Background: Studies from Rivers State have demonstrated high burden of drug resistance among pulmonary tuberculosis (PTB) patients and declining cure rate despite adequate treatment retention and highly effective directly observed treatment short-course. Aim: to explore the perception of clients on how PTB disease or its treatment affect their health (health-related quality of life), which could impact on TB treatment success rate among clients with PTB. Methods: A total of 225 adult clients with PTB were recruited by systematic random sampling method from each of the 8 randomly selected centers out of 40 active treatment centers in Obio/Akpor LGA of Rivers State. The SF 36 was used to collect responses which were grouped into 8 domains yielding 2 summary measures. Scores ≤49 were classified as poor, 50-74 relatively favourable and good for scores ≥75. Categorical data were presented as frequencies and proportions using tables and pie charts while quantitative data were presented as means and standard deviations. Results: Specific domains mean scores ranged from 34.9±33.7 (role physical) to 61.8±11.9 (general health) while physical component summary (PCS) and mental component summary (MCS) recorded 53.35±16.79 and 51.11±12.26 respectively. The overall HRQoL mean score for the study was 55.2 (± 3.6) with an undesirable score of 20.7%. Conclusion: Pulmonary tuberculosis patients in treatment centers in Obio / Akpor LGA had poor to relatively favourable HRQoL mean scores. Strengthening counselling practice may help improve support for the clients in coping with the disease and the effect of its treatment.
Original Research Article
Sept. 24, 2022
Study of Risk Factors in Patients of Pelvic Inflammatory Diseases
Uzma Eram, Nema Usman, Najam Khalique
Page Numbers : 514-519
DOI : 10.36348/sjm.2022.v07i09.009
Number of risk factors has been associated with pelvic inflammatory disease, such as age, previous sexually transmitted infection, previous PID, multiple sexual partners, or an intrauterine contraceptive device. Women who use an intrauterine device for contraception are at least 2-4 times more likely to develop PID than non-users. Women who have had PID are twice as likely to develop the infection as those who have never had it. A history of a prior uncomplicated gonococcal infection is more common among women with PID than among women without disease. The present cross- sectional study was conducted in J.N. Medical College and Hospital (J.N.M.C.H.), Aligarh Muslim University, Aligarh. Permission for doing the study was taken by the Board of Studies in the Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh. The study was carried out for a period of one year, from 1st August 2001 to 31st July 2002. The present study was carried out among ever married females in the reproductive age group of 15 to 49 years. Women, who gave positive history of PID, were asked to give their consent for the study. Their refusal was taken as exclusion criteria. Females with PID who were menstruating or who had taken antibiotic within the previous month were also excluded from the study. A total of 350 ever married females were selected from the Gynaecology OPD of J.N. Medical College Hospital (n=170), Urban Health Training Centre (n=100) and Rural Health Training Centre (n=80).A detailed clinical history and clinical examination were recorded on a pre-formed and pre tested proforma. All the females under study were subjected to per vaginal examination. The percentage of those female was more who used any cloth during menstruation. Out of 350 patients, 7.4% gave history of T.B, 24% gave history of previous episodes of PID, 12.0% gave history of MTPs/D&Cs. 5.1% had adopted IUCDs as a method of family planning.1.71% cases gave history of removal of IUCDs because of some complications. 75.0% of 80 cases (who adopted family planning) used IUCDs, OCPs and ligation. IUCDs, OCPs, ligation and irregular use of condoms probably increase chances of PID.
Sept. 23, 2022
Covid and Diabetes: A Literature Review
Suzan Eteiwi, Abdalla A. Al Eyadeh, Khaldon K. Al-Sarihin, Rania A. Al-Asa’ad, Karam Bdour, Ali A. Alzu’bi, Fares H. Haddad, Ahmad A. Al-Omari
Page Numbers : 505-513
DOI : 10.36348/sjm.2022.v07i09.008
In December 2019, the WHO China Country office was informed of an outbreak of pneumonia of unknown etiology, in Wuhan city. The pathogen was later identified as a member of the β-coronaviridae family, and the disease it caused was named Covid-19. The outbreak rapidly evolved over the next few months to become a pandemic that resulted in drastic effects on global healthcare and economy. Diabetic patients were affected equally as non-diabetic individuals; however, the impact of the disease was much worse amongst them. We aim to briefly review the incidence and characteristics of Covid-19 infection among diabetic patients, elaborating into the pathophysiology of the disease and the possible mechanisms which may explain the severity of the disease amongst them, through a review of published articles in Pubmed, Google Scholar and Cochrane databases, till the first of January 2022.
