Saudi Journal of Medicine (SJM) | Volume-6-Issue-06
June 6, 2021
Hemangioma of the Rhinopharynx: About A Case
Sefrioui TI, Lassikri O, Mahiou N, Nitassi S, Bencheikh R, Benbouzid A, Oujilal A, Essakalli L
Page Numbers : 119-121
DOI : 10.36348/sjm.2021.v06i06.001
Hemangiomas are the most common vascular lesions in early childhood. More than half of the cases involve head and neck. The case of 1 patient consulted following an epistaxis associated with a unilateral nasal obstruction. The CT and nasal sinus angio-MRI (Figure-2) objectified a heterogeneous mass of the posterior wall of the cavum, Cerebral arterography evoked a hemangioma with the presence of a vascular blush, There was no enlargement of the spheno-palatine hole. A preoperative embolization was performed to prevent massive intraoperative bleeding. Surgical management consisted of an exclusive endoscopic endonasal removal of the tumor. Histologically, mixed hemangioma is characterized by the association of lobular proliferation consisting of a central vessel surrounding smaller vessels in the breast of a stromafibromyxoıde and sinusoid lakes with blood throats.
June 6, 2021
Post-Epileptic Aphasia Revealing LANDAU- KLEFNER Syndrome in a Child
Najoua Belhaj, Razika Bencheikh, Lina EL Messouadi, Ahmed Ould mohammed, Mhammed Azedine, Ngouya Koumba Hernandez Vasthi, Mohammed Anass Benbouzid, Leila Essakalli Houssyni
Page Numbers : 122-125
DOI : 10.36348/sjm.2021.v06i06.002
Aphasia in children is generally still little explored because it is rare. Landau-Kleffner syndrome (LKS) is rare and causes specific difficulties in children with it. Among the neuropsychological difficulties (cognitive and attentional), we find a significant initially receptive aphasia. We report in this work the observation of a 13-year-old child seen in consultation for aphasia at the age of 07 years post epileptic seizure. In this patient the diagnosis of LKS was retained after the etiological assessment and the complementary examinations carried out.
Original Research Article
June 6, 2021
Association of Lipids with Hemorrhagic Stroke: A study in a Tertiary Care Hospital
Malik SS, Khan MM, Emran MM, Monsur ATMS, Faisel M
Page Numbers : 126-131
DOI : 10.36348/sjm.2021.v06i06.003
Introduction: Hemorrhagic stroke is rupture of blood vessel in focal region of the brain and spills of blood in surrounding area of brain parenchyma. The low- and middle-income countries experience 80% mortality rate among all hemorrhagic stroke. Although the association of Hemorrhagic Stroke with Hypertension, Smoking and Alcohol consumption are well establish, the association between lipids and hemorrhagic stroke has not been well investigated so far. Aim of the study: The aim of the study was to investigate the association of Serum lipids levels with hemorrhagic stroke in a tertiary care hospital of Bangladesh. Materials & Methodology: This cross-sectional study was conducted in the department of neurology in Enam medical college hospital, Dhaka, Bangladesh. Data was collected between April 2019 and May 2020. Seventy two cases with hemorrhagic stroke were randomly included. Appropriate statistical methods were used to analyze the results. Data were analyzed using SPSS 20.0 version (Chicago, Inc., USA) software and MsExcel-2016 version. Result: From 72 study people we found highest 22(30.6%) in the range of 60-69 years. There were 46(63.9%) males and 26(36.1%) females were enrolled in this study. Hypertension was found in 80.6% study people. The univariate analysis was done to see the association of lipids with Hemorrhagic Stroke. It has been obsereved that, the Total cholesterol and Serum Triglyceride level were low among the cases of hemorrhagic stroke. We found strong association in hemorrhagic stroke with Total cholesterol and Serum Triglyceride of serum lipids. Conclusion: 60-69 age ranges people had faced this stroke the most and males are predominant. The low level of serum total cholesterol and triglycerides may intensify the of risk hemorrhagic stroke.
