ISSN 1301 - 0883 / E-ISSN 1309 - 3886

  Eastern J Med: 16 (4)
Volume: 16  Issue: 4 - 2011
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1.Maintenance of sinus rhythm and treatment of atrial fibrillation in mitral stenosis
Musa Sahin, Hakki Simsek, Berkay Ekici, Sekan Akdag, Mustafa Tuncer
Pages 235 - 239
Rheumatic fever is the most common cause of mitral stenosis. The most common complication of mitral stenosis is atrial fibrillation (AF). AF precipitates symptoms, greatly increases the risk of systemic embolisation, and reduces cardiac output and exercise capacity. Systemic embolization most often occurs in patients with both AF and mitral stenosis. Maintenance of the sinus rhythm in patients with mitral stenosis is very important because of reduce the risk of cerebral embolism, conservation of cardiac output and exercise capacity, and reduction of symptoms.

2.Anthropometric Measurements of Preschool Children in North Cameroon
Andreas Chiabi, Danièle Nem, Marie Kobela, Lawrence Mbuagbaw, Marie-Therese Obama, Tetanye Ekoe
Pages 240 - 247
Nearly 30% of the world’s population is currently suffering from one or more of the many forms of malnutrition. In Cameroon, 32% of under-five children suffer from moderate and chronic under nutrition, and 13% from the severe chronic form. This study aimed at evaluating the nutritional status of preschool children using anthropometric indices and the relationship of these to the mothers’ socioeconomic status in a regional setting in Cameroon. It was a cross sectional, descriptive and analytic study in which the anthropometric indicators of 375 preschool children were measured. Z scores of height for age, weight for height and weight for age were calculated using the WHO references. These Z scores were correlated with the mother’s age, her level of education, her marital status and the size of household. Z scores < 2.0 for at least one of the following parameters viz; weight-to-age, weight-to-height and height-to-age were noted in 64 (17.1%) children. Similarly Z scores > 2.0 for at least one of the two parameters, weight-to-height and weight-to-age, were noted in 8 (2.1%) children. Hence, the overall prevalence of malnutrition among pre-school children was 19.2% and 8.5% were underweight, wasting was observed in 7.5% and obesity was observed in 0.5% of the children. Being underweight was significantly correlated with household size (P=0.036), and stunting was significantly associated with maternal age (P=0.02). Malnutrition is frequent in apparently healthy pre school children in northern Cameroon and significantly associated with the selected socio-economic parameters of the mothers. Hence, anthropometric measurements should be done during routine school health visits. This helps to diagnose growth faltering and timely referral to hospitals for appropriate management.

3.Retrospective analysis of cardiac manifestations of our patients with marfan syndrome
Hakki Simsek, Musa Sahin, Hasan Ali Gumrukcuoglu
Pages 248 - 252
Marfan syndrome (MS) is an autosomal dominant connective tissue disorder affecting mainly cardiovascular system, eyes and skeleton. However, the most serious complication in patients with MS is progressive aortic root dilatation, aortic dissection or regurgitation. We have reviewed all patients with MS in our hospital over a six year period to determine the symptoms, clinical aspects, treatment modalities and long term follow-up. The medical records of all patients with MS in Yuzuncu Yil University Department of Cardiology from January 2004 to May 2010 were reviewed. MS was defined by Ghent criteria. Individuals without a family history of MS require major criteria in at least two different organ systems and involvement of a third organ. Individuals carrying an FBN1 mutation known to cause MS or cases with a positive family history require one major criterion and involvement of an additional organ to diagnosis of MS. Eleven patients have diagnosis of MS according to Ghent criteria. Patients with mean age of 37.5 years. In our patient group wasn’t a presence woman. Main complaint of patients was dispnea. Primary findings in physical examination were apical systolo-diastolic murmur, mediastinal enlargement at chest X-ray. Aortic root dilatation, aortic regurgitation was seen echocardiographically. Mean follow-up time was 3.8 years. During follow-up six patients died. Main cause of die was aortic complication. Early detection and close monitoring of the MS are very important for prevent complications. MS patients should be followed closely especially in terms of cardiovascular complications.

4.Effect of ZnO nanoparticles on ESBL producing Escherichia coli & Klebsiella spp.
Shoeb Mustafa, Haris M. Khan, Indu Shukla, Fatima Shujatullah, Mohd Shahid, Mohammad Ashfaq, Ameer Azam
Pages 253 - 257
Zinc oxide (ZnO) nanaoparticles have been observed to have significant antibacterial properties against different gram positive and gram negative organisms. This study was done to determine the effect ZnO nanoparticles against ESBL producing organisms. Which are acting as menance in treatment of severe infective conditions. ZnO nanoparticles were tested against ESBL producing E.coli and Klebsiella. Inhibition of growth was observed by spectrophotometry. There was significant reduction in growth of ESBL positive isolates of E.coli and Klebsiella. Thus nanoparticles have a potential to be used as antibacterial agents in case of infections with ESBL positive organisms, which can be cause of high mortality and morbidity.

