British Journal of Healthcare and Medical Research 2022-09-10T05:11:48+00:00 Victoria Bloom Open Journal Systems <p>British Journal of Healthcare &amp; Medical Research (<strong>BJHR</strong>) is an international, peer-reviewed, open access journal that provides an easy access to high quality manuscripts in all related aspects of diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in human beings. The journal also focuses upon the challenges and opportunities and how healthcare can benefit from it in terms of reduced costs and improved diagnosis, therapy, and care. Access to health care manuscripts provides an insight that varies across countries, groups, and individuals, largely influenced by social and economic conditions as well as the health policies in place.</p> <p>The journal brings professionals in medicine, psychology, physiotherapy, nursing, dentistry, midwifery (obstetrics) and allied health, plus many other disciplines such as public health practitioners, community health workers and assistive personnel, who systematically provide personal and population-based preventive, curative and rehabilitative care services in health care under single roof.</p> Demographic Pattern of Chronic Myeloid Leukaemia and Chronic Lymphocytic Leukaemia in University of Medical Sciences Teaching Hospital Ondo State South-West Nigeria 2022-08-30T18:30:06+00:00 Patrick Osho Victor Koledoye Ojo Adesuwa Matilda Joseph Adejoke Adijat <p><strong><span style="text-decoration: underline;">Background</span>: The types and proportion of chronic leukemias that is presented in health institutions differ from one another depending on the demographic pattern of patients. <span style="text-decoration: underline;">Objective</span>: The objective of this study is to determine the epidemiology pattern of Chronic Myeloid Leukemia CML and Chronic Lymphocytic Leukemia CLL among patients presented in University of Medical Sciences Teaching Hospital Ondo State, Southwestern Nigeria. <span style="text-decoration: underline;">Methodology</span>: A retrospective study with 6-years data (2015-2020) retrieved from patients’ case notes in the Department of Haematology and Blood Transfusion, University of Medical Sciences, Ondo State. The data retrieved include the age, gender, occupation, locations and date of presentation of patients. <span style="text-decoration: underline;">Results</span>: A total of 30 cases were seen during the 6-year period of which 17 (56.7%) patients were diagnosed with CML and 13 (43.3%) with CLL. A male: female ratio of 2:1 was found while, the age range of 14 to 85 years was also noted. A prevalence of 20% and 13% of CML and CLL respectively were seen among females while males showed CML and CLL 37% and 30% prevalence respectively. A total of half 15(50%) of the patients are unemployed while a little above one-third 11(37) are single. <span style="text-decoration: underline;">Conclusion</span>: The study has rekindled our awareness on the rising trend on the epidemiological burden of CML and CLL in the study location and will assist to trigger further investigation into the association between the growing trend and existing possible risk factors in the study location.</strong></p> 2022-09-29T00:00:00+00:00 Copyright (c) 2022 Patrick Osho, Victor Koledoye, Ojo Adesuwa Matilda, Joseph Adejoke Adijat Evaluation of Apolipoprotein Profile in Hiv/Aids Subjects in Pre and Post 12 Months Antiretroviral Therapy Using 1.5 Mg/Ml Troponin Diagnostic Cut-Off for Myocardial Infarction in Nauth Nnewi, South Eastern Nigeria 2022-08-10T18:20:15+00:00 Ifeoma Priscilla Ezeugwunne Chinedu Charles Onyenekwe Joseph Eberendu Ahaneku Godwin Aigbedo Aikpitanyi–Iduitua Obinna David Ibemere Ike Ifeanyichukwu Samuel Victor Nwabunwanne Oguaka Amaifeobu Clement Onyedikachukwu <p><strong>Patients infected with HIV have an increased risk of developing heart disease. HIV causes Acquired Immune Deficiency Syndrome AIDS by invading the host cells and depleting the immune system. It has been reported that acute myocardial infarction might occur at 1.5 ng/ml troponin level. Information on cardiac status in HIV infected subjects in Nigeria is scanty. The aim is to evaluate the serum apolipoproteins in HIV subjects, in pre- and post- 12 months antiretroviral therapy (ART) using 1.5ng/ml troponin diagnostic cut-off for myocardial infarction. A total of 100 HIV subjects not on ART devoid of malaria co-infection were recruited in this study. Apolipoprotein parameters were re-classified based on 1.5 ng/ml troponin diagnostic cut-off for myocardial infection. 