Stroke; A Major Cause of Cardiovascular Mortality- A Review
Ezennaka RC, Dodiyi-Manuel ST
Page Numbers : 283-294
DOI : 10.36348/sjm.2021.v06i09.001
Background: The term stroke or cerebro-vascular accident refers to a syndrome of rapidly developing clinical signs of focal (or global) disturbance of cerebral function, with symptoms lasting 24 hours or longer or resulting in death with no apparent cause other than of vascular origin. Stroke can be classified into two broad types: Ischemic and Hemorrhagic. There are multiple risk factors for stroke but systemic hypertension (HBP) is the most common yet modifiable risk factor for stroke . Cardioembolic stroke is a heterogenous entity and a variety of cardiac conditions can predispose to cerebral embolism. Methodology: Literature search was done using google search, hinari research, PubMed and books from the author’s collection. Results: The GBD study for the years 2002-2030 has estimated that there were 16 million first-ever strokes and 5.7 million deaths in 2005. The prevalence of stroke in subjects with HBP has been reported by various authors worldwide to range from 19.5% in Canada to 29% in USA and 30% in England. Cardiac diseases have been shown to increase risk of stroke. Atrial fibrillation is the most powerful and treatable cardiac precursor of stroke. The cardiovascular risk factors from the current National Cholesterol Education Project Adult Treatment Panel III (NCEP ATP III) include the non- modifiable, modifiable and emerging risk factors.
Aug. 29, 2021
Drug Induced Expressible Galactorrhea in Patient with Fibromyalgia and Vascular Headache
Saran M Nair, Dr. Renoy A Henry, Roshni PR
Page Numbers : 275-278
DOI : 10.36348/sjm.2021.v06i08.007
Drug-induced Galactorrhea associated with Hyperprolactinemia has been rarely reported with agents such as antidopaminergic, antiemetics, antidepressants etc. Galactorrhea related with Hyperprolactinemia is an unwanted consequence of the treatment in which there is an increased serum prolactin levels usually associated with an abnormal whitish fluid like secretion from the breast. We report a case of expressible Galactorrhea at multiple occasions in a 44-year-old female patient with Fibromyalgia and Vascular headache related to Fluoxetine, Amitriptyline, Flunarizine, Domperidone used at different intervals of treatment. This report highlights the mechanism of these drugs which induces galactorrhea and subsequent reduction in the side effect when the active drugs are withdrawn.
Aug. 29, 2021
Bortezomib Induced Interstitial Lung Disease
Dhilshowvindhar K R, Dr. Nithya Haridas, Dr. Neeraj Sidharthan, Dr. Rema G, Roshni PR
Page Numbers : 279-282
DOI : 10.36348/sjm.2021.v06i08.008
Bortezomib is an anticancer agent used for multiple myeloma in combination with other chemotherapeutic drugs. Pneumonitis and pulmonary toxicity associated with bortezomib application has been reported in a series of cases associated with multiple myeloma. A 59-year-old male patient received 16 weeks of CyBorD regimen followed by first phase of RVD regimen and bortezomib biweekly resulted in partial remission. During the second phase of RVD regimen developed cough and whitish sputum. On high resolution computed tomography showed opacities on the lungs and diagnosed as bortezomib induced interstetial lung disease. He responded to the cortecosteroid therapy and respiratory symptoms subsided. This is a clinically proven bortezomib induced interstetial lung disease on retreatment with bortezomib for a patient with relapsed multiple myeloma.
Original Research Article
Aug. 27, 2021
Diagnosis and Treatment of Pediatric Gliosarcoma: A Systematic Review of Published Case Reports
Anas S. Alyazidi
Page Numbers : 269-274
DOI : 10.36348/sjm.2021.v06i08.006
Introduction: Gliosarcomas are a rare histopathologic variant of glioblastoma, which is the most common and aggressive malignant primary brain tumor in humans according to the World Health Organization's classification of central nervous system tumors. The survival period of gliosarcomas ranges from 4 to 18.5 months. The genetic profile might include p53 mutations, PTEN mutations, homozygous p16 deletion, and more. Symptoms' may include migraines, convulsions and others. Methods: A systematic literature review was conducted through June 2021 using the following keyword "gliosarcoma." Then, an offline search was performed in the references of the relevant previous reviews to ensure the comprehensive inclusion of all relevant reports using the Mendeley citation tool. All case reports that addressing patients of 18 years old and younger, both male and female were included. Results: The literature yielded a total number of 1398 unique articles filtered into 10 articles (12 case reports) that included various forms of diagnostic procedure including MRI, CT scan, and other techniques. Treatments were mainly focusing on surgical intervention, chemoradiotherapy alongside other medications. Discussion: Gliosarcoma is considered a difficult challenge for physicians. A combination of poor prognosis and indefinitive management procedures and treatment options; makes the disease difficult to address. In general, the increasing number of treatment courses did not guarantee an increase in survival. Even with complicated treatment many had a low survival rate. What complicated many cases are the fact that even with an initial positive outcomes there were still a deterioration in the patients' conditions often leading to their death.
