Clinical Medicine Research

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

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Volume 6, Issue 3, May 2017

  • Authors: Rodrigo Moreira Sales, Ednei Costa Maia, Rafael Moreira Sales, Gustavo Gonçalves Arliani, Carlos Tadeu Moreno, Tathiana Rebizzi Parmigiano

    Abstract: Although many health professionals believe that exercise protects the athletes against thrombosis, it is discussed whether elite athletes are exposed to many thrombogenic acquired risk factors such as: dehydration, hemoconcentration, repeated microtraumas and extended periods of immobilization during travel or injury. Additionally, the use of combined oral contraceptive (COC) may increases the risk of venous thrombosis fourfold in healthy women. We report a case of a 21-years-old professional female football athlete who developed deep vein thrombosis (DVT) followed by pulmonary embolism (PE). The outpatient hypercoagulability workup was negative and the case was associated to the use of COC pills. The patient was treated with rivaroxaban for 5 months, with complete resolution of the symptoms. There are a few cases in the literature of venous thromboembolism (VTE) involving athletes. Cases of VTE attributable to the use of COC are extremely rare in this population. The diagnosis of VTE in athletes is a challenge for physicians, because the symptoms may erroneously be confused with musculoskeletal complaints. Team physicians who work with female athletes should be alert to modifiable risk factors for VTE, as well as able to perform the early diagnosis and initial clinical management of this condition. DVT should be considered as a differential diagnosis of calf pain in women, especially in athletes, due to the well-defined increase on the risk of thrombosis with the use of COC pills.

    Received: Feb. 8, 2017 Accepted: Mar. 7, 2017 Published: Mar. 23, 2017

    DOI: 10.11648/j.cmr.20170603.11 View: Downloads:

  • Authors: Sajjad S. Issa, Samira M. Ibrahim, Abdulameer A. Al-Mussawi

    Abstract: A descriptive cross- sectional study was designed involving Basra university staff for the study of abdominal obesity. The university of Basra had two location: karmet Ali (108 samples ) and Bab Alzubiar (158 samples ), A randomly selected sample was taken from a list of the college, from the selected college we were chosen staff randomly. The total number of the selected college was 10, were all the departments in that colleges was included and the total number selected of staff was 266, from them were females 146 and 120 males. The demographic data has been obtained from each person in the study, The working team was asked to measure the height, weight, waist circumference and Random Blood Sugar for each selected sample, using a weight and height scale, tape measure and portable blood sugar measurement instrument.(SPSS), Version17 was utilized for the purpose for statistical analysis of the data. The results was 45% was males and 55% was females, BMI: 19.5% had healthy weight, 36.8% were overweight, 27.8 were obese, 12% were severely obese, 3.8% were morbidly obese, 43.6% of the sample were obese. 37.5% of the males were obese and 48.63% of the females were obese.30.8% carried positive history of obesity and 36.8% of the sample was practicing sport exercise, 87.6% were having normal blood sugar while 12.4% were having abnormal blood sugar (diabetics), 18% of the females had normal waist circumference and 47.5% of the males had normal waist circumference, that is mean 87% of the female had abdominal obesity and 52.5% of the males had abdominal obesity. The prevalence of abdominal obesity was 31.57%, high significant correlation between waist circumference and gender, significant correlation between BMI and practicing exercise and there is highly significant correlation between BMI and positive history of obesity in the family. high significant relationship between body weight and waist circumference and high significant relation between waist circumference and history of obesity, significant relation between waist circumference and number of daily meals and high significant relation between waist circumference and random blood sugar.

    Received: Feb. 3, 2017 Accepted: Mar. 3, 2017 Published: Mar. 27, 2017

    DOI: 10.11648/j.cmr.20170603.12 View: Downloads:

  • Authors: Zrinka Matak, Duska Tjesic-Drinkovic, Lana Omerza, Irena Senecic-Cala, Jurica Vukovic, Dorian Tjesic-Drinkovic

