Open Access Journals



Title : Association of serum procalcitonin with the risk of coronary artery disease
Authors : Nitin Tyagi,Ramakant Yadav,Charanjeet Kaur

Serum procalcitonin levels, coronary artery disease : Introduction Procalcitonin (PCT), a calcitonin precursor is awell established novel systemic inflammatory biomarker. Inflammation in body plays important key role in pathogenesis of coronary artery disease (CAD). In previous studies, the results shows that the increase in PCT level have strong association with the severity of atherosclerosis, which leads to increase the risk of coronary artery disease (CAD) in the patients. Various studies have been done to investigate the role of PCT in the pathogenesis and risk of CAD,yet their results have been inconsistent. So, in the current study we evaluate the correlation between the serum procalcitonin levels and risk of CAD. Aims and Objectives: The aim of the study was to find the association between the serum procalcitonin levels and risk of coronary artery disease. Materials and Methods: 100 patients selected for the study, after taken the written consent form the patients were equally divided into two group’s case and control group. In case group 50 patients with angiographically proven CAD as case group and 50 apparently healthy age and sex matched adults as control group. Serum procalcitonin levels were measured in both the groups using ELISA based kits. Results: Levels of Serum procalcitonin were 252.52 ± 17.43 ng/ml in case group as compared to 40.84 ± 15.6 ng/ml in control group and their difference was statistically significant (p < 0.0001). Conclusion: The results of our study shows that there was strong relation between serum procalcitonin levels and coronary artery disease risk.

Keywords : Serum procalcitonin levels , coronary artery disease : Introduction Procalcitonin (PCT) , a calcitonin precursor is awell established novel systemic inflammatory biomarker. Inflammation in body plays important key role in pathogenesis of coronary artery disease (CAD). In previous studies , the results shows that the increase in PCT level have strong association with the severity of atherosclerosis , which leads to increase the risk of coronary artery disease (CAD) in the patients. Various studies have been done to investigate the role of PCT in the pathogenesis and risk of CAD ,yet their results have been inconsistent. So , in the current study we evaluate the correlation between the serum procalcitonin levels and risk of CAD. Aims and Objectives: The aim of the study was to find the association between the serum procalcitonin levels and risk of coronary artery disease. Materials and Methods: 100 patients selected for the study , after taken the written consent form the patients were equally divided into two group’s case and control group. In case group 50 patients with angiographically proven CAD as case group and 50 apparently healthy age and sex matched adults as control group. Serum procalcitonin levels were measured in both the groups using ELISA based kits. Results: Levels of Serum procalcitonin were 252.52 ± 17.43 ng/ml in case group as compared to 40.84 ± 15.6 ng/ml in control group and their difference was statistically significant (p < 0.0001). Conclusion: The results of our study shows that there was strong relation between serum procalcitonin levels and coronary artery disease risk.
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Title : Clinical and Microbiological Profile of Pathogens in Febrile Neutropenia in Haematology Malignancies: A Single Center cross-sectional type of observational study
Authors : NITIN TYAGI,RAMAKANT YADAV,VIKAS JINDAL,D K GUPTA

Background Neutropenia is a clinical condition in a body occurs when a low number of neutrophils in the blood. Febrile neutropenia is a clinical condition in which development of a high fever with signs of infection in the body. It is a most common postoperative complication of anticancer treatment. The aim of the study was to evaluate the current practices used in the institution and for culture sensitivity in isolated microorganisms. Material and methods: 50 hospitalized patients are selected for the study. All the patients are provided informed consent before starting of the study. Results: 50 patients selected from the study 36 were males and 14 were females. 42 Patients were found the gram negative infections. The most common bacteria found in the culture media was Escherichia coli. 8 (15%) Patients were found the gram positive microorganisms stain and most common bacteria found in the culture media was Staphylococcus aureus. Conclusion: In our study we concluded that there decrease in the level of infection in the body due to gram positive microorganisms. For doctor the main concern was the gram negative microorganisms and further surveillance needed. In our study the results shows that the sensitivity for antibiotic therapy in antibiogram.

