Clinical Medicine Research

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

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Volume 7, Issue 1, January 2018

  • Authors: Abidemi Jude Fasae, Olusegun Adesola Busari, Rotimi Oluyombo, Musa Yusuf, Oladipo George Opadijo, Ayodele Babatunde Omotoso

    Abstract: The objective of the study was to determine the prevalence of Hyperuricemia and evaluate its correlation with target organ damage and electrocardiographic changes in newly diagnosed adult Nigerian hypertensive patients. It was a cross sectional study done at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. 150 untreated newly diagnosed hypertensive patients 18 years and above and 115 age and sex-matched normotensive individuals were recruited into the study. Data obtained was analyzed using Epi-Info version 6.04 and Statistical Package for Social Sciences (SPSS) version 14 computer software packages. The prevalence of Hyperuricemia was 36.7% and 17.4% in hypertensive patients and normotensive controls respectively. Mean serum UA in hypertensive patients and normotensive controls was 0.4±0.1mmol/l and 0.3±0.1mmol/l respectively (p<0.0001). There was an association between Hyperuricemia and left ventricular hypertrophy (x2=23.97, p<0.0001). The study showed that Hyperuricemia is prevalent in adult Nigerians with newly diagnosed hypertension. Hyperuricemia was associated with left ventricular hypertrophy which is common target organ damage and confers an increased risk of cardiovascular events in systemic hypertension.

    Received: Mar. 10, 2017 Accepted: Apr. 10, 2017 Published: Jan. 26, 2018

    DOI: 10.11648/j.cmr.20180701.11 View: Downloads:

  • Authors: Adane Bitew, Mesele Admassie, Tigist Getachew

    Abstract: Wound infection still remains a significant cause of morbidly and mortality. Hence, studying the spectrum of bacterial etiological agents and their drug susceptibility profile is critical. A prospective study was conducted at Arsho Advanced Medical Laboratory from June 2016 to July 2017. Wound specimens were collected from 366 patients following standard procedures. Specimens were plated and incubated at 37°C for 48 hours. Identification and drug susceptibility testing of cultures were carried out by using the VITEK 2 compact system. Among 366 wound samples cultured, bacteria grew in 271(74%) samples. The highest (81.9%) wound infections were documented among patients with an age group of 15-64 years. Two hundred twenty one bacterial isolates were recovered of which 43.2% were Gram-negative while, 56.8% were Gram-positive. Staphylococcus aureus and Coagulase-Negative Staphylococci were major Gram-positive bacteria while Escherichia coli and Pseudomonas spp. were the commonest Gram-negative bacteria. Gram-negative bacteria had the highest overall drug resistance rate against ampicillin. Tobramycin and piperacillin/tazobactam combination were effective antimicrobial agents against Gram-negative bacteria. The highest overall resistance rate to Gram-positive bacteria was observed against erythromycin. Vancomycin and linezolid were the most active antimicrobial agents against Gram-positive bacteria. High culture positivity rate of wound infections reported in the present study initiates many similar studies to be conducted on wound in the country. High level of drug resistance to the commonly prescribed drugs dictates a search for better choices.

    Received: Jan. 4, 2018 Accepted: Feb. 9, 2018 Published: Mar. 7, 2018

    DOI: 10.11648/j.cmr.20180701.12 View: Downloads:

  • Authors: Ikeanyi Eugene Maduabuchukwu, Ikobho Ebenezer Howell

    Abstract: Background: Twin pregnancy is as fascinating as it is high risk and its epidemiology is globally more dynamic in the recent times. It is associated with increase maternal morbidities, fetal wastage and neonatal morbidities and mortality. Objectives: To determine the current incidence, assess the trend and investigate maternal and perinatal outcomes and influencing factors of twinning. Methods: For this case control study, data was collected on twin pregnancies; the study group and singleton pregnancies; the control group between January 2009 and December 2016 at a missionary Hospital in south-south Nigeria. EPI INFO and INSTAT statistical software were used for analyses and Fisher’s exact test for tests of statistical associations setting the statistical significance at <.05. Results: Among 8769 deliveries were 207 pairs of twins, a twinning incidence of 2.4% or 1 in 42 with an upward trend in incidence. Twin mothers were relatively older with those aged 30-34 years (41.2%) as the modal age group, less literate and less likely to have prenatal care. They were more prone to anemia, caesarean birth, Postpartum hemorrhage, gestational hypertension and blood transfusion (P<0.05). Mean gestational age and birth weight of twins were 35.5±3.8 weeks and 2352.9±746.4gm respectively. The twins were associated with increased preterm births (OR 28.1, P<0.001), Low birth weight (OR 15.6-24.1, P<0.001), perinatal death (OR 3.6, P<0.001), birth asphyxia (OR 2.9-5.9, P<0.01) and Special Care Baby Unit admission (OR 9.8-12.5, P<0.001). About 7 (66.2%) and 3 (31.4%) of every 10 first twins were in cephalic and breech presentation respectively with cephalic/cephalic (44.0%) the leading paired presentations. Conclusion: There was high and increasing incidence of twinning in this population. Twin pregnancy is associated with increased maternal morbidity and perinatal morbidity and mortality. To improve twinning outcome will require quality obstetric and perinatal care.

