by Matthew Igwe Nwali, Joseph Agboeze, Onwe Abraham Bong, Obi Vitus Okwuchukwu, Ikeotuonye Arinze C and Ugadu Ikechukwu Ogwudu
Case Report
Mucinous cystadenomas are benign ovarian tumours which are characteristically slow growing with the propensity to grow up to 70 kilograms in size. It constitutes 10-20% of all epithelial ovarian neoplasms. We present the case of a patient who presenting with features that suggested a malignant ovarian tumour but was later found on histology to be a mucinous cystadenoma. She is a 50 year old Para 7+0 woman with 5 living children, 12 years post-menopausal who presented with abdominal swelling of nine months duration, uterovaginal prolapse of 8 months duration and rectal prolapse of 1 month duration, associated with excessive weight loss, pleural effusion and massive ascites. Ultrasound features suggested a malignant ovarian tumour. She subsequently had exploratory laparotomy with total abdominal hysterectomy, bilateral salpingo-oophorectomy, infracolic omentectomy and appendectomy due to the suspicion of malignancy as we did not have facility for frozen section during the procedure. Histology result subsequently showed she had a mucinous cystadenoma. She did well postoperatively and was followed up subsequently and remained healthy.
American Journal of Clinical Medicine Research. 2019, 7(2), 60-63. DOI: 10.12691/ajcmr-7-2-6
Pub. Date: November 15, 2019
7622 Views1622 Downloads
by Kunio Yui, George Imataka, Hitomi Sasaki and Ryoichi Shiroki
Original Research
This case study examined the association between epileptic activity such as epileptiform discharges and autistic symptoms; and to examine the effect of mTOR inhibitor everolimus on seizures and epileptiform discharges in three cases with TSC and autistic symptoms. The everolimus treatment improved autistic symptoms in all four cases, however, epileptiform discharges did not disappear in all four cases with everolimus treatment. Thus, epileptiform activity and autistic symptoms may be two end-results of separate brain dysfunction. The evrolimus treatment disappeared a seizure in only one case, suggesting partial overlap between mTOR hyperactivity and a seizure in small subset of cases with TSC. This study for firstly revealed that the everolimus treatment was inefficient for epileptiform discharges. Antiepileptic therapy at early stage of brain development might be effective for epileptic activity.
American Journal of Clinical Medicine Research. 2019, 7(2), 57-59. DOI: 10.12691/ajcmr-7-2-5
Pub. Date: October 30, 2019
6151 Views1654 Downloads
by Lisa Hasibuan and Miradz Hudaya
Original Research
Background: Autologous platelet-rich plasma (PRP) is a patient-derived treatment containing fibrin and high concentrations of growth factors, often known for its adhesive and hemostatic abilities. PRP has been used for various types of wounds, including chronic and burn wounds. Autologous PRP is an affordable and practical modality that has been advocated by multiple publications due to its effect in improving clinical outcomes and wound healing time in regard to skin graft in burn patients. The aim of this study is to compare the effectiveness of PRP to conventional suture fixation in skin graft transfer for deep burn patients through objective “take” percentage analysis. Methods: This controlled prospective single center study included 15 deep burn patients with a total burn area of 5 – 30% on their extremities. Each patient received skin graft treatments using both methods: autologous PRP and conventional sutures. Pictures and analysis were taken on the third day after surgery to compare the open wound area between the two methods. Result: There was no significant “take” percentage difference between the autologous PRP and conventional suture group. The mean percentage of skin graft “take” for autologous PRP was 84.36% ± 13.82%, and the result for suture fixation was 84.16% ± 15.33%. Conclusion: The use of autologous PRP in this study did not improve the “take” percentage of skin grafts compared to conventional suture fixation. However, the use of autologous PRP did reduce the surgery duration and is still a treatment modality with high potential.
American Journal of Clinical Medicine Research. 2019, 7(2), 53-56. DOI: 10.12691/ajcmr-7-2-4
Pub. Date: October 22, 2019
5681 Views1059 Downloads
by Tika Ermawati, Eddy Fadlyana and Dwi Prasetyo
Original Research
Background and Objective. Children with Cerebral Palsy (CP) have a risk of contracture or hypotonia causing difficulty in measuring their standardized height hence it requires height estimation based on the tibial length as an alternative measurement. Estimation body height formula is not available yet in Indonesia. We aim to determine the estimation body height according to tibia length in children with cerebral palsy aged 6-12 years in Bandung, Indonesia.Methods. The subjects are children 6-12 years old with CP who attended Special School, Growth and Development Clinic, Neuropediatric, and Medical Rehabilitation Outpatient Department at Hasan Sadikin General Hospital in Bandung, Indonesia between March until May 2019. This research performed a cross-sectional study. The height, body length, and tibia length of subjects who met the inclusion criteria were measured concomitantly. Data analysis was performed using linear regression. Results. We found 68 CP patients who met the inclusion criterion. Patients could be measured using the standard method are 36 children which then analyzed statistically. There were 36 subjects consisting of 22 boys (61,1%) and 14 girls (38,9%). The new calculation formula for body height estimation based on the tibia length in CP children aged 6-12 years is = 32,01 + 2,90 * tibia length (Standard error of the estimate ±1,85). Conclusion. Measurement of tibia length is important in determining the height estimation in children with CP so growth could still be monitored in the patients. There is a new calculation formula that we can use for height estimation based on the tibial length in children with CP aged 6-12 years.
