European Journal of Medical and Health Sciences https://ejmed.org/index.php/ejmed European Journal of Medical and Health Sciences European Open Science Publishing en-US European Journal of Medical and Health Sciences 2593-8339 The Eye with Ears – A Symbol-Based Aid in Medical Teaching https://ejmed.org/index.php/ejmed/article/view/977 <p>Visual clinical examination forms the diagnostic basis in skin-related conditions and is an essential element in medical teaching. The author describes a symbol-based aid to explain the dichotomy of factual observed findings with the information based on medical history: The Eye with Ears. It represents the two most relevant aspects in clinical examination of skin-related conditions and helps to clarify the contrast between the actual observation with information based on the context or past medical history. With the described aid, the author believes to have improved the quality of the teaching in clinical examination and that it has functioned as a practical help for medical students’ and residents’ professional development.</p> Alexander Salava Copyright (c) 2021 Alexander Salava http://creativecommons.org/licenses/by/4.0 2021-09-21 2021-09-21 3 5 7 8 10.24018/ejmed.2021.3.5.977 Anterior Segment Examination with Slit-Lamp Biomicroscope: What Should be Highlighted? https://ejmed.org/index.php/ejmed/article/view/1021 <div> <p class="Text"><span lang="EN-US">Ocular health assessment consists of various types of examinations that aim to find pathological conditions in the eye so that it helps ophthalmologists to diagnose and provide therapy for ocular disorders suffered by the patients. Slit-lamp biomicroscope is one of the most important eye assessments and has become the standard in assessing the pathological condition of the anterior part of the eye. This examination is performed using a stereoscopic biomicroscope instrument in combination with a bright illumination source. The results of the anterior segment examination using slit-lamp biomicroscope may provide more detailed ocular findings, such as the abnormalities of the eyelid, conjunctival lesions, abnormalities of the cornea, lens, or other parts of the anterior ocular segments. Therefore, the ability to examine slit-lamp biomicroscope is essential for the ophthalmologist. This review will discuss the eye examination using slit-lamp biomicroscope and the findings that will make it easier for clinicians to determine the direction of diagnostic approach in ocular patients. </span></p> </div> Fazella Kirara Sakti Copyright (c) 2021 Fazella Kirara Sakti http://creativecommons.org/licenses/by/4.0 2021-09-22 2021-09-22 3 5 14 19 10.24018/ejmed.2021.3.5.1021 Prevalence of Extended-Spectrum β-Lactamase-Production among Clinical Gram-Negative Bacilli Isolates in A Tertiary Hospital, Southwest Nigeria https://ejmed.org/index.php/ejmed/article/view/1031 <div> <p class="Text"><span lang="EN-US">Extended spectrum β-lactamases (ESBLs) have emerged as important mechanisms of antimicrobial resistance to beta-lactam drugs in hospitals, thereby limiting the available treatment options for infections caused by these microorganisms. The objectives of this study were to determine the prevalence of ESBL production among clinical isolates of Gram-negative bacilli from Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria as part of the global efforts to provide information for the containment of the spread of antimicrobial resistance. This is a laboratory-based study of 186 consecutive non-duplicate Gram-negative bacilli (GNB) isolated from diverse clinical samples at the Microbiology laboratory of the hospital after standard aerobic cultures. The isolates were identified by conventional biochemical test scheme and commercial GNB API 20E identification kit. Antimicrobial susceptibility testing (AST) of each isolate was determined by the disk diffusion technique. Isolates presumptively identified as ESBL producers from the AST assay were confirmed by the combination disks method. Escherichia coli (n=43; 23.1%) predominated among the organisms, followed by Enterobacter spp (n=23; 12.4%) and Klebsiella spp (n=22; 11.8%). Most of the organisms (95.7%) were resistant to tetracycline and ampicillin, but the least resistance (4.3%) was exhibited to imipenem. Fifty-eight (31.2%) isolates were ESBL producers with a preponderance of E. coli (n=15; 25.9%). The ESBL producers were commonly isolated from urine samples (n=31; 53.4%), and were significantly more resistant to levofloxacin, ciprofloxacin, nalidixic acid, gentamicin, augmentin, cefepime, ceftriaxone, ceftazidime and cefotaxime (p&lt;0.05). This study has highlighted the therapeutic implications of the presence of EBSL in clinical isolates which was depicted by their multi-drug resistance phenotypes, thus emphasizing the need for continuous surveillance of bacterial resistance, institution of antimicrobial resistance stewardship in our hospital and regular screening of ESBLs in clinical isolates to prevent treatment failure.