Clinical Medicine And Health Research Journal

The Estimation of Copper Serum Level Among Obese Children

Fri, 01 Nov 2024 00:00:00 +0000

Background: Obesity means an excess amount of body fat. No general agreement exists on the definition of obesity in children as it does adults. Most professionals use published guidelines based on the body mass index (BMI), or a modified BMI for age, to measure obesity in children. Others define obesity in children as body weight at least 20% higher than a healthy weight for a child of that height, or a body fat percentage above 25% in boys or above 32% in girls

Objective: to estimate the serum level of copper among obese children.

Methods: This comparative study was conducted on fifty of overweight and/or obese children (based on BMI) and thirty of clinically healthy, age and sex matched children's served as controls also, the cases and controls were selected randomly from the pediatrics outpatient clinic of Benha University Hospital and Sheben El Kom Educational hospital, in the period between 2013 to 2015. Parental consent was obtained for all children included in the study.

Results: In the current study there were no significant difference found between patients and control group regarding age, sex and residence, but there was significant difference between the two groups regarding income and socioeconomic state. P=0.04. Also, there were no static difference in height in patient when compared to control group, and patients had a higher statically significant Weight, BMI and Skin fold thickness when compared to control group. Additionally, that there were significantly higher rate of frequent bad nutritional habits including shipping breakfast (p=0.022) consumption of energy- dense food and food consumption during TV watch in patients than controls. P< 0.001 and the children's physical activity levels were lower in the patient’s group than the control group. P<0.001.

Conclusion: The obesity varied remarkably with different socioeconomic levels. Obese children had a characteristic nutritional pattern like skipping breakfast and consumption of energy dense food

Using Lipid Parameters in Predicting Preterm Infants with Respiratory Distress Syndrome

Ebtessam Mohammed Mahmoud Silema — Fri, 01 Nov 2024 00:00:00 +0000

Background: Respiratory distress syndrome is a clinical diagnosis which is warranted in a preterm newborn with respiratory difficulty, including tachypnea (>60 breaths/min), chest retractions, and cyanosis in room air that persist or progress over the first 48-96 hr of life, and a characteristic chest radiographic appearance.

Objective: to assess the cord blood lipid profile for predicting of preterm infants with respiratory distress syndrome.

Methods: This is a case control study which was conducted on 50 preterm neonates admitted to the neonatal intensive care unit of Shebin El-Kom teaching hospital between January 2011 and October 2011.

Results: the mean of weight gain during pregnancy in mothers of preterm with RDS was lower than the control group and the difference was statistically highly significant (P<0.01). Also, there was significant difference (P<0.05) regarding mode of delivery and antenatal steroid, however; no statistical significant difference was detected regarding maternal age, maternal weight, maternal BMI, pre-gravid height, the ruptured membrane > 24 hr and parity between both groups. the mean of total cholesterol, HDL-cholesterol and LDL-cholesterol in the cord blood was lower in group A than in group B and the difference was statistically highly significant (P <0.01), but there was no significant difference regarding the mean of both triglycerides and VLDL-cholesterol in both groups (P>0.05).the mean of total cholesterol, HDL-cholesterol and LDL-cholesterol was lower in mothers of preterm infants with RDS than in control group and the difference was statistically highly significant (P <0.01), but there was no significant difference was detected regarding the mean of levels triglycerides and VLDL-cholesterol in both groups (P >0.05).the cutoff values of cord blood (total Cholesterol, HDL-C, and LDL-C) below which RDS can be predicted are 80, 45.5 and 23.2 mg/dl respectively with a sensitivity of 83.3%, 86.7% and 86.7% and with specificity of 95%, 80% and 70% respectively.

Conclusion: We conclude that RDS is accompanied with lipid alteration in the infants and their mothers. The results of this study point to the importance of measuring of maternal serum and cord blood lipid profile as a predictor for the occurrence of RDS.

Studies of Lipid Profiles Among Infants with Respiratory Distress Syndrome

Fri, 01 Nov 2024 00:00:00 +0000

Background: Respiratory distress syndrome (RDS) is known as hyaline membrane disease (HMD). It is the major cause of neonatal respiratory distress, especially in preterm infants Infants with RDS present with tachapnea, cyanosis, grunting, subcostal and intercostal retractions and nasal flaring. Oliguria with mild generalized edema may be present. Oxygen requirement may increase rapidly and is typically higher than that seen in infant with transient tachapnea of the newborn (TTN).