    Abstract: To prevent the development of malnutrition in hospitalized children, it is important to develope an early identification of nutritional depletion, ideally at the time of admission to the hospital. In 2009 Hulst et al. proposed new guidelines for assessing the nutritional status of hospitalized children called STRONGkids questionnaire (Screening Tool Risk on Nutritional Status and Growth). This study was designed to describe the current prevalence of malnutrition on admission to a pediatric gastroenterology hospital unit and to compare the value and feasibility of STRONGkids scoring system versus anthropometric World Health Organization (WHO) criteria in identifying children at risk of developing malnutrition during hospital stay. The prospective observational study involved 124 children hospitalized at the Department of Pediatrics, University Hospital Center Zagreb. Nutritional status and risk for malnutrition were estimated by STRONGkids questionnaire and anthropometric measurements of subjects. Statistical analysis was performed using the computer program STATISTICS 10, StatSoft. Inc. 1984-2011; using descriptive statistics, Fisher's exact (FE) test and non-parametric Kruskal-Wallis (KW) test. Total malnutrition was observed in 18.5% of patients. Larger number of children at risk for malnutrition were identified by STRONGkids questionnaire than by anthropometric measurements (STRONGkids questionnaire: 75.8%; anthropometric measures: 40.3%). Patients that lost weight during hospitalization (33.1%) were further analyzed: 8/41 were not detected to be at risk by either method, 11/41 were identified by STRONGkids and anthropometry, and 22/41 were detected only by STRONGkids (Fisher's exact test p=0,08). This study justifies the inclusion of the STRONGkids questionnaire in the initial evaluation of children on admission to the hospital, in order to recognize those who need special nutritional support and thus prevent the development of malnutrition during hospitalization.

    Received: Jan. 27, 2017 Accepted: Mar. 14, 2017 Published: Apr. 10, 2017

    DOI: 10.11648/j.cmr.20170603.13 View: Downloads:

  • Authors: Weiting Wang, Chunhua Hao, Rui Zhang, Yinzhong Ma, Shuangyong Sun, Zhuanyou Zhao, Lida Tang

    Abstract: Current evidence indicates that anesthetics produce important effects to protect myocardium against ischemia-reperfusion (I/R) injury. The imbalance between pro- and anti-inflammatory cytokines might contribute to the mechanism of progression of I/R injury. To investigate experimental methodology of inflammatory factors in myocardial I/R with anesthetics preconditioning. This paper discusses the methods from the several aspects, including animal species, methods for model preparation, patterns of common anesthetics intervention, and the results of the intervention inflammatory factors including TNF-α, IL-1, IL-6, IL-8, IL-10 together with nuclear transcription factor NF-kB which regulates inflammation were explored in I/R models. The results showed that anesthetics exerted the protective effects on the injury of ischemia reperfusion injury through the regulation of inflammatory factors.

    Received: Feb. 21, 2017 Accepted: Mar. 21, 2017 Published: Apr. 10, 2017

    DOI: 10.11648/j.cmr.20170603.14 View: Downloads:

  • Authors: Hirokazu Touge, Katsuyuki Tomita, Shizuka Nishii, Tsuyoshi Kitaura, Yasuto Ueda, Keiji Matsunami, Hiromitsu Sakai, Akira Yamasaki, Yuji Kawasaki, Eiji Shimizu

    Abstract: Frailty is at the core of geriatric syndromes that are characterized by multiple morbidities and mobility limitations. The purpose of this case-control study was to assess the frailty scale and muscle mass on the acute phase in hospitalized elderly patients with community-acquired pneumonia (CAP). Thirty-two elderly patients, aged 75 years or older, who were hospitalized with CAP, and 32 control patients hospitalized without CAP were recruited. Frailty scale and muscle mass were assessed using the Reported Edmonton Frail Scale (REFS) and rectus femoris (RF) thickness by ultrasound, respectively. There was a significant increase in the frequency of frailty among CAP patients (50%), compared with control patients (22%). Frailty scale correlated inversely with RF thickness and activity status. Based upon the piece-wise linear regression analysis between REFS and RF thickness decreased rapidly with the pre-frailty status among CAP patients. Elderly patients with CAP exhibit a significant impairment of activity status with frailty due to decreased thickness of RF prior to admission.

