Original Research Article

PROBIOTIC Rhodotorula mucilaginosa ISOLATED FROM FERMENTED FOOD: INVESTIGATION OF PUFA PRODUCTION AND STRATEGY FOR HEALTH IMPROVEMENT

R. JASMINE, R. GANESH, S. MOHANAPRIYA, R. DHARANI

Asian Journal of Advances in Medical Science, Volume 4, Issue 4, Page 5-11

Polyunsaturated fatty acids (PUFAs) are a vital component for human health. PUFA cannot be synthesized by human system and hence dependance on other sources has become inevitable.

Though porcine liver and fish oil were the dependable sources for ages past, yet cheaper microbial source was sought after and have gained importance as well. Such microbial oils normally used as biofuels can also be used for several therapeutic purposes. Hence, this study was designed to evaluate the quality and quantity of lipids produced by a probiotic yeast, Rhodotorula mucilaginosa. The lipid production potential of Rhodotorula mucilaginosa has indeed attracted a lot of attention. Isolation and characterization of the probiotic yeast with enhanced lipid production and determining the lipid components have become the aim of the work.

Original Research Article

EFFICACY OF ANTI-BACTERIAL AND ANTI-FUNGAL ACTION ON THREE MEDICINAL PLANTS EXTRACT THE Rosa gallica, Psidium guajava AND Vitis vinifera AGAINST Streptococcus mutans AND Candida albicans -AN In-vitro STUDY

SUNAYANA MANIPAL, SAJID HUSSAIN, TH SOMORENDRO SINGH, . VENKAT

Asian Journal of Advances in Medical Science, Volume 4, Issue 4, Page 12-18

Introduction: World health organization has been an initiative for the widespread practice of herbal medicine been practiced in developing countries and created a scientific basis to treat infection.

Aim: The aim of the study was to test the anti-bacterial and anti-fungal activity of three medical plant extract the Rosa gallica, Psidium guajava L and Vitis vinifera against the streptococcus Mutans and Candida albicans organisms.

Settings and Design: An in-vitro study was conducted collaborated with the department of microbiology and the Department of Public Health Dentistry in SRM Dental College and Hospital for a period of four months. The extract of medical plant of Rosa gallica, Psidium guajava L and Vitis vinifera was tested in different concentration to find out the effective anti-bacterial and anti-fungal action.

Methods and Materials: Extract obtained from the medicinal plant of Rosa gallica, psidium guajava L and Vitis vinifera was procured and powdered. The minimum inhibitory concentration of the obtained extracts was determined by using the tube dilution method and the bacterial strains of Streptococcus mutans and Candida albicans was cultured into the extract obtained at concentration of 1 mg/ml, 500 µg/ml, 250 µg/ml, and 100 µg/ml respectively.

Statistical Analysis Used: Descriptive statistics was done to analysis the bacterial count in different concentration.

Results: The extracts obtained from Rosa gallica and psidium guajava L had a better anti-bacterial property when compared to the other medicinal plants and the extracts obtained from Rosa gallica and psidium guajava L had a better anti-fungal property when compared to the other two medicinal plants.

Conclusions: These plants extracts showed anti-bacterial property in previous studies to add on to the review of literature in our study it proved that Rosa gallica and psidium guajava L had a better anti-fungal activity when compared to another two medicinal plant extract. The clinical significance of the medicinal plant extract can be effectively used as anti-bacterial and anti-fungal agent as it was compared with the gold standard values of kanamycin and Ketoconazole.

