https://ejmed.org/index.php/ejmed/issue/feed European Journal of Medical and Health Sciences 2021-06-12T02:58:59-04:00 Editor-in-Chief editor@ejmed.org Open Journal Systems European Journal of Medical and Health Sciences https://ejmed.org/index.php/ejmed/article/view/812 Mechanisms Lead towards Improved Health: Massage with Earthing 2021-06-09T21:13:27-04:00 Madiha Khalid msmadihakhalid@gmail.com Jeremy Madvin jeremym@zetatherapy.com <p>Massage can alleviate the inflammatory process, help to accelerate recovery, and relieve pain resulting from muscular injuries. In this paper, we combine the idea of mechanotransduction (conversion of mechanical stimulus into electrochemical activity) using grounding in massage to investigate beneficial mechanisms. Grounding massage has been discovered to stabilize the physiology of the body, help reduce pain, inflammation, stress, enhance sleep, increase energy, and blood flow, and enhance well-being by connecting the body with the electrical charges of the Earth. Such effects are systemic and basic, and often quickly evolve. This process can reduce secondary injury, collateral sprouting, and nerve sensitization by modifying inflammatory signaling pathways, resulting in improved damage recovery and pain reduction or prevention. Research shows that grounding, when simultaneously combined with many CAM clinical practices, can offer great potential to improve their effectiveness. The paper aims to explain how massage therapy, combined with geographically and simultaneous earthing, causes a potentially beneficial and properly activated immunomodulatory pathway.</p> 2021-05-03T02:41:13-04:00 Copyright (c) 2021 Madiha Khalid, Jeremy Madvin https://ejmed.org/index.php/ejmed/article/view/813 Research on Nutritional Interventions to Recuperation for the Elite Swimmer in the Period Preparation for Competition of 29th SEA Games at Malaysia in 2017 2021-06-09T21:13:27-04:00 Linh Nguyen Thi My nguyenducthanh71@gmail.com Thinh Do Trong thanhnd@hcmute.edu.vn Phuong Le Quy huydongmd@gmail.com <p>The purpose of the study was efficiency the interventions nutritional to recovery and the requirements related to the use of food and food ingredients for health stability, promotion efficiency of the competition exercises of swimmer by through the indicators reflect about recovery: Hematocrits, Hemoglobin, Testosterone, Creatinine, Rest lactic acid, Maximal Lactic Acid, Creatinine, Blood Pressure, Weight. The results of the study show that, after 6 weeks of the experimental, the swimmer's health is well maintained, swimmer's fitness strength and ability to adapt to the physical training and the swimmer have won 8 gold medals at the competition at the SEA Games 2017 in Malaysia.</p> 2021-05-04T06:24:21-04:00 Copyright (c) 2021 Linh Nguyen Thi My, Thinh Do Trong, Phuong Le Quy https://ejmed.org/index.php/ejmed/article/view/293 Spirometric Indices in Type 2 Diabetes Mellitus Patients in a Nigerian Tertiary Institution 2021-06-09T21:13:26-04:00 Adekunle O. Adeoti kadeoti2002@yahoo.com Taiwo H. Raimi taiwo.raimi@eksu.edu.ng Joseph O. Fadare jofadare@gmail.com Raphael Ibidapo raphibidapo@gmail.com <p><em>Background:</em> Diabetes mellitus is a non-communicable disease of global health importance. It is a metabolic disorder caused by increased levels of blood glucose over a prolonged period of time. Type 2 diabetes mellitus (T2DM) is usually associated with obesity and insulin resistance. Several studies have also revealed that diabetes mellitus hampers pulmonary functions. This study was aimed at estimating the spirometric indices in type 2 diabetes mellitus patients.</p> <p><em>Methods:</em> A cross-sectional study of T2DM patients and apparently healthy control attending the medical outpatient clinic in a tertiary institution in south western Nigeria.</p> <p><em>Results:</em> A total of 146 participants with 73 patients with T2DM and 73 control groups. There were no significant differences in the age, body mass index, and gender distribution of the diabetics and control. However, patients with diabetes had higher SBP (133.2±20.17 mmHg vs 111.6±6.5&nbsp;mmHg p&lt;0.0001), and DBP (78.4±11.8mmHg vs 73.7±6.3 mmHg, p=0.003) when compared to the control. The mean FEV (1.98±0.5 vs 2.09±1.2, p=0.033), FVC (2.35±0.6 vs 2.53±1.3, p=0.045) and FEV/FVC ratio (83.61±7.2 vs 81.14±10.7, p=0.029) were significantly lower in diabetic patients when compared to matched controls. There was no significant difference in the PEF and FEF of both groups.</p> <p><em>Conclusion:</em> Type 2 diabetes mellitus patients had significant decrease in their spirometric indices, hence pulmonary function should be included in the periodic comprehensive diabetic check for holistic management.</p> 2021-05-07T15:02:24-04:00 Copyright (c) 2021 Adekunle O. Adeoti, Taiwo H. Raimi, Joseph O. Fadare, Raphael Ibidapo https://ejmed.org/index.php/ejmed/article/view/688 Additive Effect of Sulfantil to Lidocain and Bupivacain for Supraclavicular Brachial Plexus Block 2021-06-09T21:13:25-04:00 D. S. Lodhe dlodhe@rediffmail.com V. V. Akulwar dlodhe@rediffmail.com S. Deshmukh dlodhe@rediffmail.com <p><em>Purpose:</em>&nbsp;We evaluated the effect of adding Sufentanil to the mixture of Lidocaine and Bupivacaine used for supraclavicular brachial plexus block in reducing postoperative pain.</p> <p><em>Method:</em>&nbsp;This double-blind clinical intervention trial was conducted in 2007. Patients scheduled to undergo upper limb orthopedic surgeries under supraclavicular brachial plexus block were recruited. Participants of one arm were given the mixture of Sufentanil, lidocaine, and bupivacaine (Group S) while those of the other arm were given the mixture of later two drugs (Group C). Postoperative pain assessment was done every hour postoperatively till the first administration of systemic analgesic. We used a subjective pain score and duration of lack of muscle movement as a parameter to judge outcomes. The mean and standard deviation were compared of both arms.</p> <p><em>Result:</em>&nbsp;We included 50 patients in both arms. The mean duration of the motor blockade in group S and C were 342.8 (± 145.4) and 171.1 (±50.2) minutes respectively. The additive effect of Sufentanil in motor blockage was 171.7 (95% CI 128.5–214.9) (p = 0.1×10<sup>-6</sup>). The mean duration of analgesia in group S and C were 892 (±34.7) and 350 (±72.1) minutes respectively. The additive effect of Sufentanil in analgesia was 542 (95% CI 524–559) (p = 0.1×10<sup>-6</sup>). In group S, one patient developed cardiac pain following pneumothorax and two had temporary Horner syndrome.</p> <p><em>Conclusion:</em>&nbsp;Analgesia in the postoperative period can be enhanced with the addition of Sufentanil (an opioid) to local anesthetics in supraclavicular brachial plexus block.&nbsp;</p> 2021-05-12T11:43:51-04:00 Copyright (c) 2021 D. S. Lodhe, V. V. Akulwar, S. Deshmukh https://ejmed.org/index.php/ejmed/article/view/811 Seroprevalence Of Rubella Virus Antibodies Among Pregnant Women Attending Antenatal Clinic in Ekiti State 2021-06-09T21:13:24-04:00 O. Ojo Bola ojobolaoluwatosin01@gmail.com T. O. Korode koledade72@gmail.com D. E. Oguntunnbi ojobolaoluwatosin01@gmail.com F. B. Ajimojuowo ojobolaoluwatosin01@gmail.com A. A. Aladejare ojobolaoluwatosin01@gmail.com O. Jegede ojobolaoluwatosin01@gmail.com O. S. Adeniyi ojobolaoluwatosin01@gmail.com <p>Rubella virus infection poses a great threat to the foetus whose mother acquires the infection. This study was therefore carried out to determine the seroprevalence of rubella virus IgM antibodies among the pregnant women attending Federal Teaching Hopsital, Ido Ekiti. One hundred and ninety two (192) sera were collected from pregnant women and screened for rubella virus IgM antibodies. A structured questionnaire was administered to subjects to obtain socio-demographic data. The sera samples were analysed using Enzymes Immunosorbent Assay (EIA) IgM rubella kit. Out of 192 pregnant women screened, 6(3.1%) subjects were sero-positive. Age group 31-35years recorded the highest prevalence 3(1.56%). Pregnant women with tertiary education had the highest prevalence of 4(2.08%) among different educational level; civil servants have a prevalence of 4(2.08%) compared with other occupational status. However, prenatal screening and post-partum is highly encouraged to detect congenital rubella syndrome. There is also a need to include rubella screening as part of the routine procedure for the expectant mother.