I, II, and III based on the severity and age of onset of symptoms. However, the differences between the types are not always clear-cut, and some researchers believe the signs and symptoms reflect a spectrum instead of distinct types. Cockayne syndrome type II is also known as cerebro-oculo-facio-skeletal (COFS) syndrome, and while some researchers consider it to be a separate but similar condition, others classify it as part of the Cockayne syndrome disease spectrum.

Keywords: cockayne syndrome. Cerebto-Oculo-Facio-Skeletal (COFS), Progeria, Metronidazole.

Title: Case report on Cockayene Syndrome

Author: Zahra Fadaeian

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Mauritius and China represent two diverse applications of community nursing principles by professionals. The Chinese scenario is one where the country boasts of adequate funding as well as the affluence of society. The community in major cities such as Guangzhou and Shanghai do not represent social health concerns as are in Mauritius. Mauritius is an African island nation that struggles with the many challenges of developing countries such as poverty and ignorance. Similarly, the healthcare system lacks adequate training to dispense amicable community nursing practices and principles. It is vital that as the people of Mauritius under the government efforts seek to improve the state of nursing in the country, that there be more training opportunities offered to the medical professionals in the country. The healthcare sector requires that there be more tools and facilities for doctors and nurses to dispense adequate care in community nursing centers. In China, concerns over outbreaks have been noted, and government policies continue to guide the general handling of medical emergencies in the country. In summary, the efforts taken by the Chinese government and the National Health Council (CHC) in China should be replicated in Mauritius as well.

Keywords: Mauritius, Health Care, Community Nursing, China, National Health Commission.

Title: A comparison of the community nursing practices between China and Mauritius

Author: Gilbert Roland, Feng Hui

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Cancer, a high-risk cause of death disease becomes more popular these days. The American Cancer Society (ACS) stated that one of the leading types of new cancer cases is breast cancer. It starts from transformed cells that are getting bigger and wilder which finally spread out through the tissues and organs of the body. Based on the medical record from Sanglah Hospital, Denpasar, there were 68 breast cancer patients hospitalized during 2015. This surely brings a great concern. Every woman is vulnerable to breast cancer and the global death rate of it is up to 88%. So, the aim of this research is to find out the characteristics of breast cancer patients who entered in Sanglah Hospital in between 2014-2016 and see the description of their nutritional status as determined by their body mass index and fat composition value. This research is an observational research with cross sectional study. To know the body mass index and fat composition value of the breast cancer patients at Sanglah Hospital during 2014-2016, the data of from the Medical Record Department of Sanglah Hospital are collected. The result of the data gaining is analyzed using SPSS program and presented in a descriptive form. Based on the collected data, from 75 breast cancer patients who entered and have been hospitalized in Sanglah Hospital during 2014-2016, 81.4% of them are at the age of 41-60, 40% come from Denpasar, 76% are with light and moderate workloads, and 74.7% are suffering from breast cancer stage III and IV. While the distribution of the patients’ nutritional status shows that: 10.7% is underweight, 38.7% is normal, and 50.7% is overweight or obese.

Keywords: nutrition status, body mass index, fat composition, obese.

Title: BODY MASS INDEX AND FAT COMPOSITION AMONG BREAST CANCER (CARCINOMA MAMMAE) PATIENTS AT SANGLAH HOSPITAL IN BETWEEN 2014-2016

Author: Ayu Hapsari, Gde Ngurah Indraguna Pinatih

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Acute respiratory infections (ARI) are one of the leading causes of death among children under-five years of age, and are estimated to be responsible for up to 2.2 million childhood deaths globally. But less than half of children with ARI symptoms are taken for prompt and appropriate care.

Objectives: To assess the care seeking practices and the socioeconomic factors affecting the care seeking behavior of mothers of under-five for acute respiratory infections.

Methods: A community based descriptive cross-sectional study was carried out among 385 mothers of under-five in Iwo local government, Osun state using a semi- structured interviewer-administered questionnaire.

Result: 385 participants were involved in the study; symptoms of ARI were reported by 283 out of which 223(78.4%) were taken for treatment. Only 96(24.9%) sought for care within 24 hours of onset of symptoms, 96(39.2%) sought for care in private hospital, 23.7% went to the government hospital. The main reasons for delay in seeking health care were financial cost (52%) and feeling that condition is not serious (52%).