Original Research Article

STRESS, EMOTIONS, AND COPING: THE LIVED EXPERIENCES OF PRIMARY CAREGIVERS WHO RAISE ADOLESCENTS WITH BIPOLAR DISORDER

KIMBERLY MORTON CUTHRELL

Asian Journal of Advances in Medical Science, Volume 4, Issue 4, Page 19-32

The purpose of this phenomenological study was to examine the relationship between primary caregivers and their adolescents who have bipolar disorder and the caregivers’ coping and adapting skills in handling their adolescents’ behaviors. The caregivers’ perceptions of their coping and adapting skills were interpreted and analyzed through transcribing, coding, and mapping processes by using Creswell’s six-coding step strategy [1]. The data were analyzed using Blumer’s [2] symbolic interaction, and constructs from R. Lazarus’s [3] stress and emotion theory, Selye’s [4] stress theory, and R. Lazarus and Folkman’s [5] transactional model of stress and coping provided the foundation of this phenomenological study to explore the stress and emotions of the primary caregivers of adolescents with bipolar disorder. Sixteen caregivers from North Carolina were selected by purposive sampling (snowball sampling) to share their stories during semi-structured interviews. The results of this qualitative analysis were examined using a phenomenological approach that took advantage of narrative inquiry and symbolic interaction that looked for emergent themes. Primary thematic results indicated that the primary caregivers of adolescents with bipolar disorder encountered stress, physical alignments, and emotional problems that often led to damaged marriages; strained or broken family relations; employment problems; and negative associations with neighbors, law enforcement, social services, and the school system. An unexpected finding was that the men in the study who were caring for adolescents with bipolar disorder were more likely than women in similar circumstances to prefer physical methods such as jogging and walking as ways to reduce their stress. No other studies found this specific finding. Results will be used to enhancethe current literature by providingempirical insights that support the need for further research into bipolar disorder among adolescents.

Original Research Article

AN EVALUATION OF THE POOLED LOLLI-METHOD RT-qPCR TESTING FOR COVID-19 SURVEILLANCE IN SINGAPORE

TAN MUI POH ADELENE, FOO CHUAN YAO CALEB, LIANG RENFEI, TAY SOCK PENG, LEE YUN ZHI, KENNETH LUI JUN FENG, THADDAEUS TAN JUN KIAT, LIU JIAMING

Asian Journal of Advances in Medical Science, Volume 4, Issue 4, Page 33-41

Background: Following the success of the Lolli-Method or Lolli-Test as a surveillance method in Germany, the Ministry of Health, Singapore investigated the feasibility of deploying the method as a rostered routine testing in vulnerable individuals such as children, nursing homes and frontline workers; and evaluated the sensitivity and ideal pooling ratio of the Lolli-Method. 

Methods: The study was conducted in two phases – the first phase was to assess the operational feasibility of the Lolli-Method. It was held in conjunction with air sampling at a childcare centre with children ages 2 to 6 years old across 40 days. The second phase was to evaluate the sensitivity of the Lolli-Method with different pooling ratios and was conducted in collaboration with the National Centre for Infectious Diseases (NCID) where each pool was spiked with one Lolli swab from a COVID-positive patient. All patients enrolled in this study have their viral load cycle threshold (CT) levels assessed prior to admission via a mid-turbinate oropharyngeal (MTOP) polymerase chain reaction (PCR) swab. 

Results: The sensitivity of the pooled Lolli-Test was similar to antigen rapid tests with 100% sensitivity (3/3) in a pooling ratio of 20:1 for patients with viral loads of cycle threshold (CT) levels below 20. For individuals with lower viral loads, the sensitivity of the Lolli-Test was 66.7% (2/3) in a pooling ratio of 20:1 and 100% (2/2) in a smaller pooling ratio of 15:1. The operational feasibility of the Lolli-Test was assessed to be high amongst study participants although students were noted to require some additional assistance from teachers. 

Conclusion: The Lolli-Test is an effective surveillance method with adequate sensitivity to detect a COVID-19 infected individual in a pool of up to 20 albeit largely dependent on the viral load. Furthermore, the Lolli-Test also provides a less invasive alternative sample collection method for individuals who cannot tolerate or have contraindications for the regular nasal or oropharyngeal swabs such as young children. More studies should be done to assess the Lolli-Test’s true limit of detection and to evaluate the use of the Lolli-Method in infants and for other respiratory diseases such as influenza.