Objective: to evaluate the relationship between the maternal and cord blood lipid profiles in preterm babies with respiratory distress syndrome.

Results: the mean of total cholesterol was significantly higher in infants whose mothers had received antenatal steroid for lung maturity than those whose mothers had not (P<0.05). But there was no significant difference in the mean of levels of TG, HDL-cholesterol, LDL-cholesterol and VLDL cholesterol between both groups. Also, There is a positive correlation between weight gain during pregnancy and neonatal cord blood levels of (Total cholesterol, TG, HDL-C, LDL-C and VLDL-C), There is a positive correlation between maternal blood levels of (total cholesterol, TG, LDL-C and VLDL-C) and their neonatal cord blood levels of (total cholesterol, TG, HDL-C, LDL-C and VLDL-C), There is a positive correlation between the maternal blood level of HDL-C and their neonatal cord blood levels of (total cholesterol and HDL-C).also, the cutoff values of cord blood (total Cholesterol, HDL-C, and LDL-C) below which RDS can be predicted are 80, 45.5 and 23.2 mg/dl respectively with a sensitivity of 83.3%, 86.7% and86.7% and with specificity of 95%, 80% and 70% respectively.

Conclusion: RDS is accompanied with lipid alteration in the infants and their mothers. The results of this study point to the importance of measuring maternal serum and cord blood lipid profile as a predictor for the occurrence of RDS.

An Indictment of US Public Health Policy on Pain Management

Lawhern Richard A. PhD — Mon, 04 Nov 2024 00:00:00 +0000

This paper reviews and assesses published clinical and demographic data that in the aggregate reveal that the entirety of present US public health policy on regulation of opioid pain relievers is fundamentally misdirected and wrong on both facts and ethics.

Methodology: critical review of clinical literature of addiction and pain management.

Intrinsically Ties Adjusted Median Test for Determining the Lengths of Hospitalization of Sampled Patients with Hypertension and Malaria in A Population

Okeh, Uchechukwu Marius, Emeji Emmanuel Ogwah — Wed, 20 Nov 2024 00:00:00 +0000

Background: This paper proposes and presents a nonparametric statistical method for the analysis of two sample data that intrinsically and structurally adjusts the test statistic, for the possible presence of tied observations in the sample populations.

Methodology: The proposed procedure makes it unnecessary to require the populations to be continuous as is often the case with some other methods. The populations may be measurement on as low as the ordinal scale and need not be continuous or even numeric. In situations where the original or initial null hypothesis is rejected, test statistics are developed to help determine which of the two populations of interest may be responsible for the rejection of the null hypothesis, an approach that is not possible for some other existing two sample median test.

Results: The proposed method is illustrated with some sample data and shown using the data to compare favorably with the usual median test and the Mann-Whitney U-test that could be used for the same purpose. Result showed that we rejected the null hypothesis, that hypertension and malaria patients from the population admitted to a hospital for treatment do not have equal median lengths of hospitalization for hypertension and malaria. Since The Chi-square value for testing the null hypothesis that the median length of hospitalization of hypertension patients in the population is equal to the median length of hospitalization of both hypertension and malaria patients in the population when pooled together as one population, is which with 1 degree of freedom is not statistically significant at the 5 percent significance level leading to the non-rejection of the null hypothesis. the Chi-Square value for testing the same null hypothesis with respect to malaria patients, that is that the median length of hospitalization of malaria patients in the population is the same as the median length of hospitalization of the combined or pooled population of hypertension and malaria patients when combined and treated as one population is which with 1 degree of freedom is statistically significant at the 5 percent significance level leading to the rejection of the null hypothesis.

Conclusions and recommendations: We conclude that hypertension and malaria patients in the population do not have equal median lengths of hospitalization. We may therefore conclude that the median length of hospitalization of malaria patients is statistically different from the median length of hospitalization of both hypertension and malaria patients in the sampled population and may hence be responsible for the rejection of the initial null hypothesis H0 of Equation 11 or 12 of equal population median lengths of hospitalization of the two types of patients in the sampled population. since the Chi-square value of obtained using the proposed modified ties adjusted median test for two samples is much larger than the Chi-square value of obtained using the usual ordinary unmodified ties unadjusted two sample median test, the proposed method is likely to correctly reject a false null hypothesis more often and hence is more powerful than the ordinary median test when used to analyze the same sample observations.