</p> 2021-05-15T06:44:40-04:00 Copyright (c) 2021 O. Ojo Bola, T. O. Korode, D. E. Oguntunnbi, F. B. Ajimojuowo, A. A. Aladejare, O. Jegede, O. S. Adeniyi https://ejmed.org/index.php/ejmed/article/view/836 Frequency of Side Effects after First Dose of Vaccination against COVID-19 Among the People of Bangladesh 2021-06-09T21:13:23-04:00 H.M. Khaleduzzaman raju47cmc@gmail.com Nafisa Jabin Mishu jabinjabin560@gmail.com <p>Vaccine is an important means to prevent COVID-19. It is a new modality of treatment for COVID-19 so many more to know about it especially in case of Bangladeshi people. Total 18.1% volunteers out of 1160 participated were noticed various side effects. These effects have been found within two months of observation following first dosage of vaccination against COVID-19. Fortunately, most of the side effects were mild and within 48 hours of vaccination. Its effectiveness is still questionable. To prove effectiveness, safety, side effects and additional benefit needs further study.</p> 2021-05-17T02:39:40-04:00 Copyright (c) 2021 H.M. Khaleduzzaman, Nafisa Jabin Mishu https://ejmed.org/index.php/ejmed/article/view/816 Effect of Wound Infiltration with Bupivacaine after Laparoscopic Cholecystectomy – A Randomized, Controlled Trial 2021-06-09T21:13:23-04:00 Monira Parveen dr.monira.parveen@gmail.com Dilip Kumar Bhowmick Bhowmick724bd@gmail.com Md. Shafiqul Islam shafique45@gmail.com Md. Sayedur Rahman srkhasru@bsmmu.edu.bd AKM Akhtaruzzaman akm.akhtaruzzaman@bsmmu.edu.bd <p><em>Background and Objective:</em> Adequate post-operative pain management can improve surgical outcome. Patients undergoing surgery can be affected socially, psychologically, economically with undertreated pain. We aimed to evaluate the effect of 0.25% bupivacaine infiltration on postoperative pain, analgesic requirement, satisfaction level, hospital discharge and quality of life after laparoscopic cholecystectomy.</p> <p><em>Methodology: </em>Fifty eight patients undergoing laparoscopic cholecystectomy were enrolled and randomized in two groups – placebo and intervention. Patients were infiltrated with 10 ml 0.25% bupivacaine in intervention and 10 ml 0.9% normal saline in placebo group. Post-operative pain was managed with morphine using Patient Controlled Analgesia (PCA). Pain intensity was assessed on the matrix of visual analogue scale and verbal rating scale up to 12 post-operative hours. This study also assessed its effect on analgesic requirements, hospital stay, patient satisfaction level after 24hours, pain score on discharge, time taken to return to job and quality of life (on 15<sup>th</sup> and 30<sup>th</sup> post-operative day).</p> <p><em>Results:</em> It was revealed 0.25% bupivacaine can lower post-operative pain up to six post-operative hour of performing laparoscopic cholecystectomy. Total analgesic requirement was also reduced (p= 0.0003) with decreased side effect like vomiting (p= 0.0002). However, satisfaction and quality of life were not affected by bupivacaine infiltration in this study.</p> <p><em>Conclusion:</em> 0.25% Bupivacaine infiltration offered more effective management of postoperative analgesia with decreased analgesic requirement and less incident of vomiting. But it was not effective after long duration in terms of satisfaction level, hospital discharge, time to return to job or quality of life.</p> 2021-05-19T08:50:27-04:00 Copyright (c) 2021 Monira Parveen, Dilip Kumar Bhowmick, Md. Shafiqul Islam, Md. Sayedur Rahman, AKM Akhtaruzzaman https://ejmed.org/index.php/ejmed/article/view/858 Validation of the Insomnia Severity Index on Patients Recovering from High Impact Car Accidents 2021-06-09T21:13:22-04:00 Zack Z. Cernovsky drcernovsky@gmail.com Larry C. Litman corvette033@hotmail.com Vitalina Nosonova vnosonova@medexassessments.com <p><em>Background:</em> The Insomnia Severity Index (ISI) is widely used in clinical assessments of insomnia in patients injured in high impact motor vehicle accidents (MVAs). This study examines the criterion and convergent validity of ISI on this clinical population.</p> <p><em>Method:</em> De-identified archival data were available on 112 post-MVA patients (37 men, 75 women, mean age 38.8 years, SD=13.1). They completed the ISI as well as the Brief Pain Inventory, the Rivermead Post-concussion Symptoms Questionnaire, the Subjective Neuropsychological Symptoms Scale (SNPSS), Items 10 to 12 of the Whiplash Disability Questionnaire (ratings of depression, anger, and of anxiety), Whetstone Vehicle Anxiety Questionnaire, Driving Anxiety Questionnaire (DAQ), Steiner’s Automobile Anxiety Inventory, and some of them also completed the PTSD Checklist for DSM-5 (PCL-5).</p> <p>The ISI responses were also available from a community sample of 21 controls (10 men, 11 women, mean age of 39.2 years, SD=18.5).</p> <p><em>Results:</em> The mean ISI total score of post-MVA patients (23.6, SD=13.1) was significantly higher than the one of the controls (6.0, SD=5.4) and significant between groups differences in the same direction were also observed on all 7 individual ISI items: the magnitude of these underlying relationships ranged from Pearson point biserial r of 0.68 to 87. The ISI total score also significantly correlated with ratings of post-MVA pain, depression, generalized anxiety, scores on measures of the post-concussion and whiplash syndrome, PTSD, and on Whetstone’s and DAQ measures of post-MVA driving anxiety.</p> <p><em>Discussion and Conclusions:</em> The results show an excellent level of criterion and convergent validity of ISI for clinical assessments of insomnia in post-MVA patients.</p> 2021-05-24T12:43:00-04:00 Copyright (c) 2021 Zack Z. Cernovsky, Larry C. Litman, Vitalina Nosonova https://ejmed.org/index.php/ejmed/article/view/864 Evaluation of Salivary Superoxide Dismutase Levels in Oral Submucous Fibrosis – A Cross Sectional Study 2021-06-09T21:13:21-04:00 Kavita Nagar kavitanagar0789@gmail.com G.P. Sujatha sujathashok@gmail.com Ashok Lingappa ashokl_2002@yahoo.co.in <p><em>Background: </em>Oral Submucous Fibrosis (OSMF) is a potentially malignant disorder with areca nut being the main etiological agent. Increased risk of malignant potential of OSMF necessitates the early diagnosis of the condition. Superoxide dismutase (SOD) scavenges oxygenated free radicals and can be used as a potential biomarker for oral cancer detection.</p> <p><em>Objectives: </em>The present study was conducted to estimate and compare salivary SOD levels in patients with OSMF and healthy controls and to compare its levels in different clinical and functional stages of OSMF.</p> <p><em>Methodology: </em>The study group (Group 1) included 30 patients of OSMF, and the control group (Group 2) was formed by age and sex-matched healthy individuals. Salivary SOD levels were determined by Nitro Blue Tetrazolium (NBT) chloride method. The levels of salivary SOD were compared between the two groups and the data thus obtained was subjected to statistical analysis using independent sample t-test and one way Analysis of variance (ANOVA) test.</p> <p><em>Results: </em>The mean salivary SOD in the study group was 0.583 IU/mL and 0.864 IU/mL in control group and the difference was found to be statistically significant. Thus, the patients with OSMF had significantly lower levels of salivary SOD compared to the controls.</p> <p><em>Conclusion: </em>The decrease in the salivary SOD levels in patients with OSMF suggests the role of oxidative stress in the pathogenesis of OSMF and initiation and progression of carcinogenesis. Thus, it can be used as a prognostic marker for early detection of carcinoma in patients with OSMF and thereby, improving the quality of life patients.