30 out of the 100 participants that were within 1.5 ng/ml troponin diagnostic cut-off for myocardial infection were followed up on commencement of ART for 12 months. Their blood samples were drawn at 3, 6, 9 and 12 months for some apolipoproteins and CD4 analyses using standard laboratory methods. The results showed that as months of antiretroviral therapy deepened or lengthened, the numbers of HIV positive subjects with values higher than the troponin diagnostic value reduces when compared with values before therapy (p&lt;0.05). Paired-wise comparison showed that there were significantly higher levels of CD4 counts, Apo A2, Apo C2, Apo E but lower levels ApoA1, Apo B and Apo C3 in symptomatic HIV individuals before ART when compared with values after therapy at p&lt;0.05 respectively. These lower levels ApoA1, Apo B and Apo C3 in symptomatic HIV individuals after therapy may indicate possible cardio- protective effect of the drug on the heart, which may connote immune recovery. The troponin values were significantly higher than the diagnostic cut off for acute myocardial infarction (AMI) studied amongst the group at p&lt;0.05 respectively. This may imply that AMI may occur at any group of study.</strong></p> 2022-09-10T00:00:00+00:00 Copyright (c) 2022 Ifeoma Priscilla Ezeugwunne, Chinedu Charles Onyenekwe, Joseph Eberendu Ahaneku, Godwin Aigbedo Aikpitanyi–Iduitua, Obinna David Ibemere, Ike Ifeanyichukwu Samuel, Victor Nwabunwanne Oguaka, Amaifeobu Clement Onyedikachukwu Chadox1 Ncov-19 Vaccination: A Clinico-Pathological Review of Coagulation Derangement in Four Cases 2022-08-09T17:48:46+00:00 A. O. Adekoya F. Adelekan-Popoola A. O. Fabamwo E. A. Abayomi A. O. Ajibare B. Odugbemi S. S. Soyemi <p><strong><span style="text-decoration: underline;">BACKGROUND</span>: Mass vaccination of the populace was one of the responses to mitigate the Severe Acute Respiratory Syndrome Coronavirus 2 (SARs CoV-2) pandemic. Some minor and major adverse effects have been reported. <span style="text-decoration: underline;">METHODS</span>: This study reviewed the clinico-pathologic parameters of 4 patients with clinical and biochemical coagulation abnormalities following the administration of the Oxford AstraZeneca COVID-19 (ChAdOx1 nCoV-19) vaccination. Their clinical, laboratory and radiological parameters were retrieved and documented. <span style="text-decoration: underline;">RESULTS</span>: All the patients had abnormality of coagulation with thrombus formation. Two of the reported patients had several risk factors for thrombosis and thus their diseases may not have causal relationship with the vaccination while the other 2 patients had no plausible clinical explanation for their coagulation abnormality. Mortality was recorded in two of the patients. <span style="text-decoration: underline;">CONCLUSION</span>: Severe adverse effect of ChAdOx1 nCoV-19 Vaccination may not be rare. Physicians should have a high index of suspicion and there is also a need to upscale adverse events monitoring.</strong></p> 2022-09-10T00:00:00+00:00 Copyright (c) 2022 A. O. Adekoya, F. Adelekan-Popoola, A. O. Fabamwo, E. A. Abayomi, A. O. Ajibare, B. Odugbemi, S. S. Soyemi Role of SPECT Myocardial Perfusion Imaging, in Assessment and Early Diagnosis of Asymptomatic Coronary Artery Disease; An Analytical Study Conducted in a Tertiary Care Hospital of Islamabad, Pakistan 2022-08-24T12:56:44+00:00 Shagufta Zafar Qureshi Shazia Naseem Mamoon Qadir Shahbaz A. Kureshi Shabana Saeed <p><strong>Exercise Tolerance Test (ETT) and Myocardial Perfusion Imaging (MPI) are known non-invasive modalities to detect coronary artery disease (CAD). Aim of this study was to find out better modality for early detection of asymptomatic CAD. Material and Methods: 25 asymptomatic individuals with one or more cardiac risk factors were enrolled. Probability of CAD was calculated, using Framingham scoring; patients classified as low, intermediate and high-risk group. Each (n=25) underwent ETT and MPI. ETT response was categorized as normal, ischemic or equivocal. MPI results as normal, mild, moderate to severe degree defects. 