Open Access Review Article

Impact of Chronic Periodontitis on Systemic Conditions: A Review

R. Saranyan, B. Manovijay, K. Priya, D. Jayachandran, Balaji Babu, C. Sajini Raj

Asian Journal of Medicine and Health, Page 1-10
DOI: 10.9734/AJMAH/2017/38511

The oral cavity might well be thought of as the window of the human body due to the extent of the inflammatory burden caused by periodontal disease. This can influence systemic diseases with a similar inflammatory pathology and vice versa, raising the relevance regarding periodontal and systemic health affecting each other. The interrelationship between periodontal disease and systemic health has been a matter of debate since ancient times. A theory of focal infection states that the oral pathogens had the capability to either directly enter or release their toxic products into the systemic circulation. Recent evidence reveals that we need to change our thought about the etiology and pathogenesis of periodontal disease. Although bacteria are a necessary factor in the equation, the reaction of the host’s immuno-inflammatory system is responsible for most of the destruction found in periodontal disease. Thus, it makes sense that a number of environmental and acquired factors may modify a patient’s risk of developing periodontal disease. Since oral health has a significant influence on the final prognosis of a number of systemic disorders, it is essential that we understand the underlying pathophysiology linking oral health to systemic health.

Open Access Original Research Article

Comparative Spatial Distribution of Five Infectious Diseases in Ghana

Sylvester D. Nyadanu, Harry Tagbor, Timothy Adampah, Derek N. Nawumbeni

Asian Journal of Medicine and Health, Page 1-14
DOI: 10.9734/AJMAH/2017/37139

Aims: To use exploratory geo-health informatics in probing if there are spatial homogeneities in the incidence rates and spatial co-distribution or interactions within the five commonly reported infectious diseases in Ghana.

Study Design: Ecological study design was employed.

Place and Duration of Study: District-level reported cases of the five commonly reported infectious diseases in Ghana for the periods 2010 to 2014 inclusive.

Methodology: A geo-relational database for at-risk population and disease morbidities was created using ArGIS 10.1 for the 170 districts in Ghana. The incidence rates were computed and spatially standardised with empirical Bayesian smoothening. The spatial analyses of disease mapping, followed by spatial pattern and cluster-outlier analyses with global and local spatial autocorrelations were performed. Disease interactions were also evaluated with Pearson correlation and Moran's I bivariate analyses.

Results: The results from the Bayesian smoothed maps, global and local Moran's indices suggested existence of statistically significant spatial variations in the incidences of Malaria (P =0.00), Diarrhoea (P =0.04), Typhoid fever (P = 0.00) and Intestinal worms infestation (P = 0.00) with positive Moran's I in the country with pockets of elevated rates in some locations. The Upper Respiratory Tract Infection (URTI), however, was not significant (P = 0.35). The magnitude of the z-statistics, indicating the increasing intensity of spatial clustering among the five diseases was URTI (z = -0.94), Diarrhoea (z = 2.10), Typhoid fever (z = 3.03), Malaria (z = 3.60) and Intestinal worms (z = 6.91). The number of disease-specific hotspot areas detected were 4 for Malaria, 8 each for URTI and Diarrhoea, 9 for Typhoid fever and 12 for Intestinal worms. Bivariate analyses of Pearson correlation and Moran's index established significant positive disease interactions between the incidences over space. The spatial disease interactions or co-distributions with positive Moran's indices were very strong in Malaria-URTI (r=0.53), Malaria-Diarrhoea (r= 0.56), URTI-Intestinal worms (r= 0.57), and strongest co-distribution was observed in Diarrhoea-URTI (r=0.83).

Conclusion: Among the five infections, Malaria was receiving the most spatially homogeneous health interventions but serious spatial inequalities in the other infections, especially Intestinal worms with the highest number of hotspots and greatest clustering intensity. The identified hotspot districts critically need further strengthening or improving disease-specific control strategies. The significant positive disease interactions implies possible common risk factors and that disease-and-location targeted interventions could be strategically developed to yield simultaneous or multiple disease intervention outcomes while considering the impact of the environment and neighbourhood in relation to disease clusters. Public health planners should include spatial components in health policy and practices to optimise public health administration.

Open Access Original Research Article

Work-related Musculoskeletal Disorders among Radiologists in Nigeria

R. C. Onwuchekwa, West Obaabo

Asian Journal of Medicine and Health, Page 1-6
DOI: 10.9734/AJMAH/2017/38431

Background: Work- related musculoskeletal disorders (WRMSDs) are defined as conditions that are caused or aggravated by work place activities, and they account for up to 60% of all work place illnesses. Regular operation of the ultrasound machine in addition to long sitting position during reporting of images had subjected the radiologist to development of work- related musculoskeletal disorders. The study aimed at investigating the prevalence of musculoskeletal complaints among radiologists practicing diagnostic and interventional ultrasonography in Nigeria.