</p> 2021-05-27T03:16:28-04:00 Copyright (c) 2021 Kavita Nagar, G.P. Sujatha, Ashok Lingappa https://ejmed.org/index.php/ejmed/article/view/860 Dharavi Slums (Mumbai, India): The Petri Dish of COVID-19 Herd Immunity 2021-06-09T21:13:20-04:00 Zameer Shervani shervani.nanotek@gmail.com Deepali Bhardwaj shervani.nanotek@gmail.com Roma Nikhat shervani.nanotek@gmail.com <p>The first and second serosurvey results of COVID-19 antibodies in Dharavi and Cuffe Parade slums (Mumbai, India) were studied. The seroprevalence data of the slums explained the zero novel coronavirus cases reported in the slum dwellers verified first in real on the ground the concept of much needed herd immunity against the pandemic. &nbsp;First serosurvey data showed that more than half (57%) of the population of Dharavi was infected with the virus. The antibodies were waned off in two month time and diminished to 45%, as found in the second survey conducted after two months of the first survey. The antibodies prevalence was highest at 75% in Cuffe Parade slums of Mumbai. Initially, Dharavi slums were a hotspot of novel coronavirus which later became nearly a no-new infection zone. The herd immunity acquired in Dharavi residents stopped the new infection. One million Dharavi slum dwellers living in a crowded semi-isolated cluster mimic the petri-dish model of a human population which is now a near COVID-19 free zone due to the presence of antibodies in the residents. The infection rate in Maharashtra, India, and Dharavi slums was compared. The concept of herd immunity that occurred on the ground in real has been first established. The research is very useful to vaccinate populations to eradicate the pandemic from the globe.</p> 2021-05-28T03:52:30-04:00 Copyright (c) 2021 Zameer Shervani, Deepali Bhardwaj, Roma Nikhat https://ejmed.org/index.php/ejmed/article/view/873 Decompressive Craniectomy in Traumatic Brain Injuries. Indications and Limits 2021-06-09T21:13:18-04:00 Y. Tahrir yass.med90@gmail.com A. Laaidi laidiabdelkodos@gmail.com K. Baayoud baayoudkarim@gmail.com M. Makhchoune marouanemakhchoune11@gmail.com A. Chellaoui chellaouiabdelmajid@gmail.com A. Naja najaabdessamad@gmail.com <p><em>Background: </em>Decompressive craniectomy is a surgical technique proposed in the treatment of intracranial hypertension refractory to medical treatment and engaging the vital prognosis of patients.</p> <p><em>Materials and methods:</em> We conducted a retrospective study about 41 cases of decompressive flap in the neurosurgery department of CHU ibn Rochd of Casablanca between 2015 and 2018.</p> <p><em>Aim:</em> This study aims to discuss the management of intractable ICH in adults, focusing on the role of DC in patients with traumatic brain and identify the different indications, contraindications and complications.</p> <p><em>Results:</em> The results show a clear male predominance with an average age of 40 years. The initial GCS &gt;7 was in 63%, and &lt;7 in 36% of cases, anisocoria was present in 65%. The most frequent indication for craniectomy is a neurological worsening. The type of craniectomy performed in the majority of cases is a hemi craniectomy in 92% of cases. Concerning the prognosis, we observed 32% of deaths and 68% of survivors of which 39% of patients without sequelae GOS 5 and 32% with a moderate disability GOS 4. The moderate disability GOS 3 was found in 21% and one case in vegetative state GOS 2. Regarding immediate complications after craniectomy: 33% of patients presented convulsions, 12% a new homolateral hematoma, 49% a nosocomial pneumopathy and 10% a postoperative meningitis.</p> <p><em>Conclusion:</em> Decisions to recommend DC must always be made not only in the context of its clinical indications but also after consideration of an individual patient's preferences and quality of life expectations.</p> 2021-05-31T03:30:57-04:00 Copyright (c) 2021 Y. Tahrir, A. Laaidi, K. Baayoud, M. Makhchoune, A. Chellaoui, A. Naja https://ejmed.org/index.php/ejmed/article/view/777 Dose Estimation of Absorbed X-ray Radiation to Safeguard Human DNA Alteration: A Quality Control and Quality Assurance Approach 2021-06-09T21:13:18-04:00 Oladotun A. Ojo dotun4realoj@gmail.com Musibau A. Ibrahim kunle_ibrahim2001@yahoo.com Peter A. Oluwafisoye paoluwafisoye@yahoo.com <p>The amount of absorbed X-ray dose by a particular human at a single exposure can have some effect on DNA. There is therefore the need to apply the correct range of dose to patients during X-ray. X-ray films from exposed adult patients were collected for use at a hospital. Each of the film’s optical densities was measured at various spots on the film and averaged as the mean. An estimated range of absorbed dose for the films was found to be between 0.83 mGy to 8.86 mGy. The results were compared with the 1.2 mGy value, which is the absorbed dose that should not be exceeded during an exposure, so that the DNA is not altered. The doses above this value are capable of doing harm to the human DNA. As a result, that ionizing radiation of low dose values can produce an effect on human DNA, hence this occurrence may be checked with a research work of this nature.</p> 2021-06-03T15:26:50-04:00 Copyright (c) 2021 Oladotun A. Ojo, Musibau A. Ibrahim, Peter A. Oluwafisoye https://ejmed.org/index.php/ejmed/article/view/808 Frequency Occurrence and Percentage Distribution of Rh C, Rh c, Rh E and Rh e Blood Group Amongst Pregnant Women Attending Antenatal Clinic in Port Harcourt, Nigeria 2021-06-09T21:13:17-04:00 Serekara Gideon Christian serekara.christian1@ust.edu.ng Evelyn Mgbeoma Eze evelyn.eze@ust.edu.ng Barizoge Monsi Badom serekara.christian1@ust.edu.ng Ibiere Allwell Pepple ibiere.pepple1@ust.edu.ng Christopher Aloy Simeon serekara.christian1@ust.edu.ng <p><em>Background:</em> The Rhesus (Rh) blood group is one of the most complex blood groups in humans comprising mainly of Rh D, C, c, E and e. However, only Rh D is routinely screened for in Nigeria despite the fact that other Rh antigens are clinically significant and can cause haemolytic disease of the newborn and delayed haemolytic transfusion reactions.</p> <p><em>Aim:</em> The aim was to determine the frequency distribution of Rh C, c, E and e blood groups among pregnant women attending antenatal clinic in Port Harcourt, Nigeria.</p> <p><em>Study Design:</em> The study consisted of 147 apparently healthy pregnant women within the age range of 18-45 years, attending a selected Primary Healthcare Centre (Obio Cottage Hospital) in Port Harcourt. The study was carried out from January 20, 2020 to March 27, 2020. The presence of Rh C, c, E and e blood groups were investigated using Anti-C, c, E and e monoclonal antibody in the same order.</p> <p><em>Results:</em> Rh C, c, E and e were observed in 38.09%, 100%, 17.68% and 100% in the same order.</p> <p><em>Conclusion:</em> The study indicated dominance of Rh c and Rh e over Rh C and Rh E among the studied pregnant women. It is necessary to take into cognizance the fact that the presence of Rh C, c, E and e antigens may be the cause of some delayed transfusion reactions and haemolytic disease of the foetus and newborn. Therefore, routine antigen typing for Rh antigens may help in decreasing red blood cell allo-immunization and delayed haemolytic transfusion reaction during pregnancy.</p> 2021-06-03T15:35:04-04:00 Copyright (c) 2021 Serekara Gideon Christian, Evelyn Mgbeoma Eze, Barizoge Monsi Badom, Ibiere Allwell Pepple, Christopher Aloy Simeon https://ejmed.org/index.php/ejmed/article/view/878 Gender Difference in Obesity Prevalence Among General Population of Lahore, Pakistan 2021-06-09T21:13:16-04:00 Shahrukh Khan dn.shahrukhkhan@gmail.com Hina Nauman hinanauman44@gmail.com Sania Saher saniasaher07@gmail.com Hafiza Arifa Imtiaz arifaimtiaz58@gmail.com Amina Bibi amangull655@gmail.com Hajrah Sajid sajid45847@gmail.com Tayyab Mumtaz Khan tayyab.mkhan98@gmail.com Madeeha Mumtaz madeeha.mumtaz90@gmail.com Somia Bibi somiak902@gmail.com <p>Obesity has become a pandemic problem and it is infamous for causing both physical and psychological disorders. Even though obesity is influenced by many factors which include fast food, menopause, socioeconomic status, and genetics, however, gender has paramount importance as a factor that affects obesity when we do not consider other factors. Thus, our current research study was aimed to evaluate the prevalence of obesity and influence of gender on it. Our current cross-sectional descriptive study was finished in almost 6 months from August 2020 to January 2021 among general population of Pak Aran Society Lahore, Punjab, Pakistan. 183 people were recruited in study in accordance to set criteria of exclusion and inclusion. Only those people whose age was from above 20 years to below 61 years, and who had no physical or mental illness and were willing to participate were enrolled in study. Data collection was done through one self-structured proforma and WHO Classification of Weight Status established on BMI. SPSS version 25 was applied to perform data analysis. Various statistical tests like Chi-square test, Independent Sample t-test, and One-Way ANOVA test were used to evaluate the study variables and their relationship. Overall, our current study indicates high prevalence (19.10%) of obesity among all participants, nevertheless, mean of BMI value was higher among women (26.26 SD of ±3.70) as compared to men (25.06 with SD of ±4.27) which shows that women had higher risk of development of obesity than men. However, relationship between obesity and gender was statistically insignificant (p=0.262). The difference of BMI mean value between women and men was significant statistically (p=0.046). Significance difference was also observed in BMI mean value of across four grades of weight status (p=0.0001). In summary, in general, prevalence of obesity is higher among women than among men which means female gender raises the obesity incidence among women.