by Asri Rachmawati, Nanan Sekarwana and Susi Susanah
Original Research
Background. The prevalence of school-age children with moderate malnutrition in Indonesia is high enough that growth monitoring and nutritional intervention in school-aged children are required. Moderate malnutrition in school-age children who are not well managed might reduce the quality of human resources in the productive age. Malnutrition can affects reduced protein synthesis, hypoalbuminemia, and decreased oncotic pressure, in addition to decrease in glomerular filtration rate and impaired tubular function. If the renal tubules damage, the level of Neutrophil gelatinase-associated lipocalin (NGAL) excreted in the urine will increase because NGAL can not be properly reabsorbed. NGAL is expressed by the tubules and passes through the urine quickly after the kidney is injured and inflamed. Methodology/Principal Findings. This was a cross-sectional study conducted from November-December 2017 in children aged 6–13 years old at Garuda Elementary School in Bandung. Subjects were selected through stratified random sampling. We got 39 children with moderate malnourished and 39 well-nourished children who met the study criterias. Weight, height and urine NGAL of subjects were measured. Nutritional status were determined using WHO Child Growth Standards. Urine sampling was done by collecting 10 ml of midstream urine in a sterile container, labeled with name, study registry number and date of material collection. The samples were then immediately sent to Hasan Sadikin Hospital laboratory. Urinary NGAL level was examined using ELISA method. Data analysis using Mann Whitney test. There was significant difference in urinary NGAL levels between well-nourished and moderate malnourished children (p<0.05). Median of urinary NGAL levels in moderate malnourished group were higher than in the well-nourished group with a difference of 43.6 and 95% CI between 38.3-50.1. Conclusions. The level of urinary NGAL (uNGAL) in moderately malnourished children were higher than in well-nourished children.
American Journal of Clinical Medicine Research. 2018, 6(2), 48-52. DOI: 10.12691/ajcmr-6-2-5
Pub. Date: August 13, 2018
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by Ali AlSharqi, Halima Aal Homouda, Tariq Al-Saadi and Khamis Al Hashmi
Case Report
Background: Hypertension is worldwide health burden. The major concern about hypertension is that it is usually asymptomatic until it causes end organ damages. The management of hypertension usually starts with monotherapy which fails in achieving targeted BP control in many patients. Therefore, they are switched to combination therapy. Fixed combination therapy is proven to be more effective in controlling hypertension than free combination therapy. Exforge-HCT is a fixed combination drug consisting of Amlodipine, Valsartan and Hydrochlorothiazide. Its effectiveness is not known in Omani hypertensive patients. Aim: To evaluate the role of exforge-HCT in control of blood pressure in Omani hypertensive patients attending SQUH and its effectiveness based on gender. Method:This is a retrospective study. Data was gathered using HIS from January 2013 to June 2016. Patients taking Exforge-HCT were screened for eligibility for the study. Blood pressure measurements before and after using Exforge-HCT were recorded. Patients were grouped according to gender, number of co-morbidities and number of medications used before EXFORGE-HCT into two groups; group one: those who were on triple free drug combination therapy and group two: those who were on dual free drugs. P value of less than 0.05 was considered significant. Results:Total number of patients was 115 with female being 57% and male being 42%. The Level of control of hypertension increased from 22% to 33%. Over all Significant reduction in blood pressure was observed, but there was no gender difference in response to Exforge-HCT. There was significant difference in the response to Exforge-HCT between the medication groups but the response according to gender in each group remains the same. Response to Exforge-HCT was the same regardless the number of co-morbidities in both gender. Conclusion:Exforge-HCT showed significant reduction in BP but no gender difference in response. There was significant difference in the response between the two medication groups. However, the response between genders remains the same in each co-morbidity and medication group. Further prospective study is needed to confirm these findings.