June 14, 2021
Challenges and Limitations during Management of Surgical Patients via Telemedicine during COVID-19 Pandemic
Dr. Satya Prakash Meena, Dr. Manisha Jhirwal, Dr. Mayank Badkur, Dr. Mahendra Lodha
Page Numbers : 132-136
DOI : 10.36348/sjm.2021.v06i06.004
COVID 19 disease was declared as a pandemic by the World Health Organization (WHO) in March 2020. Telemedicine facilities become a spine for health care system in developing countries for managing communicable disease as well as surgical patients. Most of the hospitals have newer experience with these organized telemedicine facilities. This comprehensive review has done with a search engine on PubMed, Google scholar with keywords like telemedicine in India, telemedicine in COVID 19, COVID 19, telemedicine guidelines, telemedicine consultation and chronic disease. In Indian scenarios, this newer modality of treatment for surgical patients has fewer limitations due to slower adaptability and lack of psychological support. The health care system required proper training for the improvement of this virtual model of consultation and examination. A hybrid form of management can bridge between telemedicine and physical consultation to provide good and adequate surgical care. A multispecialty virtual meeting may provide adequate and satisfactory telemedicine consultation for high-risk, comorbid, palliative surgical patients. Fewer limitations are needs to reconsider for a safe, assessable, adequate and convenient virtual platform like lack of good hospitality infrastructures, proper guidelines, medical education, clinical training and adaptability. Surgical and oncological society guidelines may help to triage and smooth management of COVID and Non-COVID patients. Triage of surgical patients in telemedicine OPD has a positive impact on the overall prognosis of patients with an acceptable risk of disease.
Original Research Article
June 18, 2021
Oral Symptoms and Oral Health Related Quality of Life in Patients with Grinspan’s Syndrome: A Questionnaire Based Cross-Sectional Study
Dr. Ranjitkumar Patil, Dr. Akhilanand Chaurasia, Saman Ishrat, Rini Tiwari
Page Numbers : 137-142
DOI : 10.36348/sjm.2021.v06i06.005
Introduction: Grinspan syndrome is a triad of erosive form of oral lichen planus (OLP), diabetes mellitus (DM) and arterial hypertension. The objective of present study is to evaluate the oral health and oral symptoms in patients with Grinspan’s syndrome and also an emphasis on evaluating the level of awareness about oral health in patients of this disease complex. Methods: The study subjects with Grinspan’s syndrome are included in the study while the rest were excluded along with those who are on medications for other conditions. A self-administered structured questionnaire is used as the survey instrument. After collecting all the responses from patients, it is analyzed statistically using IBM SPSS® Software (21.v). Results: The most common oral symptom found in Grinspan’s syndrome is Glossodynia (92.1%). The high arched palate (35.6%) and temporomandibular joint disorders (35.6%) are least associated with this syndrome. Glossodynia was most prevalent (91.4% and 93% respectively) and their association with gender was highly significant (p value<.001) however the association of all other oral symptoms with gender was statistically non significant (P>.001). Among the different age groups, the presentation of oral symptoms was highly variable but the association between oral symptoms and age group was statistically highly significant (P<.001). Conclusions: Glossodynia is the most common oral symptom found in Grinspan’s syndrome whereas high arched palate and temporomandibular joint disorders (35.6%) are the least associated with this syndrome, in our study. The presentation of oral symptoms depends on and varies according to the age group of patients.
Tooth brushing using toothpaste and the toothbrush remains the most common mouth cleaning method. Many dentists recommend the use of a fluoride-containing toothpaste twice daily when tooth brushing. This process retains food debris, blood, crevicular fluid, saliva, phlegm and toothpaste residues in between the bristles of the toothbrush if not thoroughly cleaned after use. These can potentially infect traumatic injuries caused by toothbrushes in the mouth and also re-infect immunocompromised persons after recovery from some illnesses or other persons when toothbrushes are shared or improperly stored. Household vectors attracted to toothpaste residues on toothbrushes can potentially infect such toothbrushes with non-endemic strains of microorganisms as well. With hundreds of millions of people around the world projected to join the class of the extremely poor by 2021 as a result of the COVID-19 pandemic, one popular professional recommendation for toothbrush hygiene- replacement every 3 or 4 months- is increasingly likely to be ignored. This paper recommends additional, cost-effective, universally adaptable ways of improving toothbrush hygiene for the removal of toothpaste residues after tooth brushing.
