European Journal of Medical and Health Sciences European Journal of Medical and Health Sciences European Open Access Publishing en-US European Journal of Medical and Health Sciences 2593-8339 Gestational Exposure to Cadmium and Dimethoate Mixture Modifies Fetal Programming in Rats During Development <p>The combined effects of environmental agents, as metals and pesticides, on human health, need be evaluated because human exposition occurs generally through mixtures, while regulatory assessment of neurotoxicity by these compounds is currently performed only on selected single substances. In the present study the effects of maternal exposure to 10 mg cadmium/l (as cadmium acetate) in drinking water and dimethoate 4 mg/kg (via gavage) during gestation on the development of motor activity (locomotion and motor coordination) and social behavior (anxiety-like behavior and aggressivity) were studied. The importance of the cholinergic system in the modulation of behaviors was studied using acetylcholinesterase (AChE) activity as a biomarker of effect. Cadmium (Cd) and dimethoate (DM) single exposition modified fetal programing for motor activity and social behavior at childhood and adulthood and leads to disturbs of the AChE activity. Exposition to the mixture of Cd and DM enhanced effects on fetal programing and AChE activity. The present results provide, for the first time, direct experimental evidence supporting that joint exposure to cadmium and dimethoate in uterus of rats seems additive and it is perturbs offspring development leading to harmful consequences on motor activity and social behavior, probably related to modulation of the cholinergic system. Our data suggest that added precautions regarding gestational exposure to metals and pesticide mixtures would be prudent to avoid the possibility of fetal programming.</p> Fábio Anselmo Daniel França Horta Antonio Francisco Godinho Copyright (c) 2020 Fábio Anselmo, Daniel França Horta, Antonio Francisco Godinho 2020-09-05 2020-09-05 2 5 10.24018/ejmed.2020.2.5.436 Impact of Physical Activity and Stress on Academic Performance of MBBS Students of Rawalpindi Medical University <p>Trend of getting medical education is increasing day by day in our society. Our tough educational system and intricate pattern of medical education is rendering the medical students to become more stressed and physically inactive affecting directly or indirectly their academic achievements and deteriorating their cognitive and learning skills. The purpose of our study is to evaluate how physical activity and stress level affect academic performance of medical students.&nbsp; It is a descriptive cross-sectional study with sample size of 304. The study population was from all the five years of MBBS in Rawalpindi Medical University. The study duration was 1-month. Data collection was done through International physical activity questionnaire (IPAQ) and through perceived stress scale (PSS). Analysis was done through SPSS V. 23. The gender and academic performance are showing&nbsp;&nbsp; significant association with females being on high achievers’ side as compared to males. The physical activity and gender association was also significant with males being physically more active. However, the association of academic performance with stress level and physical activity was not significant with (P-value &gt;0.005). PSS-score between high achiever and low achiever was not significant with (P-value = 0.187) and confidence interval of 95%. However, Pearson's correlation between IPAQ score and academic performance was significant with (P-value = 0.036), It was negative showing that high IPAQ score Correlates with low academic performance. Male students were physically more active, obtaining relatively less percentage academically with less preponderance towards high level of stress as compared to female students.