</span></p> </div> Babatunde Odetoyin Oluwaseun Adewole Copyright (c) 2021 Babatunde Odetoyin, Oluwaseun Adewole http://creativecommons.org/licenses/by/4.0 2021-09-21 2021-09-21 3 5 9 13 10.24018/ejmed.2021.3.5.1031 Assessment of Stress Level of Young Undergraduates Before and After a Degree Examination Using Heart Rate Variability Analysis https://ejmed.org/index.php/ejmed/article/view/1008 <p>This study aimed at assessing the value of heart rate variability (HRV) as a stress indicator before and after a final re-sit exam among healthy sixth grade medical students. Fifty participants were recruited for the study (test group, n = 30; control group, n = 20). Each participant was examined for 5 minutes pre and post exam periods using the Heartmath proprietary protocol. EmWave equipment was used to detect, record and analyze the HR and to plot out the variability in discrete percentages for low, medium and high coherences. Results indicated that mean percentage coherence score was significantly higher in the test group (p &lt; 0.05) at low cardiac coherence domain, but lower (p &lt; 0.05) at the high coherence domain, compared with the control. Coherence score was significantly higher (p &lt; 0.05) after the exam indicating release from stress, as compared to before the examination when stress was observable among the exam candidates. There were no significant gender differences observed in cardiac coherence scores before and after examination. Our findings indicate that HRV is a reliable indicator of real-time exam stress and supports future clinical use of HRV as a non-invasive and simple stress test.</p> A. Obi E. O. Nwobodo U. Dimkpa S. O. Maduka E. Fintan Copyright (c) 2021 A. Obi, E. O. Nwobodo, U. Dimkpa, S. O. Maduka, E. Fintan http://creativecommons.org/licenses/by/4.0 2021-09-14 2021-09-14 3 5 1 6 10.24018/ejmed.2021.3.5.1008 How Combining Grounding and Acupuncture Simultaneously Increases Beneficial Outcomes Over Traditional Acupuncture? https://ejmed.org/index.php/ejmed/article/view/1025 <div> <p class="Text"><span lang="EN-US">Multidisciplinary studies showed that when the human body is electrically in contact with the Earth (earthing or grounding), it produces intriguing consequences on the physiology and health of the human being. These effects are related to treating acute and chronic inflammatory and autoimmune illnesses, immunological responses, wound treatment, and prevention. At the same time, acupuncture in Traditional Medicine has been widely utilized for its low side effects and therapeutic effectiveness as primary therapeutic therapy. However, the electrical reaction to acupuncture stimulation has not been investigated in conditions with acupuncture that could alter acupuncture therapeutic effectiveness. The study's objective is to inform scientists of the apparent innovative approach to inflammation studies; and alert researchers to the importance of the duration and the degree of grounding, which may affect the results of inflammation, injury, and tumorigenesis studies. Grounding with acupuncture decreases pain and changes the quantity of circulating neutrophils and lymphocytes and circulating chemical substances linked to inflammation. This work reviews the potential of acupuncture with earthing as an easy and readily accessible worldwide modality of substantial clinical importance is reviewed in this work.</span></p> </div> Madiha Khalid Jeremy Madvin Copyright (c) 2021 Jeremy Madvin, Madiha Khalid http://creativecommons.org/licenses/by/4.0 2021-09-23 2021-09-23 3 5 20 24 10.24018/ejmed.2021.3.5.1025 Herpes Zoster Anterior Uveitis with Hyphaema https://ejmed.org/index.php/ejmed/article/view/1010 <div> <p class="Text"><span lang="EN-US">Herpes zoster ophthalmicus usually manifests in elderly people as a unilateral painful skin rash in a dermatomal distribution of the ophthalmic division of the trigeminal nerve shared by the eye and ocular adnexa. It is the reactivation of varicella-zoster infection. Most common ocular manifestations of this disease include keratitis, conjunctivitis, and anterior uveitis. Severe hyphemia as a complication following herpes zoster uveitis is uncommon. We report a rare case of a 90-year-old lady with herpes zoster ophthalmicus and diabetes mellitus with unusually severe hyphemia. The disease responded well to systemic and topical steroids with improved vision outcome. Early referral to an ophthalmologist, detailed evaluation, and immediate treatment are mandatory to prevent permanent vision loss in these patients.