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Association of the MYH9 Gene Polymorphisms with Chronic Renal Disease Secondary to Hypertensive Nephrosclerosis, in a Caucasian Population
Diez-Ojea Beatriz,
Marin Rafael,
Coto Eliecer,
Tavira Beatriz,
Fernandez-Vega Francisco,
Alvarez Rafael,
Fernandez-Fresnedo Gema,
Pobes Alfonso,
Suarez-Laures Ana,
Garcia-Monteavaro Camino,
Gorostidi Manuel,
Sanchez Emilio,
Arias Manuel,
Ortega Francisco
Issue:
Volume 2, Issue 6, November 2014
Pages:
95-101
Received:
8 September 2014
Accepted:
25 September 2014
Published:
30 October 2014
Abstract: Background: Hypertensive nephrosclerosis (HN) is a chronic kidney disease (CKD) associated to essential hypertension, but their causal relationship is controversial. New evidence suggests that MYH9 gene alterations are associated with HN in African Americans. The aim of this study is to investigate the role of this gene in Spanish Caucasians. Methods: We compare high-risk MYH9 variants of patients with HN recruited according to standard clinical criteria (CKD stages 3-5), with essential hypertensives without renal disease (estimated glomerular filtration rate (eGFR) > 60 ml/min/1,73m2 and albuminuria < 300 mg/g creatinine), and also CKD patients with HN and progressive impairment of renal function with those who were stable. Diabetics were excluded. Results: A blood sample was obtained for genetic study of 238 patients with HN-CKD and 233 hypertensive controls. The rs3752462-T and rs4821480-T (risk alleles for CKD) were more frequent in the CKD group, but without significant difference. We found no differences for these SPNs with blood pressure, creatinine, albuminuria or renal disease progression. Conclusions: The effect of two common MYH9 single nucleotide polymorphisms (SPNs) on the development of CKD secondary to HN in our Spanish Caucasian population is low or zero; in any case less than that found in other, mainly African Americans.
Abstract: Background: Hypertensive nephrosclerosis (HN) is a chronic kidney disease (CKD) associated to essential hypertension, but their causal relationship is controversial. New evidence suggests that MYH9 gene alterations are associated with HN in African Americans. The aim of this study is to investigate the role of this gene in Spanish Caucasians. Metho...
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First European Case of TAFRO Syndrome Associated with Sjogren Disease
Lynn Antoun Abdo,
Clement Philippe Morin,
Rocco Paolo Collarino,
Jean Paul Cabane,
Marc Albert Gatfosse
Issue:
Volume 2, Issue 6, November 2014
Pages:
102-105
Received:
3 July 2014
Accepted:
5 November 2014
Published:
20 November 2014
Abstract: We herein describe a case of an unusual multicentric castleman disease(MCD) accompanied by Thrombocytopenia, Anasarca, myeloFibrosis and Renal failure, compatible with TAFRO syndrome and associated with Sjogren disease. The treatment with corticosteroids dramatically improved the symptoms. The clinical features of this case were similar to those reported previously in Japan but this appears to be the first European MCD with negative HHV8 and HIV that meets the criteria of TAFRO syndrome, associated with Sjögren disease.
Abstract: We herein describe a case of an unusual multicentric castleman disease(MCD) accompanied by Thrombocytopenia, Anasarca, myeloFibrosis and Renal failure, compatible with TAFRO syndrome and associated with Sjogren disease. The treatment with corticosteroids dramatically improved the symptoms. The clinical features of this case were similar to those re...
