Abstract:

There is correlation between Down syndrome and Type 1 Diabetes (T1DM). Many researchers have fuelled this concept by chromosomal analysis, anatomical and physiological analysis aand has provided support by assessing the prevalence of diabetes mellitus (DM) in persons with Down Syndrome. The objective of this study was to provide information of the risk of DM in persons under the age of 20 years with Down Syndrome and the awareness of caregivers (parents/guardians and teachers) of Down syndrome children on the potential development of T1DM in those children. The study was conducted with the use of two groups involving children with Down Syndrome and their caregivers. Questionnaires were distributed to the caregivers and a rrandom blood glucose analysis was performed on the children using the glucose oxidase method. The results show that 38% of Down syndrome children were at risk of becoming diabetic having blood glucose levels above 140mg/dl. The mean blood glucose in this study was 141.2mg/dl. Children 6-10 years had the highest mean blood glucose levels (143 mg/dl). Males had greater proportion (14%) of very high blood glucose as compared to females (4%). Children whose parents/guardians answered yes to monitoring their diet had a high blood glucose level mirroring those that were not monitored. Caregivers were also not aware of the predisposition to diabetes. The results have indicated that the situation requires attention from parents, the schools and the Ministry of Health and Education in Guyana and in turn they have to address this problem as soon as a child is born and diagnosed with Down syndrome so as to combat the potential situation from the inception.

Word for index: Trisomy- 21, Down syndrome, Glucose, Children, Guyana, Type 1 diabetes mellitus.

References:

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[8]. Badiu, Corin, et al. Autoimmunity Puzzle in Down Syndrome. Down Syndrome Education Online. [Online] January 2010. [Cited: January 9, 2012.] http://www.down-syndrome.org/case-studies/2138/.

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[17]. Insulin resistance in an 18-year-old patient with Down Syndrome presenting with hyperglycaemic coma,hypernatraemia and rhabdomyolysis. Hoorn, E J, De Vogel, S and Zietse, R. 3, The Netherlands : Blackwell Publishing Ltd , 2005, Vol. 283.

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[20]. Down syndrome and coexistent autoimmune diseases. Chistiakov, Dimitry. 2, Pittsburgh : University of South Bohemia , 2007, Vol. 5. ISSN 1214-0287.

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Abstract:

In this review, we discussed about updated concept about diastolic dysfunction of left ventricle and mechanism behind the diastolic heart failure with normal Ejection fraction of LV using modern and advanced non-invasive technique of 2D Echocardiography. In actual way, the invasive data obtained from cardiac catheterization is considered the gold-standard to study LV filling pressures and LV pressure volume curves. 2D Echocardiography with advanced technology is useful, affordable and more convenient to the patients those who have Hypertension, diabetes, thyroid disorders, infiltrative, restrictive or hypertrophic cardiomyopathy, valvular disorders, pericarditis, severe pulmonary hypertension and pre and post operative procedures. We can differentiate diastolic heart failure from systolic heart failure based on parameters such as increased myocardial stiffness, delayed isovolumic relaxation, increased LV filling pressure and decreased LV Compliance but preserved LV Ejection fraction or systolic function when patients present with dyspnoea on exertion or worsen heart failure.

Keywords-2D Echocardiography, diastolic functions, heart failure, advanced diastology.

References:

Journal Article

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[10]. Paulus WJ. Beneficial effects of nitric oxide on cardiac diastolic function: “the flip side of the coin.” Heart Fail Rev. 2000; 5: 337–344.

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[32]. Jianwen Wang, PhD, MD; ( Nov. 2007):Left Ventricular Untwisting Rate by Speckle Tracking Echocardiography, Circulation 2007, 116:2580-2586 .

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Book Articles

[1]. Eric J. Topol; Robert M. Califf (2007). Textbook of cardiovascular medicine. Lippincott Williams & Wilkins. pp. 420–. ISBN 978-0-7817-7012-5. Retrieved 16 November 2010.

[2]. Crowley, Leonard V. (2013). An Introduction to Human Disease: Pathology and Pathophysiology Correlations. Jones & Bartlett Publishers. p. 323. ISBN 9781449632403. Retrieved 16 August 2014.

[3]. Germing, A.; Gotzmann, M.; Schikowski, T.; Vierkötter, A.; Ranft, U.; Krämer, U.; Mügge, A. (2011). "High frequency of diastolic dysfunction in a population-based cohort of elderly women - but poor association with the symptom dyspnea". BMC Geriatrics 11: 71. doi:10.1186/1471-2318-11-71. PMC 3219735. PMID 22047619. edit Hurst (2001), p. 709.

