Vol 6 Issue 2 October 2018-March 2019

Abstract: Latent autoimmune diabetes in adults (LADA) is a progressive autoimmune disease that result slowly in insulin deficiency and the need of insulin injection. The prevalence of this non-classical form of diabetes is growing higher and the evaluation of the main criteria of diagnose and the importance of metabolic syndrome is essential. As a result, we took a sample of the Albanian population with type 2 diabetes and LADA in order to compare the parameters of the metabolic syndrome and insulin resistance in both groups and to evaluate the potential correlation.

Materials and Methods: The study design was cross-sectional and it involved 149 participants, 50 females and 99 males. All participants met the criteria above: 1) new diagnose of diabetes in patient over 30 years old, 2) onset of disease in less than a year 3) no use of insulin since the diagnose. Anthropometric data, level od C-peptide and fasting insulin were measured in all participants. All data were analysed with SPSS 10.0 and ANOVA One-Way.

Results:  The mean age of the participants in the study was 43,22 ± 7,1 years old. Patients with LADA had BMI of 25,07 3,82, lower than in type 2 Diabetes. Fasting insulin concentration was lower in LADA than in type 2 diabetes in our study (26,8 ± 0,4 versus 31,5 ±19,3) confirming the insulin deficiency in LADA in comparison with type 2 diabetes where the main event is insulin resistance rather than insulinopenia. The same goes to the level of C-peptide where in the LADA group is lower than in type 2 Diabetes.

The presence of GAD antibodies was significantly higher in LADA (6.83  5,6) than in type 2 Diabetes (0.57 0,09).

Conclusions: Our observations indicate that metabolic syndrome and insulin resistance are present in LADA but not higher than in type 2 diabetes. Higher BMI was present in type 2 Diabetes but was not significant in diagnose of LADA. Insulin and C-peptide level were lower in LADA and anti-GAD was statistically important in LADA rather than type 2 Diabetes confirming its role in differential diagnose.

Keywords: Latent autoimmune diabetes in adults (LADA), insulin resistance metabolic syndrome.

Title: EVALUATION OF THE PARAMETERS OF INSULIN RESISTANCE AND METABOLIC SYNDROME IN TWO GROUPS: LATENT AUTOIMMUNE DIABETES IN ADULTS AND TYPE 2 DIABETES

Author: Gerond Husi, Matilda Kelmendi, Violeta Hoxha, Elizana Petrela, Adela Haxhiraj, Agron Ylli

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Meckel’s diverticulum is the most common congenital malformation of the gastrointestinal tract occurs in 2% of the general population. Whoever it can cause complications in form of bleeding, obstruction, perforation, fistula and tumors but majority of patients remain asymptomatic. Despite advances in the medical imaging and technology still there is a difficulty in diagnose it pre-operatively. Here I present a case of bleeding Meckel’s Diverticulum in an 18 years old male, which diagnosed and managed by minimal invasive surgery after failed pre-operative imaging to detect it.

Keywords: Meckel’s Diverticulum, Gastrointestinal bleeding.

Title: LOWER GASTROINTESTINAL BLEEDING CAUSED BY MECKEL’S DIVERTICULUM

Author: MOHAMMED S. ALFEHAID

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Bronchiectasis is characterized by an abnormal irreversible dilatation of the bronchi. It can be categorized according to radiographic and pathologic findings of airway obstruction and damage. A 48 year old male farmer by occupation was admitted to Intensive Care Unit of Pravara Rural Hospital 5 months back. The patient presented in the hospital with chief complaints of cough with expectoration associated with breathlessness and fever since 6 months. As per the investigations done in the hospital, the patient was diagnosed with cystic bronchiectasis. Outcome Measures PImax was assessed by Hand Held Pressure Manometer. Threshold Inspiratory Muscle Training was given as an intervention to the patient for mucus clearance. The intervention was given 5 days in a week for a period of 2 weeks. After 2 weeks of intervention, there was significant improvement in Maximal inspiratory pressure. This case report established the evidence for the use of Threshold Inspiratory Muscle Training.

