Open Access Review Article

Differences of Polycystic Ovary Syndrome (PCOS) Effects among Asian and Caucasian Women

Wooyoung Choi, Jae Suk Park, Adegoke Oluwatobiloba, Olugbenga Morebise

Asian Journal of Medicine and Health, Page 29-36
DOI: 10.9734/ajmah/2021/v19i830354

PCOS, Polycystic ovary syndrome, is the most common endocrine disorder occurring in women with normal reproductive age. General symptoms of PCOS include irregular menstrual cycles, polycystic ovaries, hirsutism, and hyperandrogenism. Also, Insulin resistance that is associated with obesity, skin conditions such as acne, and even psychiatric conditions have been reported. Comparison of prevalence of PCOS is not an easy task due to the fact that there are too many variables to consider. The biggest one is that each research uses different diagnostic criteria. Also, some studies use small sample sizes, and some studies are too specific in location to represent the whole country. This study reviewed articles to determine how geographical and ethnic differences among Asians and Caucasians would affect the prevalence of polycystic ovary syndrome.

Open Access Review Article

Key Parameters for Healthcare Quality

Farah Azhar, Farah Ahmad, Sadaf Anwar

Asian Journal of Medicine and Health, Page 48-53
DOI: 10.9734/ajmah/2021/v19i830356

Over several decades, a wealth of expertise and experience in improving the quality of health care has accrued globally. Despite this wealth of expertise, the challenge that is often faced by country level policymakers in both high- and low-medium income countries is to know which quality policies are being implemented. The goal of this report is to highlight and critically evaluate quality metrics published in the literature for healthcare establishments. Its goal is to present an integrated quality model that combines both technical and supportive quality indicators in order to reach the highest level of patient satisfaction. As some of the priorities of doctors and nurses are to improve patient satisfaction and patient care in a healthcare system Out of all the most critical criterion for evaluating the quality of service offered to the customer by a service provider is customer satisfaction. The quality of patient care and patient satisfaction can be assessed by the quality of facilities and training, the expertise of staff and the reliability of operating processes indicating that if the personal rights and working environment of health workers are not improved, the quality of health care cannot be expected to increase.

Open Access Review Article

Peptic Ulcer Perforation: An Enigma Since Antiquity

Sujan Narayan Agrawal

Asian Journal of Medicine and Health, Page 67-71
DOI: 10.9734/ajmah/2021/v19i830359

Peptic ulcer disease (PUD) is a serious medical condition. The perforation of peptic ulcers (PPU) causes a steep rise in mortality and morbidity. It accounts for 70% of deaths associated with PUD. More than 60% of perforations occur in the anterior wall of the duodenum, while 20% of it is in the antrum. The gastric ulcer perforation contributes to approximately 20% and is in lesser curvature. The risk factor includes non-steroidal anti-inflammatory drugs (NSAID), Helicobactor pylori (H. Pylori), smoking, alcoholism, Corticosteroid, and stress are some of the risk factors. There is a change in the epidemiology of PUD recently. The improvement is remarkable and is due to improved socio-economic status, identification and treatment of Helicobacter pylori, and introduction of proton pump inhibitors. The H pylori infection remains one of the most important causes of PUD and its complications like PPU. The reason for reviewing and writing this paper is to evaluate the most common ideas on the treatment of peptic ulcer perforation, opinion on conservative treatment, and surgical treatment options.

Open Access Original Research Article

Breast Cancer Knowledge and Mammography Uptake among Women Aged 40 Years and Above in Calabar Municipality, Nigeria

Grace Okaliwe, Glory Mbe Egom Nja, Isaac Olushola Ogunkola, Regina Idu Ejemot-Nwadiaro, Don Eliseo Lucero-Prisno III

Asian Journal of Medicine and Health, Page 1-10
DOI: 10.9734/ajmah/2021/v19i830351

Background: Breast cancer is the commonest cancer among women globally. Early screening remains a critical approach to reducing morbidity and mortality. Mammography, one of such screening tools, is vital in improving outcomes and survival. However, poor knowledge and ignorance have been touted as major barriers to health services uptake in Low/Middle-income countries. This study therefore determined breast cancer knowledge and mammography uptake among women aged ≥40 years in Calabar Municipality.

Methods: A cross-sectional study design was used to elicit information from 365 women that were randomly selected using a semi-structured questionnaire. Data analysis was carried out using SPSS version 20. The results were descriptively presented by frequencies and percentages. Pearson Chi-Square (ꭓ2) analysis was performed to detect the association between variables at 5% level of significance (p-value of ≤ 0.05).

Results: Majority of the 365 study participants 121 (33.3%) were aged between 40 – 44 years and had attained tertiary level of education 231 (63.2%). Most of the respondents had low knowledge score 214 (58.6%) of breast cancer and mammography. Only 36 (9.9%) of the respondents have had mammography out of which most 22 (61.0%) used it only once. Knowledge level of breast cancer and mammography was statistically significantly associated with uptake (p = .00001). Conversely knowledge of breast cancer and mammography was not statistically significantly associated with educational attainment (p = .54).