American Journal of Clinical Medicine Research. 2019, 7(2), 48-52. DOI: 10.12691/ajcmr-7-2-3
Pub. Date: October 17, 2019
10617 Views1575 Downloads2 Likes
by Onuchukwu Victor Jude Uchenna, Obi Vitus Okwuchukwu, Nwafor Johnbosco Ifunanya, Onwe Blessing Idzuinya, Ugoji Darlington-Peter Chibuzor, Obi Chuka Nobert, Ibo Chukwunenye Chukwu and Agu Chidinma Joy
Original Research
Background:Pregnancies in women of advanced maternal age have been historically regarded as high risk pregnancies because of the associated increase in risk of maternal and perinatal morbidity and/or mortality. Hence, there is a need to evaluate the pregnancy outcome of elderly primigravidae in our setting. Aim: To determine the pregnancy outcomes in elderly primigravidae compared to the younger primigravidae at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Materials and Method: This was a retrospective case-control study of pregnancy outcomes of 49 elderly primigravidae (case group), who delivered at the hospital over a 5-year period, were compared with those of 98 younger primigravidae (control group) (≤ 34 years old) that delivered during the same period. Data collection was done using a pre-designed proforma; analysis was done using Epi Info 7.2.1 CDC. Result:During the study period, there were 11703 deliveries. The incidence of elderly primigravidity was 0.42%. The mean age of the study group was 36.5 ± 1.7 years and that of the control group was 24.3 ± 4.2 years. Forty-four (89.8%) patients were booked in the study group, while 71 (72.8%) patients were booked in the control group. Elderly primigravidae were more likely to book before 14 weeks’ gestational age compared with younger primigravidae (χ2=33.29, P<0.0001). The average gestational age at delivery for the study group and control group were 39.0 ± 3.7 weeks and 37.0 ± 4.1 weeks respectively. The incidence of malaria infection was higher in the younger control group while in the elderly primigravidae the rate of diabetes mellitus, hypertensive disorders, multiple gestation and anaemia were higher ; but not statistically significant ((p>0.05)). The caesarean section rate in the case group was higher but of no statistical significance (p=0.51). There was no recorded maternal death in both groups. Conclusion: Elderly primigravidity is not uncommon in our environment. Due to the anxiety associated with such pregnancies they were more likely to book earlier than the younger primigravidae. Although they were more likely to have medical complications, the maternal and perinatal outcomes were not statistically different from younger primigravidae.
American Journal of Clinical Medicine Research. 2019, 7(2), 44-47. DOI: 10.12691/ajcmr-7-2-2
Pub. Date: August 12, 2019
5940 Views1169 Downloads2 Likes
by Okoro OS, Ugwu EO, Dim CC, Ozumba BC, Nkwo PO, Ajah LO and Okeke TC
Original Research
Castor oil has long been used as a way of inducing labor and preventing post-term pregnancy. However, its safety and effectiveness has not been conclusive thereby necessitating the need for further studies. This article evaluated the effectiveness of single oral dose of castor oil at 40-41 weeks of gestation for prevention of post-term pregnancy, in a low resource setting. This was a randomized controlled trial of pregnant women attending antenatal care clinic at the University of Nigeria Teaching Hospital Enugu, Nigeria. The eligible participants were randomized into two groups; group A (intervention group) received oral castor oil (60mls) and group B (control group) did not receive castor oil. The intervention group had a lower incidence of post term pregnancy compared to the control group (18/105(17.1%) vs 44/106(41.5%), RR= 0.41, NNT= 4). The proportion of women requiring formal induction of labor with misoprostol or with oxytocin was significantly lower in the intervention group than in the control group (18/105 (17.1%) vs 44/106(41.5%), RR= 0.41, NNT= 4). The intervention group were less likely to have their labor augmented with oxytocin compare to the control 41/87(47.1%) vs 44/62(71.0%), RR 0.66, NNT 4). The route of delivery and the need for new born special care unit admission were similar in the two groups. There was no significant difference in the maternal complications due to castor oil in the two groups. Single oral dose of Castor oil administration significantly lowers the incidence of post- term pregnancy, without higher risk of maternal and/ or neonatal complications.
American Journal of Clinical Medicine Research. 2019, 7(2), 37-43. DOI: 10.12691/ajcmr-7-2-1
Pub. Date: June 28, 2019
8499 Views1242 Downloads