Original Research Article
Aug. 25, 2021
Knowledge and Perception Regarding Diabetes Mellitus among Diabetic and Nondiabetic Populations in Jeddah, Saudi Arabia
Abdullah Y. Almaghrabi, Abdulrahman A. Alshaikh, Weam B. Alshora, Bassam E. Yaghmoor, Maktoom M. Almalki
Page Numbers : 251-256
DOI : 10.36348/sjm.2021.v06i08.004
Background: Diabetes mellitus (DM) is a chronic metabolic disease resulting from either a deficit in insulin secretion (type 1) or a function (type 2) that results in an increased level of glucose in the blood. Diabetes mellitus increases the risk for developing many serious complications including microvascular, macrovascular, decreased reproductive activity, and frequent infections. Objective: The aim of this study was to assess the awareness level regarding DM risk factors, symptoms, signs, management, and complications in both the diabetic and the nondiabetic population. Method: This cross-sectional, descriptive study was conducted among the general population of Jeddah, Saudi Arabia, in 2019. A total of 24 questions from a pre-piloted questionnaire were interpreted into Arabic. The questionnaire contained a series of questions arranged in four parts: Assessing DM general knowledge, risk factors, symptoms, and complications. Result: This study included 1324 participants; 52.5% were female. The largest age range among the participants (41.5%) was 15–23 years, followed by the 44–53 (18.8%) year age group. Regarding the questions answered correctly: a total mean score achieved by the whole population was 13.9 ± 3.6 out of 19 points (73.9 ± 19.3%). The diabetic participants achieved higher scores than the nondiabetics in each category. Conclusion: The study found that the largest gap in knowledge regarding DM is in the knowledge of its complications. The role of health education needs emphasis at all levels starting with schools and universities. This is in addition to general public health education, distributing knowledge through brochures and social media.
Aug. 25, 2021
Diagnostic Utility of Genes Associated with SARS-CoV-2: A Review
Dr. Sharique Ahmad, Shivani Singh, Dr. Kshama Tiwari, Tanish Baqar, Dr. Saeeda Wasim, Dr. Mohd Asif Shaikh
Page Numbers : 257-268
DOI : 10.36348/sjm.2021.v06i08.005
COVID-19 associated infection is caused by the virus SARS-CoV-2, the virus is single stranded positive sense binds with greater affinity to Angiotensin Converting Enzyme-2 present in human cells it is 30 kb pair long RNA genome which take over the host cell machinery, immune system of host cell with the help of accessory proteins leads widespread infection. COVID-19 contains structural protein spike, membrane, Nucleocapsid, and envelope. The epidemiology of COVID-19 is based on dynamics of RdRp, N, and E genes for diagnosis of COVID-19 and knowing the exact understanding of this infection. The protein RNA dependent polymerase (RdRp) is responsible which performs replication of virus in host cell. As there is not any homolog of RdRp is seen till now, so it can be a promising gene for COVID-19 associated diagnosis. There are mainly two techniques responsible for detection of COVID-19 associated infection one is immunological assay performed through antigen and antibody and other is molecular technique based of genome analysis real-time reverse transcriptase polymerase chain reactions (RT-PCR). Among both of them more reliable is RT-PCR which is based on diagnosis of RdRp gene, N-gene, E gene. Envelope protein is involved in assembly, budding and pathogenesis of virus also perform viroporin and interacts with host cell and CoV proteins. Nucleocapsid protein is involved in forming complexes membrane of virus and its assembly this protein is also involved in increasing the transcription efficiency of virus, recent studies had revealed that N-proteins are the multifunctional protein. This review article aim is to reveal the functioning of all the three genes (N, E and RdRp) associated SARS-CoV-2 infection.
Original Research Article
Aug. 18, 2021
Evaluation of Clinical and Laboratory Features of Newly Diagnosed Chronic Myeloid Leukaemia Patients Seen in Enugu, South-East Nigeria over a 2-Year Period Using Gen Expert Technology
Dr. Augustine Nwakuche Duru, Dr. Richard Okebaram, Dr. Kelechi Chikezie, Dr. Helen Okoye, Dr. Angela Ugwu, Dr. Charles Nonyelu, Dr. Ikechukwu Anigbogu, Dr. Ebele Muoghalu, Dr. Nneka Amu, Dr. Onochie Obodo, Dr. Anazoeze Madu, Dr. Theresa Nwagha, Mrs. Chika Rose Duru, Prof Sunday Ocheni
Page Numbers : 241-250
DOI : 10.36348/sjm.2021.v06i08.003
Background: Chronic Myeloid Leukaemia (CML) is a myeloproliferative neoplasm (MPN) of abnormal marrow stem cell with BCR-ABL1 fusion gene as a pathognomonic feature. In resource-poor countries, clinical and laboratory parameters were invaluable tools used in the diagnosis. However, the advent of GeneXpert technology was a paradigm shift in the detection of the fusion gene. Aim of the study: To highlight the clinical usefulness of geneXpert in the evaluation of clinical and laboratory features of newly diagnosed patients. Patients and Methods: A cross-sectional descriptive study was conducted at University of Nigeria Teaching Hospital (UNTH) Enugu. Sixty-five BCR-ABL 1 positive consenting patients were evaluated using demographic, clinical and laboratory data. Data was analyzed using GraphPad Prism software version 9 with probability <0.05 as statistically significant. Results: A total of 65 patients with mean age 45.22 + 15.44 years were studied. Age group 39 – 49 were mostly affected 20 (30.8%) with Enugu State having the highest disease burden 20 (30.8%). Abdominal swelling was the most common presenting feature 57 (87.7%) while splenomegaly was the most common finding on imaging 60 (92.3%). Mean WBC and BCR-ABL1 were 207.37 + 87.57 x 109/L and 41.02 + 24.53% (IS) respectively (r = -180, P = 0.015). Majority of the cases were in chronic phase 56 (86.2%). Risk assessment of cases on presentation using Sokal and Hasford scores were statistically significant (t = 20.23, P < 0.0001), [CI = 1429 to 1739]. Conclusion: There was improved diagnostic yield of cases of CML using the molecular diagnostic technique.