Saudi Journal of Medical and Pharmaceutical Sciences (SJMPS) | Volume-5-Issue-10
Volume-5-Issue-10
Case Report
Oct. 30, 2019
Large Early Aneurysm of the Inferior Wall
Ballouk R, Ahchouch S, Ait Kajjate O, Lahlafi Z, Falioun H, Assfaloui I, Raissouni M, Lakhal Z, Benyass A, Zbir E
Page Numbers : 899-900
DOI : 10.36348/sjmps.2019.v05i10.011
A left ventricular aneurysm (LVA) is a localized dyskinetic area of infarcted myocardium that bulges in systole and diastole. It is a well studied structural complication seen post myocardial infarction although decreasing in incidence due to major improvements in reperfusion therapy. Persistent ST elevation is the most widely reported electrocardiographic manifestation of left ventricular aneurysms. LVA may be evident on chest x-ray, as observed in this case. Diagnosis is non invasively confirmed using echocardiography. Complications of LVA include congestive heart failure, ventricular arrhythmias and rupture that can lead to sudden cardiac death. Surgical treatment is usually effective and followed by a marked improvement in function but is burdened with a heavy post operative mortality. We report the case of a 55-year-old man, with a history of myocardial infarction presenting with a large left ventricular aneurysm.
Original Research Article
Oct. 13, 2019
Alloxan Dose Optimization to Induce Diabetes in Albino Mice and the Determination of the Induced Diabetes Type
Seham T. M.Oshkondali, EL-Mahmoudy, FadiaTaufik Samira, A alacrouk, Khaled Milad Abu, AhlamRashed, Ali Elahrash Zuhur, RajabAlmesai
Page Numbers : 813-816
DOI : 10.36348/SJMPS.2019.v05i10.001
Several chemical compounds are used worldwide to induce diabetes in animals. Alloxan monohydrate and streptozotocin are among those are commonly used because of their cheap coast. However, other chemical compounds are less toxic but more expensive. This pilot study was conducted to use alloxan as diabetes inducer, and to determine the suitable dose which can make a diabetic albino mice model. The type of induced diabetes was also differentiated by using glimepiride tablets. Three mice were injected with three doses of alloxan monohydrate intraperitoneally (150mg-100mg-150mg)/kg in two days intervals respectively in order to induce and maintain diabetes. The fasting blood sugar measured before and after each alloxan injection. Results showed an increasing in blood glucose levels from an average of 81 mg/dl to 168.6 mg/dl after the first dose (150 mg /kg) of alloxan, after 2nd dose (100 mg /kg) of alloxan from 117.83 mg/dl to 154.67 mg/dl, and from 154.67 mg/dl to 173 mg/dl after 3rd dose (150 mg/kg). On the other hand the glimepiride which was given to mice orally caused dramatic decrease in blood sugar level from 173 mg/dl to 93.67 mg/dl after 4 hrs of administration. From this study it was conducted that the use of different doses of alloxan can induce and maintain diabetes and the induced diabetes is type II. Further work is in progress to examine the use of plant extracts in order to regulate blood sugar levels in induced diabetic mice.
Original Research Article
Oct. 11, 2019
Thin Layer Chromatography (TLC) and Phytochemical Analysis of Moringa Oleifera Methanol, Ethanol, Water and Ethyl Acetate Extracts
Many medicinal plants were studied for their phytochemical contents. Moringa oleifera is one of these plants. It is widely distributed in tropical and subtropical areas. It has an important medical uses with high nutritional value. This study, primarily aimed to carry out a preliminary phytochemical screening to detect the major classes of bioactive compounds presented in Moringa oleifera dry leaves. Many solvents (Methanol, ethanol, ethanol acetate and water) used to determine the best solvent can be used for extraction and to perform thin layer chromatography (TLC) profiling of all sequential extracts. TLC was carried out in silica gel plates using many mobile phase protocols, chloroform: methanol: ethanol (1:1:1), (2:2:0.5) and Chloroform: Glacial acetic acid: methanol (4:5:1) and use four mentioned solvents. Phytochemical screening of four extracts showed the presence of alkaloids, flavonoids, tannins, and phenols in all solvent extracts. However, the concentration of these compounds is more with ethanol and ethanol acetate extracts (+++). As well as thin layer chromatographic studies of the Moringa olifera leave extract (methanol, ethanol, ethanol acetate and water) constituted different colored phytochemical compounds with different Rf values. Methanol and ethyl acetate extracts were the best which show 4 bands with Rf less than 1 while with ethanol extract 5 bands with Rf less than 1 and with water extract no band appeared by using chloroform: methanol: ethanol (1:1:1). Furthermore with the other mobile phases detect fewer bands with different solvent extracts. The results obtained in the present study revealed that the concentration of the bioactive compounds of Moringa oleifera leaves extracts by using ethanol and ethyl acetate as a solvent is more than the other solvents. On the other hand, TLC showed 4 bands with better Rf by using methanol and ethyl acetate extract. Conclusion, the methanol and ethyl acetate extracts for Moringa oleifer leaves contain a
Original Research Article
Oct. 11, 2019