</p> 2021-06-04T12:04:49-04:00 Copyright (c) 2021 Shahrukh Khan, Hina Nauman, Sania Saher, Hafiza Arifa Imtiaz, Amina Bibi, Hajrah Sajid, Tayyab Mumtaz Khan, Madeeha Mumtaz, Somia Bibi https://ejmed.org/index.php/ejmed/article/view/880 Side Effect Profile of COVID-19 Vaccine among Health Workers in a Tertiary Health Institution in South-South Nigeria 2021-06-08T11:08:13-04:00 Peter C. Oriji chibuzor54@gmail.com Dennis O. Allagoa dennisallagoa@yahoo.com Lukman Obagah chibuzor54@gmail.com Obielumani I. Oguche chibuzor54@gmail.com Onyekachi S. Ohaeri chibuzor54@gmail.com Ebiye S. Tekenah chibuzor54@gmail.com Stanley E. Ozori chibuzor54@gmail.com Gordon Atemie chibuzor54@gmail.com <p><em>Background:</em> Side effect following vaccination usually ranges from mild to moderate and occasionally severe in a small proportion of people. Covid-19 vaccine is no exception as side effects have been reported which are mostly mild to moderate and transient. The chances of any of these side effect following vaccination differ according to the specific COVID-19 vaccine.</p> <p><em>Objective: </em>To determine the side effect profile of the Health workers that received the COVID-19 vaccination in the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.</p> <p><em>Materials and Method:</em> This study was a descriptive cross-sectional study. It was carried out between 15th and 30th April 2021 among 151 health workers that received COVID-19 vaccination in the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria. The data were collected with a predesigned questionnaire and were analysed using IBM SPSS 23.0 version.</p> <p><em>Results:</em> About 52.3% were female health workers, 49.0% were aged between 36–45 years. Side effects were reported in 9 of every 10 health workers who received the vaccine. Most side effects (53.0%) started on the day of vaccination. The most common side effect was pain at the injection site, and it was reported by 104 recipients of the vaccine (68.9%). Fever, headache, tiredness and chills were reported in 57.0%, 49.0%, 47.7% and 43.7%, respectively.</p> <p><em>Conclusion:</em> As with medications and other vaccines, COVID-19 vaccines have side effects. Protective immunity against COVID-19 is developed following vaccination. In the face of a still rapidly evolving situation, what seems obvious is that vaccination currently remains the best route to achieving herd immunity.</p> 2021-06-08T11:08:13-04:00 Copyright (c) 2021 Peter C. Oriji, Dennis O. Allagoa, Lukman Obagah, Obielumani I. Oguche, Onyekachi S. Ohaeri, Ebiye S. Tekenah, Stanley E. Ozori, Gordon Atemie https://ejmed.org/index.php/ejmed/article/view/746 Pattern of Keratitis: A Study of 500 Cases in Tertiary Hospital of Bangladesh 2021-06-09T15:17:28-04:00 Md. Ashraful Haque ashraf.djmc03@gmail.com Rebeka Sultana ashraf.djmc03@gmail.com Md. Shahnewaz Parvez ashraf.djmc03@gmail.com Md. Abdul Quader ashraf.djmc03@gmail.com Mujtahid Mohammad Hossain dr.ms.parvez@gmail.com <p><em>Background:</em> Keratitis is a potentially serious corneal infection and a major cause of visual impairment worldwide. Most common form of which is infectious variety; pathogens may be bacteria, viruses, fungi and parasites which varies with age and predisposing factors. Topical antimicrobials and cycloplegic agents are the mainstay of treatment. Pattern of causative organisms and drug sensitivity changes from time to time and differs from one to another geographic location.</p> <p><em>Objective:</em> To assess and evaluate the pattern of diagnosed patient of keratitis presented in a tertiary hospital.</p> <p><em>Material and methods:</em> This cross-sectional study was conducted on 500 diagnosed patients of keratitis in the department of cornea of National Institute of Ophthalmology &amp; Hospital, a well-known tertiary care hospital with 500 beds for a period of 6 months. Patients were selected based on specific selection criteria. Detail history was taken, and thorough ocular examination was done in every patient. Corneal scrapings were taken for Gram’s stain and 10% potassium hydroxide wet mount preparation. All the relevant data was recorded in a predesigned data collection sheet.</p> <p><em>Results:</em> The mean age of the study subjects was 38.49 years. Male (43.2%) and female (56.8%) ratio was almost equal. The prevalence was highest among lower economic class (56.8%) as usual, and lowest among affluent class (3.8%) but not sparing them. In terms of regional distribution, majority (42.6%) of the patients came from rural area, whereas 37% from urban non-slum area and 20.8% from urban slum area. The problem was mostly observed among day-laborers (24.8%) with gradually declining trend among students (20.6%), housewives (20%), service holders (14.2%), businessmen (3.2%) and unemployed (2.2%), surprisingly! Presentation of the cases were mostly in between 2<sup>nd</sup>-3<sup>rd</sup>week (55%), while 30% patients were presented within 1<sup>st</sup> week &amp; 15% after 4 weeks of diagnosis. Among the cases, it was found that 28.8% patients had corneal injury, which were caused by vegetative trauma in 16% cases, 4% dust or sand trauma, 2.8% animal injury, 2.2% stick injury, 1% nail injury and 2.8% patients had history of other injury like stone, wooden materials, flying insects, dirty wire etc. Ocular diseases predispose to corneal ulcer were present in 9% patients. These were chronic dacriocistitis, entropion and trichiasis. 1.2% patients were diabetic, and 1% patients had history of inadvertent use of steroids. On the contrary, there were no specific predisposing factors in 71.2% cases. Among the cases, 96.6% experienced photophobia, 90% had foreign body sensation, 88.4% had reduced vision, 85.4% had eye pain, 78.8% suffered from watering, 73.6% had discharge, 48.8% had burning sensation, 12.2% had decreased corneal sensation and 11.2% patients noticed white spot in cornea in first stage. Slit lamp bio-microscopic examination of the patients shows 90% patients had conjunctival injection, 70% had epithelial defect, 28.6% patients had stromal infiltration, 18.4% patients had hypopyon, 14% patients had feathery pattern, 8.8% patients had suppuration, anterior chamber reaction was present in 4.4% cases and 2.2% patients had satellite lesion. The evaluation of etiology on the basis of clinical appearance reveals 61.4% of cases were presented with viral keratitis, 23.0% fungal corneal ulcer, 11.4% with bacterial corneal ulcer, 2.2% with marginal keratitis, 0.8% with exposure keratitis, 0.8% with filamentary keratitis and 0.4% cases with Acanthamoebic keratitis at the time of presentation. While assessing the depth of keratitis of the study subjects, 73.2% found superficial while 26.8% found deep. Assessment of area of corneal involvement in terms of punctate epithelial defect showed that in 46.8 % cases less than 3mm of cornea was involved, 3 to 6 mm of the cornea involved in 19.6 % cases and in 11.8 % corneal involvement was found in more than 6 mm area. Corneal scraping done in 118 (23.6%) out of 500 patients. Among them, Fungi were found in 11.2% cases, mixed organism in 4%, Bacteria in 5.6% and Acanthamoeba found in o.4% cases while 2.4% remains unidentified.</p> <p><em>Conclusion:</em> Analysis of the study findings shows diversity in the pattern, presentation, predisposing factors of different form of keratitis which may be helpful as basis of further study on this problem.