Open Access Original Research Article

Knowledge, Attitude and Predisposing Risk Factors of Non-Albican Vulvovaginal Candidiasis among Symptomatic Women in Port Harcourt

K. T. Wariso, J. A. Igunma

Asian Journal of Medicine and Health, Page 1-7
DOI: 10.9734/AJMAH/2018/40741

Background: The profile of non Candida albicans has risen greatly as a causative agent of Vulvovaginal candidiasis. However, little is known about the predisposing factors or the contributory attitude of those affected. This has made prevention and control of these agents difficult and for a long time, had been neglected because of the assumption that Candida albicans causes all or almost all cases of Vulvovaginal candidiasis.

Aim: To determine the knowledge, attitude and risk factors predisposing female patients to the acquisition of Non-Candida albicans vulvovaginitis in Port Harcourt using questionnaires, mycological culture technique, and germ tube testing.

Materials and Methods: High vaginal swab (HVS), demographic data and epidemiological risk factors were collected from 247 respondents with symptomatic vulvovaginal Candidiasis. Germ tube testing method was used to differentiate between albicans and non Candida albicans. The data was analyzed using the SPSS version 20. Association between variables was compared by using the Chi-square (χ2) test and level of significant was set at P < 0.05.

Results: The prevalence of non Candida albicans among symptomatic women with Vulvovaginal Candidiasis was 76.68%,the notable associated risk factors elicited from the study  were  inappropriate antifungal used which was found among 56.03% of the  total  non Candida albicans positive respondents this was statistically significant another was  poor health seeking behavior, as much as 41.0% of the  positive respondent treated their previous VVC at patent medicine store also was significant statistically P<0.005 while the  poor knowledge of etiology of VVC was also outrageously high with as much as 50.86% of positive respondent believed VVC was a toilet infection, while 20.68% have no knowledge of the etiology and  10.34%,8.62%, 9.48%  respectively  attributed VVC etiology to sexual activity, poor hygiene and ovulation.

Conclusion: The associated risk factors of this  high prevalence of non Albican candida in the study are common practice in our environment, hence there is need for coordinated health education to create adequate awareness to mitigate against this rising profile of non Candida albicans in  our environment.

Open Access Original Research Article

Coagulation Profile of Children with Snake Envenomation in Yola, Nigeria

Emmanuel Asuquo Etim, Adjekuko Ohwonigho Collins, Sallawu F. Abdullfatai, Henry Langand Badung, Ezekiel Chagwa Friyanda

Asian Journal of Medicine and Health, Page 1-8
DOI: 10.9734/AJMAH/2018/36407

Background/Objective: Coagulation profile includes Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), and Platelet count. It is a common hematological test use to determine the degree of coagulopathy cause by snake venom. Snake bite envenomation is a common rural accident. This study aims to evaluate coagulation profile of children with snake bite injuries in Yola, Nigeria.

Materials and Methods: 137 subjects comprising of 69 children with snake bite (21 females and 48 males with mean age of 10.465.64 years) and 68 clinically healthy subjects (with mean age of 11.23 comprising of 29 female and 39 males) participated in this present study.  Platelet count was estimated using sysmex XP 300 hematology analyzer.  PT and APTT values were determined in the blood using one-stage prothrombin test method and Modified Kaolin Method respectively.

Results: The mean value of APTT test in patients was 47.0 seconds while that of the control group was 39.47 seconds, P< 0.05. The mean value of the PT test and the International Normalized Ratio (INR) in patients were 29.90 and 6.30 respectively P < 0.05. The correlation of PT versus APTT value was significant with the correlation coefficient (r) of 0.86 at P < 0.05.

Conclusion: Snake bite occurred more in male children than females. Children with snake envenomation had prolonged PT and APTT time as well as thrombocytopenia. It is believed that information provided in this study will assist to improve clinical management of this group of patients in Yola, Nigeria.

Open Access Original Research Article

Hematological Profile in Pregnancy and Its Effect on Birth Outcomes; a Longitudinal Study of the Komfo Anokye Teaching Hospital, Kumasi

Olivia Nyarko Mensah, Kweku Bedu-Addo, Alexander T. Odoi, Prince Adoba, Richard K. D. Ephraim

Asian Journal of Medicine and Health, Page 1-9
DOI: 10.9734/AJMAH/2018/33380

Background: Pregnancy causes remarkable and dramatic changes in hematological variables which have an impact on pregnancy and its outcome.

Objective: This descriptive longitudinal study examined maternal hematological parameters during pregnancy and its effect on pregnancy outcomes.