A Study on Role of Chest Radiograph in Diagnosis of Etiology of Tachypnea in Children Less Than Five Years of Age
Mehebub Alam
Page Numbers : 821-837
DOI : 10.36348/sjmps.2019.v05i10.003
Introduction: Respiratory diseases are the commonest cause of death in children under 5 year. Pneumonia is the leading killer of children worldwide. In developing countries childhood pneumonias are diagnosed using clinical parameters, usually based on presence of cough and increased respiratory rate. Although this is cheap, sensitive and maximizes the number of children identified and treated empirically, it is also nonspecific and highly dependent on the context in which it is being applied. So the simple chest radiograph has been an important investigative tool in the diagnoses of diseases, since the discovery of X-rays in late nineteenth century. Chest radiograph is frequently used in the management of acute lower respiratory infection in children and still considered to be the gold standard for diagnosing respiratory infection and pneumonia. Objectives: To study the role of chest radiographs in diagnosing the etiology of tachypnea in children less than five years of age and to correlate findings of chest radiographs with etiology of tachypnea. Materials and Methods: A case control study was conducted in the Department of Pediatric Medicine, CNMC, Kolkata on tachypneic children aged between 2 months to 59 months during October 2017 to September 2018, presenting to Pediatric OPD, CNMC (Calcutta National Medical College) with clinical features of tachypnea.
Original Research Article
Oct. 11, 2019
Studies on Haemostatic Parameters of Type 2 Diabetics in Owerri, Imo State
Edward Ukamaka C, Nwanjo Harrison U, Nwosu Dennis C, Obeagu Emmanuel Ifeanyi
Page Numbers : 838-845
DOI : 10.36348/sjmps.2019.v05i10.004
Type 2 diabetes mellitus is a chronic metabolic disorder which has emerged as a health challenge globally due to its insidious on set, late recognition and complications. The present study was aimed at evaluation of haemostatic parameters in Owerri. Cross Sectional Studies was conducted at Federal Medical Center and Imo State specialist Hospital, Owerri. A total of three hundred subjects which include each one hundred and fifty type 2 diabetics and apparently control subjects between the ages forty and sixty nine years were recruited. Ten millimeters of venous blood as aseptically collected from thesubjects. Platelet count and coagulation assay were used for determination of these parameters .The data was analyzed using statistical package for social science 20.0. Test with a probability value of P<0.05 was considered statistically significant. Results from haemostatic parameters showed higher statistically significant value (P = 0.001) in platelet count (226.68 ± 19.40 vs 205 .86 ± 13.33x109/l), and fibrinogen (370.19) ± 21.55 v 2.63.56 ± 32.31mg/dl) when type 2 diabetics was compared with control subjects. Inversely, there was statistically significantly lower values; (P = 0.031) in prothrombin time (13.47 ± 0.96 v 14.06 ± 0.96s) and (P = 0.001) in activated partial thrombopalstin time (34,39 ± 2.17 v 37.25 ± 1.82 ).There was statistically significant progressive increase in activated partial thromboplastin time (33.56 ± 1.56, 34.44 ± 2.32, 36.60 ± 180s) and ( P = 0.001) fibrinogen (362.22 ± 21.72, 369.82 ± 22.65, 378.54 ± 17.69mg/dl).Also higher significant value in female compared with male (380.21 ± 16.62 v 360.17 ± 21.35. The increase found in acute proteins, malondialdehyde, platelet count, fibrinogen and decrease in antioxidants, prothrombin time and APTT showed that type 2 diabetics is a state of chronic low grade inflammation, increased oxidative stress and hypercoagulable state which may result in increase morbidity and premature mortality of type 2 d
Original Research Article
Oct. 20, 2019
Assessment of Nurses’ Knowledge and Practice for Prevention of Infection in Burn Patients
Objective: To assess nurses’ knowledge and evaluate their practice for prevention of infection among burn patients, also to suggest guidelines especially of nursing practice for prevention of infection in burn patients. Study Design: A descriptive cross sectional study. Place and Duration: Six months, from April 2017 to Sep 2017, in burn units of 03 selected hospitals of Lahore. Methods: The study included all nurses who were providing care to burn patients (N=48). Nurses’ knowledge was assessed by using a self-structured questionnaire and their practices were evaluated by direct monitoring using an observational Checklist. Results: Females constituted 100% of study participants. 62.5% of nurses had a GNM whilst 37.5 % had a Nursing degree. 73% (35) of participants had less than 2 years of experience working in the Burns Unit. Knowledge regarding infection control was received by 89% of nurses but their source of information was practice not in-service educational programs. Consequently they had unsatisfactory level of knowledge and practices indicated by knowledge and practice score less than 75%. Conclusion: The findings of the current study revealed nurses’ low level of knowledge and practices. Hence, healthcare settings are required to organize advanced training sessions and to develop unit specific clinical guidelines and protocols.