&nbsp;</p> 2021-06-09T15:17:28-04:00 Copyright (c) 2021 Md. Ashraful Haque, Rebeka Sultana, Md. Shahnewaz Parvez, Md. Abdul Quader, Mujtahid Mohammad Hossain https://ejmed.org/index.php/ejmed/article/view/875 Leisure Activities for Patients with Diffuse Connective Tissue Diseases 2021-06-10T11:54:21-04:00 Marielle Fornazzaro Nascimento marielle.camille@hotmail.com Paulo Eduardo Neves Ferreira Velho pvelho@unicamp.br Raphaela Espanha Corrêa raphaespanha@yahoo.com.br Rute Estanislava Tolocka nupemlab@gmail.com <p>Leisure is everyone right, regardless of the clinical condition of each individual. The quality of life (QoL) of patients with dermatoses has been related to the practice of leisure activities (PLA); however, little is known about this practice in these patients. This study aimed to verify the PLA in patients with Diffuse Connective Tissue Diseases (DCTD). This is a descriptive, qualitative, and quantitative field study with patients seen at the Dermatology Outpatient Clinic (Hospital de Clínicas) of the University of Campinas (UNICAMP), São Paulo, Brazil.&nbsp; A form was used, containing closed questions about the sociodemographic and clinical profiles, and an open question about leisure. The responses were categorized according to the classification of leisure cultural content. Descriptive statistics, construction of a crosstable and the Mann-Whitney and Kruskal-Wallis tests were used. Data from 62 patients were collected, who aged between 19.4 and 75.3 years (average of 49.32±12.55 years). Among the patients, 80.6% were female and 70.9% were diagnosed with Cutaneous or Systemic Lupus Erythematosus (LE). The most practiced leisure activities were those related to manual and virtual content, mentioned by 24.6% of the patients. Another 18.0% reported preferring to stay at home or sleep (other activities), and no patient reported physical-sports or tourist leisure practices. The PLAs were little varied, showing 75.8% of the patients taking only one type of content related to these practices and 12.9% not carrying out any leisure activities. The elderly were the ones who most reported manual and virtual activities. An association was found between the variety of leisure content practiced and literacy level. Illiterate patients were those who least reported activities related to leisure, when compared to those who completed elementary school (X² = 24.686; <em>p</em>= 0.035). Before diagnosis, 56.5% of the patients performed physical activities, of which 27.4% could be classified as physical-sports leisure. After the disease development, only 19.7% of them maintained physical activities, and, of all the activities practiced by them, only 9.7% could be considered as leisure activities, but none as physical-sports leisure. Thus, it appears that leisure practices among patients with DCTD are scarce and little varied, which interferes with their QoL. The orientation and practice of these activities are necessary so that they can make choices and vary the types of activities practiced. Likewise, more studies, which can support actions that encourage and enable the leisure practices of these patients, play an important role.</p> 2021-06-10T11:54:21-04:00 Copyright (c) 2021 Marielle Fornazzaro Nascimento, Paulo Eduardo Neves Ferreira Velho, Raphaela Espanha Corrêa, Rute Estanislava Tolocka https://ejmed.org/index.php/ejmed/article/view/883 Cross-Sectional Household Survey of Risk Behaviors Related to Viral Hepatitis among Adults in Sokoto-Nigeria 2021-06-12T02:58:59-04:00 Shuaibu A. Hudu hudu.shuaibu@udusok.edu.ng Nabil S. Hamal nabil.harmal@gmail.com <p><em>Background</em>: Viral hepatitis is a deadly disease which can manifest as acute, chronic, hepatocellular carcinoma, and liver failure and responsible for 1.34 million deaths globally, a number comparable to deaths caused by tuberculosis and higher than those caused by HIV.</p> <p><em>Objectives:</em> The goal of this survey was to find the vastness of different risk factors associated with Viral Hepatitis and to describe the connection between these risk and sociodemographic factors among adults in Sokoto-Nigeria.</p> <p><em>Methods:</em> This cross-sectional survey was carried in nine local government areas in the state. A two-stage cluster sampling was utilized and adults who were living in the selected household were interviewed. A multivariate linear regression model was used to evaluate the relationship between sociodemographic indicators and different viral hepatitis risk factors.</p> <p><em>Results:</em> Seven hundred and twenty eight respondents were recruited for this survey. Sharing nail cutters, body piercing, and razor blade use were the most pervasive risk factors among respondents. Males, married couples, respondents somewhere in the range of 27 and 40 years of age, and people with low educational achievement were more likely to be exposed to risk factors associated with Viral Hepatitis.</p> <p><em>Conclusion:</em> The risk of viral hepatitis was moderately high among the survey subject. Consequently, explicit projects like forum, classes and persistent instruction on preventive measures for viral hepatitis ought to be custom fitted to these forums. These projects could be directed by government specialists like the Ministry of Health Sokoto and other support agencies and non-governmental organizations.&nbsp;</p> 2021-06-12T02:58:59-04:00 Copyright (c) 2021 Shuaibu A. Hudu, Nabil S. Hamal https://ejmed.org/index.php/ejmed/article/view/810 Maxillary Sinus Mucopyocele: About an Endoscopic Management 2021-06-09T21:13:27-04:00 Y. Lakhdar lakhdar.interne@gmail.com M. Hakimi lakhdar.orl@gmail.com O. Benhoumad benhoummadorl@gmail.com Y. Rochdi rochdi_86@hotmail.com A. Raji raji.abdelaziz@gmail.com <p><em>Introduction: </em>Mucocele is a benign but expansive cystic formation, lined by a respiratory epithelium. When its content is infected, it is called a mucopyocele. It usually develops in the frontal-ethmoid complex. The maxillary sinus location is exceptional.</p> <p><em>Case report:</em> a 43 year old man, presented with chronic unilateral nasal obstruction, purulent rhinorrhea and anosmia. Rhinoscopy showed a bulge in the middle meatus. The computed tomography (CT) showed complete filling of the left maxillary with low-density mass. Magnetic resonance imaging (MRI) confirmed the diagnosis of mucpyeocele of the left maxillary sinus. Patient underwent endoscopic endonasal marsupialization with complete recovery.</p> <p><em>Conclusion:</em> Mucopyocele of the maxillary sinus is a benign rare lesion, however destructive. A radiological assessment is essential to guide the choice of surgical treatment. The endonasal route remains the reference treatment for this pathology.</p> 2021-05-03T02:37:04-04:00 Copyright (c) 2021 Y. Lakhdar, M. Hakimi, O. Benhoumad, Y. Rochdi, A. Raji https://ejmed.org/index.php/ejmed/article/view/815 Management of Hyperlipidaemia through Ayurvedic Intervention 2021-06-09T21:13:26-04:00 Jaya Saklani Kala ditiayurveda@gmail.com Swapnil Singhai ditiayurveda@gmail.com <p>The potential of hyperlipidemia to engage in the pathology of atherosclerotic diseases such as coronary heart disease, which dominates the scenario of diseases causing morbidity and mortality in the world. Hyperlipidemia is defined as elevated serum levels of cholesterol, triglycerides, or both. It is characterized by abnormally elevated lipid concentrations in blood caused by impaired lipid and lipoprotein metabolism and has the potential to cause a variety of complications such as cardiovascular disease, diabetes, obesity, hypertension, atherosclerosis, and so on. Hyperlipidemia is classified as Medoroga in Ayurveda. The results obtained for the lipid profile parameter demonstrated a significant change. The difference in total serum cholesterol is 36 mg/dl, serum triglycerides is 32 mg/dl, serum LDL is 40 mg/dl, serum VLDL is 15 mg/dl and serum HDL is -3 mg/dl.</p> 2021-05-06T09:10:49-04:00 Copyright (c) 2021 Jaya Saklani Kala, Swapnil Singhai https://ejmed.org/index.php/ejmed/article/view/817 A Mysterious Tale of Cardiogenic Delirium Induced by COVID-19 2021-06-09T21:13:26-04:00 Saquib Navid Siddiqui sns.saquib@gmail.com <p>A novel corona virus (SARS-COV-2) started to spread around the world eventually being declared as a global pandemic crisis by WHO in March,2020. Total number of cases have reached to a staggering 140 million by 17th April, 2021 with sad demise of 4 million of the world population. A few number of patients appear to be suffering from cardiac conductive abnormalities have been noted to be associated with SARS-CoV-2. This case unfolds story of a cardiogenic delirium induced by COVID-19. It’s a roller coaster journey of a 62-year -old gentleman presenting with acute delirium which was later found to be due to low brain tissue perfusion resulting from complete heart block. After ruling out all possible causes for the sudden development of complete heart block we came into conclusion of association of SARS-CoV-2 in the development of complete heart block which retrospectively lead the gentleman to become delirious.