Open Access Original Research Article

The Usefulness of 99mtechnetium-sestamibi Parathyroid Scintigraphy in Preoperative Localization of Parathyroid Adenoma in Patients with Primary Hyperparathyroidism at an Academic Hospital in South Africa

Chizindu A. Alikor, Gerrit Engelbrecht

Asian Journal of Medicine and Health, Page 1-7
DOI: 10.9734/AJMAH/2017/34067

Background: Primary hyperparathyroidism (PHPT) is an endocrine disorder with increased secretion of parathyroid hormone and elevated serum calcium level. Parathyroid adenoma is the most common cause. The introduction of preoperative localization of parathyroid adenoma using 99mTc-sestaMIBI has made parathyroid surgery minimally invasive. It becomes important to determine its usefulness in actual localization of parathyroid adenoma by correlating such with surgical and histological outcomes.

Methods: This is a retrospective evaluation which involved electronic data retrieval for patients with biochemical diagnosis of hyperparathyroidism who presented for parathyroid nuclear scan and subsequently had surgical resection and histopathological diagnosis at the UAH. A total of 11 patients were involved in this study. Data obtained was analysed. 

Results: The mean age of the study group was a 55.82±15.46 year (age range of 29 years to 81 years) and females constituted 81.8% of the study group. The mean corrected calcium level was high preoperatively (2.93±0.5) but normalized post-operatively (2.29±0.3) (p <0.001) while preoperative mean parathyroid hormone level was also high (26.86 ±44.5) but normalized post-operatively (5.66± 2.2) (p <0.001). All the 11 patients had positive 99mTc-Sestamibi scan for parathyroid adenoma and 27.3% of these patients had multiple (two) parathyroid adenomas. A total of 14 parathyroid adenomas were therefore detected. The surgeons detected and excised parathyroid adenomas at locations depicted by the 99mTc-sestamibi scan for all the eleven patients and 14 sites. All of the fourteen excised tissue were subsequently confirmed by histology to be parathyroid adenoma.

Conclusion: Findings of this study showed accurate localization of parathyroid adenoma in all the patients as confirmed by surgery, histology and normalized post-operative corrected calcium and parathyroid hormone. Hence dual-phased 99mTc-sestamibi scintigraphy in the preoperative localization of parathyroid adenoma in patients with primary hyperparathyroidism at the Universitas Academic Hospital, Bloemfontein is a useful procedure.


Open Access Original Research Article

Lymphatic Filariasis in Muri Emirate: Clinical and Parasitological Studies in Jalingo LGA, Taraba State, Nigeria

O. S. Elkanah, D. S. Elkanah, J. A. Wahedi, A. B. Samaila, S. L. Kela, G. I. Anyanwu

Asian Journal of Medicine and Health, Page 1-7
DOI: 10.9734/AJMAH/2017/33898

Survey of prevalence of clinical manifestation of lymphatic filariasis was carried out in Jalingo LGA. Informed oral consent of individuals were sought and obtained before they were examined in secrecy for clinical signs and symptoms of filariasis. Night blood samples of consenting individuals were also obtained using finger-prick method between 20.00hrs and 01.00hrs. Four-hundred and fifty eight night blood samples were collected, and 33.58% were infected with Wuchereria bancrofti. There was a significant difference in infection among the different age groups. The various clinical manifestations encountered were: itching, adenolymphagitis, dermatitis, elephantiasis, hydrocoele, hernia and lymphoedema of breast at varying rates. There was a close association between the occurrence of W. bancrofti and itching, adenolymphagitis, hydrocoel, dermititis; while weak association were observed between microfilaraemia and Hernia, elephantiasis of the limb and lymphoedema of the breast. The prevalence of chronic and irreversible manifestations of the disease create strong imperative on the need to initiate control programmes within the province.


Open Access Original Research Article

Effects of the Ethanol Extract of the Stem Bark of Nauclea latifolia Smith [Rubiaceae] on Certain Biochemical and Haematological Indices of Swiss Albino Mice

Chinweizu Ejikeme Udobi, Betseabasi Edward Umoh, Ememobong Gideon Asuquo

Asian Journal of Medicine and Health, Page 1-9
DOI: 10.9734/AJMAH/2017/33284

The ethanol extract of the stem bark of Nauclea latifolia was investigated for its effect on certain haematological and biochemical indices of the swiss albino mice. Phytochemical screening of the extract for bioactive compounds indicated the presence of saponins, tannins, terpenes, cardenolide, balsams, alkaloids, flavonoids and cardiac glycosides, phlobatanins, cyanogenic glycosides and anthraquinones. The LD50 was determined to be 1414.2 mg/kg body weight. Sub-acute and chronic administration of the extract caused a significant increase of some heamatological indices as the dose administered increased from low to high while WBC level was observed to decrease. Biochemical indices such as globulin, urea and AST levels increased significantly as the dose administered increased from low to high, while albumin, total protein, ALT and ALP levels were observed to decrease. Results obtained also suggests certain effects on the heart and kidney with prolonged use. Nuclea latifolia stem bark extract should be used with caution.