</p> Shahzaib Maqbool Hafiz Abu Safian Haider Mubeen Laraib Arsh Muhammad Sarfraz Khan Omaima Sundus Copyright (c) 2020 Shahzaib Maqbool, Hafiz Abu Safian, Haider Mubeen, Laraib Arsh, Muhammad Sarfraz Khan, Omaima Sundus 2020-09-08 2020-09-08 2 5 10.24018/ejmed.2020.2.5.467 High Levels of Pro B-Type Natriuretic Peptides Are Associated with Adverse Outcomes in COVID-19 Disease: A Single Center Experience <p>Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus-2, has caused widespread morbidity and mortality worldwide. Cardiac injury is reported to be common in hospitalized patients. We evaluated whether Pro B-type Natriuretic Peptide (proBNP) levels measured on admission in COVID-19 patients were associated with worse outcomes. A retrospective analysis of laboratory-confirmed COVID-19 patients who were admitted between February 2020 and July 2020 to Al Kuwait Hospital, Dubai, UAE. Patients were divided into two groups: normal proBNP (≤125 ng/L) and high proBNP (&gt;125 ng/L) upon admission. Clinical characteristics and outcomes were compared between the two groups. A total of 389 patients were studied. Overall, mean age was 50.2 years (range 16-94 years), 77.3% were males, 35.7% diabetics, 35.2% hypertensives and 5.6% had history of cardiovascular disease. Compared to the group with normal proBNP; patients with high proBNP on admission were: older, more diabetics and hypertensives, with more history of cardiovascular disease; they presented with abnormal chest radiograph; and had lower lymphocytes, higher neutrophils, lower eGFR, higher D-dimers, higher CRP and higher procalcitonin on admission laboratory tests. These patients had more risk of developing critical illness during the hospitalization, undergoing mechanical ventilation and risk of death. Elevated pro B-type natriuretic peptide levels on admission in COVID-19 patients may predict subsequent risk of developing critical illness, undergoing mechanical ventilation, and significant high risk of death.</p> Kashif Bin Naeem Najiba Abdulrazzaq Copyright (c) 2020 Kashif Bin Naeem, Najiba Abdulrazzaq 2020-09-14 2020-09-14 2 5 10.24018/ejmed.2020.2.5.480 Knowledge of Modern Contraceptives Methods and Its Uptake Among Female Students of a Tertiary Educational Institution in South- South Nigeria <p>Background: The use of modern forms of contraception can significantly improve women reproductive health. The rate of sexually transmitted disease, unwanted pregnancies and maternal morbidity and mortality can be significantly reduced following the use of modern forms of contraception. However, there is paucity of studies on the place of modern forms of contraception in improving women reproductive health in Yenagoa.</p> <p>Objective: This study aimed to access the knowledge of modern forms of contraceptive methods and its uptake among female students of Federal University Otueke, Bayelsa State.</p> <p>Methods: This was a descriptive cross-sectional study that was conducted among the female students of Federal University Otueke Bayelsa State. To elicit information about their knowledge of modern forms of contraceptives methods and its uptake. A structured interviewer administered questionnaire was used to obtain required information for the study from a total of 424 students.</p> <p>Results: A total of 424 female undergraduates students of the Federal University Otueke were enrolled for the study. The mean age group of the participants was 20.9±3.2 years. The study showed that most of responds have good knowledge of contraceptives (97.4 %). The awareness of family planning was 96.7%. The study showed that age was found to influence the awareness of contraceptives. (x2=11.8;df=3;p&lt;0.05). Most of the respondents had used oral contraceptive pills 146 (34.4%); followed by those that had used Condom 138 (32.5%).</p> <p>Conclusion: Our study showed that the respondents demonstrated a high level of knowledge and awareness of family planning. However, it is worrisome to note that the uptake of modern forms of contraceptives was low. The importance of improving the uptake of these forms of contraceptives cannot be over-emphasized, especially in our societies where the protection of the reproductive health of young women is paramount.