Conclusion: Though mothers have a relatively good health seeking behavior, health education is very essential to improve their knowledge on the cause and course of ARI and their care seeking behavior in order to reduce the burden of ARI.

Keywords: Acute respiratory infection, health care seeking behavior, mothers, under-five.

Title: ASSESSMENT OF HEALTH CARE SEEKING PRACTICES OF MOTHERS OF UNDER FIVE TO ACUTE RESPIRATORY INFECTIONS IN IWO LOCAL GOVERNMENT

Author: Grace Ademuyiwa, Oluwaseyi Olabisi,Taiwo Dosumu

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: A 68-year-old man was referred to our tertiary eye hospital with a suspicion of choroidal melanoma in the left eye. Clinical examination showed a choroidal lesion with extensive subretinal hemorrhages. Next follow up visit showed a rapid decrease in the size of the lesion. The lesion was considered vascular in nature based on extensive hemorrhages and rapid variability in size. Later on, the lesion showed a slow grow up over time together with additional b scan findings that led to the final diagnosis of choroidal melanoma.

Keywords: choroidal melanoma, choroidal hemorrhagic lesion, Polypoidal choroidal vasculopathy, masquerading melanoma. 

Title: A suprachoroidal hemorrhagic lesion of medium-sized melanoma presenting with features of polypoidal choroidal vasculopathy

Author: Abdullah A Almarshood

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Dental caries is one of the most prevalent diseases affecting human beings and persists till date as a challenge to the medical and dental profession, in particular, and the society in general.

Objectives: The aim of this study is to estimate the occurrence of dental caries at PSMCHS in Dhahran including the influence of socio-demographic factors.

Method: A cross sectional study was conducted at PSMCHS in Dhahran. A total of 266 male students aged 18 – 41 were randomly selected from pre-clinical and clinical students, by proportionate departments. The Data were collected according to the  WHO criteria to diagnose dental caries. Finally , an analysis was done using IBM SPSS version 22.

Results: Out of a total of 266 student completing the questionnaire and the test, the occurrences of DMFT was 53.38% among the population, the occurrence of decayed teeth was 50%, missing teeth was 11.74% and filling teeth was 38.26%.

Conclusion and recommendations: In general, dental caries among students at PSMCHS were high; therefore, a major effort should be done to improve this condition. According to our findings, it should be focused on the prevention of DMFT.

Keywords: PSMCHS, Dental caries, WHO criteria.

Title: PREVALENCE OF DENTAL CARIES AMONG PRE-CLINICAL YEAR AND CLINICAL YEAR STUDENTES AT PRINCE SULTAN MILITARY COLLEGE OF HEALTH SCIENCES, DHAHRAN, SAUDI ARABIA

Author: Anwar Al Aithan, Ali Hijles, Ibrahim Al Makrami, Noor Al khowetam, Col.\ Dr. Mohammad Alzahrani, Ms. Diaa Almutairi

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: According to WHO, cancer is one of the most causes of death worldwide, to be precise, it is the second most prevalence disease after cardiovascular diseases. One of the most common type of cancer with the highest prevalence currently is breast cancer. Obesity is believed as one of the risk factors of breast cancer; however this is only valid when the woman is on her post-menopausal period. This study aim to know the correlation between obesity and menopause status among breast cancer patients. This study was using cross-sectional study design and data were obtained using systematic random sampling through an interview and anthropometrics observation in the oncologic policlinic and wards Sanglah Central Hospital within the period of July 2016 until December 2016. Obesity was measured using BMI, waist circumferences and arm circumferences. This study found that there was a significant correlation between obesity and breast cancer using all of the anthropometrics measurements (p value 0.013; 0.03; and 0.024 respectively). It can be concluded that obesity is one of the risk factors of breast cancer among post-menopausal woman. It is suggested that further study compare a similar study within the rural and urban population.

Keywords: Obesity, menopause, breast cancer.

