Clinical Medicine Research

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

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Volume 7, Issue 5, September 2018

  • Authors: Tsegahun Asfaw, Moges Lewetegn, Helen Tariku

    Abstract: Tuberculosis (TB) remains major Public health problem and among the top ten leading causes of human deaths worldwide. Moreover, TB is the leading cause of morbidity, one of the three major causes for hospital admission, and the second killer next to malaria in Ethiopia. Early diagnosis, effective treatment and continues assessment of treatment outcome are important to improve TB management program. Retrospective study design was conducted to assess trend and treatment outcomes of TB in Debre Berhan referral hospital. 4 years (2014 to 2017) TB case records was reviewed with standard check list and entered in to EpiData 3.1 and analyzed using SPSS version 16. Among the total registered TB patients with complete record (n=506), 256(50.6%) were males and 250(49.4%) Female. The treatment cured rate varies from 23.29% in 2006 E.C to 47.45% in 2007 E.C, whereas treatment completed varies from 46.91% in 2007 E.C to 67.08% in 2009 E.C. Majority of the smear-positive pulmonary tuberculosis patients 183 (97.3%) were cured at the end of their anti-TB treatment. The proportion of HIV co-infection among TB patients was 21.3%. However, overall cure rate was nearly the same in both HIV positive and negative patients. As conclusion majority of the smear-positive pulmonary tuberculosis patients were cured at the end of their anti-TB treatment. There was also a continuous increment of treatment success rate, indicating that the hospital is within the track of WHO target currently. However the proportion of HIV co-infection among TB patients was higher which signifies the urgent need for staff capacity building and increasing public awareness.

    Received: Aug. 27, 2018 Accepted: Sep. 10, 2018 Published: Oct. 24, 2018

    DOI: 10.11648/j.cmr.20180705.11 View: Downloads:

  • Author: Xubao Zhang

    Abstract: We present extensive experimental data to objectively evaluate the benefits and limitations of common directional microphones in real-world sound fields. The microphones include a conventional directional microphone(DM), a balanced DM, etc., plus the Omni microphone (mic) as a benchmark. The evaluation focuses on noise outputs, signal-to-noise ratios(S/Ns) and distortions; the real-world sounds include male voices, female voices, babble noises, white noises and talking interferences. Each type of noises is at 4 or 5 levels, from 30 to 70 dB SPL, at 10 dB step, and each talking interference is at 3 levels: 50, 60 and 70 dB SPL. The research methods include analytically deriving sensitivity-gains, statistically calculating the three mics’ outputs, experimentally viewing waveforms and spectra, and using large-sample wave files for a high confidence level. According to the experimental results, this paper concludes that 1) for a conversation in a quiet field, in soft or low noise field, the common DMs achieve comfortable S/Ns: 7 to 33 dB, similar to what the Omni mic does; 2) for a conversation in low, competing or strong talking interference fields, the common DMs achieve about 16 dB better S/N than the Omni mic does; 3) for a conversation in competing or strong surrounding noise field, the common DMs do not achieve beneficial S/N to understand speech; the common DMs’ noises are close to the Omni mic noise; 4) in various experiments, the balanced DM preserve speech fidelity well as the Omni mic does, while the conventional DM does poorly. This paper further introduces the Simulink experimental manipulations, such as digital FIR filters’ design, stereo channels’ wave files creation, etc., in the Appendix.

    Received: Sep. 6, 2018 Accepted: Sep. 26, 2018 Published: Oct. 26, 2018

    DOI: 10.11648/j.cmr.20180705.12 View: Downloads:

  • Authors: Erin Elizabeth Milner, Absone Rowland, Jessica Jeanette Fasio, Lam Henry