Protein-Energy Malnutrition and Its Progression in Dialysis Patients in West Delhi Centre: A Prospective Study

Deepshikha khattar — Thu, 21 Nov 2024 00:00:00 +0000

Background: There is a high prevalence of protein-energy malnutrition in patients with chronic renal failure who are undergoing maintenance hemodialysis. Apart from this the pathogenic mechanisms of malnutrition are complex and involve an interplay of multiple pathophysiologic alterations including decreased appetite, decreased nutrient intake and dialysis related abnormalities.

Methods: The study subjects were patients of CKD 5 (MHD) of age 18 to 60 years enrolled from Anjuman Medical centre in West Delhi. Total 30 subjects (15 males and 15 females) were enrolled from Dialysis centre and their basic demographic profile socio economic status, dietary habits and physical activity details were recorded. Dietary nutrient (calories, protein, fats, carbohydrates, sodium, potassium, phosphorus and fluid) was calculated by Diet Cal version 10.0 software using a 3-day dietary recall and analysed was done using SPSS software version 21.0. Nutritional status were measured at baseline , 2 months and 3 months. Knowledge, Attitude, practice and Quality of life also recorded at 1 month and at 3 months after nutritional counselling.

Results: The average BMI, weight, and height of males were (24.2 kg/m2, 67.6 kg, and 166 cm) and females were (22.2 kg/m2, 54.8 kg, and 158 cm) respectively. Blood pressure was 129±13 systolic and 79±10 mmHg diastolic. 23.3% had pallor, and 60% of patients were moderate and 33.3% were severely malnutrition. Handgrip was 21.7±6.9 kg. Protein intake changed from 52±15.9 to 73.2±11.4 in males and 47.8±50.4 to 57.0±13.7g in females after three months of the study. And energy improved from 1477±333 to 2253±494 in males and 1201±255 to 2106±346 kcal in females. Similarly, fat and phosphorus intake improved from 49.2±37.9 to 56.5±17.9 (p>0.080) and 728.9±287.7 to 1160.0±290.1 (p>0.000) respectively. While KAP was (8.5±2.0, 75.3±10.6 and 25.8±2.3) respectively and QoL also improved from 27.0±4.0 to 30.9±2.7 after 3 months of the study.

Conclusion: After 3 months of study, QoL and KAP significantly improved. Further, there were significant changes in intake of energy, protein and phosphorus in all dialysis patients. In nutritional status weight, MUAC and handgrip showed significant increase result. Blood pressure, pallor and MIS score also improved.

Unravelling the Diagnostic Dilemma of Juvenile Scleroderma: A Case Report

Obichukwu NG, Ofiaeli OC, Mbachu CNP — Tue, 26 Nov 2024 00:00:00 +0000

Juvenile scleroderma (JS) is a rare and often overlooked connective tissue disease in Paediatric populations. Its diagnosis is particularly challenging due to its multi-systemic involvement, and in developing countries like ours, the lack of diagnostic tools further complicates timely identification. We present the case of an 11-year-old male who presented to our children’s emergency room with a 2-year history of progressive skin thickening, flexion contracture and immobility of the right thumb. There was generalized body pain and swelling of the right upper limb. Additionally, the patient experienced recurrent cough, night sweats, easy fatigability, and occasional palpitations, though without significant weight loss.

After an initial misdiagnosis and several ineffective treatments, the suspected diagnosis of JS led to a trial treatment with methylprednisolone and methotrexate, to which the patient responded favourably. This case underscores the importance of a high index of suspicion for the prompt diagnosis and management of rare childhood rheumatic diseases, as delay in diagnosis can exacerbate morbidity and increase mortality.

A Qualitative Approach to Cancer Awareness Among Rural Women

Nadupuru Neha PG, Nallapu Samson Sanjeeva Rao — Thu, 28 Nov 2024 00:00:00 +0000

Introduction: The incidence of various types of cancers in India are set to increase thereby putting an increased burden on the health system. There is a need for people to know sufficiently about cancer, the various types, the risk factors, the early symptoms and signs etc. so that they can come for professional diagnosis early. However, the fear of cancer prevents screening, early diagnosis and prompt treatment.