Title: RELATION BETWEEN OBESITY STATUS AND MENOPAUSAL STATUS IN CANCER PATIENT AT SANGLAH PUBLIC HOSPITAL DURING JULY 2016-DECEMBER 2016

Author: Annastasya Isabelle, I.B. Tjakra Wibawa Manuaba

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Hypertension is still a public health problem in Indonesia and its prevalence increases considerably. Hypertension arises from the interaction of various risk factors. The main risk factor of hypertension on patient at Tembuku I Of Community Health Center,Bangli are by family and physical activities factor. To know the description of family and daily activities factors on hypertension patient at Tembuku I Of Community Health Center, Bangli. The type of research is a descriptive cross sectional study. The total subjects in this study is about 84 respondents. The research took place at Tembuku I Of Community Health Center,Bangli on 2017. Sample taken by convenience sampling. Data obtained through questionnaires and direct interviews and physical examination of blood pressure measurement. From the research on hypertension patient showed, family history mostly has history of hypertension in father about 69%. The proportion of activity-based hypertensive patients is almost half of respondents have moderate physical activity that is about 46.4%. Public recommended to modify lifestyle and avoid risk factors of uncontrolled hypertension. Suggested to the Tembuku I Of Community Health Center staff to increase health promotion related to the prevention and treatment of hypertension

Keywords: Hypertension, Family History, Activities.

Title: PROPORTION OF FAMILY AND DAILY ACTIVITIES FACTORS IN HYPERTENSION PATIENT AT TEMBUKU I OF COMMUNITY HEALTH CENTER, BANGLI ON 2017

Author: Erwinsyah, Anak Agung Sagung Sawitri

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Wound is a disruption of the anatomic structure and function in any body part. It includes burns, bone fracture, ulcers, skin break, muscle tear etc. The infection of a wound can be defined as the invasion of organism through tissues following a breakdown of local and systemic host defences leading to local and systemic presentation. Infection is also due to tissue infestation by microorganism with inflammation response. Antibiotics agents are the most as often as possible recommended medication for prevention of bacterial infection. Antibiotic are effective against various microorganism and the susceptibility to reduce adverse effect. Wound infections have a huge impact on patient quality of life. Rational use of antibiotics is important because the emergence of resistance has become a global threat. Antibiotics resistance is the ability of the microorganism to withstand the effect if any antibiotics, the microorganism changes in a way that reduces the effectiveness of the drug. Objective: To analyze the Prescribing pattern of antibiotics in wound infection and the resistance of microorganism in surgery department. Methodology: This was an observational study carried out over a period of 6 months among inpatient in the department of Surgery. The entire patient admitted in the Surgery ward meeting our inclusion criteria and exclusion criteria in this study were included. All the documented data were evaluated by applying appropriate statistical analysis like mean and standard deviation. Results: A total number of 130 patients was enrolled in our study performed in surgery department. From our study, the majority of study population were male (77.69%) and female were (22.30%).The high number of people belongs to group age of 56-65 years was 38 peoples. In wound infection, Diabetic foot (43.07%) was found to be a major problem followed by gangrene (28.84%) and cellulitis (12.31%).In our study, out of 130 cases, culture sensitivity test was performed for 95 cases and no culture sensitivity performed for 35 cases. Several samples such as Pus (53), wound swab (37) were collected. With reference to the culture sensitivity test, the major organisms isolated were categorized under gram negative such as E. Coli 22, Pseudomonas Aeruginosa 31. It can be observed that out of 130 patients included in our study 127 received antimicrobial therapy empirically while 3 patients did not received. Total of 18 different antibiotics were prescribed from which the most commonly prescribed were Metronidazole, Ceftriaxone and also the combination of ceftriaxone +metronidazole or Ceftriaxone + Metronidazole + Amikacin / Meropenem. Conclusion: The most antibiotics prescribed in the surgery department regarding wound infection were Metronidazole, Ceftriaxone and slightly Amikacin. The judicious use of antibiotic prophylaxis and reporting can be the most effective means to reduce the wound infection rate. Antimicrobial resistance in bacterial pathogens is a significant challenge that has a high morbidity and mortality.

Keywords: Wound infection, antimicrobial resistance, antibiotics agents, Ceftriaxone, Amikacin, Diabetic Foot.