    Abstract: Herein we report a modified Pointe Scientific method for Glucose-6-Phosphate Dehydrogenase (G6PD) testing which eliminates time-consuming and labor intensive pre-analytical steps previously required. Pre-lyse and on-board lyse Pointe Scientific methods were compared to the on-board lyse Trinity Biotech method using Abbott Architect c8000 analyzers integrated into an a3600 track system. In order to streamline the implementation of this method involving both G6PD and hemoglobin analysis, we sought to capitalize on the Instrument Manager (IM) middleware and the a3600 Abbott track system for high-throughput analysis using the Abbott Architect c8000 platform. IM rules were developed to route the whole blood specimen to the wait area of the Input Output Module (IOM) while the initial result is determined. When the initial result is intermediate or deficient, the G6PD activity per gram of hemoglobin (U/g Hgb) is determined by rerouting the specimen to the analyzer as an automated reflex test. The data associated with method comparison, precision, carryover and linearity studies completed per regulatory guidelines indicate the assay parameters reported herein are available for the immediate implementation of fully-automated G6PD testing. A viable method that includes on-board lysing and reflex testing has been implemented allowing for high-throughput G6PD testing in a clinical laboratory. Given market research yielded limited vendors with Food and Drug Administration (FDA)-cleared G6PD assays, the automation of the Pointe Scientific method will allow Department of Defense (DOD) laboratories to rapidly screen service members in order to ascertain the tolerability of a Primaquine dosing regimen.

    Received: Aug. 27, 2018 Accepted: Sep. 13, 2018 Published: Nov. 12, 2018

    DOI: 10.11648/j.cmr.20180705.13 View: Downloads:

  • Authors: Ming Li, You Lu, Alun Rongxiang Wang

    Abstract: Curl rent hypotheses of insulin resistance mostly emphasize cellular mechanisms in peripheral tissues. Although received broad recognition, these opinions may have overlooked the interaction between pancreatic endocrine cells and the peripheral tissues in the process of establishment and maintenance of insulin resistance in the whole body. It has been suggested that basal hyperinsulinemia is the root cause of insulin resistance. Basal insulin release does not share the same intracellular mechanism of high glucose stimulated insulin release; instead, it is regulated by local Ca2+ fluctuation and activation of the cAMP-Epac2/Rap1 signaling pathway. Basal insulin release is controlled by the interaction between pancreatic head β-cells and pancreatic tail α-cells, which release insulin and glucagon, respectively. In diabetes, an elevated basal insulin level would mitigate the sensitivity of peripheral tissues to insulin; the decreased insulin sensitivity and elevated plasma glucose concentration could further stimulate more basal insulin release partially by increasing T-type Ca2+ channel expression and activity in β-cells. This interaction forms a positive feedback loop. Therefore, T-type Ca2+ channel antagonists can potentially be employed to break this positive feedback loop, thus reversing insulin resistance.

    Received: Aug. 20, 2018 Accepted: Oct. 31, 2018 Published: Nov. 26, 2018

    DOI: 10.11648/j.cmr.20180705.14 View: Downloads:

  • Authors: Takenori Tomite, Hidetomo Saito, Hiroaki Kijima, Kimio Saito, Noriyuki Ishikawa, Yuji Hatakeyama, Hiroshi Tazawa, Satoshi Yumoto, Ryo Syoji, Toshiaki Aizawa, Naohisa Miyakoshi, Yoichi Shimada

    Abstract: Deep vein thrombosis is one of the main complications of total knee arthroplasty. Hematoma is another complication often seen following total knee arthroplasty, but a search of the literature found no reports of deep vein thrombosis caused by hematoma. A case of a 68-year-old woman with knee osteoarthritis who underwent total knee arthroplasty, with subsequent onset of thrombosis caused by hematoma, is reported. The surgery was performed through the medial parapatellar approach with measured resection and the implant was put in place with cement fixation. On postoperative day 7, there was still leakage of exudate from the wound, and swelling of the lower leg appeared. Therefore, infection or thrombosis was suspected, and contrast-enhanced computed tomography was performed. Accumulation of fluid was found from the thigh to the knee, and when paracentesis was carried out, blood was drawn, resulting in a diagnosis of hematoma. In addition, the blood vessels were under pressure from the hematoma, and thrombosis was diagnosed based on the clinical, blood analysis, and ultrasound findings. There was concern about treatment due to coexistence of hematoma and thrombi, but through application of a Robert Jones bandage and administration of edoxaban, the patient made good progress with no major complications. A case of deep vein thrombosis caused by hematoma following total knee arthroplasty was reported. The patient recovered without major complications through administration of edoxaban and application of a Robert Jones bandage.

    Received: Sep. 19, 2018 Accepted: Oct. 26, 2018 Published: Nov. 28, 2018

    DOI: 10.11648/j.cmr.20180705.15 View: Downloads:

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