Title: Effectiveness of Threshold Inspiratory Muscle Training on Cystic Bronchiectasis - A Case Report

Author: Dr. Karuna Kamble, Dr. Maria Lamuvel

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Caesarean section is a surgical procedure in which the incision is made on the mother’s abdomen and uterus to deliver the products of conception.² In India, as per District level household survey 3 (DLHS), CS rate is 28.1% in the private sector and in public sector health facilities is of 12%.⁴ Post LSCS wound infection is not only a foremost cause of prolonged hospital stay but a major cause of the widespread dislike to caesarean delivery in developing countries. We reported case of a female having post caesarean wound gaping. And the effectiveness of low level laser therapy and therapeutic exercises was assessed, after two weeks the patient showed better wound healing and reduction in symptoms of Post natal Depression.

Keywords: Caesarean, wound gaping, Low-level Laser Therapy, REEDA, Edinburgh Depression Scale.

Title: Effectiveness of Low-level Laser Therapy in Post Caesarean Wound Healing: A Case Report

Author: Aditi Khot, Nupoor Kulkarni

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Biomedical waste and its influence on nosocomial infections was studied. Passive air sample was performed using settle plates, waste water samples from the drippings, soil sediment underlying solid waste and soil adjacent to the dump site were collected from a depth of 0-30cm with UCTH and General and Hospital Calabar, Calabar . The samples were evaluated using standard microbiological techniques. The result of the total microbial count of air samples within the waste dumpsite of the hospital showed that the total viable count (TVC), total coliform count (TCC) and total staphylococcal count (TSC) ranged from 164.1±0.5 to 179.0±0.8cfu/m³, 21.0±0.2 to 30.0±0.3cfu/m³, 6.0±0.1 to 9.0+0.2cfu/m³ respectively, while the air within the reception unit (AR) ranged from 62.0±2.0 to 73.2±2.8cfu/m³, 6.3±1.0 to 10.4±1.2cfu/m³, 3.9±0.1 to 6.0±0.3cfu/m³ respectively. Unlike the control air samples, a lower TVC, TCC and TSC which ranged from 21.4±0.71 to 29.8±0.92cfu.m³, 2.0±0.01 to 7.4±0.02cfu/m³, 0 to 3.8±0.01cfu/m³ respectively were observed. The total microbial count of soil samples underlying solid waste samples from the hospitals had a TVC, TCC and TSC which ranged from 2.4±0.4 x 10⁸ to 3.9±0.8 x 10⁸cfu/g, 2.0±0.6 x 10⁴ 2.9 ± 0.9 x 10⁴cfu/g, 2.3±0.7 x 10² to 3.47±1.0 x 10²cfu/g respectively, while that of samples from the soil adjacent to the dumpsite ranged from 4.2±0.2 x 10⁷ to 4.8±0.2 x 10⁸cfu/g, 2.2±0.5 x 10⁴ to 2.4± 0.7 x 10⁴cfu/g, 2.0. ± 0.1 x 10² to 2.81 ± 0.6 x 10²cfu/g respectively. Similarly, a lower count was observed in the control soil from the two hospitals with the TVC, TCC and TSC ranging from 3.4±0.7 x 10⁴ to 3.9±0.8 x10⁴cfu/g, 1.8±0.2 x 10³ to 2.0±0.3 x 10³cfu/g, 1.7±0.1 x 10² 1.9± 0.2 x 10²cfu/g respectively. The microbial count of the dripping samples from the waste dumpsite in UCTH and General hospital Calabar had a TVC, TCC,  and TSC that ranged from 7.4±1.8 x 10⁷ to 9.2±2.0 x 10⁷cfu/ml, 3.4±1.0 x 10³ to 3.8±1.0 x 10³cfu/ml and 1.5±0.6 x 10²cfu/ml to 2.1±0.8 x 10²cfu/ml respectively. The microorganisms isolated from the various samples and control were  identified as Staphylococcus aureus, Escherichia coli, Klebsiella sp., Bacillus sp., Streptococcus sp., Pseudomonas sp., Corynebacterium sp.,  and Shigella sp. However, the high microbial load densities encountered in this study, suggests that the activities of hospital wastes in the environment is a major health and environmental threat as well as a potential source of nosocomial infection. Therefore, there is an urgent need to raise awareness, education and management strategy on biomedical waste issues to ensure public health and environmental safety.