Original Research Article

EVALUATION OF THE BURDEN OF PEDESTRIANS’ INJURIES IN QATAR FROM ROAD TRAFFIC ACCIDENTS IN TERMS OF HEALTH CARE RESOURCES AND COST

AHLAM ALNAQEB, ANAAM RUSTOM, ESRAA BARAKAT, YOUSRA FARE

Asian Journal of Advances in Medical Science, Volume 4, Issue 4, Page 42-53

Background: Road traffic injures is a significant public health issue which increase the global concern after being the tenth leading causes of death worldwide. The major victims from this issue are road users which include drivers, passengers, cyclists and pedestrians. According to Qatar National Road Safety Strategy, every year around 220 people lose their lives and a further 550 victims are seriously injured due to road traffic accidents (National Road Safety Strategy, 2013-2022). However, pedestrians’ fatal injuries constitute about twelve percent of the total death rate.

Objective: To investigate the health care resources and costs burden of pedestrian injuries from Road Traffic Accidents (RTAs) in Qatar during 2009 to 2011 and to estimate the injury severity score and mortality rates among these patients in order to provide evidence on the burden of managing pedestrians’ injuries in Qatar.

Methods: A retrospective cross sectional analysis of data collected from Hamad General Hospital trauma registry between January 2009 and December 2011. We used a cost model for various healthcare services used by the HMC Finance Department. Resource use and cost data are produced across various injury severity scores and years. Since this study is investigating and analyzing pedestrians’ injury resources and costs, the injury severity score is chosen as the main variable reflecting the total cost, length of stay (LOS) cost, intensive care unit (ICU) cost, ward unit cost, total procedure cost, total diagnostic cost, and blood unit cost. The frequency of sex, nationality 1 (Arab – Non-Arab – Qatari), nationality 2 (Nepal, India, Pakistan, Bangladesh, Philippines, and others), and year were analyzed. Data were analyzed using SPSS program.

Results: The discoveries of this report could be determined as the following; the majority of pedestrians’ injury was males and the highest rate of admission was in year 2011. It can be noticed that there are significant differences in diagnosis cost due to years with p-value <0.0001. The injury severity score had a strong relationship with the total cost, length of stay (LOS), total procedure cost, total diagnostic cost, and blood unit cost. Thus, there are significant differences between groups of total procedure cost, LOS cost, blood unit cost, and total cost due to ISS with p-value <0.0001. The injury severity score had a strong relationship with the total cost, length of stay (LOS), total procedure cost, total diagnostic cost, and blood unit cost.

Conclusion: This report offers evidence on healthcare resources and costs burden of pedestrians’ injuries over three years period in Qatar. It gives indication on how to better manage these patients in terms of healthcare resource allocations, and can be used in future planning by policy makers.

Original Research Article

DETERMINATION OF T. vaginalis AND OTHER ASSOCIATED STIs AMONG PREGNANT WOMEN IN ABA NORTH, ABIA STATE NIGERIA

VICTOR S. NJOM, ANITA CHIKODI CHIBUKO

Asian Journal of Advances in Medical Science, Volume 4, Issue 4, Page 54-61

Trichomoniasis is a global public health problem affecting human genitals especially women with severe complications in pregnancy. It is poorly reported. A cross sectional survey of pregnant women in Aba North local council, Abia State southeast Nigeria was undertaken using specimen microscopy and structured questionnaire. Of 286 women investigated the overall prevalence of T. vaginalis alone in the population was 2.1%.  T. vaginalis disease proportion was associated with age (p < 0.05). Age range of 25-29 years had highest prevalence (4.8%) while 30-34 years had the least infection (1.05%). Pregnant mothers < 18 years and those within 35 years and above had no T. vaginalis infection. There was no association between trimester and disease proportion (p > 0.05). Of other STIs observed, Candida infection was highest (35.3%) while Chlamydia sp had the least prevalence (0.35%). Pregnant mothers within age of 25–29 years had more Candida infection (63.9%) than age group of 40 years and above. E. coli, Bacteria vaginosis, Staph aureus, and Chlamydia sp, had prevalences of 11.6%, 6.32%, 15.79%, and 1.05% respectively. Proportion of T. vaginalis, Candida, and E. coli infections in relation to age were statistically significant (p < 0.05). Proportions of observed STIs were significantly (p<0.05) associated with marital status. Candida sp and Staph aureus infections were more prevalent among traders and least among housewives. T. vaginalis and other STIs were not associated with level of education (p>0.05). There was significant (p<0.05) relationship between number of sex partners and sexually transmitted infections. Use of contraceptive such as condom was associated with proportion of infection (p < 0.05). T. vaginalis and other STIs are important public health threat in Aba hence routine screening and education of women about safe sex are highly recommended.