Keywords : Pathogens , Febrile Neutropenia , Malignancies Abstract
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Title : Deficiency-related Pancytopenia: retrospective study of 34 cases
Authors : Hafid Zahid,Abdelkader Belmekki,Abdelhak El Khazraji,Rachid Hadef,Nezha Messaoudi

Introduction: The goal of this work was to determine the place of the deficiency-related etiology in Pancytopenia, facilitation of the diagnosis and the definition of the epidemiological, clinical and para-clinical characteristics of deficiency-related Pancytopenia. Methodology: It is a retrospective study of 112 Pancytopenia cases of which 34 were Deficiency-related Pancytopenia taken from a data taken from a period of 5 years (2006-2010) from the Hematology Laboratory of the Mohammed V Teaching Military Hospital Rabat. Results: 112 Pancytopenia cases were found. The result from a comparison between 2 groups of patients of medium age with or without etiological deficiency-related Pancytopenia by the “Student Test” was t = 0.001070744<0.025 and the comparison of the parameters of the Hemogram by the ANOVA Test gave the following values: F= 0.41, p= 0.565 greater than alpha= 0.05 for a limit of 5%. For the 34 cases of deficiency-related Pancytopenia studied, 11 were women and the rest men. The medium age was 48.47 years. The medium level of Hb was 6.11 g/dl. Leukocyte and platelet Numeration Media were respectively 2.55 g/l and 58.78 g/l Discussion: The etiology deficiency-related is the principal cause of Pancytopenia in the department of Hematology of the Mohammed V Teaching Military Hospital Rabat. This diagnosis demands the use of myelogram and or the determination of the quantity of vitamins or the use of therapeutic tests. The epidemiological, clinical and para-clinical characteristics are similar to those found in literature. Conclusion: We observed the need for early diagnosis of vitamin deficiency (Vit B12 and Vit B9) coupled with the systemization of preventive measures for all persons at high risk. It is however primordial for regular follow-ups of the progression over a long period of time of patients under treatment at the aim of correcting the deficiency-related Pancytopenia

Keywords : Pancytopenia- Megaloblastosis- Deficiency- Vitamin B12- Vitamin B9
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Title : Lactulose induced warfarin toxicity- an interesting drug interaction
Authors : Kiran Shivaraj,Muhammed Faizan Ahmed

Warfarin one of the most commonly used anticoagulants in the world is affected by the vitamin K levels in the body, which in turn depends upon many factors like drugs and diet. Here we present a case of a drug interaction between 2 commonly drugs especially in the elderly population. In this case Lactulose interacts with absorption of vitamin K from the gut and thereby potentiating the effect of warfarin toxicity. Hence it is important for every physician to be aware of this drug interaction and warn their patients regarding the same.

Keywords : Lactulose , Vitamin K , toxicity , anticoagulants , drug interaction , laxatives
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Title : Satisfaction with postnatal care services among women delivering in Embu Hospital, Embu County, Kenya
Authors : Joyce Wachira,George Otieno,Harun Kimani

determining the level of women’s satisfaction with postnatal care, determining the influence of socio-demographic characteristics on satisfaction with postnatal care. Descriptive cross-sectional research design was used. The study population was postpartum women aged 15-49 years who had delivered in Embu hospital. The study employed systematic random sampling method to come up with a sample size of 205 respondents. A structured client exit questionnaire, focused group discussions and key informant interviews were used to collect data. Data was analyzed using SPSS version 20 and presented in percentages, frequencies and cross tabulations. The study findings revealed that majority of the women 54.6% were satisfied with postnatal care services provided. Findings from this study also showed that socio-demographic variables like age, marital status, education level, occupation and monthly income did not have a significant relationship with women’s satisfaction with postnatal care. The study concluded that there is still a percentage of women 45.4% who were still dissatisfied with the postnatal care services provided. The study recommended that the county government together with the hospital administration should help in installation of Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) to help seek feedback from customers hence improve the satisfaction level of clients. The study also recommended that the same study should be done in other hospitals within the Sub Counties and in the rest of 47 Counties to enable generalization of results.

Keywords : client satisfaction , postnatal services , postnatal period : Patient satisfaction has been increasingly recognized as an important outcome for the health care delivery system and is increasingly studied in developing countries. Many women report lower levels of satisfaction with care and support they receive during the postnatal period than any other phase of their maternity care. The objectives of the study were
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Title : DIRECT COST OF HOSPITAL MANAGEMENT OF HEART FAILURE AT THE INTENSIVE CARDIOLOGICAL CARE UNIT OF BEFELATANANA UNIVERSITY HOSPITAL, ANTANANARIVO
Authors : Ramiandrisoa Lahatriniavo Ritchy,Andriamihary Mandimbisoa Noely Oberlin,Randriamihangy Narindrarimanana Avisoa

living expenses: 20.15%

Keywords : cost , hospitalization , heart failure , Madagascar.
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Manuscript Code : expenses for accompanying persons: 5.58%. More than 80% were the responsibility of accompanying persons and/or families. Conclusion: Heart failure is a condition that is very expensive in Madagascar. It is essential to have a good health insurance system and focus on prevention.