Keywords: Biomedical, Nosocomial, Infections, Waste, Pollution, Environment.         

Title: INFLUENCE OF BIOMEDICAL WASTE ON NOSOCOMIAL INFECTIONS

Author: TIKU, D.R., ASIKONG, E.B.E., BASSEY, I.U.

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Heterotopic pancreas is a rare condition and its preoperative diagnosis is difficult. It is generally asymptomatic, but it may become clinically evident depending on the size, location, pathological changes and complications similar to those observed in the normal pancreas .Heterotopic pancreas can occur anywhere in the gastrointestinal tract. Most commonly seen in the duodenum, stomach, and jejunum.

We report a case of a 27 -year-old female patient with epigastric pain due to ectopic pancreatic tissue in the stomach is described. The difficulty in making an accurate diagnosis is highlighted. Distal gastrectomy was performed and a histological diagnosis of heterotopic pancreas was established on microscopic examination. The patient had an uneventful postoperative course and remained symptom free in the follow-up of six months. Areview of the literature on this pathology is hereby presented. Although heterotopic pancreas is rare, it should be considered in the differential diagnosis of pancreatitis and of a submucosal gastric tumour.

Keywords: ectopic pancreas; stomach; pancreas; histology; heterotopic pancreas; gastrectomy.

Title: Gastric heterotopic pancreas masquerading as a stromal tumor: A case report

Author: Manal Mubarak Alquaimi

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Klüver-Bucy (KBS) syndrome is a rare neurobehavioral disorder, characterized by hypersexuality, hyperphagia, hyper-orality, visual agnosia and placidity. Here I present a case of A-21-year-old Saudi female with a Kluver-Bucy syndrome secondary to left unilateral parieto-temporal tumor resection who responded to a combination of carbamazepine and risperidone.

Keywords: Klüver-Bucy syndrome; temporal lobe; carbamazepine; risperidone.

Title: Risperidone and Carbamazepine Combination in Treatment of Klüver-Bucy Syndrome: A Case Report

Author: AlJadani Ahmed Hamed

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Scarring is a common consequence of acne vulgaris. Acne scars can lead to physical disfigurement and significant emotional distress. Acne scars may be atrophic, hypertrophic, or keloidal. Atrophic acne scars constitute the most common presentation of acne scars. Atrophic acne scars can be divided into ice pick, rolling, and boxcar scars based upon morphology. Presentations of acne scars are different, treatment modalities are multiple, and optimizing is a skill.

Keywords: acne vulgaris, Acne scars, Atrophic acne, hypertrophic.

Title: Optimizing the Treatment of Acne Scars

Author: Zaid Almohsen

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: The Knowledge, Attitude & Practice Study were conducted at DHH, Dhenkanal ,a secondary care hospital in Odisha from July-2017 to Feb-2018.The major objective for this study was to know the current level of knowledge of all the categories of staffs regarding bio-medical waste management particularly segregation & dis-infection.

Also the aim of the study was find out the gaps & taking further corrective measures for implementation of revised BMW Rule. The 4 major research questions were:-

• What is the present knowledge, attitude & practice level of staffs of DHH, Dhenkanal towards proper Bio-Medical Waste Management?
• How KAP analysis will be helpful in implementation BMW New Rule 2016?
• How this study will helpful for decrease of Surgical Site Infection Rate?
• Which category of staff will be given emphasis (those having more gaps) for better practice of BMW Rules & its implementation?

Accordingly KAP questioners were prepared & data collection was done from all the categories of staffs (doctors, staff nurses, pharmacists, Laborotory Technicians, Radio graphers, sweepers, and attendants) randomly & with convenient sampling.