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Assessment of Quality Assurance Program of HIV Testing in Ethiopia
Issue:
Volume 2, Issue 6, November 2014
Pages:
106-108
Received:
1 November 2014
Accepted:
11 November 2014
Published:
20 November 2014
Abstract: Background: HIV/AIDS is one of the most challenging health crises facing the world today. The availability of excellent HIV (Human immunodeficiency virus) tests does not automatically guarantee reliable result. Many steps are involved between specimen collections to the moment when reported to physician and at each step something may go wrong. Measures to control the quality of result in HIV diagnostic laboratories are extremely important, because of the consequence of either false positive or false negative results are huge. Methods: A cross sectional study conducted to assess quality assurance program of HIV testing in Addis Ababa Hospitals and Clinics, Ethiopia from May to October 2012. A well designed and structured questionnaire, Checklist and onsite observation were used to collect data. Data was processed and analyzed with SPSS version16.0. Results: Out of 20 assessed hospitals and clinics cases, 3(14%) laboratory personnel’s who conduct HIV testing were found to have no training in HIV testing. Some laboratories 2 (10%) do not follow HIV testing algorithm and also 2 (10%) laboratory personnel’s do not know what to do in case of indeterminate result. HIV testing methods used were Rapid/ simple 20(100%), ELISA 13 (65%), and Western blot 1(5%). All laboratories use controls that are supplied with kit but 2 (10%) laboratories use external control (pooled sera) additionally. Seventeen (85%) uses manual (guidelines) supplied with kits but none of them uses SOPs (Standard operating procedures). There was poor participation in EQA (External Quality Assessment) program (50%). Conclusion: This study showed that there is lack of qualified human resources, not following HIV testing algorithm and poor participation in External quality assessment program. Therefore having a good quality assurance program and participation in external quality assessment scheme is indispensable. In addition, provision of refreshment training for laboratory personnel’s’ who conduct HIV testing and involving them in planning and management will increase the quality of HIV testing.
Abstract: Background: HIV/AIDS is one of the most challenging health crises facing the world today. The availability of excellent HIV (Human immunodeficiency virus) tests does not automatically guarantee reliable result. Many steps are involved between specimen collections to the moment when reported to physician and at each step something may go wrong. Meas...
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Methicillin-Resistant Staphylococcus Aureus Meningitis Associated with Spondylodiscitis and Psoas Abscess in an Immunocompetent Patient
Hicham Bakkali,
Rafai Mustapha,
Belkouch Ahmed,
Tahir Nebhani,
Naoufal Chouaib,
Saad Zidouh,
Lahcen Belyamani
Issue:
Volume 2, Issue 6, November 2014
Pages:
109-112
Received:
21 November 2014
Accepted:
26 November 2014
Published:
28 November 2014
Abstract: Methicillin-resistant staphylococcus aureus (MRSA) meningitis are rare. They are mostly considered as a nosocomial complication of a neurosurgical procedure or a contiguous infection. In this paper we discuss the case of an immunocompetent patient with methicillin-resistant staphylococcus aureus meningitis associated with bacteremia, spondylodiscitis of the lumbar spine and psoas abscess. The patient successfully followed an antibiotic therapy associating Levofloxacin, Rifampin and Vancomycin. This case highlights the importance of early diagnosis and proper treatment.
Abstract: Methicillin-resistant staphylococcus aureus (MRSA) meningitis are rare. They are mostly considered as a nosocomial complication of a neurosurgical procedure or a contiguous infection. In this paper we discuss the case of an immunocompetent patient with methicillin-resistant staphylococcus aureus meningitis associated with bacteremia, spondylodiscit...
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Abnormal Serum Uric Acid Levels in Health and Disease: A Double-Edged Sword
Christopher Ekpenyong,
Ernest Akpan
Issue:
Volume 2, Issue 6, November 2014
Pages:
113-130
Received:
19 November 2014
Accepted:
27 November 2014
Published:
2 December 2014
Abstract: Abnormal serum uric acid (UA) level is a highly prevalent condition worldwide and is increasing in the general population. This alarming epidemiological trend has enormous public health implications due to the central role of abnormal serum UA levels in the initiation, progression, and long-term effects of many metabolic and systemic diseases. Metabolic disorders are major causes of global morbidity and mortality. Altered serum UA level, both above and below the reference ranges for individual traits and contexts, is potentially harmful and described by many researchers as a double-edged sword. Concrete prevention plans in susceptible individuals and treatments to restore normal levels in individuals already affected are advocated. Lifestyle adjustment, including regular moderate physical activity, weight management, healthy eating, and regular serum UA screening are recommended for individuals susceptible to derangement in serum UA levels due to age, sex, genetics, and other acquired conditions. Public health efforts to create awareness about the menace of abnormal serum UA levels, particularly in susceptible individuals, should be encouraged.