</p> O. J. Agbo A. O. Eguvbe P. W. Alabra D. O. Alagoa Copyright (c) 2020 O. J. Agbo, A. O. Eguvbe, P. W. Alabra, D. O. Alagoa 2020-09-14 2020-09-14 2 5 10.24018/ejmed.2020.2.5.450 Anesthetic Techniques for Urological Surgeries in Benue State University Teaching Hospital (BSUTH), Makurdi, Nigeria <p>Background: Urological surgery entails operating on the urinary system. Like every other surgery, they require anesthesia for the elimination of surgical pain. The organ to be operated as well as surgical approach determines the choice of anaesthesia used. This may be in the form of regional (including neuroaxial anesthesia) or general or even local anesthesia. This study was conducted to ascertain the anesthetic techniques employed for urological surgeries in the Benue State University Hospital (BSUTH), Makurdi, Nigeria.</p> <p>Methodology: This was a three-year retrospective study carried out in BSUTH, Makurdi, Nigeria. A total of 125 case files of eligible patients were retrieved from the records department following approval of an application. Relevant information was extracted from the patients’ folders and transferred into a prepared proforma. The data collected were analyzed using SPSS version 25 using simple statistics.</p> <p>Results: The age group with the highest number is that between 61 and 70 years, recording 40 (32.0%). The mean age was 54.0±20.4 Males were a clear majority with 119 cases accounting for 95.2% while only 6 cases (4.8%) involved females. The male to female ratio was 19.8:1. Most of the patients belonged to ASA II which recorded 70 (56.0%). Of the total of 125 diagnoses made, cancer of the prostate (CaP) was the highest with 63 (50.4%). The most common surgical procedure was prostate biopsy which was undertaken 58 times accounting for 46.4% of the procedures. Caudal block was employed most with 59 (47.2%). This was followed by Local infiltration with 30 (24.0%). Eighty-eight patients had surgery on day case basis while 37 patients underwent surgery as in-patients representing 70.4% and 29.6% of the study group respectively.</p> <p>Conclusion: Urological procedures are mostly infra-umbilical and are thus quite amenable to either regional or local anesthesia. This study has shown that caudal epidural block is the anesthetic technique of choice in urological surgery in this centre. Local anesthesia and sub-arachnoid block are next in that order. GA is not often employed. LA and regional techniques involve fewer disturbances to the respiratory system, and these were the anaesthetic methods mostly employed as established in this study.</p> M. E. Efu E. I. Ogwuche B. A. Ojo B. A. Eke Copyright (c) 2020 M. E. Efu, E. I. Ogwuche, B. A. Ojo, B. A. Eke 2020-09-16 2020-09-16 2 5 10.24018/ejmed.2020.2.5.403 α-Glucosidase Inhibitory and Antiradical Properties of Acacia macrostachya <p>In this work, the anti-diabetic activity of three extracts of <em>Acacia macrostachya</em> was investigated by following the inhibitory effect of these extracts on -glucosidase using the in vitro model. The antiradical activity of these extracts was also determined. Methanol extracts of root and stem barks showed a very significant inhibitory effect against the enzyme activity of -glucosidase with IC<sub>50</sub> 2.487 ± 0.441 µg/mL and 1.650 ± 0.229 µg/mL respectively. For antiradical activity, the same extracts presented the highest scavenging of the radical DPPH<sup>●</sup> with IC<sub>50 </sub>values of 9.307 ± 0.262 µg/mL and 5.242 ± 0.068 µg/mL respectively. With the cationic radical ABTS<sup>●+</sup>, IC<sub>50 </sub>varied from 45.049 ± 0.730 µg/mL for methanolic root barks extract to 14.136 ± 0.161 µg/mL for methanolic extract from stem barks. Thus, the methanol extracts of the root and stem barks of <em>Acacia macrostachya</em> possess compounds with very interesting anti-diabetic and antiradical properties and could justify its traditional use.</p> Hamidou Têeda Ganamé Yssouf Karanga Ousmane Ilboudo Wende-Konté Hazael Conania Nikiema Richard Wamtinga Sawadogo Issa Tapsoba Copyright (c) 2020 Hamidou Têeda Ganamé, Yssouf Karanga, Ousmane Ilboudo, Wende-Konté Hazael Conania Nikiema, Richard Wamtinga Sawadogo, Issa Tapsoba 2020-09-18 2020-09-18 2 5 10.24018/ejmed.2020.2.5.465 Indoor Air Pollution and the Risk of Cardiovascular Disease <p>Objective: To measure an association between factors related to indoor air pollution and CVD in the Hail population of Saudi Arabia.</p> <p>Methodology: A case control study was conducted in King Khalid hospitals. Convenience and random sampling techniques were used to recruit cases and controls. Structured Questionnaire was used to collect data from 302 CVD cases and 300 controls. Data analysis was carried out using SPSS 24.0 statistical software.