18 patients had follow-up angiograms. Results: Risk stratification showed 14 patients were in intermediate group, 4 had high and 7 had low risk of CAD. In intermediate group, 6 patients had ischemic ETT changes, 10 had perfusion defects on scan and all 10 patients had ≥ 70% stenosis on coronary angiograms. In high-risk group; 2 subjects had positive ETTs, 3 had positive scans and all 3 showed significant vascular involvement on coronary angiogram. In low risk group 3 patients had positive ETT and MPS, 2 had mild vascular stenosis. Considering angiography as gold standard, we observed that MPI had sensitivity (86.66%) and specificity (90%), whereas ETT had 66.6% and 70% respectively. Positive and negative predictive values of MPI were 92.8% and 81.8 % respectively. Post-test probability of MPI was i.e. 0.72-0.88; compared to ETT which was 0.55-0.78. Conclusion: MPI is a better modality than ETT for early diagnosis of occult CAD, especially in intermediate and high risk group.</strong></p> 2022-09-10T00:00:00+00:00 Copyright (c) 2022 Shagufta Zafar Qureshi, Shazia Naseem, Mamoon Qadir, Shahbaz A. Kureshi, Shabana Saeed Diagnostic Accuracy of MRI in the Detection of Intradural Intramedullary Spinal Tumors 2022-08-20T14:41:20+00:00 Shahzad Saeed Aasma Ashraf Abdul Malik Hayat Rabia Basharat Muhammad Imran Khan Mehwish Nizam <p><strong><span style="text-decoration: underline;">Objective: </span>To determine the diagnostic accuracy of MRI in the detection of intradural intramedullary spinal tumors taking histopathology as gold standard. <span style="text-decoration: underline;">Methodology: </span>This study comprised of 140 patients with clinical suspicion of intradural spinal tumor. Magnetic resonance imaging on a 1.5-T Philips whole body magnetic resonance system was performed. The cases were operatedand histopathological results were recorded. The results of magnetic resonance imaging and histopathology were compared taking histopathology as gold standard. <span style="text-decoration: underline;">Results: </span>Out of 140 patients, 122 patients (87.2%) had an intradural spinal tumor, out of which 26 patients (18.6%) had an intramedullary tumor on MRI. After comparison of results of MRI with histopathology, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of magnetic resonance imaging were 96.2%, 98.2%, 97.9%, 92.6% and 99.1% respectively. <span style="text-decoration: underline;">Conclusion: </span>MRI is a highly accurate, non-invasive, safe and convenient imaging modality for the evaluation of intradural spinal tumors and is valuable for early detection, planning management and guiding surgical biopsies.</strong></p> 2022-09-10T00:00:00+00:00 Copyright (c) 2022 Shahzad Saeed, Aasma Ashraf, Abdul Malik Hayat, Rabia Basharat Gender Differences in Academic Performance of Medical Students 2022-08-28T08:28:16+00:00 Alsawi Y. A. Yusuf Abdelsalam M. H. Elfaki <p><strong><span style="text-decoration: underline;">Background</span>: The number of female medical students increased steadily over the last decades, outnumbering the male students in some medical schools including ours. Gender differences in academic performance among male and female medical students were addressed in many studies with variable results. The aim of this study is to investigate the difference in grades scored in different medical school subjects in a 6-year curriculum by female students, compared with the scores of fellow male students. <span style="text-decoration: underline;">Methods</span>: Three cohorts of students, graduated in the years 2011, 2012 and 2013 were selected. The total number of students was 1254, 876 females (69.9%) and 378 males (30.1%). The achieved scores (grade-point average or GPA) were