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A Rare Case of PeutzJegher Syndrome Presenting with a Solitary Polyp in the Jejunum – A Case Report
Prabakaran Sundararajan,
Saravanan Natarajan,
Kasthuri Thilagam Kannaian
Issue:
Volume 4, Issue 4, December 2018
Pages:
80-83
Received:
17 August 2018
Accepted:
12 September 2018
Published:
19 October 2018
DOI:
10.11648/j.ajp.20180404.11
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Abstract: Background: Intussusception is a common abdominal emergency requiring surgical intervention in newborns and infants. They commonly present in babies less than 2 years of age. A vast majority of intussusceptions are idiopathic. They rarely present in older age groups and in adults. Certain autosomal disorders may be linked to intussusceptions. Peutz Jegher Syndrome is a rare autosomal dominant disorder resulting due to mutation in the SPK 11 gene located in chromosome 19q13.3. The disease is characterized by multiple hamartomatous polyposis, jejuna intussusceptions and hyperpigmented melanotic spots in the mucocutaneous regions like mouth, etc. Case report: We present a case of 12 year old girl with chronic stomach pain and occasional vomiting. General examination showed presence of hyperpigmented spots in the soles, cheeks, lips and mouth. CECT abdomen showed presence of jejunal intussusception. The patient was taken up for laproscopy and laparotomy was performed after reducing the intussusceptions. A soliatary sessile polyp was removed and histopathological examination confirmed the presence of hamartomatous polyp. There is an increased susceptibility of cancers of gastrointestinal system and several other organs like breast, ovaries, etc. Conclusion: Further research in this area may be carried out to explore the risk factors and genetic mechanisms which may help in early detection and prevention of such rare syndromes.
Abstract: Background: Intussusception is a common abdominal emergency requiring surgical intervention in newborns and infants. They commonly present in babies less than 2 years of age. A vast majority of intussusceptions are idiopathic. They rarely present in older age groups and in adults. Certain autosomal disorders may be linked to intussusceptions. Peutz...
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Oxidative Modification of Lipids and Lipoproteins in Steady State Sickle Cell Anemic Patients from South-Eastern Nigeria
Sylvester Ogbonna Ogbodo,
Christopher Bismarck Eke,
Emmanuel Ikechukwu Nwobodo,
Ejike Felix Chukwurah,
Vitus Obinna Agama
Issue:
Volume 4, Issue 4, December 2018
Pages:
84-88
Received:
6 August 2018
Accepted:
12 October 2018
Published:
7 November 2018
DOI:
10.11648/j.ajp.20180404.12
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Abstract: Sickle cell anemia is a genetic disease associated with constant medical crises. These crises are due to many biochemical and hematological changes arising from multi-organ damages. This study was aimed to assess changes in the plasma levels of lipids and specific lipoproteins in sickle cell anemia patients who were in their steady states. The study is a cross-sectional one involving 75 patients with sickle cell anemia, who were in their stable states while attending their routine check-up at the sickle cell clinic of University of Nigeria Teaching Hospital, Enugu, Nigeria and 72 age and sex-matched apparently healthy school children with normal blood genotypes. The patients were made up of 40 males and 35 females while the controls were 36 males and 36 females. The results of the study showed that patients have the following; total cholesterol 135 ± 38.6mg/dL, HDL-cholesterol 22.7 ± 8.1mg/dL, LDL-cholesterol 91.4 ± 41.2mg/dL, VLDL-cholesterol 20.5 ± 5.0mg/dL and triglycerides 102.7 ± 25.2mg/dL, while the results from the controls were; total cholesterol 162.2 ± 27.4mg/dL, HDL-cholesterol 36.6 ± 7.9mg/dL, LDL-cholesterol 100.2 ± 23.9mg/dL, VLDL-cholesterol 25.4 ± 3.7mg/dL and triglycerides 127.0 ± 18.4mg/dL. These results showed that there were significant decreases (p<0.001 in all) in these parameters in sickle cell anemia except LDL-cholesterol (p=0.28), indicating oxidative modifications of the lipids and the lipoproteins. However, there were no significant differences (p>0.05) between the parameters obtained in males and females in both patients and controls. Lipids and lipoproteins were significantly reduced in steady state sickle cell anemia, causing the patients to depend mainly on limited carbohydrates and proteins for the provision of energy. This may account for constant lack of energy as well as the frail and fragile appearances of these patients.
Abstract: Sickle cell anemia is a genetic disease associated with constant medical crises. These crises are due to many biochemical and hematological changes arising from multi-organ damages. This study was aimed to assess changes in the plasma levels of lipids and specific lipoproteins in sickle cell anemia patients who were in their steady states. The stud...