Title : TUBERCULOSIS AND INTESTINAL PARASITOSIS COINFECTION IN MAHAJANGA, MADAGASCAR
Authors : Rivo RAKOTOMALALA,Stephanie ANDRIAMIHARISOA,Cathérine RAZAFINDRAKOTO,Miraimila BOTOVOLA,Tsiry RAMAVOSON,Tahirimalala RABENANDRIANINA,Davidra RAJAONATAHIANA,Odilon TIANDAZA,Rondro RAHARIMANANA,Rasoamialy RAZANAKOLONA,Olivat RAKOTO ALSON,Ralison ANDRIANAIVO ,Andry RASAMINDRAKOTROKA

Tuberculosis and intestinal parasitosis with their coinfection are among public health problems in developping countries. This preliminary study aims to determine the prevalence of coinfection, investigates relationship between infestation of parasites and age, gender, residence, occupation or BMI of patients and to identify the parasites species. A prospective study was then conducted at the Pneumology and Phthisiology hospital unit in collaboration with the UHC PZaGa laboratory from December 2015 to October 2016. Patients with tuberculosis to whom was performed parasitological examination of stool were included in the study. In whole, 60 TB patients were investigated. The prevalence of the coinfection was 15%. All the infested patients were male (p < 0.05). The age of TB patients varied from 17 to 68 (p>0.05). A large majority of them were from rural area (67%). This result was statistically significant (p<0.05). Patients from rural area were mostly hit by the infection (p<0.05). The parasitic infestation was not associated to the body mass index of TB patients (p>0.05). Four species of parasites were identified, namely Ancylostoma duodenale, Strongyloides stercoralis, Giardia intestinalis and Entamoeba coli, respectively with 45%, 22%, 22% and 11%. Few TB patients were screened with parasitological examination of stool. This study showed how significant the analysis was before improving therapy and care.

Keywords : tuberculosis , intestinal parasites , coinfection.
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Title : TOXOPLASMA GONDII INFESTATION AMONG PREGNANT WOMEN IN MAHAJANGA, MADAGASCAR
Authors : Rivo RAKOTOMALALA,Francine RAKOTONINDRINA,Eustache FANOMEZANTSOA,Fanilo RAFILIPOJAONA,Cathérine RAZAFINDRAKOTO,Tahirimalala RABENANDRIANINA,Davidra RAJAONATAHIANA,Odilon TIANDAZA ,Norotiana RABESANDRATANA,Pierana RANDAOHARISON,Rasoamialy RAZANAKOLONA,Olivat RAKOTO ALSON,Andry RASAMINDRAKOTROKA

Toxoplasmosis, pregnant women, IgG, IgM. : Toxoplasmosis is a public health concern mostly among pregnant women in developping countries. The study aims to determine the seroprevalence of the infection on pregnant women, to identify whether it is a recent or an old infection and to assess risk factors. A prospective and detailed survey was then conducted from July to October 2016 at the the integrated health centre of Mahabibo and the basic health centre of Tanambao Sotema in Mahajanga which is a west north city of Madagascar. The blood specimens were collected and then sent to the University Hospital Center Zafisaona Gabriel laboratory. In whole, 49 subjects were investigated with a mean age of 25 years old. The seroprevalence of the old infection (IgG+ and IgM-) was of 61% (n=30), non-immunized pregnant women (IgG- and IgM-) represented a rate of 39% (n=19). None of them was diagnosed with an acute infection (IgG+ and IgM+). No significant relation was associated between the infestation of Toxoplasma gondii and household cats, neither with housekeeping occupation nor with education level, whether being aware or not of the infection (p>0.05). Toxoplasmosis is poorly known at Malagasy people. The seroprevalence in non-immunized pregnant women and those at risk is revealed to be high.