recorded for each subject’s final examination. Data was analyzed using PSPP statistical software. <span style="text-decoration: underline;">Results</span>: T-test for the first examination (anatomy, physiology and biochemistry) showed a slightly higher male mean total score (6.38) versus 5.76 for female, but the difference was not significant (P= 0.12). For the second exam (pathology, pharmacology and microbiology), the mean score of male students was also higher than female students' mean score (5.19 versus 4.65) but the T-test was not significant (p= 0.14). For the third exam (medicine, surgery, pediatrics, obstetrics and gynecology) the mean scores were almost equal (8.31 for females, 8.3 for males) and the T-test was not significant (P=0.98). Female students performed slightly better than males in obstetrics and gynecology and surgery, while male students scored better in medicine and pediatrics. However, these differences were not significant (p= 0.6). <span style="text-decoration: underline;">Conclusion</span>: The academic performance of medical students shows no significant differences among male and female students. The small differences noted could be explained by many factors influencing the performance of both sexes rather than attributed to gender only.</strong></p> 2022-09-17T00:00:00+00:00 Copyright (c) 2022 Alsawi Y. A. Yusuf, Abdelsalam M. H. Elfaki Obstructed Labour as Seen in Umuahia; Southeast Nigeria 2022-08-22T15:21:49+00:00 Patience O. Odusolu Emeka C. Nkwo Glory C. E. Nkwo <p><strong>Background: </strong>Obstructed labour is one of the leading causes of maternal mortality accounting for 8% of maternal deaths globally and consuming scare resources budgeted for healthcare in Nigeria and Sub-Saharan Africa.</p> <p><strong>Materials and Methods: </strong>This was a retrospective study carried out at the department of obstetrics and gynecology, Federal Medical Center Umuahia, Southeast Nigeria. The folders of all women who were diagnosed with obstructed labor in a 10-year period between January 2006 and December 2015 were retrieved and data extracted. The data was analyzed using proportions, frequencies, and percentages.</p> <p><strong>Objective:</strong> To evaluate the sociodemographic profile, causes and feto - maternal outcomes of obstructed labor at the Federal Medical Center Umuahia.</p> <p><strong>Results: </strong>The incidence of obstructed labor was 2.2%. Most of the women (93.7%) were between 20 and 39 years of age, (58.2%) were nulliparous while. Majority (61.1%) had secondary education though (93.7%) of the patients were unbooked. The commonest cause was cephalopelvic disproportion (61.2%) followed by malpresentation (30.5%). Commonest mode of delivery was emergency caesarean section (90.0%) and the least was symphysiotomy 3(1.2%). Hysterectomy 10 (4.2%) or uterine repair 11(4.6%) with or without bilateral tubal ligation were done for those with uterine rupture. The most frequent maternal complication was puerperal sepsis (26.2%) and there were 3(1.3%) maternal deaths. Majority (72.4%) of the babies were live births while 27.6% were stillbirths.</p> <p><strong>Conclusion: </strong>Over ninety percent of the cases of obstructed labor were unbooked in this study. There is a need for education on the importance of antenatal care and skilled supervision during labor.</p> 2022-09-17T00:00:00+00:00 Copyright (c) 2022 Patience O. Odusolu, Emeka C. Nkwo, Glory C. E. Nkwo Schwannoma of Cervical Sympathetic Chain 2022-07-17T17:54:57+00:00 Gundaram Vikram Reddy M. R. Vennila Aradhana Premkumar Rufus Ranjitsingh Edwin Arcot Rekha <p><strong>Schwannomas may occur spontaneously or in the context of a familial tumour syndrome such as neurofibromatosis type 2 (NF2), schwannomatosis and Carney's complex. Schwannoma arising from the cervical sympathetic chain is an uncommon benign nerve tumour and is a diagnostic challenge. This tumour most often presents as an asymptomatic solitary neck mass, with slow-growing and rare malignant degeneration. Definitive pre-operative diagnosis may be difficult and investigations are not usually helpful. Diagnosis relies on clinical suspicion and confirmation is often obtained using surgical pathology. Surgical excision is the treatment of choice for this tumour, with recurrence being rare. Horner’s syndrome is a common postoperative neurological consequence but does not appear to cause problems to the patient. we describe our experience with clinical presentation, surgical management, and the outcome of a patient who presented with this pathology.