</span></p> </div> Rajagopal Arvinth Mimiwati Zahari Sagili Chandrasekhara Reddy Copyright (c) 2021 Rajagopal Arvinth, Mimiwati Zahari, Sagili Chandrasekhara Reddy http://creativecommons.org/licenses/by/4.0 2021-09-03 2021-09-03 3 5 1 3 10.24018/ejmed.2021.3.5.1010 Congenital Cyst and Fistula of the Dorsum of the Nose: A Case Report and Literature Review https://ejmed.org/index.php/ejmed/article/view/1001 <div> <p class="Text"><span lang="EN-US">Congenital cyst and fistula of the dorsum of the nose is a rare congenital entity. We report a new case of dorsum nasal fistula in a 5 years old male patient that communicates the frontal region with the subcutaneous surface. Radiologic imaging showed a median 5mm defect, in the projection of the metopic suture that leads to a communication between the frontal region and the skin figure. Complete resection was performed by an external approach with vertical incision of the cyst. The histological diagnosis was consistent with a dermoid fistulized cyst. The follow-up displayed unremarkable finding, the patient did not present any diplopia nor decreased visual acuity, or any signs of meningitis or cerebrospinal fluid rhinorrhoea, or saddle nose.</span></p> </div> O. Benhoummad F. E. Rizkou S. Salhi Y. Rochdi A. Raji Copyright (c) 2021 O. Benhoummad, F. E. Rizkou, S. Salhi, Y. Rochdi , A. Raji http://creativecommons.org/licenses/by/4.0 2021-09-13 2021-09-13 3 5 4 7 10.24018/ejmed.2021.3.5.1001 Primary Hyperparathyroidism Superimposed on a Pre-existing Familial Hypocalciuric Hypercalcemia Diagnosis https://ejmed.org/index.php/ejmed/article/view/1023 <div> <p class="Text"><span lang="EN-US">Familial hypocalciuric hypercalcemia is a rare clinical condition of persistently elevated serum calcium and reduced urinary calcium levels with an autosomal dominance inheritance pattern to the three out of four large types of this condition known. This rare condition goes largely undiagnosed as patients are largely asymptomatic and where symptoms are present, other causes of hypercalcemia are considered first. Hyperparathyroidism, super-imposing on FHH, is an even rarer occurrence. We present the case of an adult male with an initial provisional assessment of FHH, which was later confirmed with a genetic study. He went on to develop hyperparathyroidism (with evident enlarged parathyroid glands on Sestamibi parathyroid scan done, and an eventual histologic diagnosis of parathyroid adenoma after surgery). It remains to be established if this is an incidental occurrence or if there is a causal relationship between FHH and an onward development of parathyroid hypertrophy or adenoma(ta).</span></p> </div> Alamin Alkundi Rabiu Momoh Copyright (c) 2021 Alamin Alkundi, Rabiu Momoh http://creativecommons.org/licenses/by/4.0 2021-09-14 2021-09-14 3 5 8 11 10.24018/ejmed.2021.3.5.1023 Diagnosis and Management of Internal Hemorrhoids: A Brief Review https://ejmed.org/index.php/ejmed/article/view/1014 <p>Hemorrhoidal disease is a pathological condition due to the abnormal engorgement of the arteriovenous plexus beneath the anal mucosa. Anatomically, it can be located under the skin on the outer part of the dentate line, known as external hemorrhoid; or inside the anus on the proximal part of the dentate line, called internal hemorrhoid. Internal hemorrhoid may further develop from a painless anal mass into protruded and painful mass throughout the anal canal, often accompanied by inflammation and more severe symptoms. Various management strategies need to be considered carefully to ensure the success of therapy and improve the quality of life of patients with internal hemorrhoids. Conservative management is the initial stage that can be performed, including the provision of high-fiber nutrition, education related to bathroom habits, and the use of flavonoid regimens. Surgical therapy can be divided into outpatient intervention and conventional surgeries. This review will encompass the comprehensive diagnostic approach and management of internal hemorrhoids to help clinicians understand the appropriate management and provide better clinical benefits for the patients.</p> Stephen William Soeseno P. Agus Eka Wahyudi Febyan Febyan Copyright (c) 2021 Stephen William Soeseno, P. Agus Eka Wahyudi, Febyan Febyan http://creativecommons.org/licenses/by/4.0 2021-09-06 2021-09-06 3 5 1 5 10.24018/ejmed.2021.3.5.1014