The entire study was done through Deming’s PDCA cycle & all the datas were analysed by using following quality tools in Minitab.

• Pareto Analysis
• Control Chart
• Run Chart
• Co relation

Finally, it was observed that Bio-Medical Waste Management Practice among staff nurses & sweepers were not upto the mark & it needed to be strengthened.

The interesting observation during this study was doctors were highest in all the aspects i.e. Knowledge, Attitude & Practice, which is very rarely seen in other studies.

But the staff nurses are called as the heart & soul of Bio-Medical Waste Management Practices & IMEP. So as far as their knowledge was not up gradated, it will be very tough for proper implementation of BMW New Rule-2016.

This study will be very much helpful for need base training & implementation of BMW New Rule 2016.

Keywords: KAP, Pareto Analysis, Control Chart, Run chart.

Title: KNOWLEDGE ATTITUDE PRACTICE STUDY ON BIO-MEDICAL WASTE MANAGEMENT AT DISTRICT HEAD QUARTERS HOSPITAL, DHENKANAL, ODISHA

Author: Dr.Chinmayee Swain

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Combination of Infantile haemangioma, multiple cardiac anomalies, congenital heart block secondary to maternal systemic lupus erythematosus is a rare event. Herewith, we present 30 weeks neonate women known case of systemic lupus erythematosus for five years. He delivered by emergency cesarean section when he developed severe bradycardia due to heart block diagnosed intrauterine as complication of long term use of dexamethasone and developed infantile haemangioma. Multidisplinary team was formed for the management of the cases, including cardiologist, dermatologist and neonatologist. From the cardiac side propranolol contraindicated in presence of complete heart block so the plan to wait for pacemaker insertion then to start medication. Once pacemaker inserted the propranolol was started and the lesion was started to decrease inside with no ulceration.

Keywords: Infantile haemangioma, systemic lupus erythematosus, propranolol, heart block.

Title: Infantile Haemangioma with Neonatal Systemic Lupus Erythematosus, Rare Combination, Case Report and Review of Literature. Experience from King Abdulaziz Medical City, Riyadh Saudi Arabia

Author: Hayat Ibrahim Aljutaily

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Hypertension is a common global health problem in many countries including developing countries. The objective of this study was to determine the prevalence of hypertension among the patients who attend internal medicine outpatient clinics in a local hospital and highlight the common medical conditions associated with it.

Keywords: Prevalance, Hypertension, Risk Factors, Diabetes.

Title: Prospective Study on The Prevalence of Hypertenion among the Patients who Attend Internal Medicine Outpatient Clinic of a Local Hospital in Makkah

Author: Wafaa M.Alshehri, Abdullah Hawsawi, Fayza AlGhamdi

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: GERD or acid reflux is a digestive disorder wherein stomach contents rise up into the esophagus, resulting in either symptoms or complications. It basically involves the lower esophageal sphincter (LES). In most cases, GERD can be relieved through diet and lifestyle changes; however, some people may require medication or surgery. GERD is a highly prevalent disease condition throughout the world. The factors involved in the etiopathogenesis of reflux are multifactorial. some of the factors include malfunctioning LES, smoking, food, caffeine, obesity, etc. Patients usually have a post-prandial burning sensation, chest pain, regurgitation and many more. Long term complications include esophageal ulceration, stricture, Barrett's esophagus and sometimes esophageal cancer. Some of the preventive measures can help prevent symptoms like weight loss and dietary changes. Treatment includes- anti-acid medications like antacids, PPIs and H2 blockers. Refractory cases can be treated with endoscopic procedures like-TIF and surgery like Nissen's fundoplication. Transoral incisionless fundoplication (TIF) is an advanced endoscopy procedure that provides relief from acid reflux (heartburn) symptoms associated with chronic GERD. Fundoplication procedures have been used to effectively treat patients with GERD for over 50 years. The TIF procedure differs from a traditional fundoplication procedure because it is performed through the mouth rather than through laparoscopy or open abdominal incisions. Overall TIF is a safer alternative to the classical Nissen's fundoplication.