Title: PRESCRIBING PATTERN OF ANTIBIOTICS IN WOUND INFECTION IN SURGERY DEPARTMENT

Author: Cla Gondo Dohanon Benedicte, Monica Chanchal, N’goran Hiwo Stephanie Laetitia, Salome Daniel Slahay, Dr.Raksha Yoganand, Dr.Divya Mol E.C

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Type 2 DM is a prevailing chronic disease worldwide. It is associated with a number of complications and has very significant mortality and morbidity as well. The main pathophysiology of diabetes is the understanding of carbohydrate metabolism. Insulin resistance, mainly caused by obesity and physical inactivity, both precedes and predicts type 2 diabetes. This insulin resistance is commonly due to metabolic factors other than Weight, Fat distribution, Race, Inactivity, Family history, Age, Prediabetics, Areas of darkened skin, usually in the armpits and neck and Gestational diabetes. DM-2 is also associated with a number of complications like Heart and blood vessel disease, Nerve damage (neuropathy) and kidney damage. Metformin remains the first line and most effective medication, yet it is not the best use as a single drug regime in most of the patients. Nowadays the most effective treatment in Type 2DM is a combination of multiple oral hypoglycemic drugs. SGLT-2 Inhibitors and GLP-1 Agonist are some of the efficacious 2nd line treatments for Type 2 DM. One of the most important questions is what are the factors that should be taken into account to guide the choice between SGLT-2 inhibitors and GLP-1 Agonists. It is estimated that Both GLP-1 Agonist and SGLT-2 Antagonist are beneficial in reducing the number of complications especially associated with cardiovascular outcomes. SGLT-2 Inhibitors are particularly more efficacious in preventing cardiovascular risks.

Keywords: SGLT-2 Inhibitors, GLP-1, pathophysiology, cardiovascular risks.

Title: SGLT-2 Inhibitors and GLP-1 Receptor agonist on Cardiovascular mortality reduction

Author: Dr. Shivam Singla, Dr. Ashish Shrivastava, Dr. Aditya  Keerthi Rayapureddy, Dr. Sarraa Aljalily, Dr. Chhaya Kamwal, Dr. Kirti Juneja, Dr. Vinesh Kumar, Dr. Anil A. Kumar, Dr.  Tanya Aggarwal

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Leprosy reaction also known as lepra reaction is the inflammatory reactions of the skin, nerves, and other organs, characterized by sudden appearance of redness, swelling, pain, and sometimes tenderness of the skin lesion. It occurs due to sudden alteration in the immunological status of the host against the living or dead bacilli. The reactions usually occur shortly after initiating treatment of leprosy but can occur any time (including years after treatment). Leprosy reactions can affect up to 30% to 50% of patient and can cause permanent nerve loss. Leprosy reaction is of two major types type 1 lepra reaction (reversal reaction), type 2 lepra reactions (Erythema Nodosum Leprosum (ENL). A type 1 reaction or reversal reaction is expressed clinically by inflammatory exacerbation of the skin lesions and nerve trunks, consequently leading to sensory and motor alterations. Mechanism: Delayed hypersensitivity against M.Leprae antigens. Management: reduce the stimulating antigen with MDT, while suppressing the CMI response with steroid therapy. This reaction typically occurs within the first two months of treatment.  It is accompanied by pain or tenderness of one or more nerves.

Keywords: Lepra reaction, Reversal reaction, Erythema Nodosum Leprosum (ENL), MDT (Multidrug therapy), M. Leprae (mycobacterium leprae), PB leprosy, MB leprosy, corticosteroids.

Title: Case report on Type 1 Lepra Reaction

Author: Salome Daniel Slahay

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Evans syndrome is a rare disorder in which the body’s immune system produces antibodies that mistakenly destroy red blood cells, platelets and sometimes certain white blood cell known as neutrophils. This leads to abnormally low levels of these blood cells in the body (cytopenia). The premature destruction of red blood cells (hemolysis) is known as autoimmune hemolytic anemia or AIHA. Thrombocytopenia refers to low levels of platelets (idiopathic thrombocytopenia purpura or ITP in this instance). Neutropenia refers to low levels of certain white blood cells known as neutrophils. Evans syndrome is defined as the association of AIHA along with ITP; neutropenia occurs less often. In some cases, autoimmune destruction of these blood cells occurs at the same time (simultaneously); in most cases, one condition develops first before another condition develops later on (sequentially). The symptoms and severity of Evans syndrome can vary greatly from one person to another. Evans syndrome can potentially cause severe, life-threatening complications. Evans syndrome may occur by itself as a primary (idiopathic) disorder or in association with other autoimmune disorders or lymphoproliferative disorders as a secondary disorder. (Lymphoproliferative disorders are characterized by the overproduction of white blood cells.) The distinction between primary and secondary Evans syndrome is important as it can influence treatment. Treatment for Evans syndrome depends on many factors, including the severity of the condition; the signs and symptoms present; and each person's response to certain therapies. For example, people who need to be hospitalized due to severe anemia or thrombocytopenia are often treated with blood transfusions followed by therapy with corticosteroids or intravenous (IV) immune globulin. Other treatment options include immunosuppressive drugs. Most affected individuals respond to these treatments; however, relapse is frequent.