Conclusions: Knowledge level of breast cancer and uptake of mammography among women aged ≥40 in Calabar Municipality was very poor. The need to increase awareness about breast cancer and breast cancer screening are highly advocated.

Open Access Original Research Article

Prevalence and Risk Factors for Cutaneous Mycoses among Boarding Secondary Schools Students in Coast Region, Tanzania

Emmanuel B. Deogratias, Kennedy D. Mwambete

Asian Journal of Medicine and Health, Page 11-19
DOI: 10.9734/ajmah/2021/v19i830352

Aims: To determines the prevalence and risk factors for cutaneous mycoses (CMs) among boarding secondary schools’ students in Coast Region, Tanzania

Study Design: It was a cross-sectional survey-based study involving boarding secondary schools’ students. Cluster sampling technique was employed for data collection using semi-structured questionnaire.

Place and Duration of Study: It involved students from both government and private boarding secondary schools in a period between January and June 2020.

Methodology: The study involved 320 students (equal number of females and males). The questionnaire inquired on these key issues: contraction of CMs and/or other skin related infections, and risk factors associated with CMs, previous exposure to antifungal agents, reasons for the use, duration of use and its outcome. Obtained information was analyzed using the SPSS version 20. Multivariate and logistic regression were employed to determine association among investigated variables. Differences among the variables were considered statistically significant when p<0.05.

Results: Prevalence of CMs among the students was 61.5% (n = 197/320). Higher proportion of students in government schools had CMs as compared to private ones (35.9% vs. 25.6%; p <0.01). The former schools were twice more likely to contract CMs (OR = 2.43, 95%CI: 1.53-3.86, p <0.01) than those in private schools. Correlations existed between students’ ages and recurrence of CMs (Pearson’s R = 0.044; p<0.01); and between students’ bodyweights and prevalence of CMs (R= 0.139; p = 0.02). Association existed between non-adherence to antifungal treatment and prevalence of CMs (p = 0.001).

Conclusion: High prevalence of CMs was revealed among students, which was relatively higher among males than females. Risk factors for CMs included poor personal hygiene and sanitary conditions, students’ ages and bodyweights. Education on risk factors for CMs among the respondents is required for earlier, prevention and control. Further studies involving larger samples size are highly recommended.

Open Access Original Research Article

Prevalence and Causes of Low Vision and Blindness among Adult Patients Attending Eye Clinic in a Tertiary Hospital in South East, Nigeria

O. A. I. Otuka, N. C. Ekeleme, E. N. Akaraiwe, E. C. Iwuoha, L. I. Eweputanna, A. Kalu

Asian Journal of Medicine and Health, Page 20-28
DOI: 10.9734/ajmah/2021/v19i830353

Background: Low vision and blindness are significant public health issues worldwide. They result in educational, occupational, and social challenges in the affected persons. Their care givers/ families are also severely affected. There is however limited data on the magnitude of visual impairment in Aba, South East Nigeria.

Objective: To determine the prevalence and causes of low vision and blindness among adult patients attending eye clinic in a tertiary hospital in South East Nigeria.

Materials and Methods: This was an institutional-based retrospective, descriptive study involving 457 patients who attended Abia State University Teaching Hospital eye clinic between April and September 2018. Data was obtained from patient’s hospital records within the period under study and analyzed using IBM SPSS version 25.0. Statistical significance was set at a P-value of < 0.05.

Results: Data of 457 ophthalmic patients who met the inclusion criteria for this study were analyzed. Mean age of respondents was 48.5 ± 17.7 years. A total 5.4% of the patients had bilateral low vision, while 30.2% and 7% had monocular and bilateral blindness respectively. Cataract-related diagnosis, refractive errors and glaucoma (28.4%, 28.2% and 14.7%) respectively were the major causes of low vision and blindness among the patients. Statistically significant association was found between respondent’s diagnosis and age as well as occupation (P<0.001).

Conclusion: Results from this study will aid in planning low vision & blindness preventive programs and improving eye care services.

Open Access Original Research Article

Characteristics of ESRD Patients who have been on Long-term Hemodialysis Therapy in Egypt

Abir Farouk Megahed, Nagy Sayed-Ahmed

Asian Journal of Medicine and Health, Page 37-47
DOI: 10.9734/ajmah/2021/v19i830355

Background: It is well-known that hemodialysis extends the life of end-stage renal disease  (ESRD) patients, who would have otherwise died. The characteristics of long-term patients on hemodialysis (HD) were not evaluated before in Egypt. We aimed at identifying the specific characteristics of the patients who have survived on hemodialysis for more than 20 years in Egypt. Subjects and Methods: During the years 2018 and 2019, the twenty-seven governorate health affairs Directories of the Egyptian Ministry of Health were contacted to participate in data collection. The dialysis physicians in each hemodialysis unit were sent a questionnaire form requesting to submit information, on the characteristics of patients who have been on HD therapy for twenty  years or more.