</p> 2021-05-08T12:09:29-04:00 Copyright (c) 2021 Saquib Navid Siddiqui https://ejmed.org/index.php/ejmed/article/view/819 A Camouflaged Case of Disseminated Tuberculosis Presenting as Adrenal Crisis 2021-06-09T21:13:25-04:00 Saquib Navid Siddiqui sns.saquib@gmail.com <p>Lymphohematogenous spread of mycobacterium tuberculosis to multiple organs presents a complex diagnostic challenge to any physician. A holistic and vigilant approach is required in the quest to diagnose disseminated tuberculosis causing adrenal failure. Although tuberculosis can affect various endocrine glands of the body yet adrenal remains the most common.[1] It is also the fifth most common site for extra-pulmonary tuberculosis.[2] The incidence of tuberculous Addison’s disease has lowered courtesy of anti-tubercular medications accounting for only 7-20% of cases.[1] Here we showcase a rare incidence where a 39 years old gentleman with no constitutional symptoms and no known co-morbidities presenting with neck pain went into adrenal crisis and eventually was found to be due to disseminated tuberculosis which affected his lungs, adrenal glands, cervical spine, and brain.</p> 2021-05-10T01:38:50-04:00 Copyright (c) 2021 Saquib Navid Siddiqui https://ejmed.org/index.php/ejmed/article/view/822 A Case Study of Pachyonychia Congenita in Bangladesh 2021-06-09T21:13:25-04:00 Zahed Parvez zahedparvezmmc@gmail.com Samina Akter samina.mithila123@gmail.com <p>In 1906 Jadassohn and Lewandowsky described a rare genodermatoses and named it pachyonychia congenita. Pachy means thick. It is a group of genodermatoses involving keratin mutation with thickened nails and variable associated findings. Pachyonychia congenita is a rare disease having four types. However, type 1 and type 2 can be considered common among them. It can often mimic with fungal infection as nail hyperkeratosis can occur in both.</p> 2021-05-11T03:05:51-04:00 Copyright (c) 2021 Zahed Parvez, Samina Akter https://ejmed.org/index.php/ejmed/article/view/827 Fibromatosis Colli: A Review of 4 Cases 2021-06-09T21:13:24-04:00 Maha Hakimi mahahakimi1@gmail.com Omar Oulghoul Oulghoul@gmail.com Benhoummad Othmane medoth1@hotmail.com Youssef Rochdi Rochdi_86@hotmail.com Abdelaziz Raji Raji.abdelaziz@gmail.com <p>Fibromatosis colli is a rare congenital pseudotumor of the sternocleidomastoid muscle, mainly found in the pediatric population. We propose to present four cases diagnosed in the ENT-Neck and head surgery department of the university medical center Mohammed VI in Marrakech, moreover we will recap the management strategy of this entity but also its evolution. We received in the pediatric emergency three infants of 1, 3 and 6 months old and one child of 7 years old, with as a main symptom a painful congenital torticollis. The ultrasound added to our clinical inspection allowed us fairly easily to diagnose the patients. No drug or surgical treatment was prescribed in the infant cases, though surgical treatment was inevitable in the 7 years old patient’s case. During the follow-up, carried out each month, we observed a gradual regression of swelling and torticollis. The prevalence of FC is estimated at 0.3-2% of births. The diagnosis is made at the age of 3 to 4 weeks of life by a thorough inspection of a torticollis associated with a later cervical mass in the framework of a difficult delivery (use of forceps or suction cup). Ultrasonography allows us to diagnose this entity due to the typical aspect of a fusiform thickening of the Sternocleidomastoid muscle. Surgical and medical treatment is rarely useful, and only symptomatic treatment is indicated. The spontaneous evolution of Fibromatosis colli is, even in the absence of treatment, the regression spontaneously in 4 to 6 months. Fibromatosis colli is a relatively rare entity, its frequency in Africa remains to be established, but it is clear that an early diagnosis is key to a speedy recovery.</p> 2021-05-13T05:33:52-04:00 Copyright (c) 2021 Maha Hakimi, Omar Oulghoul, Benhoummad Othmane, Youssef Rochdi, Abdelaziz Raji https://ejmed.org/index.php/ejmed/article/view/831 An Infectious Cause of Esophagobronchial Fistula 2021-06-09T21:13:24-04:00 Abdul Basit Ibne Momen abdulbasit17@gmail.com Rafa Faaria rafa.alam27@gmail.com Farhana Khan farhanakhan488@gmail.com Sadia Saber sadiasaber201477@gmail.com Md Tarek Alam mtarekalam16@gmail.com <p>An infected cause of esophagobronchial fistula between&nbsp;left&nbsp;bronchus and esophagus is mentioned who is a 32 year old male with a history of smoking and I/V drug abuse. The scientific reasons for suspecting an esophagogastric-bronchial fistula in an adult are discussed, as well as a description of the different etiologies of this condition. Intra thoracic malignancy, injuries, and infections are the most frequent causes of esophageal-bronchial fistula. These fistulas are caused by the rupturing of caseous peribronchial lymph nodes into adjacent structures such as the esophagus and bronchi. It's difficult to determine what the right course of action is. Such cases are surgically treated, while others can only be treated conservatively. Diagnosing bronchoesophageal fisula is usually challenging and often delayed, since there have not been many cases found. Any patient who presents with cough after deglutition should be suspected of having an esophagobronchial fistula, and tubercular origin should also be considered, particularly in an endemic region, since early diagnosis and treatment with anti-tubercular therapy typically results in resolution.</p> 2021-05-15T04:56:57-04:00 Copyright (c) 2021 Abdul Basit Ibne Momen, Rafa Faaria, Farhana Khan, Sadia Saber, Md Tarek Alam https://ejmed.org/index.php/ejmed/article/view/839 Langerhans Cell Histiocytosis of the Temporal Bone in Children: Two Cases Report 2021-06-09T21:13:23-04:00 Y. Labani youness.labani@gmail.com O. Oulghoul youness.labani@gmail.com O. Benhoummad youness.labani@gmail.com Y. Rochdi youness.labani@gmail.com A. Raji youness.labani@gmail.com <p>Langerhans cell histiocytosis is a rare hematologic disease due to multiplication and accumulation of Langerhans cells, which are immature dendritic cells. The clinical presentation is highly variable and can range from isolated, self-healing skin or bone lesions to life-threatening multisystem disease. We report 2 cases confirmed by Histological and immunohistochemical evaluation of temporal bone biopsies. The first case is a 2-year-old child with chronic bilateral otorrhea and polyuria-polydipsia syndrome. Physical examination showed bilateral retroauricular redness and induration with filling all of the right and left external ear canal. Computed tomography showed osseous lysis of the temporal bone bilaterally. Magnetic resonance imaging of the brain showed the presence of pituitary infiltration. The second case is 2-year-old girl with chronic left otorrhea. Clinical examination objectified the presence of redness and induration in the left mastoid with the presence of an inflammatory polyp filling the entire left external auditory canal. Computed tomography revealed a left temporal bone lysis. Both patients were treated with chemotherapy.</p> 2021-05-24T12:29:10-04:00 Copyright (c) 2021 Y. Labani, O. Oulghoul, O. Benhoummad, Y. Rochdi, A. Raji https://ejmed.org/index.php/ejmed/article/view/857 Bicortical Screw and Needle Welded Together as Effective Implant Technique for Immediate Load of SINGLE Tooth in Aesthetic Zone Characterized by Severe Bony Reabsorption: Cases Report 2021-06-09T21:13:22-04:00 Luca Dal Carlo lucadalcarlo@gmail.com Marco E. Pasqualini dott.marcopasqualini@gmail.com Franco Rossi francorossi020@gmail.com <p>After a long period of time in which submerged implants were used just with delayed load, scientific evidence has led to immediate loading, finally re-evaluating the long lasting experience gotten with one-piece implants.</p> <p>In aesthetic area, if bone is deep and wide, immediate load can be performed with any type of implants, with scarce risk of failure.</p> <p>Situations in which bone is scarce are frequent and impose to choose between performing a suitable technique compatible with immediate loading or renouncing to immediate loading.</p> <p>In our experience, implant technique based on the welding-in-mouth of a titanium needle to main implant is regularly destined to success, because the needle implant, deeply anchored to bone, compensates the lateral forces that normally push the tooth forward.