</p> <p>Results: The bivariate analysis showed significant association between (i) socio-demographic characteristics (ii) air quality and occupation related variables (iii) ventilation and cooking related factors and (iv) exposure of different types of smoke, and CVD (p&lt;0.001).&nbsp; The independent risk factors of CVD by Multivariate logistic regression analysis with adjusted odds ratios of variables are:&nbsp; age groups (25-50 &amp; &gt;50 years) (2.95&amp;22.84); education level (uneducated &amp; primary) (4.39&amp;2.64); cigarette smoking (1.89); shisha smoking (2.12), exposed to cigarette smoke (2.50); burning scented wood (3.09), burning of mosquito repellent (2.18) and kitchen type (2.83) (p&lt;0.001).</p> <p>Conclusions: This study shows various sources of air pollutants are associated with CVD. The composition of indoor and outdoor air is same in Hail city but amount of contaminants is high in indoor environments. Future studies longitudinal studies are required to confirm the findings of this study.</p> Waffa Aswaq Al-Shammari Copyright (c) 2020 Waffa Aswaq Al-Shammari 2020-09-20 2020-09-20 2 5 10.24018/ejmed.2020.2.5.459 Ecological Survey of Man-Biting Mosquitoes in Nnewi Metropolis South-East Nigeria <p>The survey on the ecology of man-biting mosquitoes in Nnewi was undertaken between April and June 2019. Larval stages of mosquitoes were sampled from gutters, used discarded tyres, plastic containers, water pots, clean ground water pools, plantain and banana plants axils and dirty ground water pools using ladle, sieves and bowels. Indoor biting and resting mosquitoes were collected using pyrethrum knockdown collection method (PKC) while outdoor biting mosquitoes were collected using human being volunteer as baits and collectors. Two hundred and two (202) mosquitoes comprising of four mosquito speciesnamely; Aedesaegypt36(17.8%), Culexquinquefasciatus 43 (21.3%), Culextrigripes 16 (7.9%) andAedesalbopictus 107 (53.0%) was the highest larva to be collected. A total of sixty-eight (68) mosquitoes collected as adult made up of two speciesCulexquinquefasciatus 64 (94.1%) and Anopheles gambiae 4 (5.9%) were collected indoors. Culexquinquefasciatus 64 (94.1%) constituted the highest percentage of indoor biting and resting mosquito species. One hundred and fifty-two (152) mosquitoes comprising of four species; Aedesaegypti 51(33.6%), Aedesalbopictus 96 (63.2%), Aedesleuteocephalus 2 (1.3%) and Culexquinquefasciatus 3 (2.0%) were collected as outdoor biting mosquitoes. Aedesaegyptiwas the commonest outdoor biting mosquitoes in the community. One hundred and forty-three (143) mosquitoes were collected with ovitrap, Aedesalbopictus (41.9%), Eretmapoditeschyrysogaster 2(1.4%) and Aedeaegypti81(56,6%) been the highest collected.</p> Onyeka Chukwudalu Ekwebene Chukwuanugo N. Ogbuagu Benjamin Uzonna Ononye Angela E. Orji Copyright (c) 2020 Onyeka Chukwudalu Ekwebene, Chukwuanugo N. Ogbuagu, Benjamin Uzonna Ononye, Angela E. Orji 2020-09-20 2020-09-20 2 5 10.24018/ejmed.2020.2.5.461 The Current Situation of Anterior Cruciate Ligament in Sports and Effective Treatment Methods in Ho Chi Minh City (Vietnam) <p>Athletes’s anterior cruciate ligament (ACL) injury in Vietnam is very common and tends to increase rapidly in the number of cases as well as the cost of treatment. Therefore, it is necessary to study effective treatments for these types of trauma. This article shows that patients who have had ACL reconstruction surgery in Ho Chi Minh City (Vietnam) had a quite large success rate of 75-95% and their recovery results were very good after ligament reconstruction surgery.