</strong></p> 2022-09-17T00:00:00+00:00 Copyright (c) 2022 Gundaram Vikram Reddy, M. R. Vennila, Aradhana Premkumar, Rufus Ranjitsingh Edwin, Arcot Rekha Uterine Artery Doppler Velocimetry in the Prediction of Pre-Eclampsia 2022-09-07T19:06:23+00:00 Waleola H. Akinboboye Ekaidem Benedict Ebiogbo Stanley Ozori Abuchi L. Okpara Ochuko M. Alabintei Peter I. Ogidigba <p><strong>A major goal towards improving antenatal management of pre-eclampsia is to develop accurate prediction model that identifies women at high risk of this disease for appropriate interventions. The objective of this study was to evaluate the usefulness of uterine artery Doppler screening at 18-20 weeks gestation in predicting the development of preeclampsia. This study involved 100 healthy pregnant women between the gestational ages of 18-20 weeks with singleton fetus recruited from the antenatal care clinic. All the women had uterine artery Doppler ultrasonography done. Abnormal results were defined as systolic/diastolic (S/D) ratio, resistivity index &gt; 95<sup>th</sup> centile and the presence of a uterine artery diastolic notch. All participants were followed up till delivery and outcome measure (development of preeclampsia) was obtained from antenatal records. The statistical significance level was set at <em>P </em>&lt; 0.05. There was significant association between an abnormal uterine artery S/D ratio (χ2 = 9.34, P = 0.02), uterine artery R.I (χ2 = 9.53, P = 0.02), uterine artery diastolic notch (χ2 = 13.46, P = 0.01), and the combined uterine artery indices (χ2 = 14.26, P = 0.001) with subsequent development of Preeclampsia. It was concluded that abnormal uterine artery Doppler indices were associated with development of Preeclampsia and may be considered as a tool to be used in screening for Preeclampsia.</strong></p> 2022-09-21T00:00:00+00:00 Copyright (c) 2022 Ebiogbo Stanley Ozori, Waleola H. Akinboboye, Ekaidem Benedict, Abuchi L. Okpara, Ochuko M. Alabintei, Peter I. Ogidigba Retrospective Analysis for Taste, Tolerability and Efficacy Within a Low Calorie Diet with Spaghetti for Special Medical Purposes (Afms) 2022-09-07T18:39:28+00:00 Giulio Tarro Francesco di Tuoro Anna Folco Veronica Di Caprio Valentina Corato Bruna De Felice Concetta Montanino <p><strong>The maintenance and control of body weight loss are finely regulated by the interaction of a series of biochemical processes, which include homeostatic, environmental and behavioral factors. To maintain weight loss during over time, subjects must become aware of the physiological adaptations, which would favor their recovery, and then apply dietary strategies capable of modulating insulin, tryptophan, ghrelin and leptin, hormones that intervene to reduce the dreaded 'yo -yo effect'. Spaghetti plays an important role in human nutrition, also in nutritional programs for weight loss or maintenance because it is considered a balanced food in diets for calorie content, about 360 Kcal / 100gr, for low-medium glycemic index and for frequent use in Italian cuisine. The nutritional properties of spaghetti can improve and vary considerably in relation to the ingredients, drawing, rolling and drying. There are many works concerning the integration of pasta products obtained from wheat with unconventional raw materials with a high content of micronutrients and for this reason we realize how pasta, given its widespread use, ease of use, its shelf life and its intrinsic food value (Antognelli, 1980) can be improved with nutritional principles to be considered as a functional food.</strong></p> 2022-09-24T00:00:00+00:00 Copyright (c) 2022 Giulio Tarro, Francesco di Tuoro, Anna Folco, Veronica Di Caprio, Valentina Corato, Bruna De Felice, Concetta Montanino