Abstract:

Background: There are various types of medical board and each board has different and specific function. Medical Board of Mozambique, which called junta Medico( in protégées)/ joint medical report, is an organ of the Ministry of Health of Mozambique. It corrects decision taken by health technicians and other level of medical professionals regarding the capacity of work of different categories of workers of Government and nongovernment organizations. There was no single study carried out on this subject neither in Mozambique nor another country. There were needing to see the various factors responsible for requesting Medical board for evolution a change to moderate categories of work, incapacity to work till recovery, evolution for retirement, evaluation to start work after recovery from diseases, evolution to justify absenteeism after long sick leave, evolution to send for treatment to super specialty hospital, to transfer the work place near the hospital for a disease has associated, transfer to further treatment of hospital in the country or out of the country

Methods: There were taken randomly 44 patients, those got evaluated their health status by physician on request of the Medical Board of province of Nampula to take decisions. Patients evaluated by OPD by taking medical history ,physical examination, investigation necessary for diagnosis, finally writing medical reports in the format provided by the Ministry of Health Mozambique to present back to Medical board.

Results: There were found the commonest age group appeal to the medical board for various purposes; age 41-60, predominant of the male sex, urban population group, professor highly prevalent ,HIV were most common cause of appeal from. FOR A CHANGE FROM NORMAL CAPACITY OF WORK TO MODERATE WORK -25 % work in relation to HIV and hypertension with CVA 2. EVALUTION OF JUSTIFICATION OF ABSENT LONG TERM PERIOD OF THEIR SERVICES WITHOUT JUSTIFICATION -22.7%.

Conclusions: There were found from cause of appeal to the medical board , commonest among HIV diseases, change moderate category of work and unjustified sick leaves.

Keywords:-ADSE the General Directorate of Social Protection to Employees and Agents of Public Administration, ID , Identification, CBC Complete blood count, VDRL Venereal Disease Research Laboratory, PSA Prostate-specific antigen,

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Abstract:

Herpes Zoster is primarily a dermatologic condition, and its gastrointestinal complication is rarely reported. Acute constipation is a very unusual complication of Herpes Zoster. In this case report, we describe a 59-year old male who was admitted with complaints of abdominal distension and severe constipation for five days, accompanied by multiple itchy vesicular eruptions in the area of T7-T12 dermatomes for four days. The patient was diagnosed with visceral neuropathy leading to acute constipation due to Herpes Zoster. He was managed conservatively with antiviral medication and laxatives and showed dramatic improvement in his symptoms. Early recognition of this complication of Herpes Zoster is very important because timely diagnosis can result in preferable outcome with conservative treatment only, thus avoiding unnecessary surgical intervention.

References:

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[4]. Siakir M, Anastasia M, Hakan N, Konstantinos M. Acute constipation due to abdominal herpes zoster: an unusual association. Annals of Gastroenterology. 2012;25:374–375.

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Abstract:

The review is a critical analysis of the article” Factors Influencing Referral of Patients with Voice Disorders from Primary Care to Otolaryngology” published in the Laryngoscope.

In the review of this article, first summary is given, secondly assessment of the print structure is done, keeping in view its layout and reader friendly format. Lastly the aim of the review of this article is towards a critique analysis , evaluating its authority, currency, accuracy, objectivity and coverage. Any tables, graphs, diagrams and illustrations are also analyzed.

References:

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Abstract:

OBJECTIVE—The goal of this study was to estimate the prevalence of diabetes and complications of the number of people of all ages with diabetes those got attended in OPD of Diabetes of Hospital central Nampula.

RESEARCH DESIGN AND METHODS—Data on diabetes prevalence limited 24 patient randomly selected of OPD of central Hospital Nampula. Patients were taken information regarding Identification, history & physical examinations. There were used results of Investigations of hematological, biochemistry etc, Radiologic examination if needed, Monofilament test, Tunic fork, ophthalmoscope, blood pressure apparatus, Glucometer.

RESULTS— During evolution of patient of OPD of Diabetes in Central Hospital Nampula found, DM 1 was less than 15 years of age group and DM 2 start from age 31 and picks age 46 to 60 years. There was male sex had higher % of DM it also related to culture as male was more sedentary life style did manual work and women were used to do house work which taken physical work. There were profession which involved life style sedentary, high calories intake, rich in economy professors and student, Urbanization also was one factor which responsible for development of Diabetes. There were most common complication Diabetic Neuropathy and impotency but less common Diabetic Retinopathy and Nephropathy.