Methodology: A qualitative study was done about cancer awareness among women in the rural areas using qualitative methods like Focus Group Discussions (FGD), In Depth interviews and Key Informant interviews.

Results: Incurability of cancer, stigma, fear of cancer, need for support – physical, emotional & spiritual, lack of discussion in the community, causes of cancer, knowledge about cancer and personal experience with cancer are the themes identified in this study.

Discussion: Stigma concerning cancer is a challenge to cancer awareness and control activities in any society. “Cancer fear” is any fear, anxiety, or worry related to cancer, including causes or consequences of cancer such as fear of treatment for cancer. Social support is necessary for physical adaptation, wellbeing and emotional adjustment in people suffering with cancer.

Conclusion: This study reveals that knowledge about cancer in rural women is low and there are many misconceptions. There is reluctance to discuss about it due to fear and stigma.

Recommendations: Following appropriate cancer education programmes with a stress on rural populations, prevention and screening programmes must be taken up urgently. Healthcare workers and volunteers in rural health care must be given necessary training to be able to give adequate cancer awareness, addressing key misconceptions.

Knowledge, Attitude, And Practice of Dermatologists and Family Physicians Regarding Probiotics in Atopic Dermatitis in Saudi Arabia

Khulood Yahya — Thu, 05 Dec 2024 00:00:00 +0000

Background: Despite the growing evidence of significant probiotics’ role in various diseases, including dermatological conditions, there is limited data on awareness dermatologists and family phsycians about its role in atopic dermatitis in Saudi Arabia.

Objectives: To assess knowledge, attitude, and practice of dermatologists and family physicians regarding probiotics in atopic dermatitis in Saudi Arabia

Methods: This study was a web-based cross-sectional study. Data were collected via an online questionnaire, targeting dermatologists and family physicians from different Saudi regions.The questionnaire included closed-ended questions on sociodemographic characteristics, knowledge, attitude, and practice of probiotic in atopic dermatits. Knowledge level and atitude scoring were assessed and compared based on participants’ characteristics.

Results: The study analyzed responses from 273 participants, with a mean age of 34.5 ± 8.3 years. The majority of respondents were dermatologists (71.8%). Among the participants, 23.1% demonstrated good knowledge about probiotics in relation to atopic dermatitis, with a significantly higher level of knowledge observed among consultants (38.5%), dermatologists (24%), and those with 10 or more years of experience. While most respondents displayed a positive attitude toward the use of probiotics, actual prescription rates were low. Notably, 53.8% of participants did not engage in prescribing probiotics, and only 33.3% monitored patient outcomes associated with their use. The main barrier identified was a lack of knowledge, with 66.7% of respondents citing this as a significant challenge.

Conclusion: The study highlights the need for improved educational resources to enhance healthcare providers' understanding and confidence in using probiotics for atopic dermatitis. This research contributes to the growing body of literature on probiotics and underscores the need for targeted interventions to support healthcare professionals in delivering evidence-based care.

Obstructive Sleep Apnea (OSA) A Daily Nightmare That Can Be Avoided

Tue, 10 Dec 2024 00:00:00 +0000

We are living with an explosion of cardiovascular diseases in the modern world. It is known that the quality of life has worsened in the world scenario and the control of risk factors, access to medical services and adherence to the proposed treatments is the great challenge for many countries, and its excellence is a privilege of few. The knowledge of traditional risk factors such as high blood pressure, diabetes, obesity, sedentary lifestyle, increased cholesterol for the development of these diseases is known, but other factors such as sleep apnea still need to be further disseminated. A significant portion of the adult population suffers from this condition, which is considered a new risk factor for the development of cardiovascular diseases and for increasing systemic blood pressure. It is up to scientific departments and public agencies related to human health to disclose ways of suspecting this condition of later formalization of the diagnosis and proper treatment. The anamnesis looking for signs of physical fatigue, lack of concentration, drowsiness, irritability, restless sleep and the presence of snoring, associated with increased neck circumference and increased hematocrit are easy to identify. [1] Obstructive sleep apnea (OSA) should be treated as a serious risk factor for the development of cardiovascular diseases and a more intense approach is necessary.