Abstract: Abnormal serum uric acid (UA) level is a highly prevalent condition worldwide and is increasing in the general population. This alarming epidemiological trend has enormous public health implications due to the central role of abnormal serum UA levels in the initiation, progression, and long-term effects of many metabolic and systemic diseases. Meta...
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Adverse Events Profiles during Initiation of Treatment with Amlodipine or Hydrochlorothiazide in Type 2 Diabetic Nigerians with Essential Hypertension
G. B. S. Iyalomhe,
E. K. I. Omogbai,
A. O. Isah,
S. I. Iyalomhe
Issue:
Volume 2, Issue 6, November 2014
Pages:
131-137
Received:
30 November 2014
Accepted:
14 December 2014
Published:
19 December 2014
Abstract: Background: Although, amlodipine (AML) and hydrochlorothiazide (HCZ) are recommended to initiate therapy in hypertensive patients, it has not been properly evaluated whether AML or HCZ would demonstrate a better adverse events profile. Objective: To determine whether AML or HCZ would be preferable to initiate antihypertensive treatment in type 2 diabetic Nigerians by comparing the adverse events profiles of the 2 drugs. Methods: Forty male (M) and female (F) newly diagnosed hypertensive subjects with controlled type 2 diabetic mellitus (T2DM) aged 43-68 years were randomized to AML and HCZ treatment groups of 20 patients each (10 Ms, 10 Fs), and they were treated respectively, with AML 10mg and HCZ 25mg, both drugs being given once daily for 48 weeks. Body mass index (BMI) was calculated for each subject. Blood pressure (BP), heart rate (HR), 24h urine volume were assessed at baseline and at the end of weeks 1, 3, 6, 12, 24, 36, and 48. Adverse events profiles were also recorded from week 1 through 48. Results: The drugs significantly reduced BP, though the effect of AML was significantly greater compared to that of HCZ (P<0.01). Diuresis was significant in HCZ group (P<0.01). There were 48 adverse events (48.5%) in the AML group including weight loss and mild tachycardia. No patient had peripheral pedal edema. Fifty one events (51.5%) occurred in HCZ group, weight loss, mild tachycardia, polyuria and myalgia/cramps being the commonest as well as impotence and visual disturbance. Conclusion: Though the two drugs appeared to be well tolerated, AML demonstrated a better BP-lowering effect and adverse events profile. Drugs that ensure adequate BP control and have the lowest possible risk for adverse events like AML, should be preferably used in diabetic Nigerian patients with essential hypertension.
Abstract: Background: Although, amlodipine (AML) and hydrochlorothiazide (HCZ) are recommended to initiate therapy in hypertensive patients, it has not been properly evaluated whether AML or HCZ would demonstrate a better adverse events profile. Objective: To determine whether AML or HCZ would be preferable to initiate antihypertensive treatment in type 2 di...
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Ischemic Cerebrovasular Accident, Uncontrolled Seizures and Acute Myocardial Infarction Associated with Synthetic Marijuana Abuse
Farah Hussain,
Hanan Al-musawi,
Eman Al-khateeb,
Alaa Abu sayf
Issue:
Volume 2, Issue 6, November 2014
Pages:
138-143
Received:
6 December 2014
Accepted:
14 December 2014
Published:
22 December 2014
Abstract: Introduction: Designer Cannabinoids is a newly emerging drug of abuse that gained popularity among adolescent and young adults in the past few years. These drugs are marketed as incense or potpourri under different brand names such as spice. The potency of these drugs is variable and the range of adverse effects range from simple to severe and life threatening adverse effects such as myocardial infarction (MI), Ischemic cerebrovasular accident (ICVA) and seizures. Case report: we describe a 23 male patient who was admitted to the hospital several times suffering from severe side effects following spice abuse. In his first admission, he provided spice sample that we later confirmed to have at least two different synthetic cannabinoids. In his last admission for uncontrolled seizures he start feeling chest pain which was later diagnosed as acute MI. This appears to be the first case report where a spice abuser develops ICVA, uncontrolled seizures and MI at the same time with negative work up towards the etiology other than spice abuse. Discussion: the mechanism behind the possible proconvulsant effect of synthetic marijuana is not known, but it may be due to either their effects at the cannabinoids receptor or due to the absence of the anticonvulsant phytocannabinoids in spice products. Synthetic cannabinoids cause tachycardia and vasospasm due to their high affinity to cannabinoid receptors and this may lead to acute MI however the deep inhalation adopted by spice smokers increase carboxyhemoglobin concentrations and may also contribute to this atheromatous disease. Conclusion: given the patient negative history for thromboembolization, vasculitis, and hypercoagulable state, and the multiple admissions of this patient after smoking spice suggest an association. We hypothesize that synthetic marijuana or the herbs mixed with it might cause the ICVA, MI and seizures in his last admission. Based on extensive review of the literature this appears to be the first case report where a single spice abuser developed ICVA, uncontrolled seizures and MI with negative workup towards the etiology other than spice abuse. Screening for synthetic marijuana should be warranted in all teenagers with new onset seizure disorder. Furthermore, the possibility of MI and ICVA should be part of teenager's counseling sessions as by now it is increasingly reported in literature.
