Clinical Medicine Research

ISSN Online: 2326-9057 ISSN Print: 2326-9049

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Volume 2, Issue 5, September 2013

  • Authors: Chalachew Misganaw Alemayehu, Sofia Kebede Birhanesilasie

    Abstract: Introduction: Stroke is becoming a leading cause of death and adult disability in the developing world. The global burden of disease study indicates that 80% of stroke deaths occur in low- and middle-income regions. Objective: To assess the clinical characteristics and risk factors among patients presented with stoke in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods and patients: This is a prospective cross sectional survey of all patients with stroke presenting to Tikur Anbessa specialized hospital for consecutive six months (November 2012-April 2013). The data included 114 stroke patients. Data of these patients was collected by an emergency medicine physician through a pre-designed questionnaire. Data was entered and analyzed by a computer software SPSS version 20. Monovariate analysis, bivariate analysis and multivariate analyses to control for confounder variables were done. CI which doesn’t contain 1 is significant. Result: Out of the total patients seen, 63 (55%) were females with females to males ratio of 1.23 to 1.One quarter of patients (25%) were below 34 years of age followed by age greater than 65 and 55-64 years with 21% and 23.6% score respectively. The major risk factors identified were hypertension and Diabetes Mellitus with 69.3 % and 14.9% respectively. Nine (7.8 %) were found to be both hypertensive and diabetic. Atrial fibrillation is the third risk factor associated with stoke with a frequency of 11.4%. More than half of our patients (55.3%) had hemorrhagic stroke. Majority of the patients presented with sever neurological manifestations; hemiplegic deficit by 67 (58.8%), asphyxia by 16% and coma by 15.8 %of patients. Only 46 (40.4%) were on treatment and 7% of patients presented within the first three (golden) hours of onset of their illness; the majority of patients (41.2%) presented after 48 hrs. of onset of their symptoms. Those patients who presented with hemorrhagic stroke were 2.8 times (AOR=2.8, 95% CI: 1.5-7.7) to be presented with hemiplegic deficit as compared to those patients with ischemic stroke. Conclusion and recommendation: Stroke happened more frequently in women than in men and the risks associated with increased age were not evident. The major risk factors identified were high blood pressure and diabetes and atrial fibrillation. Hemorrhagic stroke associated with sever neurological presentations were the most prevalent stroke sub-types. Education of the public on active screening and prompt treatment and sign and symptoms of stroke together with improving the quality of stroke management are very crucial

    Received: Aug. 10, 2013 Accepted: Published: Sep. 20, 2013

    DOI: 10.11648/j.cmr.20130205.11 View: Downloads:

  • Authors: Baba Usman Ahmadu, Yakubu Mava, Joshua Habila Sharah, Abdurrahman Raji Maryam, Paul Dogra, Salihu Akbar

    Abstract: Mid-gut volvulus in the absence of malrotation of the gut is rare in neonates and rarer in term babies and can be fatal if intervention is delayed. Herein we report a case of a neonate who had billous vomiting, abdominal distension and moderate dehydration. His abdominal radiograph showed gaseous distension of the stomach, ground glass pattern and calcifications. Exploratory laparotomy revealed mid-gut volvulus complicated by atresia and 75 centimeter length of intestinal gangrene involving the distal one-third of the jejunum and ileum. However, no evidence of malrotation of the gut was found. Resection of the gangrenous segment with jejuno-caecal anastomosis was carried out in addition to blood transfusion, antibiotic and fluid therapy. Patient’s condition improved, he passed stools on the 5th postoperative day, and oral sips were commenced.

    Received: Aug. 20, 2013 Accepted: Published: Sep. 20, 2013

    DOI: 10.11648/j.cmr.20130205.12 View: Downloads:

  • Authors: Fatma Y. Saleh, Sherif Shoukry Awad, Irene M. Sadek

    Abstract: Background. Lymphocytic dermal infiltrations accompany the melanocytes loss in depigmenting vitiligo skin. These lymphocytes are incriminated during the pathogenesis of the disease. Fas receptor is a death receptor on the surface of cells that leads to programmed cell death (apoptosis) and FasL is its ligand. Fas/FasL system plays a crucial role in modulating apoptosis. Objectives. This study investigates the lymphocytic expression of apoptotic markers Fas/FasL in vitiligo. Methods. The present study was conducted on 45 vitiligo samples obtained from 15 vitiligo patients including 8 females (53.3%) and seven males (46.7%). Biopsies were obtained also from control volunteers. All specimens were routinely stained with Hematoxylin &Eosin and immunohistochemically for Fas & FasL apoptotic markers. Results. Fas & FasL were significantly expressed by infiltrating lymphocytes in vitiligo biopsies compared to control. Lymphocytic expression of Fas & FasL was higher on the edge biopsies than the center. Considerable lymphocytic infiltration and attack of B.M. were associated with higher lymphocytic Fas and FasL expression. During vitiligo activity lymphocytic Fas & FasL expression was also significantly higher. Conclusions. Lymphocytic Fas and FasL are significantly expressed in vitiligo patches which may trigger epidermal apoptosis and loss of melanocytes. At the same time these factors have a role in switching-off of the immune responses and cell mediated cytotoxicity.

    Received: Aug. 24, 2013 Accepted: Published: Sep. 20, 2013

    DOI: 10.11648/j.cmr.20130205.13 View: Downloads:

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