Results: Seventy-three patients were encountered from a total number of 26000 HD patients to have been on HD therapy; with a range between 20 and 30 years. Males constituted the majority of these patients. Sixty-eight patients were dialyzed through working arteriovenous fistulas (A-V fistulas). The mean urea reduction ratio (URR) of these patients was 0.65±0.095. Acute  intradialytic complications afflicted only 20.3% of these patients. More than three-quarters of the patients had a positive serology test for HCV antibodies. None of these patients has diabetes mellitus. On the other hand, complaints related to the skeletal system were present in 47.4% of the patients. There is a statistically significant higher rate of acute complications in the female gender and a statistically significant higher fertility rate after hemodialysis in the male gender.

Conclusion: Long-term dwellers on hemodialysis therapy are not unusual in Egyptian ESRD patients and their characteristics are reasonable.

Open Access Original Research Article

Gender and Age Differences in COVID-19 in Iraqi Patient Detected By Real-Time PCR

Zainab Fadhil Abbas, Baqer J. Hasan

Asian Journal of Medicine and Health, Page 54-59
DOI: 10.9734/ajmah/2021/v19i830357

Since the SARS-CoV-2 epidemic started, it became clear that the impact of the infection incidence and fatality rate were nearly related to the population structure. The outbreak of COVID-19 have severe impacts on the population, lead to different affection in women and men. epidemic in Iraq as elsewhere penetrate rapidly across the country, identifying vulnerable groups and gender analysis and also understanding the communities help to make an effective decisions. Our study Aimed to found the differences of gender and age in Iraqi people from the coronavirus disease 2019. 21545 cases were extracted from Razi Medical center in Baghdad from October 12, 2020 to March 3, 2021, 488 where positive result was according the performance of real-time reverse transcription-PCR (RT-PCR) assays used to targe different gene of SARS-CoV-2 based on kit manuscript. For each group, we calculated cumulative positive rates stratified age and gender for corresponding risks for men vs. women. the positive 358 patients (73.4 %) were men and 130 patients (26.6%) were women. The major part of cases was in the age group of 40-60 years of old and the male to female ratio was 2.75:1. The findings of the study represented higher positive cases rate in men than women. so Male gender and older age notably associated with the risk of positive COVID-19 patients. paying special attention to male elderly patient one of the most important strategies against spreading COVID-19.

Open Access Original Research Article

Incidence of Drug-drug Interactions in Prescriptions of General Practitioners and Specialists in Bangladesh

Kazi Al Mamun, . Soleyman, Md. Ariful Islam, Tahmida Sharmin, Kushal Biswas

Asian Journal of Medicine and Health, Page 60-66
DOI: 10.9734/ajmah/2021/v19i830358

Aim: Drug-drug interactions (DDI) can cause unexpected side effects, changes in drug efficacy, metabolism or overall action of any particular drug and DDI is one of the major prescription errors. DDI can be caused by using concomitant administration of a second drug. This study aims to find DDI in prescriptions of 10 different medical specializations of Bangladesh. 

Study Design and Methodology: This study is based on the evaluation of prescription, type, and clinical significance of drug-drug interaction. For this study, 21088 prescriptions were evaluated from 45 different medical institutions and 10 different specializations including general practitioners, cardiologists, medicine specialists, general surgeons, gynecologists, ENT specialists, neurologists, urologists, pediatricians, and ophthalmologists. After the collection of prescriptions, all prescribed medications were checked by using several sources to point out the probable interactions.

Results: Among all the prescriptions most DDI was found from cardiologists (6.17%) and the least DDI was found from pediatricians (3.29%). Clopidogrel and warfarin were the most common medications causing drug interaction while drug interaction with cardiovascular drugs and antibiotics generic were most common among all. Polypharmacy, absence or shortage of pharmacists, workload, miscommunications and lack of knowledge were found as the leading causes of DDI.

Conclusion: Active participation of the pharmacist in crosschecking the prescribed medication, proper communication of the physician and patients, relevant workshops regarding DDI and distribution of the workload of the physicians in different levels can play a role in minimizing DDI.

Open Access Short Research Article

Application of Mathematical Models in Drug Release Kinetics of Cyanocobalamine Fast Dissolving Sublingual Film

Adil Patel, Ami Kalsariya, Srushti Patel, Chandni Patel, Shreya Patel

Asian Journal of Medicine and Health, Page 72-81
DOI: 10.9734/ajmah/2021/v19i830360

The aim of present work is to determine and analyse the kinetics of drug release from the fast dissolving sublingual by employing various mathematical models. A study was done with Cyanocobalamine fast dissolving sublingual films, 1.5 mg/film by employing solvent casting technique using dehydrated banana starch and Gelatin. The in-vitro drug release profile was carried out in pH 6.8 phosphate buffer (900 mL) using USP dissolution apparatus I (Basket) at 50 rpm for 20 mins. The drug release data was obtained, quantitatively correlated and interpreted with various mathematical models viz. Zero order model, first order model, Higuchi model, Hixson-Crowell model and Korsmeyer-Peppas model and evaluated to understand the kinetics of drug release. The criterion for the most suitable model was based on the high degree of coefficient of correlation of drug release profile of Cyanocobalamine fast dissolving sublingual films.