Original Research Article
June 24, 2021
To Correlate Glycemic Status in Acute Op Poisoning with Severity and Clinical Outcome
Dr. Sheshan.VS, Dr. Yaduraj. D.K, Dr. Vijay Vasudev, Dr. Madhumathi R, Dr. Kavya ST
Page Numbers : 148-153
DOI : 10.36348/sjm.2021.v06i06.007
Background: Organophosphorus (OP) poisoning, in addition to its cholinergic manifestations shows metabolic derangements leading to hyperglycaemia. The present study aims to assess the glycaemic status of OP poisoned patients and its association with severity and clinical outcome. Random blood sugar (RBS) level is an important factor influencing the severity of organophosphorus (OP) compound poisoning. RBS and its association with POP Scale can be used as a prognostic and mortality indicator in OP compound poisoning. Objectives of the study: 1. To estimate Serum Pseudocholinesterase and Random blood glucose levels in Acute OP Poisoning. 2. To correlate with the clinical criteria described by the POP scale at initial presentation and the severity of poisoning. Methods: This is a prospective study done on 90 patients above 18 years of age admitted to hospitals attached to Bangalore Medical College and Research Institute with history of Acute OP poisoning from November 2018 to May 2020. They were categorized into 3 grades-mild, moderate and severe based on the Peradeniya Organophosphorus Poisoning Scale. The routine biochemical parameters along with serum cholinesterase and Random blood glucose level were estimated in the study group. Results: Hyperglycaemia (RBS>200) was observed in 18(20%) of patients. Mean age group of patients was 32.68. Out of 90 subjects, 18 subjects had RBS levels above 200 and 72 subjects had RBS levels less than 200. Out of 18 subjects, 7 had mild POP scale, 8 had moderate POP scale and 3 had severe POP scale. Out of 18(100%) subjects having RBS scores of above 200, there were 7(38.9%) mortality noted (2-mild, 2-modertae and 3 severe POP scale). Out of 72(100%) subjects having RBS scores less than 200, there were 2(2.8%) mortality noted (1-modertae and 1 severe POP scale).Chi- square test showed significant association between POP scale and mortality in group having above 200 RBS levels(p<0.05). Conclusions: Glycemic status and POP Scale at the time of presentation in OP poisoning may play a role in predicting the need for ICU, Ventilator and Mortality in peripheral health centres in developing countries.
Original Research Article
June 24, 2021
Practice of Self-Prescribed Analgesics from the Students of Physical Therapy
Dr. Raee Saeed Alghtani, Dr. Muhamad Yaseen Mughal, Dr. Adel Alshehrani, Dr. Muhammad Asif Sheikh, Dr. Hashim Ahmed, Muhammad Jarar Abdu-ur-Rehman
Page Numbers : 154-158
DOI : 10.36348/sjm.2021.v06i06.008
Objective: Determine the Practice of self-prescribed analgesics from the students of physical therapy. Methodology: 150 students of physical therapy were selected to be a part of the study through randomized sampling. All of them were informed of the study and after taking verbal consent were asked to fill a questionnaire pertaining to self-prescription. Data was analyzed using SPSS Version 20.0.The Chi Square test was applied to determine the statistical significance which was kept at P=<0.05. Results: 77(51.3%) male candidates and 73 (48.7%) female candidates in our study of 150 physical therapy students showed that there was no significant difference in self-prescription of systemic analgesics with P=0.156. Conclusion: The prevalence of Self-prescription was found to be high among physical therapy students. Better regulation of over the counter medicines and efficient counseling is highly necessary to reduce the amount of self-medication ongoing.