Methods: The subjects were radiologists who had completed their fellowship and residents in radiology with more than three years experience in the practice of radiology. Structured self administered questionnaires were distributed to the subjects at two International Conferences with radiological meetings session.

Results: 124 questionnaires were analyzed, consisting of 50(40.3%) females and 74(59.7%) males, giving female/male ratio of 1: 1.48. The mean age was 42± 0.97 years. The neck was the part of the body commonly affected by WRMSD, with 68 (54.84%) respondents. This was followed by low back seen in 66(53.23%) respondents and shoulder/upper back seen in 52(41.94%) respondents. 94(75.8%) of the respondents have had visual acuity test for eye strains and poor vision.

Conclusion: There was high prevalence of work – related musculoskeletal disorders among radiologists in Nigeria. These ranged from pains at the neck, shoulder, spine, upper and lower limbs as well as eye strain.

Open Access Original Research Article

Pattern of Ultrasound Request at the University of Port Harcourt Teaching Hospital, Nigeria

R. C. Onwuchekwa, O. West

Asian Journal of Medicine and Health, Page 1-6
DOI: 10.9734/AJMAH/2017/38189

Aim: The aim of the study is to evaluate the pattern of ultrasound request in our tertiary health institution in order to make adequate recommendation on management and financing of imaging facilities in a hospital with limited resources.

Patients and Methods: This was a prospective study of all consecutive cases of ultrasound scan referred to the radiology department of University of Port Harcourt Teaching Hospital (UPTH). The study lasted for three months; January 1st 2017 to March 31st 2017. The request forms and duplicate copies of the report of all the cases scanned each day were collected and used for this study. Information on patient’s biodata, clinical indication for the ultrasound scan, ultrasound scan findings and radiologist advice were extracted and analysed, using SPSS.

Results: Two hundred patients had ultrasound sound scan during the period. There were 147 (73.5%) females and 53(26.5%) males, giving male to female ratio of 1: 2.8.

The department of Obstetrics and Gynaecology referred the highest number of patients 81(40.5%). Abdominopelvic scan 58(28.57%), obstetric scan 47(23.15%) and abdominal scan 40(19.70%) were the more common type of the scans. Ultrasound finding was in agreement with the clinical indication in 92(46%) cases, no agreement in 72 (36%) cases and none specific in 36 (18%) cases. Sixty three, (31.5%) cases were referred to appropriate alternative imaging evaluation.

Conclusion: Ultrasound scan is an invaluable imaging modality that aids in diagnosing patients’ ailments and monitoring of treatment progress. Ultrasound scan is in high demand in obstetric and gynaecological management as depicted in this study and other studies evaluated in our discussion, hence we recommend that there should be point of care ultrasound scan service in the department of obstetrics and gynaecology to enable easy access for the patients.

Open Access Original Research Article

Analysis of Clinical Factors Associated with Preterm Infant Death with Clustered Data Using Marginal Models

Daniel Biftu Bekalo, Million Wesenu Demissie

Asian Journal of Medicine and Health, Page 1-13
DOI: 10.9734/AJMAH/2017/37910

Background: Preterm infant death is the most sensitive indicator of population health. A birth
occurring before the 37th week of pregnancy is a preterm birth. Ethiopia is among the few countries
that bear the highest burden of preterm infant deaths.
Methods: A retrospective study design was used to collect the data from the neonatal chart of preterm infants admitted to the neonatal intensive care unit in Jimma University Specialized Hospital Neonatology Clinic, SouthWest of Ethiopia from January, 2013 to December, 2015. Marginal model families; generalized estimating equation and alternating logistic regression model have been used to analyze the effects of selected variables on preterm infant death by taking gestational age as a clustering effect.
Results: From the descriptive analysis the results showed that among those eligible premature infants, 171 (34.9%) died. Based on the model comparison analysis, alternating logistic regression was the best model to fit the data. The clustering effect parameter alpha (α) in the model is statistically significant with p-value = 0.0001, indicating that based on their gestational age, there is a strong correlation among the preterm infants in regard to death. Analysis from alternating logistic regression models leads to the decision that respiratory distress syndrome (OR=2.8811), sepsis (OR=2.2702), jaundice (OR=8.9289), hyaline membrane disease (OR=3.5145), birth weight (OR=0.4005), antenatal care visit (OR=0.5847), prenatal asphyxia (OR=7.1306) and multiple pregnancy of the mother (OR=1.7976) were significant risk factors of preterm infant death. Furthermore, sex of neonate, mother’s residence, mode of delivery, age at admission, hypoglycemia, and hypothermia were not significant risk factors of preterm infant death in this study.
Conclusions: This study shows that as there is a strong correlation within categories of preterm infants based on their cluster (gestational age) and they share similar risks toward death. The study also shows that the alternating logistic regression model was the best model that fits the preterm data than generalized estimating equation. More importantly, this study contributes to the understanding of clinical risk factors influencing preterm infant death.