Methods: Three hundred and fifty (350) pregnant women with singleton pregnancies who delivered at the Obstetrics and Gynecology Unit of the Komfo Anokye Teaching Hospital (KATH) were randomly enrolled. Full blood count (FBC) was estimated and a well-structured questionnaire was used to collect socio-demographic data and obstetric history of participants.

Results: Haemoglobin levels steadily decreased from first to the third trimester, with a rise during parturition and neonatal periods. Anemia was most prevalent in the third trimester of pregnancy (47.1%). White blood cell (WBC) count increased from the first trimester till the puerperium, platelet (PLT) count was similar in the three trimesters, with a significant decrease at parturition and puerperium. Except for the mean corpuscular volume (MCV), all the other hematological indices did not show a significant correlation with Apgar score < 7 at the 5th minute in our study (P > 0.05). No correlation was found between maternal hematological indices at parturition and neonatal birth weight (P > 0.05). Maternal WBC count showed a positive significant relationship (β = 0.095, P = 0.012) with the neonatal WBC count.

Conclusion: Pregnant women have altered hematological indices during pregnancy, parturition and puerperium. Parturient hematological indices did not have any significant association with Apgar score < 7 at the 5th minute and birth weight.

Open Access Original Research Article

A Randomized Placebo Controlled Study to Determine the Efficacy of Oral Diclofenac Sodium in the Treatment of Symptomatic Osteoarthritis of the Knee in Nnewi, South Eastern Nigeria

Chima Collins Ihegihu, Ebere Yvonne Ihegihu, Afamefuna Victor Egwuownu, Joseph Onuwa Umunnah

Asian Journal of Medicine and Health, Page 1-9
DOI: 10.9734/AJMAH/2018/40535

Background: Diclofenac sodium is a non-selective non-steroidal anti-inflammatory drug (NSAID) that is widely used therapeutically for its analgesic and anti-inflammatory properties in the treatment of knee osteoarthritis (KOA) but no scientific study has been carried out at Nnewi, a town located in the Southeastern part of Nigeria to determine its therapeutic efficacy. The purpose of this study was to determine the efficacy of oral diclofenac sodium in the treatment of KOA in the local population using knee joint pain intensity, quadriceps muscle strength and 30.4 metres walk-time as outcome measures.

Materials and Methods: The research population comprised of participants who had symptomatic osteoarthritis of the knee according to the criteria established by the American College of Rheumatology (ACR). Seventy-six participants were randomly and equally distributed into two groups: the study group (oral diclofenac sodium) and control group (placebo). The participants in the study group were given one tablet of 50 mg diclofenac sodium and one tablet of vitamin B complex twice daily while those in the control group took only one tablet of vitamin B complex twice daily. Each participant in both groups took the drugs for seven consecutive weeks. The Statistical Package for Social Sciences (SPSS) version 20 software package was used for the data entry and analysis.

Results: Fifty-eight participants comprising of 19(32.8%) males and 39(67.2%) females completed this study. The male to female ratio was 1:2. There was a significant reduction in the knee joint pain intensity score in the study group at the end of seven weeks of treatment which was statistically significant (p=0.001) and also a statistically significant reduction in 30.4m walk-time of the participants in the study group (p=0.010), however there was no statistically significant change in the quadriceps muscle strength (p=0.056). There were no statistically significant changes in any of the outcome measures in the control group.

Conclusion: This study provides evidence to show that oral diclofenac sodium is efficacious in relieving symptoms in patients who have symptomatic KOA, when used with caution in selected patients at Nnewi. 

Open Access Case Study

A Case of Adult Stills Disease: Not So Uncommon Cause of Fever of Unknown Origin

Arun Agarwal, Aakanksha Agarwal, Abu Saad Khan

Asian Journal of Medicine and Health, Page 1-7
DOI: 10.9734/AJMAH/2018/41263

Adult still’s disease (ASD) is a defined clinical entity and a known cause of fever of unknown origin (FUO). It is a rare systemic inflammatory disorder characterized by a triad of symptoms: daily (quotidian) spiking fever (>39°C), arthritis and an evanescent salmon-colored rash. First described in 1971, it is a uncommon, difficult to diagnose, auto inflammatory, multisystem disorder. The disease is characterized by two subsets according to clinical and laboratory features: systemic or articular. Early diagnosis and treatment of the disease can prevent morbidity and mortality with a favorable outcome. We present and discuss a young male patient who presented as FUO and was diagnosed timely as ASD and treated with corticosteroids with a favorable prognosis.