</p> Nguyen Duc Thanh Phan Vuong Huy Dong Copyright (c) 2020 Nguyen Duc Thanh, Phan Vuong Huy Dong 2020-09-23 2020-09-23 2 5 10.24018/ejmed.2020.2.5.486 EMG Based Clinical Evaluation of IndoKnee <p>IndoKnee is an unpowered knee assisting device designed and patented by Newndra Innovations. In this paper, we report a clinical study to characterize the reduction in load on the major muscles of the knee from the use of this device. Thirty healthy subjects without any history of knee problems underwent this trial. The protocol consists of three sets of events which are a) without IndoKnee (WOD), b) with IndoKnee at a minimum level of support (WDmin) and c) with IndoKnee at a maximum level of support (WDmax). Each set consists of five sitting and five standing activities. Surface electromyography was recorded from six major knee flexion/extension muscles, which are Bicep Femoris (BF), Semitendinosus (ST), Semimembranosus (SM), Rectus Femoris (RF), Vastus Medialis (VM) and Vastus Lateralis (VL). Paired t-tests were performed on our comparison between WOD vs WDmin and WOD vs WDmax to establish a significant difference in the EMG peak amplitudes during sitting and standing activities. The average reduction in all the six muscles for sitting activity is about 15% for both level of support and the standing activity, it is about 15% at a minimum level of support and 20% at a maximum level of support. In our investigation, IndoKnee did effectively reduce the required muscular effort for the knee flexion/extension. Thus, IndoKnee may prove to be an effective device in reducing knee pain, supporting osteoarthritis patients and faster rehabilitation from knee injuries.</p> Ashish Sahani Anil Kumar Jain Nilesh Satiram Gupta Aalok Pandya Priya Agarwal Ganesh Ram Jangir Copyright (c) 2020 Ashish Sahani, Anil Kumar Jain, Nilesh Satiram Gupta, Aalok Pandya, Priya Agarwal, Ganesh Ram Jangir 2020-09-26 2020-09-26 2 5 10.24018/ejmed.2020.2.5.492 Outcomes of Kawasaki Disease in Families <p>An epidemiological study showed that a positive family history of Kawasaki disease (KD) was a risk factor for intravenous immunoglobulin (IVIG) therapy resistance, coronary artery lesions (CALs), and KD recurrence. However, real-world outcomes of KD patients with a family history remain unclear. The objective of this study was to elucidate the outcomes of KD patients with a family history in the era of 2 g/kg IVIG therapy. This retrospective study included data from 201 KD patients who underwent acute-phase treatment from January 2009 to June 2020, with 184 (91.5%) receiving 2 g/kg IVIG therapy. The patients were divided into 13 (family group) with and 188 (nonfamily group) without a family history of KD. The rates of IVIG resistance (8.3% vs. 22.1%, P = 0.315), rescue therapy (8.3% vs. 12.8%, P = 1.000), CALs (0.0% vs. 2.7%, P = 1.000), and KD recurrence (0.0% vs. 3.2%, P = 1.000) were similar between the family and nonfamily groups.</p> Toshimasa Nakada Copyright (c) 2020 Toshimasa Nakada 2020-09-26 2020-09-26 2 5 10.24018/ejmed.2020.2.5.494 The Effects of Changes in Teaching/Learning Schedule Pattern in Physiology Subject among 2nd M.B., B.S Students from University of Medicine, Magway <p>The failure rates of the medical students had increased during the past few years. There are many supportive factors for deteriorating the students’ performance. One of these might be due to some defect in teaching/learning system. Therefore, the aim of this study is to determine the effects of changes in teaching/learning schedule pattern in Physiology Subject among 2<sup>nd</sup> MB BS students from University of Medicine, Magway. A Comparative study was done. Data was collected from 2<sup>nd</sup> MBBS students studying at University of Medicine, Magway, Myanmar (n = 230). Class test-1 was done before the introducing of the new teaching/learning schedule pattern. There was 3-month intervention of introducing the new teaching/learning schedule pattern. At the end of this program, class test-2 was done. Scores of all students in class test-1 and class test-2 were compared and analyzed. In the present study, the average marks of class test-1 and class test-2 were 38.23±14.56 and 43.32±18.42, respectively. It was found that the average score of the students in class test-2 was higher than that of class test-1(p&lt; 0.001). Both class test-1 and class test-2 included 2 sections which involved multiple choice questions (MCQs) and multiple short questions (MSQs). In MCQs section, 22.17% of the total students were passed in class test-1 whereas it was increased to 33.48% in class test-2 (p&lt; 0.01). In MSQs section, it was indicated that 29.56% of the total students were passed in class test-1 and 39.56% of the students were passed in class test-2 (p&lt; 0.001). In the average score of both MCQs and MSQs, the students passed rate is increased from 26.96% to 36.96% after the changing of teaching/learning style (p&lt; 0.001).This findings suggested that the new teaching/learning style was more effective than the traditional teaching.