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Teething Problems: Knowledge, Attitude and Intending Practice Among Clinical Medical Students in Bingham University Teaching Hospital, Jos
Maryam Shehu,
Hassan Shehu
Issue:
Volume 4, Issue 4, December 2018
Pages:
89-93
Received:
29 September 2018
Accepted:
12 October 2018
Published:
7 November 2018
DOI:
10.11648/j.ajp.20180404.13
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Abstract: Teething in children describes the period when deciduous teeth cut through the gum pads to appear in the oral cavity. Myths and controversies have been associated with this process. The main aim of this study is to find out the knowledge, attitude and intending practice on teething problems among clinical students in BHUTH, Jos. The sampling method was consecutive sampling of all the students until sample size was obtained. A total of 164 questionnaires were distributed and 164 were duly filled and returned. One hundred and sixty-four students were enrolled into the study. There were 103 (62.80%) females and 61 (37.20%) males with M:F ratio of 1:1.67. The knowledge about teeth eruption among the students was good in the definition of teething with 111 (76.7%) getting the correct answer. The knowledge on the total number of milk teeth was the worst with only 24 (14.6%) getting the correct answer. One hundred and thirty- five (82.3) agreed that teething causes irritability and lack of sleep in infants, 113 (69.0%) agreed that teething is also associated with drooling. Only 15 (9.2%) agreed that symptoms seen during tooth eruption are coincidental. The highest source of information about teething was from teachings (34.2%), with the least being from grandparents (2.7%). Of the 849 multiple responses on the symptoms of teething gotten from sources apart from teaching or lectures; 124 (14.6%) associated excessive crying with teething, closely followed by diarrhea with 117 (13.8%); while 7 (0.8%) of the responses associated convulsion with teething. Excessive crying was the highest symptom that the students, 127 (25.3%) of the 222 multiple responses, believed to be associated with teething. Vomiting was the lowest with 44 (8.8%). The attitude of the students towards having lectures/teachings/presentations on teething was good with 161 (98.2%) of the students agreeing to the need of teaching on teething. The intending practice on teething by the students was good with 108 (50.0%) of the 216 multiple responses saying they will send the children with symptoms of teething to see a paediatrician. One hundred (61.0%) will not give pacifiers to children with symptoms of teething, while 64 (39.0%) will give pacifiers to children with symptoms of teething. There are still a lot of controversies about the symptoms associated with teething, therefore the need to educate medical students about teething, so they can help in giving out the correct information about teething.
Abstract: Teething in children describes the period when deciduous teeth cut through the gum pads to appear in the oral cavity. Myths and controversies have been associated with this process. The main aim of this study is to find out the knowledge, attitude and intending practice on teething problems among clinical students in BHUTH, Jos. The sampling method...
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Prevalence of Head Lice Infestation (Pediculosis Capitis) Among Primary School Students in the Meshkin Shahr of Ardabil Province
Abbasgholizadeh Nategh,
Moradi-Asl Eslam,
Adham Davoud,
Soudi Roghayeh,
Ganji Akbar,
Brije Hassan,
Salehzade Mehdi
Issue:
Volume 4, Issue 4, December 2018
Pages:
94-99
Received:
20 August 2018
Accepted:
5 October 2018
Published:
27 November 2018
DOI:
10.11648/j.ajp.20180404.14
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Abstract: Head lice infestation is so common in all parts of the world such as Iran especially in places with high population with poverty and lack of observing personal health principles. The maximum prevalence of louse infestation in children was observed in elementary school. Over prevalence of infestation in this age group and its relationship with education system and thus its generalization to the total population was the main reason of selecting this age group for the present study. This study was descriptive-analytical which aimed to determine the prevalence of head lice in elementary schools students of Meshkin Shahr city in Ardebil province in academic year 2015-2016. 1950 students were selected from 20 schools. For data analysis, the variables were analyzed as multivariate by chi-square test. In general, 1950 students were selected from 20 schools from which 200 students (10.25%) were infested to head lice. From 200 infested students (61%) were city and 78 students (39%) were from village. The ratio of the students in classes with more than 20 students was two times the others and the ratio of the students that studied in the schools with more than 100 students was three times the other schools. The difference between both groups was significant in terms of Pediculosis infestation. (P<0.01). It can be concluded that a set of important factors like crowdedness of students in classroom and school, high population of family, low level of parents’ education were the main reasons of louse infestation and its increase in the current societies.
Abstract: Head lice infestation is so common in all parts of the world such as Iran especially in places with high population with poverty and lack of observing personal health principles. The maximum prevalence of louse infestation in children was observed in elementary school. Over prevalence of infestation in this age group and its relationship with educa...
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Unusual Case of Coloboma of the Iris with Dextrocardia and Criss Cross Heart Presented Later with Left Sided Diaphragmatic Hernia: First Case Report
Sam Hassan,
Sameer Sajwani,
Pramond Warhekar,
Ghassan Nakib,
Syed Rizvi
Issue:
Volume 4, Issue 4, December 2018
Pages:
100-103
Received:
24 October 2018
Accepted:
7 November 2018
Published:
3 December 2018
DOI:
10.11648/j.ajp.20180404.15
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Abstract: Coloboma of the iris (CI) is an embryonic condition resulted from an incomplete formation of the iris which either presented unilateral or bilateral and as a single eye defect or in association of other eye anomalies. It happens either as an isolated condition or as part of syndromic features or other associations that are well reported in literatures. Coloboma of the iris has been reported in association with diaphragmatic hernia and in some syndromes with dextrocardia. It can happen in families with genetic presentation looks like autosomal dominant pattern, however other genetic pattern were also reported. The combination of CI, dextrocardia, Criss Cross Heart (CCH) which is a rare condition by itself and the congenital diaphragmatic hernia (CDH) has not been reported before. This report is about an unusual case of a boy presented after birth with left sided CI associated with dextrocardia and CCH, who presented later at the age of 16 months with left sided congenital diaphragmatic hernia that was not been diagnosed early. As far as this search for the English literatures concerned, this is the first report of this exclusive association. It is therefore, highly recommended to investigate cases of CI for an associated CDH especially if it is associated with congenital heart defects such as dextrocardia and CCH.