Sept. 23, 2022
Vesiculo-Bullous Eruption Following COVID Vaccination
Raghda Saeed Al Maashari, Al Mahmood Noaf S, Saleem Tausif
Page Numbers : 501-504
DOI : 10.36348/sjm.2022.v07i09.007
Bullous pemphigoid (BP) is an autoimmune sub-epidermal bullous disorder with a complex etiopathogenesis, predominately affecting the elderly. We report a case of COVID vaccination- induced BP, in a 30-year-old previously healthy Indian male who presented with a 1month history of itchy generalized vesiculo-bullous eruption that developed 3 days after receiving the first dose of the COVID vaccination. Histological examination and direct immunofluorescence study showed a sub-epidermal blister with a dermal inflammatory infiltrate and linear epidermal staining of IgG and C3 along the basement membrane zone in an n-serrated pattern. Treatment with oral prednisolone and oral doxycycline resulted in significant improvement in his condition. To our knowledge, there are limited case reports to date particularly in the Middle-East, which describe BP triggered by COVID vaccination.
Original Research Article
Sept. 22, 2022
Knowledge, Attitude and Practices (KAP) of Preconceptional Folic Acid supplementation among pregnant women (18-45years) attending antenatal clinic in Alex Ekwueme Federal University Teaching hospital Abakaliki, Ebonyi State, Nigeria
Chinemerem Henry Ugo, Etiedu Christopher Ekara, Ozioma Chinwendu Chukwudi, Michael Chijioke Chiwenite, Robert Chibueze Osuji, Gladys Nnanna, Uju Maryanne Onuorah
Page Numbers : 485-500
DOI : 10.36348/sjm.2022.v07i09.006
Background: Folate deficiency is associated with poor pregnancy outcomes and is one of the most common vitamin deficiencies in women, especially those of reproductive age. Folic acid intake prior to, and during, the first months of pregnancy significantly reduces the risk of fetal neural tube defects. Maternal folate status has been associated with other adverse pregnancy outcomes such as preeclampsia, malformations (orofacial clefts, Neural tube defects, anencephaly and encephalocele resulting from incomplete neural tube closure during early embryogenesis), spontaneous abortion, fetal death, fetal growth restriction and preterm delivery. Methods: The study embraced a cross-sectional study that assess Knowledge, Attitude and Practice of preconceptional folic acid supplementation among pregnant women (18-45years) attending antenatal clinic in Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State. 152 women attending antenatal clinics in Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State were interviewed using structured questionnaire. Data collected were analyzed using SPSS version 21 for frequency and percentage at P < 0.05 significance level. Results: 98.7% of the participants had heard about folic acid, but an analysis of data shows that 26.6% of them knew that folic acid is a vitamin. In addition, very few (29.6%) knew that folic acid could prevent neural tube defects. The main source of information about folic acid supplementation among the surveyed women were through the health workers. Incidence of at least one episode of adverse pregnancy outcome was noted in about 35.5% of the population under study though a majority indicated the form for their loss were miscarriage and stillbirth. Finding showed that 37.5% of the respondent claimed to have used folic acid before pregnancy while 40.1% of the women in this study were aware of the right time to start using folic acid. 46% of the women took folic acid during Antenatal care and their reason were attributed to late presentation for antenatal care, delayed prescription of the folic acid for women during pregnancy, unplanned pregnancy while others claimed they are getting enough folate from food. Approximately 40.8% of the respondents had started supplementation on antenatal booking and from analysis of data on the preferred/normal booking time of the respondents it shows that a high percentage of them attended antenatal from the third month of pregnancy this shows that the majority of the respondents started supplementation too late which is inconsistent with the ideal time to start folic acid supplementation in prevention of neural tube defect. In this study it has been revealed that 48% of the respondents could identify green leafy vegetable as the only source of folate in local foods and 0.7% could identify other food sources like legumes and fruits as sources of folate. Conclusion: There is a low overall level of awareness of folic acid among pregnant women including lack of understanding of its natural sources, usefulness in preventing Neural Tube Defects and preconceptional intake recommendation. Health education regarding the preconceptional use of folic acid among women of reproductive age is recommended.