    Received: Feb. 27, 2017 Accepted: Mar. 20, 2017 Published: Apr. 11, 2017

    DOI: 10.11648/j.cmr.20170603.15 View: Downloads:

  • Authors: Ikeanyi Eugene Maduabuchukwu, Ibrahim Isa Ayuba

    Abstract: Background: The Total Fertility Rates have declined below the replacement rates globally and in the industrialized countries. The rates are still high in Nigeria and most other poorer countries. Too much childbirth is associated with increased adverse obstetric outcomes and socioeconomic implications. There has been profuse literature on high parity but limited data on the reasons for high parity. We set out to explore the reasons the women have for high parity in Nigeria. Aim: To investigate the reasons women have for high parity in order to improve reproductive health services. Methods: This was a cross-sectional descriptive study on 288 grandmultiparas (para≥5) in South-south Nigeria between 2012 and 2016. EPI INFO software was used for analysis with statistical significance set at P<.05. Results: The mean age of respondents was 35.3±4.2 years. About 85% and 12% were in first marriage and remarried relationship respectively. The mean parity was 5.95±1.3 and ranged 5-11births. Respondents leading reasons for high parity were mistake (unplanned) 30.9%, desire for specific gender 22% (male child 15.6%) and personal desire for more children 15.3%. Over 90% was aware of contraception, only 29.2% ever used any method. The younger (OR=4.9, P=0.02), less educated (OR=0.39, P=0.01) and employed (OR=0.23, P=0.02) and (OR=6.9, P= 0.04) respondents significantly cited spouse desire, desire of male child, child loss and contraception failure for high parity respectively. Conclusion: Mistake, desire for male child and large family were the leading reasons women gave for high parity. Maternal age, education and employment significantly influenced the reasons for high parity. There was high contraceptive awareness but poor utilization among the respondents; a huge unmet need of contraception in this population.

    Received: Mar. 22, 2017 Accepted: Apr. 1, 2017 Published: Apr. 27, 2017

    DOI: 10.11648/j.cmr.20170603.16 View: Downloads:

  • Authors: Oumer Abdu, Ermias Diro, Abera Balcha, Mohamed Abdulkadir, Daniel Ayanaw, Seid Getahun, Tadesse Mitiku, Melles Mebrehatom, Zekarias Gesssesse

    Abstract: Hypertension is a common health problem worldwide. It doubles risk of stroke, myocardial infarction, chronic kidney diseases and peripheral arterial disease. Good control of hypertension is important to decrease these complications. For Good control, life style modification (low salt diet, exercise, weight reduction and cessation of smoking) and Different antihypertensive medications are used. The medicines have to be taken adherently and one has to be consistent in life style modifications. Here the blood pressure control status of hypertensive patients on treatment was assessed. Cross sectional study was conducted collecting data using a pretested questionnaire among all hypertensive patients on treatment at the cardiovascular follow up clinic of University of Gondar Hospital from March 1, 2016 to October 30, 2106. A consecutive of 310 hypertensive patients on pharmacologic therapy for at least 6 months were included. Good blood pressure control was defined as BP < 150/90 for those aged 60 years or above and <140/90 if younger than 60 years. Data was entered and analyzed by using SPSS version 20. Results are depicted descriptively using tables and graphs. Logistic regression was used to evaluate associations.A total of 310 participants (118 males & 192 females) were evaluated. Poor blood pressure control was observed in 115 (37%) of the study participants. Presence of diabetes mellitus (OR: 3.6; CI (1.46-8.8)) and poor adherence to antihypertensive drugs (OR: 6.6; CI (1.5-28.5)) were associated with poor BP control. However duration of hypertension, type or number of antihypertensive medications used were not associated with BP control. Patient older than 60years had good BP control. More than one third of patients have poor BP control. Poor blood pressure control was associated with poor adherence to antihypertensive medications & the presence of diabetes. However, elderly people (≥ 60years) were found to be associated with good BP control.