</p> <p>The long lasting experience accrued since over 30 years in our professional offices leads us to suggest this technique as a standard solution while dealing with bone reabsorption in the aesthetic area. We are certain that further studies will confirm our conclusions.</p> 2021-05-24T12:38:38-04:00 Copyright (c) 2021 Luca Dal Carlo, Marco E. Pasqualini, Franco Rossi https://ejmed.org/index.php/ejmed/article/view/851 Neonatal Choanal Atresia: A Series of 13 Cases 2021-06-09T21:13:22-04:00 F. Hadid fz.hadid@gmail.com M. Hakimi mahahakimi1@gmail.com O. Benhommad fz.hadid@gmail.com Y. Rochdi fz.hadid@gmail.com A. Raji fz.hadid@gmail.com <p>Choanal atresia is a congenital disease that Is manifested at birth when it is bilateral. Unilateral forms can be observed later in life as they are usually well tolerated. Choanal atresia’s frequency is difficult to estimate. It is estimated to be 1 case per 5000 to 8000 births [1]-[3]. Our work is a retrospective study of the cases of choanal atresia that were managed in the ENT department of the Mohamed VI University Hospital during a period of eleven years from January 2010 to December 2020. We identified 13 cases of choanal atresia. The aim of this work is to analyze the elements of the diagnosis, the indications and the surgical techniques as well as our results of the endonasal endoscopic approach in order to identify a therapeutic strategy. The average age of our patients was 21 days, with extremes ranging from 1 day to 28 days. The maximum number of cases was observed in newborns during the first week of life, with a slight female predominance of 7/6. The sex ratio was 0,85. In our series, the delay was most often short with extremes ranging from day 1 of life to day 22. There were 9 bilateral imperforations (69.23%), and 4 unilateral imperforations (30.77%), 2 on the right side (50%) and 2 on the left side (50%). The diagnosis of choanal atresia was confirmed by computed tomography (CT) and nasal endoscopy. All our patients underwent surgical treatment by endonasal endoscopic approach with calibration with a favorable evolution. Through this study, we concluded that the frequent association with other anomalies requires a clinical and paraclinical evaluation and a long-term follow-up. Nasal endoscopy and CT scan have completely revolutionized the diagnostic and therapeutic approaches of choanal atresia, and the endoscopic endonasal approach remains the best therapeutic choice.</p> 2021-05-25T12:45:17-04:00 Copyright (c) 2021 F. Hadid, M. Hakimi, O. Benhommad, Y. Rochdi, A. Raji https://ejmed.org/index.php/ejmed/article/view/814 Congenital cervical teratoma: about a case 2021-06-09T21:13:21-04:00 Othman Benhoummad benhoummadorl@gmail.com Mohamed Chehbouni dr.chehbouni@gmail.com Youssef Rochdi rochdi_86@hotmail.com Abdelaziz Raji raji.abdelaziz@gmail.com <p>Congenital cervical teratomas are benign but serious germinative cell tumors. The possibility of air compression structures and the risk of invasion of vascular and nervous noble elements are crucial prognostic factors in this kind of tumor. Prenatal diagnosis raises on ultrasound examination precising locoregional consequences of the tumor and surgical possibilities. In the propitious cases, prenatal MRI examination is useful to precise tumor’s limits and cerebral status of the foetus. At birth, coordinate management involving anaesthetists, paediatricians and specialized surgeons decrease morbidity and mortality. The recent observation of a case gave us the opportunity to make a literature review of this exceptional afection. It was a newborn female, aged 25 days allowed for anterior cervical mass evolving since the birth associated with moderate dyspnea. Cervical ultrasound coupled to CT scan had objectified a heterogeneous mass with cystic areas and calcifications. The excision was complete and the histopathological study revealed a mature teratoma. The postoperative course was uneventful, with some food and phonatory transient disorders. Cosmetic outcome at 6 months was excellent. Cervical teratoma is a rare tumor, diagnosed mainly in the neonatal period, which requires a prenatal diagnosis and multidisciplinary early management. The prognosis depends mainly on the presence of neonatal respiratory distress and histological form. There are opportunities sudden worsening respiratory and malignant transformation that justify early surgical excision and prolonged follow-up.</p> 2021-05-26T05:01:13-04:00 Copyright (c) 2021 Othman Benhoummad, Mohamed Chehbouni, Youssef Rochdi, Abdelaziz Raji https://ejmed.org/index.php/ejmed/article/view/861 High Flow Priapism on ¹⁸FDG PET/CT in a Patient with Urothelial Carcinoma: Case Report 2021-06-09T21:13:21-04:00 A. Ouboukdir amine1ouboukdir@gmail.com J. Benouhoud jaafarbenouhoud@gmail.com H. Lachhab Lachhabhoussame@gmail.com C. Waffar chouaibwaffar@gmail.com Y. Ghannam Ghannamyoussef@gmail.com <p>We studied a 52-year-old man diagnosed with a high-grade urothelial carcinoma of the upper urinary tract treated with nephroureterectomy and chemotherapy who presented a benign high-flow priapism with intensive <sup>18</sup>F-fluorodeoxyglucose (FDG) uptake as an unusual finding in the positron emission tomography (PET)/computed tomography (CT) that also showed mediastinal and lumbo-aortic node involvement and liver metastases. Upon examination, the patient had a painless erection that lasted for five days with no episode of recurrence at two-month follow-up.</p> 2021-05-26T10:33:55-04:00 Copyright (c) 2021 A. Ouboukdir, J. Benouhoud, H. Lachhab, C. Waffar, Y. Ghannam https://ejmed.org/index.php/ejmed/article/view/853 Restoration of a Traumatically Amputated Finger by a Traditional Glove-Type Prosthesis: A Case Report 2021-06-09T21:13:20-04:00 Simarpreet Kaur simarmehra7869@gmail.com Mandeep Kaur dr.mandeepkaur@ymail.com Anupama Verma anupamaverma2508@gmail.com Tarun Singh tarunkashyap95@gmail.com <p><em>Background:</em> Each organ serves a specific function in the human body. Congenital absence or loss of even minor parts of it can pose extreme psychological trauma in addition to the functional impairment and esthetic issues encountered by the individual. Amputation of complete or a part of phalange of hand is frequently encountered either due to trauma or necrosis. Restoration of such defects become mandatory to improve general form and function combined with the esthetic requirements of the patient. It can either be done by microvascular reconstruction or prosthetic rehabilitation. The latter becomes the means of choice in cases where the former is either not possible, unavailable, unsuccessful, or unaffordable.</p> <p><em>Case Report:</em> A case report has been presented of a 60 years old patient with an old traumatic partially amputated index finger.</p> <p><em>Treatment Plan:</em> A custom-made glove-type prosthesis was fabricated using silicone elastomer.</p> <p><em>Conclusion:</em> A ring is provided for better esthetics and special adhesive is recommended for retention of the prosthesis.&nbsp;</p> 2021-05-28T03:44:53-04:00 Copyright (c) 2021 Simarpreet Kaur, Mandeep Kaur, Anupama Verma, Tarun Singh https://ejmed.org/index.php/ejmed/article/view/852 Nasopharngeal Tuberculosis Simulating Cancer: About 2 Cases 2021-06-09T21:13:20-04:00 F. Hadid fz.hadid@gmail.com O. Oulghoul fz.hadid@gmail.com H. Benjelloun fz.hadid@gmail.com O. Benhommad fz.hadid@gmail.com A. Raji fz.hadid@gmail.com Y. Rochdi fz.hadid@gmail.com <p>Primitive tuberculosis of the nasopharynx is rare. Clinical symptoms and paraclinical examinations are often confusing. Pseudotumour forms are frequent, which poses a problem of differential diagnosis with cavum cancer. We reported two cases of nasopharyngeal tuberculosis, followed up in the ear, nose and throat department of the Arrazi Hospital of the Mohammed VI University Hospital in Marrakesh. The first case concerned a 22-year-old female patient admitted to hospital for an etiological assessment of a right spinal adenopathy evolving in a context of altered general condition with weight loss, anorexia, and night sweats. The second case was a 14-year-old patient with a fistulised right spinal adenopathy with nasal obstruction and homolateral deafness. Nasofibroscopy in both patients showed a burgeoning tumour on the right posterolateral wall. A biopsy of the cavum was indicated. The histological study of the biopsies revealed an epithelial-giganto-cellular granuloma with caseous necrosis. This allowed to make the diagnosis of nasopharyngeal tuberculosis, and an antibacillary treatment was instituted. The evolution was favorable.