Original Research Article
Sept. 20, 2022
Risk Factors and Major Symptoms in COVID-19 Suspected Patients: A Single-Center Study in Bangladesh
Dr. Md. Monir Hossain, Prof. Dr. Mujibul Haque Mollah, Dr. Ashikuzzaman, Dr. Lubaib Manzoor
Page Numbers : 480-484
DOI : 10.36348/sjm.2022.v07i09.005
Background: The outbreak of Covid 19 started in China in December 2019 and from then it rapidly spread around the whole world. Know a day, knowledge on the risk factors as well as the major symptoms of Covid 19 for its early detection and successful treatment of suspected Covid 19 patients. Aim of the Study: The aim of this study was to assess the risk factors and major symptoms in covid-19 suspected patients. Methods: This was a cross-sectional study and was conducted in the Department of Medicine, Shahabuddin Medical College Hospital, Gulshan, Dhaka, Bangladesh, during the period from November 2020 to March 2022. In total 126 suspected Covid 19 patients attended the mentioned hospital during the study period were selected as the study people. Data were collected from patients and/or their attendants through direct or telephonic interview by using a pre-designed questioner. The statistical analysis was done by the SPSS version 22.0. Results: In this study, in analyzing the risk factors among the participants we observed that, 10% and 7% were with ‘recent exposure to a Covid 19 patient’ and the ‘higher length of symptoms before the indexing’ respectively which were noticeable. Besides these, 6%, another 6%, 3% and 2% were with Bilateral lung infiltrates, peripheral lung infiltrates, Neutrophil count <7.5 × 103/L and LDH > 500 U/L respectively. As the major symptoms, the highest number of participants was with cough which was found among 54%. Besides this, 38%, 23% and 17% patients were found with shortness of breath, Hypoxemia/Oxygen use and lower limb swelling respectively. Conclusion: As per the findings of this current study we can conclude that, the ‘recent exposure to a Covid 19 patient’ and the ‘higher length of symptoms before starting treatment, may be considered as the most potential risk factors for suspected Covid 19 patients. On the other hand, cough is the most common symptoms for suspected Covid 19 patients.
Original Research Article
Sept. 18, 2022
Lipid Disorders among Diabetic Patients: An Observational Study
Mohammad Mahbubul Haque, Raihan Rotap Khan, Mohammad Mushahidul Islam, Mohammad Shamsul Alam, Nur Faysal Ahmed, Mohammad Mahmudul Hasan
Page Numbers : 475-479
DOI : 10.36348/sjm.2022.v07i09.004
Background: Lipid disorder is one of the common disorders which is seen in most of the diabetic patients that causes cardiovascular disorders. The incidence of coronary artery diseases is 3 to 5 times higher in diabetic patients compared to general population. Although this has been demonstrated for the Caucasian population few data are available for Asian Indians and Bangladeshi population. Individuals with diabetes may have several forms of dyslipidemia leading to additive cardiovascular risk of hyperglycemia. The aim of this study was to evaluate the levels of lipid disorder among diabetic patients in Bangladesh. Methods: An observational study was conducted at the Department of Medicine in Sheikh Hasina Medical College Hospital, Jamalpur, Bangladesh during the period from August 2020 to April 2021. One hundred and four (104) diabetic patients were enrolled as study participants in the study. Proper written consents were taken from all the participants before starting data collection. A pre-designed questionnaire was used in patients` data collection. The serum total cholesterol (TC), HDL-cholesterol and triglycerides (TG) were assayed in patients and controls, using standardized assay methods. All data were processed, analyzed and disseminated by MS Office and SPSS version 21 as per need. Result: In this study, we observed that the mean (±SD) TC (mg/dl) of case and control group participants were 208.9±54.6 and 257.4±103.4 respectively where we found significant correlation between the groups (P=0.006). We did not find any correlation between the groups in analyzing TG (mg/dl), HDL (mg/dl) and LDL (mg/dl). In case group the mean (±SD) TG (mg/dl), HDL (mg/dl) and LDL (mg/dl) level were found 216.4±306.0, 39.2±11.0 and 114.8±47.4 respectively. On the other hand, in the control group the mean (±SD) TG (mg/dl), HDL (mg/dl) and LDL (mg/dl) level were found 222.9±124.0, 39.8±6.2 and 122.4±46.3 respectively. Conclusion: In this current study, in analyzing the comparative statuses of lipid profile we found significant correlation between the groups of diabetic and non-diabetic patients in serum total cholesterol component. Although in analyzing other components of lipid we did not get any significant correlation between the groups, we think lipid profiling may be a potential predictor of diabetic patient screening.