Abstract: Introduction: Designer Cannabinoids is a newly emerging drug of abuse that gained popularity among adolescent and young adults in the past few years. These drugs are marketed as incense or potpourri under different brand names such as spice. The potency of these drugs is variable and the range of adverse effects range from simple to severe and life...
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Prescribing Pattern and Utilization of Antihypertensive Drugs and Blood Pressure Control in Adult Patients with Systemic Hypertension in a Rural Tertiary Hospital in Nigeria
Olusegun Adesola Busari,
Rotimi Oluyonbo,
Abidemi Jude Fasae,
Olusegun Emanuel Gabriel,
Lawrence Majekodunmi Ayodele,
Segun Matthew Agboola,
Adekunle OlatayoAdeoti
Issue:
Volume 2, Issue 6, November 2014
Pages:
144-149
Received:
14 December 2014
Accepted:
17 December 2014
Published:
23 December 2014
Abstract: Background: Hypertension is a major public health concern globally and is associated with high morbidity and mortality in sub-Saharan Africa. Although antihypertensive therapy is effective in lowering blood pressure, a large proportion of patients do not have optimal blood pressure control. Aims: To describe the prescribing pattern and utilization of antihypertensive drugs and assess blood pressure control in a rural reference tertiary hospital in Nigeria. Methods: We conducted a cross-sectional study of 212 adult patients with hypertension attending the cardiology clinic of the Federal Medical Centre, Ido-Ekiti, Nigeria, between February 2012 and July 2012. Anthropometric, clinical and therapeutic data were collected using a pre-tested pro forma. Data analysis was done using SPSS 16.0 software (IBM, Chicago, Il, US). P value < 0.05 (two-sided test) was considered to be statistically significant. Results: We study 212 adults with hypertension, 48.1% of whom were male and the male-to-female ratio was 0.9. The mean age (± SD) of the patients was 61.5±15.1 years. Thirty two (15.1%), 95 (44.8%), 67 (31.6%) and 18 (8.5%) patients were on mono-, dual-, triple- and quadruple therapy respectively. Diuretics (84.9%) and calcium channel blockers (56.6%) were the most frequently used antihypertensive drugs. Blood pressure was controlled in only 45.3% of patients. Dual- and triple-therapy produced more patients with controlled blood pressure (dual-therapy, p=0.30; triple-therapy, p=0.11). Conclusions: Our study showed that diuretics were the most frequently prescribed class of antihypertensive drugs in our rural tertiary hospital as in many studies from urban centres in Nigeria and sub-Saharan Africa. Consistent with the global trend, the rate of controlled blood pressure among hypertensive patients was low, with combination therapy achieving control in more patients.
Abstract: Background: Hypertension is a major public health concern globally and is associated with high morbidity and mortality in sub-Saharan Africa. Although antihypertensive therapy is effective in lowering blood pressure, a large proportion of patients do not have optimal blood pressure control. Aims: To describe the prescribing pattern and utilization ...