Keywords : Toxoplasmosis , pregnant women , IgG , IgM. : Toxoplasmosis is a public health concern mostly among pregnant women in developping countries. The study aims to determine the seroprevalence of the infection on pregnant women , to identify whether it is a recent or an old infection and to assess risk factors. A prospective and detailed survey was then conducted from July to October 2016 at the the integrated health centre of Mahabibo and the basic health centre of Tanambao Sotema in Mahajanga which is a west north city of Madagascar. The blood specimens were collected and then sent to the University Hospital Center Zafisaona Gabriel laboratory. In whole , 49 subjects were investigated with a mean age of 25 years old. The seroprevalence of the old infection (IgG+ and IgM-) was of 61% (n=30) , non-immunized pregnant women (IgG- and IgM-) represented a rate of 39% (n=19). None of them was diagnosed with an acute infection (IgG+ and IgM+). No significant relation was associated between the infestation of Toxoplasma gondii and household cats , neither with housekeeping occupation nor with education level , whether being aware or not of the infection (p>0.05). Toxoplasmosis is poorly known at Malagasy people. The seroprevalence in non-immunized pregnant women and those at risk is revealed to be high.
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Title : Comparison of Plasma Proteins in Type 2 Diabetes Mellitus And Non-diabetics
Authors : G. S. Chandrashekhar

Total Protein, Albumin, Globulin, Type 2 DM:Introduction: Insulin resistance in type 2 diabetes mellitus is known to alter fractional synthetic rates of different plasma proteins. Objective of the study was to compare plasma total proteins and albumin in type 2 diabetics with that of non-diabetic controls. Methodology: This retrospective study was conducted in Adarsha Superspeciality Hospital, Udupi, Karnataka. Data of plasma proteins and demographic profiles of 173 type 2 diabetes mellitus patients was compared with that of 121 healthy non-diabetics. Mann Whitney U test was used to compare the data. Results: A significantly low albumin (p= 0.0080) , significantly high globulin levels (p = 0.0246) were observed in type 2 DM. However differences in total protein levels were insignificant. Albumin/globulin ratio was found to be low very significantly (p=0.0006) in patients. Conclusion: We conclude that hypoalbuminemia and hyper gamma globulinemia were observed in patients of type 2 DM as compared to non-diabetics.

Keywords : Total Protein , Albumin , Globulin , Type 2 DM:Introduction: Insulin resistance in type 2 diabetes mellitus is known to alter fractional synthetic rates of different plasma proteins. Objective of the study was to compare plasma total proteins and albumin in type 2 diabetics with that of non-diabetic controls. Methodology: This retrospective study was conducted in Adarsha Superspeciality Hospital , Udupi , Karnataka. Data of plasma proteins and demographic profiles of 173 type 2 diabetes mellitus patients was compared with that of 121 healthy non-diabetics. Mann Whitney U test was used to compare the data. Results: A significantly low albumin (p= 0.0080) , significantly high globulin levels (p = 0.0246) were observed in type 2 DM. However differences in total protein levels were insignificant. Albumin/globulin ratio was found to be low very significantly (p=0.0006) in patients. Conclusion: We conclude that hypoalbuminemia and hyper gamma globulinemia were observed in patients of type 2 DM as compared to non-diabetics.
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Title : Irreducible plantar dislocation of the interphalangeal joint of the hallux: about a case
Authors : Youssef Benyass,Bouchaib Chafry,Salim Bouabid,Driss Benchebba,Mostapha Boussouga

fixation, open reduction, plantar plate, surgery, x-pins:The plantar dislocation of the interphalangeal joint of the hallux is a very rare lesion. The mechanism of this lesion was a combination of an axial load with plantar flexion. We present a case report with 1 year follow-up data of a male soldier of 25 years old, who has exhibited an interphalangeal dislocation of the right hallux for three weeks when the patient struck his hallux against the edge of the stairs. The patient did not consult urgently. Three weeks later, and in the face of persistent pain, deformation and difficulty in footwear, especially during military exercises and during walking, the patient presented himself in orthopedic consultation. Clinical examination and radiographic examination are in favor of a plantar dislocation of the interphalangeal of the hallux. Open cut was achieved after failure by external maneuver reduction. The dislocations of plantar feet are very rare. Their treatment depends on the patient's previous activity and the time between the injury and the final treatment.

Keywords : fixation , open reduction , plantar plate , surgery , x-pins:The plantar dislocation of the interphalangeal joint of the hallux is a very rare lesion. The mechanism of this lesion was a combination of an axial load with plantar flexion. We present a case report with 1 year follow-up data of a male soldier of 25 years old , who has exhibited an interphalangeal dislocation of the right hallux for three weeks when the patient struck his hallux against the edge of the stairs. The patient did not consult urgently. Three weeks later , and in the face of persistent pain , deformation and difficulty in footwear , especially during military exercises and during walking , the patient presented himself in orthopedic consultation. Clinical examination and radiographic examination are in favor of a plantar dislocation of the interphalangeal of the hallux. Open cut was achieved after failure by external maneuver reduction. The dislocations of plantar feet are very rare. Their treatment depends on the patient's previous activity and the time between the injury and the final treatment.
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