Keywords: Transoral incisionless fundoplication (TIF), gastroesophageal reflux disease (GERD), abdominal incisions, surgery, endoscopic.

Title: Transoral Incisionless Fundoplication (TIF)-A minimally invasive endoscopic technique for gastroesophageal reflux disease (GERD)

Author: Dr. Ashish Shrivastava, Dr. Nikhila Chadalawada, Dr. Inshiya Dawoodi, Dr. Maheen Hassan, Dr. Magdelene J Anthony, Dr. Sailaja Vinnakota, Dr. Khalida Khaliq, Dr. Roy M. Lim, Jr., Dr. Laraib Fakhare Alam

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Multiple myeloma is a plasma cell malignancy involving the bone marrow. Patients may have smoldering (asymptomatic) disease or most of them will present with signs or symptoms related to the infiltration of plasma cells into the bone or other organs or to kidney damage from excess light chains and present with significant morbidity. Prompt recognition of symptomatic multiple myeloma is critical, because delayed diagnosis is associated with increased complications. In this review article we aim to enumerate the clinical presentation, pathophysiology, diagnosis and treatments modalities for multiple myeloma.

Keywords: Multiple Myeloma, Monoclonal gammopathy, Plasma cells, bortezomib, Plasmacytoma.

Title: Multiple Myeloma: A Review

Author: Dr.Wafaa M.Alshehri

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: All consenting 50 cases of nor pregnant women and 50 women with pre-eclampsia attending antenatal clinic for antenatal checkup of >/= 20 who fulfills the inclusion and exclusion criteria were included in this study. Each patient were included only once in the study. Gestational age, parity, socioeconomic status and BMI were matched between cases and controls. History noted and after general physical and obstetric examinations, urine analysis is done to note the extent of proteinuria by dipstick method or by 24 hours urine protein estimation. Then 4 ml of venous blood is drawn from the subjects and sample is analysed for magnesium. Serum magnesium was measured by Calmagite method. Result: The study has been conducted on 100 primigravidae pregnant women. Out of them 50 cases of pre-eclampsia women were in the age group of 18-30 years and belonging from low socio-economic status and the mean serum magnesium was 1.156+/-0.328. In contrast out of 50 cases of pregnant women were in the age group of 18-30 years and belonging from low socio-economic status and the mean serum magnesium was 1.907+/-0.321. The difference between the mean serum magnesium level in pre-eclampsia women and normal pregnant women cases were statistically significant (p=0.0016). From the study presented below it is clear that there are numerous factors that contribute to the causality of pre-eclampsia and from our analysis it was clear that the serum magnesium levels shows an irregular pattern of fluctuations in cases suffering from pre-eclampsia. This irregular behavior of fluctuations in the pre-eclampsia cases can be attributed to numerous physiological causes, some of which are given in our study.

Keywords: Eclampsia, pre-eclampsia, proteinuria, serum magnesium.

Title: HIGH INCIDENCES OF LOW SERUM MAGNESIUM IN PRE-ECLAMPSIA AND ECLAMPSIA THAN IN NORMAL PREGNANCY

Author: Mrs. Chaitali Mondal, Susmita Mukherjee, Dr. Dipak Das

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: The Chemical burn is responsible for serious deep tissue damage to the lower limb due to loss of sensation in diabetic patient. Our patient presented to our specialized clinic with grade 2 superficial burn -last for prolonged periods- of her foot after standing barefoot on sodium hypochlorite (Clorox bleach) used for bathroom cleansing. Treatment and prevention of this burn were discussed.

Keywords: Diabetes Mellitus, foot burn, diabetic neuropathy, chemical burn.

Title: Chemical Burn among Diabetic Patient: A Case Report

Author: Talal H. Almalki, Ismail AlMogbil, Raheef Alatassi, Kamal Atif, Abdullah alshahrani

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Research Publish Journals