</p> Zarchi Theint Theint Hlaing Mya Pwint Phyu Sanda Kyaw Copyright (c) 2020 Zarchi Theint Theint Hlaing, Mya Pwint Phyu, Sanda Kyaw 2020-09-26 2020-09-26 2 5 10.24018/ejmed.2020.2.5.495 Hypertriglycedemic Pancreatitis: Is It Time to Embrace Plasmapheresis? <p>Acute pancreatitis is a medical condition that is caused by a number of aetiologies including gall stones, infections, alcohol excess and hypertriglycedemia. This condition has mortality ranging from 2% to as high as 30% particularly in patients with persistent organ failure. Management of acute pancreatitis usually involve treating the underlying insult while minimizing further damage and supporting the patient. Acute pancreatitis due to severe hypertriglycedemia is a medical emergency associated with serious complications hence timely diagnosis and interventions are paramount.</p> Charles Junior Limula Faisal Ozair Copyright (c) 2020 Charles Junior Limula, Faisal Ozair 2020-09-08 2020-09-08 2 5 10.24018/ejmed.2020.2.4.472 Bouchout's Tuberculoma <p>Tuberculosis is a chronic infection that is still endemic in Morocco.Eye involvement, however, is quite rare.We report the discovery of Bouchut's tuberculoma in a 52-year-old immunocompetent patient following a progressive decline in visual acuity in both eyes.&nbsp;</p> Mehdi Khamaily Wafae Akioud Joumany Brahim Salem Sidi Dahi Taoufik Abdellaoui Yassine Mouzari Karim Reda Abdelbarre Oubaaz Copyright (c) 2020 Mehdi Khamaily, Wafae Akioud, Joumany Brahim Salem, Sidi Dahi, Taoufik Abdellaoui, Yassine Mouzari, Karim Reda, Abdelbarre Oubaaz 2020-09-15 2020-09-15 2 5 10.24018/ejmed.2020.2.5.485 Flutamide Induced Liver Injury in Female Patients <p>Flutamide is the active substance of the drug and belongs to the group of drugs that have antiandrogenic effect. Flutamide prevents the action of male sex hormones, i.e. suppresses the action of testosterone and dihydrotestosterone. Primarily, the indications for the use of flutamide refer to males and the treatment of advanced prostate cancer. It is also used in the treatment of patients with testicles surgically removed, and in patients who have not responded to another type of therapy or do not tolerate other types of treatment. The efficacy of flutamide has also been proven in the treatment of acne, hirsutism and alopecia in men and women with polycystic ovaries. It is important to emphasize that flutamide can cause severe side effects, above all liver damage, so it is not justified to use it in the treatment of conditions other than prostate cancer. Numerous data on hepatotoxicity (retrospective, prospective studies, case reports, surveillance study) were available in literature, which ranged from asymptomatic to acute, fulminant hepatitis that ended in transplantation, i.e. fatal outcome. In our paper, a review of the literature with case reports of notably hepatotoxicity is presented along with a case from our clinical practice.</p> Nikola Malešević Goran Bokan Vlado Đajić Copyright (c) 2020 Nikola Malešević, Goran Bokan, Vlado Đajić 2020-09-14 2020-09-14 2 5 10.24018/ejmed.2020.2.5.476 Nanomedicine and Immunotherapy for Cancers <p>Nanomedicine contributes to cancer therapeutics in several ways, harnessing some of the remarkable properties of nanomaterials to target tumor cells with increasing specificity. Nano-scale therapeutic strategies enable the simultaneous transport of hydrophilic and hydrophobic drugs across physical and physiological barriers like the blood-brain barrier. Alternative routes of drug administration, such as the intranasal route, have become viable, with more promising therapies for highly lethal tumors like glioblastomas. Cancer nanomedicine allows increased solubility and bioavailability of anti-cancer drugs, reducing their toxicity.</p> <p>Multi-drug delivery systems such as dendrimers, noble metal nanoparticle drug delivery systems, nanoparticle-based theranostics, and nano-biomarkers may well bring about a sea change in cancer therapeutics. This review presents an overview of the scope of cancer nanomedicine, including immunotherapy for cancer.