    Received: Mar. 2, 2017 Accepted: Mar. 25, 2017 Published: Apr. 28, 2017

    DOI: 10.11648/j.cmr.20170603.17 View: Downloads:

  • Authors: Hou Zhenjiang, Mu Zhaoxin, Zhang Jingyu, Fan Hong, Hou Jianzhang, Wang Hongsheng

    Abstract: To investigate the correlation between hypothyroidism and subclinical hypothyroidism in serum thyroid hormones, blood lipid profile, blood lipid ratio and homocysteine, the authors calculated the ratio of blood lipid and carried on statistical analysis through measuring the level of serum thyroid hormones, blood lipid, homocysteine among 60 patients with hypothyroidism, 140 patients with subclinical hypothyroidism and 60 controls. As a result, firstly, the levels of serum TSH in hypothyroidism group and subclinical hypothyroidism group were significantly higher than those in the control group (P <0.001).The difference between the subclinical hypothyroidism group and the control group had statistical significance (P <0.05).What’s more, the patients, who were hypothyroidism, were significantly lower than those in the control group in the levels of serum FT3 and FT4. Moreover, compared with the hypothyroidism and subclinical hypothyroidism, on the one hand, the levels of serum FT3 and FT4 obviously decreased, on the other hand, the levels of serum TSH and Hcy were significantly increased (P <0.01). As to the correlation of thyroid hormones with blood lipid ratio and non-HDL-C, TC showed the highest correlation and the sequences were non-HDL-C, LDL-C and LCI. In the end, the authors came to the conclusion that the detection of serum TSH, blood lipid ratio and Hcy were of great value in the transformation from subclinical hypothyroidism to hypothyroidism and the prediction of hypothyroidism and the cause of cardiovascular diseases.

    Received: May 4, 2017 Accepted: Published: May 4, 2017

    DOI: 10.11648/j.cmr.20170603.18 View: Downloads:

  • Authors: Guotao Fang, Qi Zhang

    Abstract: To discuss the effects of different treatment methods on the prognosis of primary carcinoma of gallbladder (PCG) patients. The clinical statistics of 99 cases of PCG patients were retrospectively analyzed, and the prognosis multivariate analysis was performed. Results: 52% of the patients suffered from PCG and gallstones simultaneously, and 82.8% (82/99) of the patients were diagnosed as PCG before surgeries. 86 cases of patients were subjected to routine exploratory surgeryies, and the radical resection rate was 33.72% (29/86). The overall 5-year survival rate was 6.28%, and the 1-year, 3-year and 5-year survival rates of the radical resection group were 78.43%, 48.49% and 23.77%, respectively. The results were significantly different from those of the palliative surgery group, the exploratory laparotomy group and the non-surgical group. The multivariate analysis of Cox model reveals that surgical method was significantly correlated with the invasion depth of tumor and the prognosis of gallbladder carcinoma. The treatment efficacy of PCG might be improved by increasing the early diagnosis rate and performing radical resection which are accompanied by radiotherapy and chemotherapy.

    Received: May 4, 2017 Accepted: Published: May 4, 2017

    DOI: 10.11648/j.cmr.20170603.19 View: Downloads:

  • Authors: Fidelis Anayo Onyekwulu, Innocent Chidiebere Ugwu, Elias Chikee Aniwada, Tochukwu Christopher Okeke

    Abstract: This study was carried out to assess the awareness, perceptions, acceptance, and the level of utilization of epidural analgesia in relation to other methods of labor pain relief among prospective parturient attending the ante-natal clinic in south eastern Nigeria. Women attending the ante-natal clinic were interviewed using interviewer administered questionnaires containing both open and closed questions, to evaluate their awareness, perceptions, acceptance and level of utilization of labor analgesia in general and epidural analgesia in particular. Data were analysed using SPSS Statistics Version 21.0. The study included 150 women with mean age of 29.63±5.02. Most of the respondents (94.7%) had at least secondary school education. More than half the respondents (62.7%) knew about labor analgesia and 38.7% knew about epidural labor analgesia. Source of knowledge to vast majority (75.6%) were doctors and nurses. Majority of the multiparous respondents (81.27%) had moderate or severe pain in the previous confinement and only 53% had pain relieve. Of those who had pain relieve, two third hard breathing exercises while 4.8% had epidural analgesia. Majority of the respondents (72.7%) would want to have labor analgesia, and 53.3% desired epidural in their next delivery. There is poor level of awareness and utilization of epidural labor analgesia by women attending an antenatal clinic in south eastern Nigeria.

    Received: Feb. 20, 2017 Accepted: Mar. 27, 2017 Published: May 25, 2017

    DOI: 10.11648/j.cmr.20170603.20 View: Downloads:

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