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Determination of Netrin-1 Levels in Patients that Applied to Emergency Department with Stroke and Its Effects on Survival for 6 Months
Korhan Ivelik,
Ramazan Koylu,
Akinci Emine,
Basar Cander,
Zerrin Defne Dundar,
Oznur Koylu,
Haluk Gumus
Issue:
Volume 2, Issue 6, November 2014
Pages:
150-155
Received:
18 November 2014
Accepted:
19 December 2014
Published:
27 December 2014
Abstract: Introduction: We aimed to observe whether there are differences in patients presenting to the emergency department that has stroke, determination of serum levels of netrin-1, and its impact on patient survival and determine the effect on survival and stroke patients according to the type of netrin-1 levels. Methods: The study was held in the Konya Education and Research Hospital, Emergency Department between 1st of August, 2012 and 30th of November, 2012. Patients divided into sub groups after determination of hemorrhagic and ischemic stroke. Control group was created with the patients that did not have stroke. In both groups, Netrin-1 levels were studied. Findings: Totally 131 stroke 51 control patiens were enrolled the study. %13 of the patients were with hemorrhagic where as the other %87 was ischemic stroke. In the stroke group Netrin-1 was lower than the control group (p=0,003 and p<0,001). In order to distinguish between control and case groups, related with Netrin-1 ROC curve was statistically significant 0,739 (%95 Confidence Interval: 0,664-0,814). Best cutoff point for Netrin-1 is determined as 728.4. The sensitivity of Netrin-1 at this point is %71,0; selectivity is %68,6; positive predictive value is %85,3; negative predictive value is %47,9; and finally accuracy rate was found as %70,3. Although in the hemorrhagic stroke Netrin-1 is lower than ischemic stroke, the difference between groups was not statistically significant (p=0,297). There was not statistically significant difference in terms with among the patients the median survival and die patients related with Netrin-1. Discussion: Netrin-1 precursor protein is important for neural and vascular development. Netrin-1 regulates cell migration and axon in the brain in utero. On the other hand, in the SSS damage, injured in sections the migration of adult neural stem cells is located. In determining the prognosis of stroke and mortality in the literature, many markers are used. Result: Our study is the first study on this subject in stroke patients have low levels of netrin-1. According to the type of stroke did not detect a difference in netrin-1 levels. Netrin-1 levels were not associated with mortality.
Abstract: Introduction: We aimed to observe whether there are differences in patients presenting to the emergency department that has stroke, determination of serum levels of netrin-1, and its impact on patient survival and determine the effect on survival and stroke patients according to the type of netrin-1 levels. Methods: The study was held in the Konya ...
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Determinants of Eye Lid Surgical Care Utilization among Trachomatous Trichiasis Patients in Rural Communities: In the Case of Basoliben District, North West Ethiopia
Kassahun Ketema Aredo,
Adugna Birhanu Kebede,
Mekonin Aychiluhim,
Mulatu Ayana Hordofa
Issue:
Volume 2, Issue 6, November 2014
Pages:
156-161
Received:
8 December 2014
Accepted:
23 December 2014
Published:
4 January 2015
Abstract: Background: Trachomatous trichiasis is worldwide leading cause of blindness. Surgical intervention is one of the means of prevention of this blindness. Objectives: To assess determinants of eyelid surgical care utilization among trichiasis patients and associated factors. Method: A community based cross- sectional study design was employed. Sample size was determined using a single population proportion formula. Result: Among 348 interviewed patients, 253(72.7%) were in the age group of 16–45 years. Two hundred eighty nine (83.1%) were non-operated and 59(16.9%) operated trichiasis cases. Bilateral eye trichiasis cases were 245(70.4%) and 195(56%) of them were ill for 5-8 years. Ninety-seven (27.9%) believe treatment of trichiasis is surgery. Reasons for not using trichiasis surgery were distance of treatment center (X2 = 36.2), lack of awareness (X2= 46.8), and false beliefs about treatment (X2= 14.6). Conclusion: Associated factors were distance, lack of information, lack of time, fear of surgery.
Abstract: Background: Trachomatous trichiasis is worldwide leading cause of blindness. Surgical intervention is one of the means of prevention of this blindness. Objectives: To assess determinants of eyelid surgical care utilization among trichiasis patients and associated factors. Method: A community based cross- sectional study design was employed. Sample ...
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