5.The effect of prophylactic paracetamol administration on adverse reactions following DTP vaccination
Humera Hayat, Parwez Sajad Khan, Gazala Hayat
Pages 258 - 260
Immunization is one of the great accomplishments of the field of public health. Various side effects in the form of local reactions and systemic symptoms occur frequently after diphtheria, tetanus toxoids and pertussis (DTP) vaccination. The present study was undertaken to measure the effect of prophylactic paracetamol on reactions during the first 24 hours of DTP vaccination in a double blinded controlled manner, including 300 children. The adverse reactions were overall higher in placebo group compared to the prophylactic paracetamol group. In all the four age groups significant differences were noted for fever. Significant differences were also noted for fussiness in all the age groups thus concluding that there is an overall beneficial effect of prophylactic paracetamol in reducing the adverse effects following DTP vaccination.

6.Developing an instrument to measure dental flossing in Iranian adolescents
Parvaneh Taymoori, Arezoo Fallahi, Tanya Berry
Pages 261 - 268
Preventable risk factors for oral health diseases are linked to related self-efficacy, attitudes and behaviors. The purpose of this study was to develop an instrument to measure oral self-care, based on the Transtheoretical model and to report on the psychometric testing of the instrument. The findings from qualitative research from Sanandaj, Iran, was used to generate the initial items. Construct validity was tested using principal component analysis to extract factors. Results: Factor analysis yielded 7 factors (28 items) related to interdental cleaning: 1 self-efficacy factor, 3 factors related to perceived benefits and 3 factors related to perceived barriers. Cronbach alpha reliability coefficient ranged from .83 to .87. These preliminary results provide support for using the instrument to measure decisional balance and self-efficacy of interdental cleaning in Iranian adolescents.

7.Acquired dyke-davidoff-masson syndrome: a clinicoradiographic correlation
Nitin K Sethi, Prahlad K. Sethi, Josh Torgovnick, Edward Arsura
Pages 269 - 271
Dyke-Davidoff-Masson syndrome (DDMS) is characterized by unilateral cerebral atrophy or hypoplasia (hemiatrophy), ipsilateral osseous hypertrophy with hyperpneumatization of paranasal sinuses accompanied with varying degrees of contralateral hemiparesis, hemifacial atrophy and mental retardation. DDMS may be infantile or acquired later in life as a result of trauma, infection, ischemic or hemorrhagic insult to the central nervous system (CNS). We present here an 8-year-old girl with DDMS secondary to a febrile CNS infection at the age of 2 years.

8.Phrenic nerve palsy as the sole manifestation of Lyme disease
Josh Torgovnick, Edward Arsura, Nitin K Sethi, Prahlad K Sethi
Pages 272 - 273
Lyme disease is a tick borne spirochete infection caused by Borrelia burgdorferi that may present with multisystem involvement. It can affect both the central and peripheral nervous systems. The classical triad of Lyme neuroborreliosis called Bannwarth’s syndrome includes lymphocytic meningitis, cranial neuropathy and radiculoneuritis. An ever increasing number of peripheral neuropathies have been associated with Lyme borreliosis. We present here an asymptomatic 57-year-old man with right sided diaphragmatic paralysis noted on a chest radiograph performed pre-operatively prior to a total knee replacement surgery. Lyme serology came back positive. Our case is unique as phrenic nerve palsy was the sole clinical manifestation of Lyme disease and it emphasis that Lyme disease be considered in the differential diagnosis of otherwise unexplained phrenic nerve palsy specially in patients residing in endemic areas.

9.Comparison of two patients with mitral stenosis and importance of sinus rhythm: case report
Musa Sahin, Hakki Simsek, Hasan Ali Gumrukcuoglu, Serkan Akdag, Berkay Ekici
Pages 274 - 276
We present two woman patients have rheumatic mitral stenosis (MS). They complained of about shortness of breath and palpitation. First patient, she had had two stroke without any sequela (respectively 7 years and 4 years ago). And she has atrial fibrillation (AF) in electrocardiography (ECG). Another woman patient didn’t have any complaint before. Latter patient has sinus tachycardia in ECG. Transthoracic echocardiography (TTE) disclosed severe mitral valve stenosis and left atrial dilatation in both patients. But first patient has multiple thrombus in left atrium. Mitral valve surgery was suggested for both patients. In conclusion maintenance of sinus rhythm, in the patients who had MS, is very important for both the protection of left atrial thrombus and the reduction of the development of systemic embolus related to it.

10.Primary ovarian pregnancy: a report of four cases
Mehmet Aytaç Yüksel, Remzi Abalý, Fehmi Ünal, Ýlkbal Temel, Ahmet Birtan Boran
Pages 277 - 280
Primary ovarian pregnancy is a rare form of ectopic pregnancy that constitutes 0.15-3 % of all ectopic pregnancies. Ovarian pregnancy results from the fertilization of trapped ovum within the follicle. Exact pre-operative diagnosis is often difficult, and with a few exceptions, the initial diagnosis is made on the operation table and the final diagnosis only through histopathology. The treatment of choice for ovarian pregnancy is usually ovarian wedge resection or oophorectomy, also there is a place for medical treatment of selected patients. Between October 2005 and May 2010, four cases of ovarian pregnancy that were detected and treated during laparotomy for suspected rupture of ectopic pregnancy are described. Three cases were treated by ovarian wedge resection. In one case, a single dose of 50 mg/m2 methotrexate treatment was given, but the same mentioned surgical procedure were performed due to rupture of gestation. In all cases diagnoses were confirmed by pathologic examination. We aimed to discuss a rare form of ectopic pregnancy, primary ovarian pregnancy, and highlight the diagnostic criteria

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