</p> A. A. Navas N. Doreswamy P. J. Joseph Francis Copyright (c) 2020 N. Doreswamy, A. A. Navas, P. J. Joseph Francis 2020-09-16 2020-09-16 2 5 10.24018/ejmed.2020.2.5.482 Review article Epidemiology of Talaromycosis (Penicilliosis) Marneffei in India: An Update <p>Talaromycosis marneffei (Penicilliosis marneffei) caused by a thermally dimorphic fungus, <em>Talaromyces (Penicillium) marneffei</em> is emerging as an important systemic opportunistic mycosis in HIV infected patients in several countries in Southeast Asia and in northeast India. This study presents an update on epidemiological and clinical aspects of talaromycosis marneffiei in India. A thorough search of literature was done in Medline, PubMed, and Google Scholar, for accessing relevant data. Fifty-three cases of this disease have originated from the Manipur State. Several cases have been reported from Assam, a few are also known from Meghalaya, Mizoram, Nagaland, Sikkim, Delhi and Maharashtra. Clinical manifestations of disseminated infection in AIDS patients are fever, anemia, weight loss, weakness, lymphadenopathy, hepatosplenomegaly, respiratory signs, and characteristic skin lesions. The bamboo rat (Cannomys badius) has been found to be a natural host of <em>Talaromyces (Penicillium) marneffei</em> in Manipur. It is noteworthy that one of the ten T. marneffei isolates from bamboo rats shared the genotype with a human isolate from that area providing evidence for common source of infection for the rats and humans and host to host transmission. Natural reservoir of <em>T. marneffei</em> has not been established, though it has been demonstrated that the fungus can survive in sterile soil for several weeks, but only for a few days in unsterile soil. There is need for comprehensive investigation of <em>T. marneffei </em>infection in humans, and for occurrence of the fungus in bamboo rats and in soils of the rat burrows in India employing conventional and molecular techniques.</p> Harish C. Gugnani Neelam Sood Copyright (c) 2020 Harish C. Gugnani, Neelam Sood 2020-09-16 2020-09-16 2 5 10.24018/ejmed.2020.2.5.478 The Health Beliefs and Perceptions of Adults Living with Diabetes Type 2 in Nigeria <p>Introduction: The disease burden of Type 2 diabetes in Nigeria amongst the 54 countries of the African continent. This is so in terms of disease prevalence, morbidity and mortality. Diabetes Type 2 is chronic condition requires regimented management in the form of self-care with implications for health-related behavior. Central to health-related behaviors is the focus on health beliefs and perceptions that underly self-management practices in public health. This systematic review explored health beliefs and perceptions of adults with Type 2 diabetes in Nigeria. The review’s objective was to identify challenges to self-management and role of belief systems in such challenges. The study also aimed to draw from the experiences of adults living with Type 2 diabetes in Nigeria to explore the design of future public health interventions.</p> <p>Method: The following electronic databases- Medline via Web of Science; Cinahl via EBSCO; Web of Science and PubMed were consulted. In addition, Google Scholar, which is an index of other databases was also utilised. The studies were selected based on an inclusion and exclusion criteria. A systematic literature search generated thirteen relevant studies, which were synthesized to address the objectives.</p> <p>Results: The findings indicated the complex circumstances in which Type 2 diabetes is experienced in the Nigerian population. Themes explored in this review included - lay understandings of type 2 diabetes; traditional healing beliefs and practices; health literacy and self-management; and access to diabetes services, support and counselling.</p> <p>Conclusion: The findings called for the need to address challenges in terms of engaging beliefs to inform interventions, health education and healthcare delivery systems which impact on health outcomes of diabetics in Nigeria.</p> Zuwaira Paula Hashim Copyright (c) 2020 Zuwaira Paula Hashim 2020-09-24 2020-09-24 2 5 10.24018/ejmed.2020.2.5.468