Original Research Article
Oct. 21, 2019
The Prevalence of Glaucoma among Pseudoexfoliation Syndrome Patients
Ali Abdullah Taqi Al-Saffar, Dler Mustafa Ahmed
Page Numbers : 856-864
DOI : 10.36348/sjmps.2019.v05i10.006
Introduction: Pseudoexfoliation syndrome is a recognized risk factor for developing glaucoma, cataract and lens dislocation. Pseudoexfoliation syndrome is also associated with increased risk of complications during cataract surgery due to poor mydriasis and zonular weakness. Objective: The aim is to find out the prevalence of glaucoma in Pseudoexfoliation syndrome patients attended to Shaheed Doctor Aso hospital, Sulaimaniya city, Kurdistan region of Iraq and Azadi Teaching Hospital, Kirkuk city - Iraq. Patients and Methods: This cross sectional study encompassed 378 patients (756 eyes) with whom the pseudoexfoliation syndrome was detected as an incidental finding aged 50 years or older. A detailed evaluation including general and ophthalmic history, slit lamp biomicroscopy, intraocular pressure measurement (TOPCON computerized tonometer CT-80 and Goldmann Applanation tonometer), gonioscopy (Goldmann three mirrors goniolens) and dilated eye examination were performed. Oral informed consent was obtained from all participants. Results: Out of the 378 patients who had pseudoexfoliation syndrome, 58 (15.3%) were diagnosed with pseudoexfoliation glaucoma and 34 patients (9%) with ocular hypertension. In the glaucomatous patients, men to women ratio was 2:1, this was statistically significant (p = 0.001). Most of patients in the age group (70-79) years of age, represent 23.3%. Bilateral Pseudoexfoliation syndrome was associated more with pseudoexfoliation glaucoma (58.6%), while unilateral pseudoexfoliation syndrome was associated more with ocular hypertension (64.7%). The Kurdish race patients expressed the highest prevalence of pseudoexfoliation glaucoma and ocular hypertension (31.5%) followed by the Arabic race (20%) and lastly the Turkmen (16%). Conclusion: Pseudoexfoliation syndrome showed to be a significant glaucoma risk factor locally, with a prevalence of (15.3%), and if we added the Ocular hypertension (9%), it will be (24.3%). Recommendation: Patients with Pse
Original Research Article
Oct. 25, 2019
Pectoralis Major Flap: Interest in Maxillofacial Reconstruction About A Case
N’diaye A, Khalfi L, Chabi W, Sabani H, El Khatib K
Page Numbers : 865-870
DOI : 10.36348/sjmps.2019.v05i10.007
The pectoralis major myocutaneous flap (PMMC) was first described by Pickrell in 1947, and perfected in 1979 by Ariyan. The reconstruction of oral cavity defects represent a challenge esthetically and functionally. The case reported, we reconstructed oral mucosa and skin cheek-labial in one-step procedure preserving the deltopectoral flap from the same side. The patient was a 55-year-old male who had sustained squamous cell carcinoma. The tumor ablation resulted in oral cavity exposure. A PMMC flap was used to reconstruct oral mucosa and skin cheek. We opted to preserve the deltopectoral flap in the event that skin island necrosis did occur. The pedicle pectoralis major myocutaneous (PMMC) flap based on the thoracoacromial artery procedure, has been widely used in the reconstruction of head and neck defects but in literature a few case of oral reconstruction is reported. PMMC flap applications mainly in oral cancer surgery include the tongue, floor of mouth, buccal, mandible reconstruction, reconstruction of full thickness defects of the cheek. It’s due to its simple technical aspects, versatility and proximity to the oral cavity region. Disadvantages of the PMMC are reported and minor complications that did not require second procedures. The use of PMMC flaps in reconstructive oral surgery is a safe, quick, one-step procedure, not requiring microvascular experience that is particularly indicated in elderly patients and/or those with severe medical comorbidities. Whether the low rate of complications and donor site morbidity, we consider that the well-being of the patient should not be underestimated.