The liver as a major organ of metabolism is one of the first predisposed organs to food chemicals. Icacinia manni tuber, the examined agent in this study has claims of direct and indirect consumption by man as it is observed to be a source of energy which contains high amount of carbohydrates among other nutritional and anti-nutritional constituents. Four (4) weeks old Male Wistar rats were used for this study. They were fed with rat chow from vital feeds and allowed free access to drinking water throughout the experimental period. Icacinia manni tuber was washed with water to remove sand, cut into pieces and sun dried. The dried specimen was extracted with 80% Ethanol. After two (2) weeks of drying, the tuber was reduced into powder. The powder was divided into two parts. One part was macerated in 80% ethanol for 72hrs to give the crude ethanolic extract. The other part was successively macerated for 72hrs in n-hexane and ethanol to give the corresponding gradient fraction of these solvents. The liquid filtrate was concentrated and evaporated to dryness using rotary evaporator. The median lethal dose (LD50) of the extract was estimated using albino Wistar mice by intra peritoneal (ip) route. The rats which weighed between 60 and 100gm were randomly assigned four (4) groups. Group A served as the control and was given distilled water by mouth and allowed liberal food and water throughout the experimental period which was 28 days. Group B, C and D had low, intermediate and high dose of extract. Group B received 1/10 of LD50 by feeding tube i.e. 1/10 x 894.43 mg/kg = 89.44mg/kg. Group C received 2/10 of LD50 by mouth through a feeding tube i.e. 178.88mg/kg. Group D received 3/10 of LD50 by mouth through a feeding tube i.e. 268.32mg/kg. Stock concentration was 50mg/ml. On the twenty-eighth (28th) day, the animals were anaesthetized with chloroform. Blood samples were obtained by cardiac puncture. Serum obtained for biochemical analysis. The livers were harvested for histological analysis. The results showed significant higher levels (p˂0.01) of Mean Total Cholesterol and High Density Lipoprotein in treated rats compared to the untreated rats. Significant lower levels (p˂0.01) of Mean Triglycerides and Low Density Lipoprotein were observed in untreated rats compared to treated rats. The Mean Total Protein, Mean Albumin and Mean Globulin levels for treated rats were significantly lower (p˂0.01) than that of the untreated rats. The histologic photomicrographs of liver of treated rats showed moderate area cellular abnormalities with area of vascular congestion and degeneration, cellular degeneration, vacuolization and pyknotic nuclei as compared to untreated rats. This study shows the hepatotoxicity of Icacinia manni tuber and its associated risk of metabolic syndrome.
Original Research Article
June 26, 2021
Determination of the Prevalence of Substance Abuse among Students in University of Port Harcourt’s Host Communities
Page Numbers : 165-168
DOI : 10.36348/sjm.2021.v06i06.010
Background: Substance abuse refers to the use of all chemicals, drugs and industrial solvents that can produce dependence (psychological and physical). It can also refer to repeated non-medical use of potentially addictive chemical and organic substances. According to UNICEF and WHO, substance abuse includes the use of chemicals in excess of normally prescribed treatment dosage and frequency, even with knowledge that they may cause serious problems and eventually lead to addiction. Hence, this study was done to determine the prevalence of substance abuse among students in University of Port Harcourt host’s communities. Materials & Methods: The study was a descriptive cross-sectional study carried out in ALUU Community in Ikwerre Local Government Area of Rivers State. The study involved 150 volunteers recruited randomly through a multi-staged sampling technique which included secondary school students, undergraduates and post graduates who are 13yrs and above residing in ALUU community while, those who did not give consent were excluded. The data was collected using a self-structured close-ended self-administered questionnaires and data analysis done using SPSS version 25. Results and Discussions: The most frequent age category was 20-24years (42.67%), while the least frequent category was 10-14years. The most frequent gender (sex) was the males (71.33%); the most frequent educational level was undergraduate 84.67%. The study again showed that the most commonly abused substances by students were alcohol 90.57%, Nicotine 39.62%, while the least abused drugs were heroin and cocaine being 1.89% respectively. The prevalence of drug abuse seen in the study was 35.33%. Moreover, the distribution of known acquaintance of persons who abuse drugs was 78.67%. Conclusion: The prevalence of drug abuse seen in the study was 35.33%. Peer group, neighbourhood influence and parents habits of drug/substance abuse were the attributed contributing factors to the prevalence of drug/substance abuse amongst students in Aluu.