Open Access Original Research Article

Reducing Maternal Mortality: Awareness of Danger Signs in Pregnancy

Rosemary N. Ogu, Ngozi C. Orazulike

Asian Journal of Medicine and Health, Page 1-8
DOI: 10.9734/AJMAH/2017/35022

Background: Maternal mortality remains a public health challenge and the Nigerian scenario of very high maternal deaths has remained one of the worst in the world. Delay in seeking care is recognized as an important determinant of the high maternal mortality rates. The clinical features and management of avoidable pregnancy complications that occur in developing countries need to be known.  In addition, most pregnancy related complications cannot be predicted; therefore, all pregnant women need adequate information about the danger signs and actions required if a complication should arise.

Objectives: To evaluate the level of awareness of danger signs in pregnancy amongst pregnant women in Port Harcourt.

Methods: A community based survey of 414 pregnant women attending an ultra sound scan centre in Port Harcourt metropolis. Data analysis was by Statistical Package for Social Sciences (SPSS) Version 22.0 and is presented as simple percentages and charts.

Results: Labour lasting longer than 12 hours was not regarded as a danger sign by 44.2% of the women surveyed, just as 34.8% did not know that convulsion was a danger sign. Approximately 33% were unaware that retained placenta was a risk factor for maternal death. Thirty one percent were unaware that a very low blood level was a danger sign in pregnancy and 25.4% did not know that bleeding was a danger sign in pregnancy.

If any of the danger signs were present, 2.9% opted to do nothing, while 8.8% said they would go to a church.

Conclusion: The level of awareness of danger signs in pregnancy amongst pregnant women in Port Harcourt is low. A call for public enlightenment and campaigns on the danger signs in pregnancy is herein advocated.


Open Access Short Research Article

Preliminary Phytochemical Screening and Anti Bacterial Activity of Leaves of Moringa oleifera. Lamk

S. Tharshika, M. P. Vidhya, R. Shivatharsiny, A. C. Thavaranjit, T. Thayalini

Asian Journal of Medicine and Health, Page 1-5
DOI: 10.9734/AJMAH/2017/34816

Moringa oleifera is a tree belongs to the family Moringaceae. It is called as Drumstick tree in English. In traditional medicine, the leaves and flowers are used in different ways to cure different ailment. Leaf juice is used for the eye infection. Mixed with honey, it is applied as anjanam to the eyelids in eye disease. Antibacterial activity of extracts of seeds, roots and leaves has been reported previously against Escherichia coli, Staphylococcus aureus, Streptococcus pyogenes, Aspergillus niger and Candida albicans. The aim of this study is to screen the Phytochemicals and antibacterial activity of the decoction and ethanolic extract of obtained from the leaves of M.oleifera against Staphylococcus aureus (ATCC 25923), Pseudomonas aeruginosa (ATCC 27853), Escherichia coli (ATCC 25922) and Enterococcus faecalis (ATCC 29212). Fresh leaves were collected from Jaffna, Sri Lanka washed and dried under sunshade for one week. The decoction was prepared using water as solvent, and the ethanol extract was prepared using soxhlet apparatus. These extracts were used to screen the phytochemical and test its antibacterial activity. Both were qualitatively tested for the presence of chemical constituents, such as alkaloids, saponins, tannins, steroids, flavonoids, glycosides and triterpenoids. Antibacterial activity was determined by using the standard well diffusion method. The Nutrient Agar (NA) plate was inoculated with 1 mL (about 1x10⁶ CFU/mL) of each liquid bacterial culture was dispersed on the surface of NA plate and allowed to dry at 37°C for 15 min. The wells with 9 mm in diameter and 4 mm in depth were bored into the NA using a sterile cork borer and the well was completely filled with the test extract. Ethanol alone was used as control. Plates were incubated at 37°C for 24 hrs. Inhibition of growth was observed and the diameters of the zones of inhibition (ZOI) were measured. Replicates were made for the entire procedure. Ethanolic extract of leaf showed antibacterial activity against all tested gram positive and gram negative organisms. ZOI was ranged from 12 ± 0 mm to 19 ± 0 mm. Decoction showed antibacterial activity against S. aureus and E.faecalis the ZOI was 11 ± 0.18 mm. Growth inhibition was highly significant against P. aeruginosa and less significant against E. coli. in ethanol leaf extract. Degree of antibacterial activity of ethanol leaf extract was higher than decoction among the bacteria tested. Saponin, tannin and cardiac glycoside were present in both extract but terpenoid found only in ethanol leaf extract. It was also found that the extraction of bioactive compounds depend on the type of solvent used and the method of extraction. Ethanolic extract of M.oleifera leaf extract exhibited potent antibacterial activity against all tested organisms. It may be due to the presence of terpenoid. It could be used in the treatment of infections caused by these organisms.