Original Research Article
Oct. 25, 2019
Novel Analytical Method using Acquity QDa Mass Detector Coupled with LC-PDA for Impurity Profiling of Amlodipine Besylate and Olmesartan Medoxomil in Fixed Dose Tablets Formulation
A novel impurity profiling technique for Amlodipine Besylate (ADB) and Olmesartan Medoxomil (OSM) in fixed dose combined tablets has been proposed by HPLC with Acquity Quadrupole Dalton analyser (QDa) mass detector coupled to photodiode array (PDA) detector. This online coupling technique has significant advantage over conventional HPLC techniques that mass and spectral characteristics can be evaluated simultaneously in a single run. The chromatographic separation was achieved on ACE C18 (250 x 4.6mm id, 5µ particle size) column with gradient mode using mobile phase composition of ammonium formate buffer, methanol and acetonitrile. Finalized flow rate was 1.0 mL/min with quantification of 237 nm. Moreover, identification of potential degradation product in stability condition samples was carried out by online coupling of PDA/QDa mass detection. This QDa mass spectrum reveals protonated molecular ion peak [M+H]+ at m/z 875.5 for degradation product. This major degradation product was further characterized using MS/MS2 integrated analytical tools. The method was validated systematically in terms of specificity, precision, linearity, accuracy, limit of detection (LOD), limit of quantification (LOQ) and robustness as per International conference on harmonization (ICH) general guidelines. This proposed study can provide a creative idea and effective method for routine analysis of ADB/OSM in tablet formulation in quality control department where impurity profiling as well as identification of unknown impurities can be evaluated simultaneously.
Original Research Article
Oct. 27, 2019
Assessment of Health Risk of Bromate in Ozonised Bottled and Sachet Water in Aba Metropolis, South Eastern Nigeria
The study was carried out to determine the bromate contents in popular commercially available different brands of bottled and sachet drinking water in Aba metropolis. To assess the health risk of bromate in ozonised bottled and sachet water in Aba metropolis, South Eastern Nigeria Bromate determination was done using spectrophotometric method after treatment of the samples and absorbance was measured at 530 nm. The mean concentration of Br03- in different brands of bottled water was found to be 4.09±0.44 μg/l (range: 3.48±0.50 – 4.98±0.79 μg/l). On the other hand, the mean concentration of bromate ion in sachet water was 5.07± 0.78 μg/l with range 3.15±0.26 – 6.33±0.78 μg/l. Correlation analysis showed that bromate formation was influenced by the presence of bromide ions. There was a high cancer risk assessment resulting from the ingestion of bromate in bottled and sachet water which could occur overtime while both the drinking water were safe from the chemical toxicity risk point of view.
Original Research Article
Oct. 29, 2019
The ID Migraine in Migraine Headache Diagnosis: An Evaluation of its Usefulness in Calabar, Southern Nigeria
Oparah, Sidney K, Asibong, Udeme E
Page Numbers : 893-898
DOI : 10.36348/sjmps.2019.v05i10.010
Background: The under recognition and consequent mistreatment of migraine headache highlight the importance of quicker and easy to apply tools for migraine screening and diagnosis. The ID migraine fits the description of such a rapid screening diagnostic tool. Objective: To evaluate the ID migraine, in migraine headache diagnosis, among clinical students in Calabar, Nigeria. Methods: Using a cross sectional design, we compared the performance of the ID migraine with that of the IHS criteria, used as a gold standard for migraine headache diagnosis, on a set of persons with recurrent headaches. Participants were recruited from a pool of 220 apparently healthy clinical students of the University of Calabar. Data analysis was done with SPSS version 20; and the level of significance was set as p < 0.05. Results: Fifty one persons who had recurrent headaches from the pool of students, comprising 25 (49%) males and 26 (51%) females, proceeded to complete the study. The mean age of the participants was 24.22 years ± 4.575. The sensitivity, specificity, accuracy, positive predictive and negative predictive values we obtained for the ID migraine tool were 69.2%, 63.1%, 64.7%, 39.1% and 85.7%, respectively (kappa = 0.258; p= 0.043). Conclusion: The ID migraine had moderate sensitivity and specificity in our locality, and a low level of agreement with the IHS criteria. Its usefulness in our locality may be more in ruling out, rather than ruling in, migraine in persons with recurrent headaches.