Keywords: Evans syndrome, Autoimmune Hemolytic Anemia (AIHA), Idiopathic thrombocytopenia purpura (ITP), Corticosteroid.

Title: Case report on Evans syndrome

Author: Parvin Seifouri

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Antenatal care, also known prenatal care as is a type of preventive healthcare, with the goal of providing regular check-ups that allow doctors or midwives to treat and prevent potential health problems throughout the course of the pregnancy while promoting healthy lifestyles that benefit both mother and child. Current models of antenatal care originated in the early decades of the 20th century. The pattern of visits recommended at that time (monthly until 30 weeks, then fortnightly to 36 weeks and then weekly until delivery) is still recognizable today. It has been said that antenatal care has escaped critical assessment.

Objective: To assess Antenatal care services availability and accessibility in three main MCH, Hargeisa-Somaliland.

Methods: cross-sectional study design was used to assess the antenatal care services availability and accessibility in three main MCH, Hargeisa-Somaliland. Simple random sampling technique was applied to identify sample population. The data was entered in to SPSS version 20 and excel 2007 for further analysis. 

Result: A total of 138 were incorporated in the study of which majority of ANC attendees age were 20-25(31%) while 54% of them are illiterate and 79% were married. It shows that the majority of them 70% did not plan where they were going to deliver while 41% of them had late antenatal checkup. It also showed that about 24% of the respondent deliver their past pregnancies at home.

Conclusion: The study findings revealed that greater part of antenatal care attendees 54% of them were illiterate in which lack of knowledge and low antenatal care attendance goes hand in hand almost all, 79% of them were currently married. The study showed that out of 67(48.6%) who had difficulty in attending the MCH stated their reason which, 16(11.6%) was due to too much responsibility, 45(32.6%) was due to lack of transportation while 6(4.3%) was due to lack of money. While the 51% indicates those who have not had any difficulty in attending the MCH.

Keywords: Antenatal care accessibility and availability.

Title: ASSESSMENT OF ANTENATAL CARE SERVICES AVAILABILITY AND ACCESSIBILITY IN THREE MAIN MCH AT HARGEISA CITY-SOMALILAND

Author: Saad Ahmed Abdiwali, Bilan Abdirahman Abdisalam, Deka Adam Warsame, Hamda Abdilahi Yusuf, Hamda Hussein Yusuf, Hamze Abdilahi Adem

International Journal of Healthcare Sciences

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Abstract: Guillain-Barré syndrome is a rare but serious autoimmune disorder in which the immune system attacks healthy nerve cells in your peripheral nervous system (PNS). The incidence rate is fewer than 100 000 case per year in India.The type of Guillain-Barré syndrome can be classified as Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP), Miller Fisher Syndrome (MFS), Acute Motor Axonal Neuropathy (AMAN) and Acute Motor Sensory Axonal Neuropathy (AMSAN). The most common symptom are weakness of the upper body and arm, tingling, numbness and can eventually cause paralysis. The people who are more at rick of developing this syndrome are men more than women and also young adult with respect to their age group. In those case report all the patient meet the criteria and treatment for Guillain-Barré syndrome.

Keywords: Guillain-Barré syndrome, AIDP, AMSAN, Immunoglobulin infusion,Urinary Tract Infection, Pyelonephritis, Alcohol dependence.

Title: Guillian-Barre syndrome: 2 cases reports

Author: N’goran Hiwo Stephanie Laetitia

International Journal of Healthcare Sciences

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