Original Research Article

EVALUATION OF GLUTATHIONE, TOTAL ANTIOXIDANT CAPACITY, TOTAL PLASMA PEROXIDES, OXIDATIVE STRESS INDEX IN CATARACT PATIENTS IN CALABAR

ISONG, IDONGESIT KOKOABASI, AKPAN, UWEM OKON, BASSEY, IYA EZE, ANA, AUGUSTA, OFEM, NTONGHA, EMMANUEL KINGSLEY JOHN, ISONG EKPENYONG

Asian Journal of Advances in Medical Science, Volume 4, Issue 4, Page 87-95

Introduction: Cataract with prevalence of 15.4% is the leading cause of blindness among blinding eye diseases. The cause of cataracts is not fully understood and may be multifactorial, however oxidative damage to the lens proteins and lipids is suggested to be involved in the development of cataracts. This study aimed to determine the serum levels of glutathione (GSH), Total Antioxidant Capacity (TAC), Total Plasma Peroxides (TPP) and Oxidative Stress Index (OSI) in cataract patients in Calabar.

Materials and Methods: One hundred and seventeen subjects which comprise 75 diagnosed cataract patients and 42 controls were recruited. The cataract patients were sub-divided based on WHO criteria as: No visual impairment (n = 25), visually impaired (n = 25) and blind (n = 25).  GSH, TAC and TPP were determined using verified colorimetric methods while OSI was calculated. Anthropometric indices, blood pressure and sociodemographic information were obtained using standard methods. Data were analyzed using Student’s t-test, analysis of variance (ANOVA), LSD post hoc and Pearson’s correlation at P < .05.

Results: The TPP and OSI were significantly higher while GSH and TAC were significantly lower (P < .05) in cataract patients compared to the control subjects. GSH and TAC were significantly lower (P < .05) in cataract patients with blindness and visually impaired compared to those without visual impairment. Oxidative stress index correlated negatively with TAC (r = -0.607, P < .05) and positively with diastolic blood pressure (r = 0.296, P = .01) in cataract patients.

Conclusion: It can be concluded that increased oxidative stress may be associated with the formation of cataracts and further depletion of GSH and TAC may cause the progression of cataracts to blindness.

Original Research Article

SCHISTOSOMIASIS DETECTION AMONG SCHOOL AGED CHILDREN IN COMMUNITIES LIVING ALONG THE NYAMA RIVER SYSTEM IN ENUGU STATE NIGERIA

VICTOR S. NJOM, PRINCESS CHIOMA IREH

Asian Journal of Advances in Medical Science, Volume 4, Issue 4, Page 96-102

Schistosomiasis is a public health concern particularly in rural areas where poverty and poor social amenities prevail. The disease infects mostly children of school age and pregnant women, more often those living close to water bodies harbouring the snail intermediate host of the causative agent of schistosomiasis. The Nyama River system transverses many communities in Enugu State and the prevalence of schistosomiasis in these communities is unknown. This study therefore aimed to determine the prevalence of schistosomiasis infection among school-aged children living along the Nyama River system. A cross- sectional study involving urine and stool microscopy was used to demonstrate eggs of parasites respectively. The result showed an overall prevalence of 21.7% for Schistosoma haematobuim and 17.6% for Schistosoma mansoni infections; more males were infected with Schistosoma haematobuim (27.9%) than females (15.1%). There was a statistically significant difference between infections among age groups (P < 0.05) with children between 9 – 11 years having more infection than the other age groups. There was also statistically significant difference in infection among schools with Akwuke Primary school having the highest rate of infection in comparison to the other schools. It is recommended that the government develop control strategies for afflicted school children. Also, large-scale testing and treatments should be carried out for the entire community, including all age groups, to determine the transmission cycle from adults to children.