American Journal of Clinical Medicine Research. 2018, 6(2), 41-47. DOI: 10.12691/ajcmr-6-2-4
Pub. Date: July 03, 2018
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by Malak Khalifeh, Nicholas Moore and Pascale Salameh
Original Research
Introduction: With the increasing range of potent medicines available for sale 'over-the-counter' (OTC) in community pharmacies and the absence of data in Lebanon related to OTC abuse, this study sought to find opinions of the public regarding OTC medicines generally and explore views around potential misuse and abuse. Method: A cross sectional study was conducted in a community-based pharmacy setting in Lebanon. A structured random interview was used to patients visiting community pharmacy seeking for OTC drugs. Baseline characteristics and reason for self-medication were collected. The questionnaire consists of sections about sources and reasons of self-medication, attitudes towards community pharmacy and patient contact with pharmacies, attitudes towards the use of OTC medicines; views on OTC medicines’ use in terms of safety, potency and effectiveness. Result: Overall this study revealed the knowledge and attitude of general public toward OTC use in Lebanon. Self-presentation on previous experience of the same medication or through pharmacist advice. Almost half requested OTC medications more than twice per year. This show the important role of pharmacist in guiding the patients on the correct OTC use. Around 60% agreed that some non-prescription medicines may cause dependency or addiction if taken for a long period of time. Conclusion: The findings of this research should form the basis for future interventional plans to maximize benefits and minimize risks of self-medication practice. Educational programs to population, pharmacists and health care providers should be implemented to limit the potential misuse/abuse of these medicines.
American Journal of Clinical Medicine Research. 2018, 6(2), 35-40. DOI: 10.12691/ajcmr-6-2-3
Pub. Date: June 29, 2018
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by Sabitha Vadakedath, Venkataramana Kandi, Venkata Bharat Kumar Pinnelli and Vikram Godishala
Review Article
Diabetes mellitus is a chronic debilitating non-communicable disease prevalent throughout the world. There are two different types of diabetes; the type 1 diabetes usually presents in children and young adults, and the type 2 diabetes, a most frequent age-related condition usually noted among the adults aged over 40 years. The type 1 diabetes results due to an immunological reaction against insulin and the insulin secreting cells. The type 2 diabetes can occur due to various factors that include genetic predisposition, lifestyle disorders, insulin resistance, and lack of adequate insulin production. Since lifestyle management is an adjustable risk factor for diabetes, may people with genetic predisposition could delay the onset of clinical diabetes. Further there is an increasing need to understand the genetics behind the signaling pathways involved in the development of type 2 diabetes, which could pave the way for formulating, and implementing therapeutic, and preventive strategies.
American Journal of Clinical Medicine Research. 2018, 6(2), 24-34. DOI: 10.12691/ajcmr-6-2-2
Pub. Date: May 30, 2018
10289 Views2768 Downloads
by Yulia Sofiatin and Rully MA Roesli
Original Research
Epithelial sodium Channel (ENaC) protein is an important substance in maintaining plasma sodium level. Its DNA sequences are similar in rat model with and without salt sensitivity, but the mRNA number increase in salt sensitive rat model with high salt diet. This condition is assumed to be similar in human. ENaC protein is abundant in lung, gut and kidney, and plays a similar physiological process but different diseases. ENaC protein levels have to be measured from specific locations; kidney will be the good source for hypertension related sodium excretion. The possibility of ENaC protein as a marker to screen salt-sensitivity is needed to be explored. The aim of this research is to explore the possibility of ENaC protein detection in urine. This is an observational descriptive study. Enzyme-linked immunosorbent assay (ELISA), using Cloud-Clone reagent catalog number SED337Hu, was used to detect and measure urinary and plasma ENaC protein level. For the first step of study, ELISA was conducted toward various dilution of healthy individual spot urine; in the 2ndstep, several locations of repeated centrifuged spot urine and 24 hour collected urine were explored for the presence of ENaC protein; on the next step, 3 subjects, non-hypertensive, and hypertensive with and without family history of hypertension were recruited; for the fourth step, 13 (6 male and 7 female) non-hypertensive subjects were recruited; all steps are aimed to explore the detection of urinary EnaC protein level. ENaC proteins can be detected in both supernatant and sediment of centrifuged urine. In plasma of non-hypertensive, hypertensive with, and without family history of hypertension are 1.12 ng/ml, 2.7 ng/ml and 4.0 ng/mL respectively. ENaC protein levels from centrifuged urine at lower part of supernatant are lower but consistent with serum level. Mean ENaC protein level in non-hypertensive men are lower than women. Mean ENaC protein level in those with family history of hypertension are lower both in men and women. ENaC protein is detectable in spot urine; the levels differ by hypertension status, family history of hypertension and also by gender.
American Journal of Clinical Medicine Research. 2018, 6(2), 20-23. DOI: 10.12691/ajcmr-6-2-1
Pub. Date: April 26, 2018
9961 Views2926 Downloads