Abstract: Coloboma of the iris (CI) is an embryonic condition resulted from an incomplete formation of the iris which either presented unilateral or bilateral and as a single eye defect or in association of other eye anomalies. It happens either as an isolated condition or as part of syndromic features or other associations that are well reported in literatu...
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Why Mainstream SIDS Research Is Not Achieving Its Goal
Issue:
Volume 4, Issue 4, December 2018
Pages:
104-109
Received:
31 October 2018
Accepted:
15 November 2018
Published:
17 December 2018
DOI:
10.11648/j.ajp.20180404.16
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Abstract: The cardiorespiratory paradigm is used to explain the aetiology of SIDS and has been the focus of intense research for many decades without providing consistent and meaningful data to support such an hypothesis. Despite this, papers citing central nervous system, cardiac and sleep arousal findings continue to be unremittingly published but without addressing SIDS risk and other factors. This paper is a succinct analysis of current cardiorespiratory SIDS research and its relationship (or not) to the established clinicopathological data and epidemiological risk factors. Epidemiological research into the aetiology of SIDS produced a milestone with the discovery of the prone sleep position risk factor which provided support for the cardiorespiratory control hypothesis which in itself defines the approach used by mainstream researchers. Since then mainstream research has stalled. The question is why? This analysis shows that there is very poor correlation between brainstem and other central nervous system pathological findings and other clinicopathological data and SIDS risk factors. A few studies show a link to a small number of risk factors, however, for the majority of papers there remains a glaring absence of data to link central nervous system pathology findings with the key risk factor of prone sleep position which is the central column upon which the cardiorespiratory paradigm stands. Nor do the studies correlate central nervous system findings with recent infection, contaminated sleeping surfaces, maternal/obstetric/higher birth, ethnicity, non-breast-feeding, etc. or with the usual gross pathological findings of SIDS (intrathoracic petechiae, liquid blood, congested fluid-laden lungs). Because of these shortcomings, this paper should provoke questions over current research directions and invites research into other more plausible hypotheses, such as the infection paradigm.
Abstract: The cardiorespiratory paradigm is used to explain the aetiology of SIDS and has been the focus of intense research for many decades without providing consistent and meaningful data to support such an hypothesis. Despite this, papers citing central nervous system, cardiac and sleep arousal findings continue to be unremittingly published but without ...
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Childhood Typhoid Intestinal Perforation in Aba, Nigeria
Samuel Chidi Ekpemo,
Ndukuba Eleweke
Issue:
Volume 4, Issue 4, December 2018
Pages:
110-113
Received:
14 October 2018
Accepted:
30 November 2018
Published:
3 January 2019
DOI:
10.11648/j.ajp.20180404.17
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Abstract: Typhoid intestinal perforation is still prevalent in many low and middle income countries. This may be due to lack of potable water, poor refuse disposal and health education. This study is to evaluate the outcome of management of typhoid intestinal perforation in children at the Abia State University Teaching Hospital Aba Nigeria. This is a prospective study of children who were managed for typhoid intestinal perforation at the Paediatric Surgery unit, department of Surgery of the Abia State University Teaching Hospital Aba Nigeria from November 2016 to September 2018. Proforma was opened for demography, clinical features, investigation, site of perforation, type of surgery, complications and outcome. Data collected were analysed using SPSS computer software version 17 for proportions and percentages. Results: Sixty patients were seen over the sixteen months study period. Forty males and twenty females with a male to female ratio {2:1}. Their ages ranged from 3 years to 15 years with a mean age of 8.9 years. Fever, abdominal pain, vomiting and abdominal distension were the commonest clinical features in over 50% of patients. Doubled layer closure and resection and anastomosis of ileal segment were done in equal number of patients [20 patients each]. Surgical site infection was the most common complications in 50 [83.3%] of patients. Five patients died giving a mortality rate of 8.3%. Typhoid intestinal perforation is still a persistent scourge in low income countries. Morbidity is still high despite low mortality in this series. Early presentation, good nutrition and public health education will improve outcome.
Abstract: Typhoid intestinal perforation is still prevalent in many low and middle income countries. This may be due to lack of potable water, poor refuse disposal and health education. This study is to evaluate the outcome of management of typhoid intestinal perforation in children at the Abia State University Teaching Hospital Aba Nigeria. This is a prospe...
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