Original Research Article

PREVALENCE OF Cryptosporidium INFECTIONS BETWEEN APPARENTLY HEALTHY AND IMMUNO-COMPROMISED INDIVIDUALS AT PARKLANE HOSPITAL ENUGU

VICTOR S. NJOM, SAMSON OBINNA NNAMANI

Asian Journal of Advances in Medical Science, Volume 4, Issue 4, Page 109-114

Cryptosporidiosis is a disease caused by a protozoan parasite of the genus Cryptosporidium, that affect both young animals and humans. A cross-sectional study was conducted among immune-compromised and apparently healthy subjects attending Parklane Hospital in Enugu, to determine the prevalence of Cryptosporidium infection and associated risk factors. Faecal and urine samples were microscopically examined to demonstrate Cryptosporidium. While demographic data and other risk factors were obtained by structured questionnaire interview.  Only immune-compromised subjects had oocyst of Cryptosporidium with an overall prevalence of 2.82% and there was statistically significant difference (p=0.00213) in proportion of infection between immune-compromised and apparently healthy subjects. For type of samples, faecal material had 11(8.46%) positive cases while no Cryptosporidium was detected in all the urine samples. Male had the highest prevalence of 7.27%, while female had 5.00% Cryptosporidium infection. For age, the highest prevalence was in people within 15 – 25 years (9.09%) and lowest (6.25%) among 36 – 45 years old. People with educational level below primary school had highest prevalence (5.55%) though there was no association between proportion of infection and educational level of subjects (P=0.9618).  Subjects who wash their hands before meal had lowest prevalence (0.68%) while those who never wash hand before meal had highest infection (16.6%), those who said that they consumed roadside food had (6,66%) infection. Subjects who used piped water had 6.25% infection, while those who buy water from other sources had 3.06% infection. Those who source water from stream/river had 3.13% infection. Sources of drinking water were associated to proportion of infection (p<0.05). In conclusion, cryptosporidiosis is one of the health problems of immune-compromised patients in Enugu town. These findings confirmed that risk factors such as educational level, age, and types of food and water source are epidemiological factors of Cryptosporidium infection in human.

Short Research Articles

ASSESSMENT SERUM GLUCOSE AND PLASMA GLUCOSE UNDER IDENTICAL CONDITIONS

BILLY SÁNCHEZ–JACINTO

Asian Journal of Advances in Medical Science, Volume 4, Issue 4, Page 67-71

According to the International Diabetes Federation, South and Central America region has the proportion of 41.9% people with diabetes who are undiagnosed. Several factors influence the stability of glucose values after collection as “in vitro” glycolysis. Aim of this study was to compare the fasting glucose levels either in plasma or in serum under identical conditions.

Methodology: Blood samples were collected in K2 EDTA and serum tubes with clot activator and both tubes were maintained in upright position for 30 min at room temperature to allow clot formation. Also, linear regression model was used for evaluate la relationship between glucose plasma and glucose serum and multiple linear regression was used and two model for obtain coefficients adjusted by hematology parameters covariates.

Results: Mean glucose in serum tube was -1.57 mg/dl than K2 EDTA tube and that was no statistically significant difference for glucose (p = 0.41) and neither clinically significant. But on the other hand, serum glucose increases by 1 mg/dl; while EDTA glucose increases by an average of 0.59 mg/dl (p<0.05).

Conclusion: Serum glucose is similar to plasma glucose when hematology parameters between the reference range.

Review Article

ANALYSIS OF SECONDARY TRAUMATIC STRESS AMONG PHYSICIANS

KIMBERLY MORTON CUTHRELL, MARLY VILLAMAR, TANYA GREEN

Asian Journal of Advances in Medical Science, Volume 4, Issue 4, Page 72-86

The narrative review was important in understanding secondary traumatic stress among physicians. The primary aim of this narrative review was achieved by reviewing qualitative and quantitative studies to analyze if physicians were at-risk of being exposed to secondary traumatic stress when providing care to traumatized individuals. A review of the literature revealed a significant finding that identified 29 medical specialties that were more likely to be exposed to secondary traumatic stress associated with burnout when subjected to repetitive indirect traumatic exposures. An interesting finding showed that physicians were at a greater risk of secondary traumatic stress when they worked longer hours per day (12 hours or more), extended hours throughout the week (80 hours or more), and worked primarily overnight shifts. An unexpected finding in this narrative review revealed that physicians with dependents (e.g., a child/children) had an increased risk of being vulnerable to the effects of secondary traumatic stress. This noteworthy finding was compelling because factors that interlinked dependents to secondary traumatic stress among physicians were unanticipated. Though this narrative review contributes to the body of literature, further studies are necessary because research on secondary traumatic stress among physicians is limited and the lack of literature suggests needed future research.