Original Research Article
Oct. 30, 2019
Role of Magnesium Sulphate in Attenuating Succinylcholine Induced Fasiculations and Post-Operative Myalgia
Rukhsana Najeeb, Sylph Tajamul, Arshid Ahmad Sofi
Page Numbers : 901-906
DOI : 10.36348/sjmps.2019.v05i10.012
Objectives: To measure the degree of attenuation of fasciculations and the degree of reduction in post-operative myalgia caused by Succinylcholine in patients pretreated with Magnesium Sulphate during the induction of general anaesthesia. Methods: This observational study was conducted from June 2016 to June 2019 in the Department of Anesthesiology in Government Medical College Srinagar, on patients who were candidates for surgery under general anaesthesia. Patients were selected and divided into two equal groups of cases and controls using block randomization. The cases received magnesium sulphate, while the controls received normal saline. SPSS 18 was used for statistical analysis. Results: Of the 100 subjects in the study, 57(57%) were men and 43(43%) were women (p=1.0). The mean age of the two groups were 35.55±13.56 years and 32.80±13.37 years (p=0.85). The incidence of fasciculations was 06(12%) patients in group M and 43(86%) patients in group S. The incidence of fasciculations between two groups was highly significant (p = 0.001). Postoperative myalgia was present in 9 (18%) patients of Group M and 38 (76%) patients in Group S experienced myalgia in postoperative period. The results were highly significant between two groups (p = 0.001). Conclusions: Magnesium sulphate can prevent and reduce the degree of fasciculation and postoperative myalgia after anaesthesia. Therefore it can be used to prevent fasciculation and postoperative myalgia
Original Research Article
Oct. 30, 2019
Prunus Domestica L.: A Domestic Source of Natural Antioxidants
The aim of this study is to evaluate crude extract, ethyl acetate, chloroform and butanol fractions of P. domestica for their in vitro antioxidant activities using 1, 1-diphenyl-2-picryl hydrazyl (DPPH) radical scavenging and reducing power assay on 1.25%, 2.5% and 5% concentrations. According to the results fraction of ethyl acetate showed maximum free radical scavenging up to 94% at the concentration of 5%, 93% at the concentration of 2.5% and 67% at the concentration of 1.25% followed by crude extract that showed 85, 54 and 41% activity at the concentrations of 5, 2.5 and 1.25% respectively. Chloroform fraction showed 70, 55 and 39% scavenging activity at 5, 2.5 and 1.25% concentrations respectively. While butanol fraction exhibited least activity i.e. 39, 36 and 9% on 5, 2.5 and 1.25% concentrations respectively. On the other hand, by reducing power assay method, ethyl acetate exhibited 90, 70 and 55% percent reducing power, followed by crude extract which exhibited 84, 62 and 41%, while chloroform extract exhibited 70, 42 and 28% and the least activity was shown by butanol extract i.e. 45, 22 and 12% at the concentrations of 5, 2.5 and 1.25% respectively. This study showed that ethyl acetate fraction exhibited best antioxidant potential and can be further isolated for biologically active constituents for further studies.
Original Research Article
Oct. 30, 2019
The Use of WhatsApp Messaging Improves Communication in Surgery Team
Ajay Sharma, Sanjay Singhal
Page Numbers : 911-914
DOI : 10.36348/sjmps.2019.v05i10.014
Introduction: Most common mode of communication between medical professionals is by visits, telephone and mobile phone calls, meetings of doctors, and WhatsApp usage. WhatsApp has group communication and makes sending of images and videos on same group its usage most effective. Material and Methods: We did a 3 months prospective study in our Surgical Gastroenterology unit (of 15 professionals) using English and Hindi language and compared WhatsApp communication with communication by by telephone mobile phone. Results: Of the total 3462messages delivered 3219 (92.7%) were of patient care only. There were 71 (2.05%) messages related to administrative details, 5.4%(188) messages relates to teaching and academic. Multimedia messages were 145 (4.2%). Time taken to reply a message in routine working hours was found to be of 8 seconds to 25 minutes. Messages done by land line or mobile phone call systems were 184 and the time spend on each was approx 2 to 17 minutes. It was a common opinion of all members was that it’s a very useful tool, it saved time compared to the traditional methods of calling and replying. Conclusion: WhatsApp is a free of cost, easily available and a very reliable mode of use for medical practitioners. It is a development over the traditional telephone or call on mobile phone.