CONCLUSIONS—Which suggest improvement of facility of diagnosis various complication, education of patient availability of drugs, adherence of treatment, awareness of general population and professional regarding Diabetes mellitus in Nampula.

Keywords: DM1, DM2, BP, OPD, GDM, AMODIA

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Objective: To investigate whether the working or the non-working group of individuals have higher blood cholesterol as a result of an unhealthy dietary lifestyle.

Design and Methods: In 1000 adults (240 males and 760 females) aged 18-75 years were randomly selected for this study, and all subjects would have visited the WDRH. The total cholesterol levels were measured using a ChemWell chemistry analyzer and the eating habits were assessed by self-administered questionnaires.

Results: The results indicated that 64% of the working as compared to 69% non-working respondents was hypercholesterolemic. The non-working respondents (26%) snacked more for 5 times or more a week and consumed higher amounts of high dietary animal fats and proteins daily (21%). However, more working respondents ate out (10% for breakfast 5-6 times a week, 33% for lunch and 13% for dinner once a week), skipped meals (for breakfast 13% and lunch 5%) and were also greatly affected. Further, the working respondents also consumed more alcohol frequently (16%), increasing the anti-atherogenic effects and they were also more fairly knowledgeable (51%) about hypercholesterolemia.

Conclusion: The non-working respondents had higher levels of total cholesterol than the working respondents. Hypercholesterolemia in both the working and non-working respondents was favorably associated with eating habits and partially knowledge of respondents. There should be further research to assess the dietary lifestyle risk factors associated with this condition. 

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Abstract:

Diabetes mellitus (DM) is a major global health problem and it affects more than 200 million people worldwide. It is the most common serious metabolic disorder in humans. Diabetes is characterised by hyperglycaemia as a result of a relative or absolute lack of insulin or the actions of insulin on its target tissues or both. The disease is classified into two major groups, Type 1 or Insulin-Dependent Diabetes Mellitus (IDDM) and Type 2 or Non-Insulin Dependent Diabetes Mellitus (NIDDM). Type 1 diabetes represents approximately 5–10 % of all cases of diabetes and it is characterised by an auto-immune mediated destruction of the beta cells of pancreas, leading to a severe reduced capacity of these cells to produce insulin with resultant insulin deficiency. Type 2 diabetes represents more than 90 % of all cases and it is characterised by insulin resistance and relative insulin deficiency. It is mainly due to a genetic disposition, environmental and human behavioural factors, including sedentary lifestyle, overtly rich nutrition, affluence and obesity. Both forms of diabetes are associated with long-term complications that affect most of the major organs of the body, such as the eyes, brain, heart, blood vessels, kidneys and nervous system. Complications can be suppressed or prevented by good metabolic control. During the past few years, tremendous advances have been made in early diagnosis and in controlling and preventing the disease, understanding the complications and developing new forms of treatment. Research has focused on several areas of DM including the insulin pump, ion channelopathies, pancreatic islet transplant, control of obesity, salivary and pancreatic insufficiencies, contractile dysfunction of the heart and understanding the causes of retinopathy, neuropathy and nephropathy. This review focuses on the disease itself and new research into a number of areas of its long-term complications.

Key words: Diabetes mellitus, pancreas, insulin, momordica charantia, hypoglycaemia, cardiomyopathy, glucose

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Abstract:

Background- Actinomycosis is an uncommon disease caused by Actinomyces spp., Gram-positive, anaerobic or microaerobic bacteria that normally colonize the human mouth and GIT and genital tracts. Cardio-pulmonary actinomycosis with peritoneal involvement is a rare presentation.

Case report – A 29 years old female normotensive and euglycemic, smoker with poor oral hygiene was referred to us an outside hospital with complaints of right lower chest pain with severe shortness of breath and low grade fever last 4 hrs . On examination she showed dental caries, right chest bulging with diminished breath sounds, distended abdomen, raised WBC counts and normal ECG, Chest X-Ray showed right sided pleural effusion and bilateral opacities, pericardial effusion and ascites which were confirmed by 2D echo, CT chest & abdomen . Lab tests were negative for tuberculosis or malignancy. Finally she was diagnosed as an actinomycosis israelii based on culture and biopsy. She was treated with long course of appropriate antibiotics and fluid drainage.

Conclusion-Patients with actinomycosis require prolonged high doses of penicillin G or amoxicillin and other sensitive antibiotics and drainage. Early diagnosis will reduce the hospital stay or mortality in such kind of patients.

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