Mini Review Article

BIOPESTICIDES ARE THE NEED OF PRESENT TIME FOR SAFE ENVIRONMENT AND HEALTHY HUMANS

SHYAM GUPTA, JUHI GUPTA, HANSHIKA SINGH

Asian Journal of Advances in Medical Science, Volume 4, Issue 4, Page 103-108

India is one of the most populous countries in the world therefore food problems are of prime importance. Poor population of India amounts to more than 300 million people therefore to achieve food security; grain produced must be protected from depredating agents such as insects and other pests during harvesting as well as storage. The easy handling and relatively cheaper synthetic chemical pesticide controls measure are very common and most widely used in India. One of the major causes of cancer in agriculture workers is excessive use of chemical pesticides. These chemical pesticides cause negative effects on human health and quality of the environment. Ecofriendly alternatives to chemical pesticides are biopesticides because they generally affect only the target pest without any negative effect on human health and the environment. The aim of this review study was to explore the need of biopesticides in present time due to their useful aspects and also due to biological ill effects of synthetic chemical pesticide.

Case Reports / Case Studies

SOLITARY DIAPHYSEAL EXOSTOSIS OF THE ULNA: A CASE REPORT OF AN UNCOMMON PRESENTATION

ISABEL PARADA-AVENDAÑO, JORGE GIL-ALBAROVA

Asian Journal of Advances in Medical Science, Volume 4, Issue 4, Page 1-4

Background: Reporting a case of osteochondroma in an uncommon location in a pediatric patient.

Presentation of Case: A female patient with a history of limited pronation in the right forearm due to a solitary lesion in anterolateral part of distal third of the ulna, features suggesting ostechondroma both in imaging and histopathology.

Discussion: Distal ulnar exostosis are described in the literature in relation with multiple hereditary exostoses disease and deformities in ulna or both forearm bones requiring a surgical intervention but a solitary isolated forearm exostosis is rare.

Conclusion: Osteochondromas in the forearm are rare but they should be considered in the differential diagnosis if features are suggesting it.

Case Reports / Case Studies

MUCORMYCOSIS WITH FUNGAL BALL OF MAXILLARY SINUS – A RARE STUDY

KUNAL GAUR, MARY LILLY

Asian Journal of Advances in Medical Science, Volume 4, Issue 4, Page 62-66

Background and Aim: Mucormycosis is an infection caused by a group of filamentous molds within the order Mucorales. In developing countries, most cases occur in persons with poorly controlled diabetes mellitus or following trauma. Mortality associated with invasive mucormycosis is high (> 30–50%). Noninvasive fungal ball, a matted  collection of fungal hyphae, previously known as 'Aspergillomas', has been rarely reported with Mucoraceaespecies.

Case presentation: A 52-year-old man, known case of diabetes mellitus presented with a discharging sinus in left maxillary region and a blackish ulcer in Left molar region. Computed tomography scan revealed extensive cortical erosion of  left hemi-maxilla. Mucormycosis infection with a maxillary sinus fungal ball was confirmed on histopathological examination. The patient was treated with intravenous AmphotericinB.

Discussion: The incidence of fungal rhinosinusitis (FRS), once thought to be a rare condition, has dramatically increased recently. Acute invasive fungal rhinosinusitis is relatively rare that is frequently observed in immunocompromised people specifically uncontrolled diabetics or people on immunosuppressive medications, typically associated with Aspergillus and Mucoraceae species. On the other hand, a fungal ball of the paranasal sinus is noninvasive and typically found in immunocompetent, non-atopic hosts. Aspergillus species are the most commonly isolated fungi, however, fungal ball formation is rarely seen with mucormycosis.

Conclusion: An anomalous presentation of a Fungal Ball associated with mucormycosis is the primary focus of this report.

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