</p> 2021-05-28T05:15:15-04:00 Copyright (c) 2021 F. Hadid, O. Oulghoul, H. Benjelloun, O. Benhommad, A. Raji, Y. Rochdi https://ejmed.org/index.php/ejmed/article/view/896 Respiratory Distress Complicating Laryngeal Sarcoidosis 2021-06-09T21:13:19-04:00 O. Benhoummad o.benhoummad@uiz.ac.ma O. Benlenda o.benhoummad@uiz.ac.ma M. EL Fakiri o.benhoummad@uiz.ac.ma H. Nassik o.benhoummad@uiz.ac.ma <p>Laryngeal involvement in sarcoidosis is rare but can be potentially dangerous. A Severe obstruction of the laryngeal tract may appear, sometimes requiring a tracheostomy. Systemic corticosteroid therapy is the treatment of choice for most patients. We report the case of a 25-year-old patient with isolated laryngeal sarcoidosis for 12 years. She was admitted for respiratory distress. The nasofibroscopy revealed diffuse supraglottic edema, the medical care consisted of an intense surveillance and a corticosteroid therapy. Isolated laryngeal sarcoidosis is a condition that requires multidisciplinary consultation. It presents a challenge in terms of diagnosis, in terms of appropriate management of the respiratory tracts and in terms of treatment.</p> 2021-05-29T01:26:15-04:00 Copyright (c) 2021 O. Benhoummad, O. Benlenda, M. EL Fakiri, H. Nassik https://ejmed.org/index.php/ejmed/article/view/871 A Case of Stiffperson Syndrome 2021-06-09T21:13:18-04:00 Mamdouh H. Kalakatawi kalakatawi@yahoo.com Nusrat Aziz drnusrataziz@gmail.com Norhan A. K. Mostafa Norhan.ali1982@hotmail.com <p>Stiffperson syndrome (SPS) is one of the rarest neurological disorders. It is an autoimmune disease with antibodies against glutamic acid decarboxylase - enzyme needed to produce neurotransmitter GABA. This disease is very debilitating and fatal if not managed in time. A 32-year-old man presented with stiffness of abdominal and thoracolumbar paraspinal muscles first noticed 10 months back. There was history of jerkiness of hands. After excluding other mimicking conditions like multiple sclerosis, parkinsonism and axial dystonia, a diagnosis of Stiffperson syndrome was made. Treatment with IVIG therapy along with anti-spasticity drugs resulted in improved patient outcome. SPS is potentially treatable though cannot be cured. Not one treatment fits all patients with SPS and may have to be tailored according to the clinical manifestations. Increasing awareness in medical doctors and identifying the disease early can help the patients escape the disabling effects of SPS and improve the quality of life.</p> 2021-05-31T03:16:29-04:00 Copyright (c) 2021 Mamdouh H. Kalakatawi, Nusrat Aziz, Norhan A. K. Mostafa https://ejmed.org/index.php/ejmed/article/view/872 Posterior Shoulder Dislocation: A Rare Case Report and Review of the Literature 2021-06-09T21:13:18-04:00 Gusti Ngurah Wien Aryana Wienaryana@yahoo.com . Febyan febyanmd@gmail.com Agus Eka Wiradiputra wiradiputraaguseka@gmail.com <p>Posterior shoulder dislocation is a unique finding in the orthopedics field. Although it is rarely found, this condition is one that must be considered in the presence of acute shoulder pain. Most clinicians often miss this diagnosis on initial examination; therefore, imaging radiographs are often needed to confirm the diagnosis. Unfortunately, insufficient radiographic assessment can be the greatest pitfall in establishing an accurate diagnosis. Multiple radiographic projections, including anteroposterior view, scapular Y view, and the axillary view, are important to achieve an accurate diagnosis. In this study, we present a middle-aged patient with a pain and trauma history on the shoulder. Anteroposterior radiographic examination revealed an atypical finding. Fortunately, additional radiographic projections were successful in establishing the proper diagnosis of posterior shoulder dislocation. This study also presents a comprehensive review of the keys in the recognition and treatment of the injury.</p> 2021-05-31T03:25:07-04:00 Copyright (c) 2021 Gusti Ngurah Wien Aryana, . Febyan, Agus Eka Wiradiputra https://ejmed.org/index.php/ejmed/article/view/877 Hypoglycemia Caused by Endogenous Hyperinsulinism: A Case Study 2021-06-09T21:13:17-04:00 Kiran Shah drkiranshh@gmail.com Akshay Kothari arkothari13@gmail.com Ajay Bansode bansodeajay00@gmail.com Taher Aktar tahir1796@gmail.com <p>Hypoglycemia in the absence of diabetes mellitus in a healthy individual needs’ evaluation. We report a case of 45 years old female who presented with restlessness, anxiety, palpitations, excessive sweating followed by dizziness, and tremors in her hand. Eating sugar or consuming glucose water alleviated symptoms. During one such episode, the patient was taken to a nearby clinic and her capillary blood glucose was 43 mg/dl. The patient was admitted for the 72 hours supervised fast after ruling out other systemic causes of hypoglycemia. Evaluation of critical sample showed elevated levels of insulin, c-peptide, proinsulin, as well as a decreased value of beta-hydroxybutyrate and a negative urine screen for oral anti-diabetic agents, a diagnosis of endogenous hyperinsulinism, was made.</p> 2021-06-04T11:54:26-04:00 Copyright (c) 2021 Kiran Shah https://ejmed.org/index.php/ejmed/article/view/821 Impact of Stress on Human Body: A Review 2021-06-09T21:13:19-04:00 Muhammad Shahid Zafar shahidzafar478@gmail.com Museera Nauman museeranauman56@gmail.com Hina Nauman hinanauman44@gmail.com Sheema Nauman sheemanauman650@gmail.com Asifa Kabir asifakabir4679@gmail.com Zunaira Shahid zararao719@gmail.com Anam Fatima anamfatima2103@gmail.com Maria Batool mariabatool633@yahoo.com <p>Every inherent or external incentive which involves natural reactions, is recognized as stress. Extenuatory reaction to these pressures is known as stress reactions. Stress contributes to broad variety of diseases including hypertension and superior plasma cortisol, cardiac and CVDs, inflammatory bowel syndromes, type 2 diabetes, and a reduced quality of life among those suffering with cancer. Stress happens in 3 stages. The first stage is an initial stage of alarm, which produces an increase of adrenaline. Living organisms can withstand intense stress and stay alive. Second phase is a brief conflict process that the body puts up to handle the problem. Last phase is the tiredness phase, which arises when the body has utilized every part of its accessible assets. Stress affects the different organs of the whole body. As far as chronic stress is concerned, it stimulates infection in the vasculature, particularly in the coronary arteries, also can alter cholesterol levels and excessive activation of sympathetic nervous system (depletes the system of neurotransmitters, peptides, cofactors, and other mediators). Regarding, endocrine stress, it affects the hypothalamus in brain. The stress condition in n individuals experiencing pressure needs a healthy and regular eating including important supplements, moreover, physical exercise and mind rest are regularly suggested for averting stress induced anxiety-linked objections and disease.</p> 2021-05-30T01:33:19-04:00 Copyright (c) 2021 Muhammad Shahid Zafar, Museera Nauman, Hina Nauman, Sheema Nauman, Asifa Kabir, Zunaira Shahid, Anam Fatima, Maria Batool https://ejmed.org/index.php/ejmed/article/view/869 Work-related Burden of Diabetes Mellitus among Employees 2021-06-09T21:13:19-04:00 Hajar J. Alsalem hajar.ib84@gmail.com Aqil S. Alhaiz aqilalhaiz1@gmail.com <p>Diabetes mellitus (DM) is a major public health problem. The prevalence of DM had increased worldwide despite the availability of medications. Working-age group is mostly affected by DM and its complications which subsequently would affect their quality of life and work productivity. A narrative review of the related literature published in English language from January 2010 to December 2020 using PubMed and Google Scholar databases was performed to explore the burden of DM among employees. There is an increase in absenteeism from work among employees due to DM and its complications, presenteeism was negatively affected. Moreover, employees with DM went through early retirement due to DM and its complications compared to employees without DM. This call to focus on implementing a prevention program to help reduce the impact of DM in employees' work productivity.</p> 2021-05-31T02:51:16-04:00 Copyright (c) 2021 Hajar J. Alsalem, Aqil S. Alhaiz