    Received: Feb. 7, 2018 Accepted: Feb. 25, 2018 Published: Mar. 22, 2018

    DOI: 10.11648/j.cmr.20180701.13 View: Downloads:

  • Authors: Tsegahun Asfaw, Demissew Shenkute, Mihret Tilahun, Nigus Zegeye

    Abstract: Introduction: Rheumatic heart disease (RHD) remain significant causes of cardiovascular disease and mortality in children particularly in the developing countries. This study aims to evaluate ASO titer in rheumatic heart disease patients who are on secondary prophylaxis. Methods: A cross sectional study method was employed to collect blood sample from RHD patients (children) who are on secondary prophylaxis at pediatric clinic of Debre Brehan referral hospital. The blood sample was collected, transported and processed based on standard operating procedures (SOPs) for ASO titer determination. And finally, the data was analyzed using SPSS version 21and P-value less than or equal to 0.05 was taken as statistically significant. Result: A total of 123 children on secondary prophylaxis for RHD; in the age range of 5-15 years are included. Of these, 65 (52.8) were male and 58 (47.2%) were female; 69 (56.1%) were from rural and 54 (43.9%) were from urban area. The highest frequency of participant 52 (42.3%) were in the age group of 9-12 years. Among participants 74 (60.2%) had history of pharyngitis. The result of ASO titer shows 78 (63.4%) were positive in antistreptolysin O slide agglutination test; 30 (24.4%) patients have 400IU/ml ASO titer, 19 (15.4%) patients have 600 IU/ml ASO titer, 17 (13.8%) patients have ASO titer 800 IU/ml and 12 (9.8%) patients have ASO titer >1000 IU/ml. Conclusion: This study suggest that in most children admitted with RHD have recent streptococcal infection as evident by raised ASO titer.

    Received: Feb. 14, 2018 Accepted: Mar. 7, 2018 Published: Mar. 29, 2018

    DOI: 10.11648/j.cmr.20180701.14 View: Downloads:

  • Authors: Ademola Joseph Adekanmi, Arinola Esan

    Abstract: Diabetes is a serious health problem with staggering morbidity and mortality rates documented to be rising at an alarming rate worldwide, more so in low income countries. The uncontrolled effect of high blood glucose and disease complications have protean multisytemic consequences. Concomitant Diabetes Mellitus (DM) and hypertension accelerates the progression of micro and macro vascular complications including nephropathy. In this prospective comparative study amongst Diabetic hypertensives, normotensive Diabetics and healthy non-diabetic normotensive controls, we evaluated the effect of co-existing hypertension with diabetes and normotensive DM on renal vascular impedance. Demographic, clinico-laboratory data and Duplex ultrasound impedance of the renal interlobar arteries were documented and data analyzed using Statistical Package for Social Sciences (SPSS) version 23 computer software. The Intra-renal Resistive index (RI) among Diabetic hypertensives (Mean = 0.72 ± 0.15), normotensive DM patients (Mean = 0.69±0.08) and control (Mean = 0.63 ± 0.08) were statistically significant, F (2, 89) = 10.94, p <0.001. The intra renal Doppler RI showed significant correlations with age (r = 0.236, p=0.019) and duration of diabetes (r = 0.333, p=0.003). The Pulsatility index showed statistical significant associations with age (r = 0.370, p<0.001), duration of diabetes (r = 0.338, p = 0.002) and serum creatinine (r = 0.208, p = 0.039). A unit increase in mean arterial blood pressure increases the risk of concomitant hypertension in DM patients by about 3% (AOR= 1.03, 95% CI 1.10; 1.33, p <0.001). Also, an increase by 1mg/dl in cholesterol level increases the risk of concomitant hypertension in DM patients by about 1% (AOR= 1.01, 95% CI 1.00; 1.02, p = 0.044). Altogether concomitant hypertension with DM causes slightly high renal vascular impedance, particularly the RI as well as mild renal dysfunction than in normotensive persons with diabetes. Particularly among cases with clinico-laboratory evidence of good glycaemic control as well as blood pressure management. The arterial blood pressure and cholesterol levels are predictors of concomitant Hypertensive Diabetic status in this study.

    Received: Feb. 19, 2018 Accepted: Mar. 13, 2018 Published: Apr. 4, 2018

    DOI: 10.11648/j.cmr.20180701.15 View: Downloads:

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