American Journal of Clinical Medicine Research

Plasma levels of creatinine are related to the relative muscles mass, the rate of creatine turnover and the renal function. It has been accepted for years that the plasma level of creatinine is relatively un affected by the diet. However, some reports have indicated that the protein content of the diet may be indeed affect the plasma level of creatinine if it affects the individuals muscles mass. This a primary study that aims to detect rough estimation of serum creatinine in normal Sudanese athletes and soldiers. In addition to detect weather creatinine level is associated by gender, age, daily working hours or occupation of study population. Hundred (49 soldiers: 51 athletes) normal individuals from Khartoum state invited to take a role in this study (75 male: 25 female) their age was between 14-44 years. At P ≤ 0.05 this study showed no significant differences (P 0.772) in creatinine concentration with mean ± SD (1.07 ± 0.11, 1.12 ± 0.17 mg/dl) for soldiers and athletes respectively. There was no signifigant difference in creatinine concentration either between both sexes male: female (1.1 ± 0.16: 1.1 ± 0.12), or between different occupations soldiers: athletes (1.07 ± 0.11: 1.12 ± 0.17). But there was significant difference (Chi 0.027) in creatinine concentration (0.5, 1.0, 1.5) for (14-24, 25-34, 35-44) age groups respectively. Serum creatinine was not associated with daily working hours (ANOVA 0.18) with creatinine values (1.16, 1.01, 1.12, 1.13, 0.8) for weekly working hours (≤ 20, 21- 40, 41- 60, 61 – 80, 81-100). Serum creatinine is not much different depending on the gender, individual occupation or daily working hours, weather they were soldiers or athletes, but it is influenced by age progress. Sudanese soldiers and Athletes creatinine level fell within the normal international range. Research with large data collection is recommended for establishment and localization normal range of biochemical parameters for sport medicine in Sudan.

American Journal of Clinical Medicine Research. 2014, 2(4), 84-86. DOI: 10.12691/ajcmr-2-4-5
Pub. Date: September 17, 2014

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Yearly Trends in Fetal Macrosomia among Hospital Births in Enugu, South East Nigeria

by Iyoke CA, Lawani OL, Ugwu GO, Ezugwu FO and Ilechukwu GC

Original Research

Fetalmacrosomia is associated with higher risks of maternal and neonatal complications and with health risks in adulthood. Trends in fetal macrosomia could indicate fetal growth patterns and its knowledge could be useful for prenatalcare and maternal health education. The objective of the study was to describe the yearly trends in the prevalence of fetal macrosomia among singleton live term hospital births in Enugu, South East Nigeria. Routinely collected delivery data of three major maternity centres in Enugu were reviewed for the period January 2003 to December 2013. All singleton term live births that took place at the three centres during the study period were analysed and the yearly prevalences of fetal macrosomia were determined. Statistical analysis involved descriptive and inferential statistics at 95% level of confidence. A total of 22,628 singleton live term deliveries were studied. There were 2116 births of macrosomic babies giving a prevalence rate of 9.3% of singleton term deliveries. The mean weight of all macrosomic babies was 4.42kg ± 0.38. The prevalence rates of macrosomia showed a small, but significant decreasing trend over the period of study. The likelihood of fetal macrosomia was increased by male births (aOR 1.64, 95% confidence interval [C.I.] 1.10, 3.20); postdate births (aOR 2.1, 95% C.I. 1.4, 4.1) and multiparity (aOR 8.0, 95% C.I. 3.2, 16.4). It was concluded that there was a decreasing trend in the prevalence of fetal macrosomia in the study centres,and factors such as the prevalences of male births, postdate pregnancies and multiparity could have influenced this, at least in part. However, population based studies incorporating prenatal weight and medical complication data would be needed to establish the factors responsible for the actual trend in macrosomic births in the general population in this area.

American Journal of Clinical Medicine Research. 2014, 2(4), 79-83. DOI: 10.12691/ajcmr-2-4-4
Pub. Date: September 03, 2014

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The Relationship of Intact Parathyroid Hormone and Ionised Calcium in Secondary Hyperparathyroidism among Hemodialysis Patients

by T Sudhakar, Sabitha Kandi, B venugopal, K. Bhagwan Reddy and K. V. Ramana

Original Research

The parathyroid hormone (PTH) is a 115 amino acid precursor molecule; the intact PTH (iPTH) contains only 84 amino acids which is biologically active molecule. The PTH helps in regulation of serum calcium levels, either hyper or hypocalcaemia causes release of PTH. It regulates the serum calcium levels by increasing the flow of calcium from bone to extracellular fluid, by increasing the re-absorption of calcium from renal tubules and it also causes increased intestinal absorption of ionized calcium via Vitamin D. The iPTH is predominantly cleared in liver and kidney, the assay of iPTH is used for differently diagnosis of hypercalcaemia. The iPTH levels will be elevated if hypercalcaemia is due to exaggerated secretion of PTH otherwise it remains normal. Thus total calcium and ionized calcium levels will also be regulated by PTH. Secondary Hyper parathryoidism (SHPT) is a common complication of end stage renal disease (ESRD) in which there is hyperplasia of parathyroid gland. Thus, we conclude that there is an association of iPTH with ionized calcium in patients with SHPT and those undergoing hemodialysis. It is recommended that a by using a universal panel reference range in the assay of iPTH it is possible to minimize the complications in patients with chronic kidney disease.

American Journal of Clinical Medicine Research. 2014, 2(4), 75-78. DOI: 10.12691/ajcmr-2-4-3
Pub. Date: August 22, 2014

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Metastatic Malignant Melanoma Presenting as Small Bowel Obstruction: A Report of a Case

by Umobong EO, Ojo BA, Aghahowa ME, Etim O, Ngbea J, Ugwu VI, Eke BA, Nyaga T, DUDUYEMI BM and Jumbo GTA

Case Report

Small intestinal metastasis of any malignancy is rare. Cutaneous or ocular malignant melanomas are the most common tumors that metastasize to gastrointestinal tract. Patient often present several years after the initial evaluation and treatment for a previous cutaneous malignant melanoma with intestinal obstruction symptoms. Rarely, small bowel melanomas occur with clinical picture of acute abdomen due to perforation. We present a 68 year old female patient with a 4 month history of recurrent colicky abdominal pain, distention, vomiting associated with weight loss and passage of small pellet stool. Imaging studies using abdominal ultrasound and CT scan revealed a large lobulated hypo echoic mass between the gastric antrum and pancreas. She had an exploratory laparatomy for bowel obstruction. Surgical pathology of the excised mass with resected obstructed jejunum revealed a metastatic malignant melanoma. Reported cases of metastatic small bowel melanoma are becoming increasingly common and should be considered in patients with a previous history of primary cutaneous malignant melanoma.

American Journal of Clinical Medicine Research. 2014, 2(4), 72-74. DOI: 10.12691/ajcmr-2-4-2
Pub. Date: August 17, 2014

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Orofacial and Skeletal Manifestations of Hypophosphatemic Rickets in Fanconi Bickel Syndrome

by Veena R, Babitha. K and Anuradha Pai

Case Report

Wide array of systemic disorders have their manifestations in oral cavity. These disorders can be mainly syndromic, metabolic or congenital diseases. The dental features in these disorders can be expressed on a wider latitude from mild to extensive forms. Here is an incidence of a case of hypophosphatemic rickets in Fanconi Bickel syndrome with multiple oral and general phenotypic features.

American Journal of Clinical Medicine Research. 2014, 2(4), 68-71. DOI: 10.12691/ajcmr-2-4-1
Pub. Date: August 07, 2014

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