Original Research Article
June 30, 2021
Substitution Urethroplasty in the Management of Anterior Urethral Stricture Disease - A Study of 50 Cases
Ahmed ABS, Rahman MM, Mazumdar R, Mondal F
Page Numbers : 169-175
DOI : 10.36348/sjm.2021.v06i06.011
Background: The term urethral stricture refers to anterior urethral narrowing or a scarring process involving the spongy erectile tissue of corpus spongiosum. Urethral stricture is one of the most important causes of bladder out flow obstruction. There are different treatment modalities for the management of stricture urethra. Both the patient and the physician must have a good understanding of the procedure & outcome of treatment. Different types of tissues are standardized by different surgeons. Each type of graft has its own procedural advantage and disadvantage. So it is recommended to select the case for a particular type of graft. But it is evident that judicious use of specific graft has almost equal outcome. Aim: To see outcome of substitution urethroplasty in the management of long segment anterior stricture disease, to study the improvement of clinical manifestation (poor flow, narrow stream, double stream) following surgical correction of stricture urethra And to see the change in uroflowmetry following surgical correction of stricture urethra, to study the post-operative complication. Methodology: This study comprises of 50 consecutive cases of anterior urethral stricture who were admitted in department of urology Enam Medical College and Hospital from January 2018 to January 2021. All patients were attended in urology outpatient department. They were worked up properly and previous treatments were thoroughly analyzed. All of them were appropriately treated with reconstruction. The total study population was 50 patients aged 20-50 years. Results: The total study population was 50 patients aged 20-50 years, 8(16.0%) patients had 20 years to 25 years, 16(32.0%) patients had 26 years to 30 years, 10(20.0%) patients had 31 years to 35 years, 8(16.0%) patients had 36 years to 40 years, 3(6.0%) patients had 41 years to 45 years and 5(10.0%) patients had 46 years to 50 years. Average Mean value of Peak flow rate in first month in 50 patients was 29.78ml/sec. Cystoscopy was done in all patients in 3rd month to see the anastomotic site. After six months of follow up only two patients had complaints of obstructive symptom. Uroflowmetry showed peak flow rate less than 10 ml. Here we did cystoscopic examination. And stricture segment was identified proximal to the previous site which was managed by OIU. After that no such obstructive flow was reported by those patients. Retrograde Urethrogram was done in all the patients to see caliber of urethra. In case two out of 50 showed recurrence in RGU with MCU. Conclusion: This study showed better outcome than any other conventional method for the treatment of stricture urethral disease. So, it can be concluded that substitution urethroplasty is the treatment of choice for the management of long segment anterior urethral disease.
Original Research Article
June 30, 2021
Survival of COVID-19 Positive Patients: A Single Centered Comparative Study
Dr. Masum Ahmed, Dr. Kamruzzaman Md. Zahir, Dr. A. J. M. Emrul Kayesh, Dr. Shah Md. Fazlay Rahaman Khan, Dr. Mohammad Shahadat Hoshen, Dr. Anwar Hossain, Dr. Mahmudul Hassan Banna
Page Numbers : 176-180
DOI : 10.36348/sjm.2021.v06i06.012
Background: In Bangladesh for the first time, Covid-19 cases were detected in Dhaka city on the 8th March of 2020. Till then the number of Covid-19 patients is being increased. Covid-19 has the ferocious nature of affecting a large number of people within a couple of days. The mortality rate of Covid-19 differs by ages and places. In Bangladesh, we have not enough research-based information regarding the survival rate of Covid-19 positive patients. Aim of the study: The aim of this study was to assess of Covid-19 positive patient survival rate in Bangladesh. Methods: This was a prospective observational study conducted in the Department of Medicine Sher-e-Bangla Medical College Hospital (SBMCH), Barishal, Bangladesh during the period from July 2020 to 31 December 2020. In total 496 suspected Covid-19 patients who attended and completed full treatment tenure from 1 July 2020 to 31 December were selected as the study people for analysis. The study people were divided into two groups. In Group-I only death cases were enrolled and in group-II cured patients were enrolled. Before data collection, properly written consent was taken from all the participants. A pre-designed questionnaire was used in patent data collection. Data were analyzed by MS Office and SPSS version 24.0. Result: The age range of Group I patients was 16-90 which was 13- 90 in Group II. In Group I, the mean (±SD) age of the participants was 49.8±17.8 years, which was 43.9±16.7 years in Group II. We found a significant correlation in comparing the mean (±SD) ages of both groups of patients and the p- value was found 0.016. We observed, in Group I, 26% were Covid-19 positive whereas it was 15% in Group II. In total 3% (n=13) patients had been referred to other hospitals. Finally, in calculating the survival rate of Covid-19 positive patients in this study we found 89% had been survived. Conclusion: In this study, the survival rate of the Covid-19 patient was found lower than that of many other similar studies. Increasing several treatment facilities along with ventilation may reduce the mortality rate of Covid-19 patients in Bangladesh.