International Journal of Medical Advances and Discoveries

International Journal of Medical Advances and Discoveries ISSN 2756-3812 Vol. 15 (2), pp. 001-006, February, 2024. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Best Practices for NT-proBNP Reference Values: Findings from the CLEAN Assessment

Larry H. Bernstein¹*, Michael Y. Zions^1,4, Mohammed E. Alam^1,5, Salman A. Haq¹, John F. Heitner¹, Stuart Zarich², Bette Seamonds³ and Stanley Berger³

¹New York Methodist Hospital, Brooklyn, New York, USA.
²Bridgeport Hospital, Bridgeport, Connecticut, USA.
³Mercy Catholic Medical Center, Darby, Philadelphia, Pennsylvania, USA.
⁴Touro College, Brooklyn, New York, USA.
⁵Medgar Evers College, Brooklyn, New York, USA.

Accepted 8 September, 2023

Abstract

The natriuretic peptides, B-type natriuretic peptide (BNP) and NT-proBNP that have emerged as tools for diagnosing congestive heart failure (CHF) are affected by age and renal insufficiency (RI). NT-proBNP is used in rejecting CHF and as a marker of risk for patients with acute coronary syndromes. This observational study was undertaken to evaluate the reference value for interpreting NT-proBNP concentrations. The hypothesis is that increasing concentrations of NT-proBNP are associated with the effects of multiple co-morbidities, not merely CHF, resulting in altered volume status or myocardial filling pressures. NT-proBNP was measured in a population with normal trans-thoracic echocardiograms (TTE) and free of anemia or renal impairment. Study participants were seen in acute care for symptoms of shortness of breath suspicious for CHF requiring evaluation with cardiac NT-proBNP assay. The median NT-proBNP for patients under 50 years is 60.5 pg/ml with an upper limit of 462 pg/ml, and for patients over 50 years the median was 272.8 pg/ml with an upper limit of 998.2 pg/ml. We suggest that NT-proBNP levels can be more accurately interpreted only after removal of the major co-morbidities that affect an increase in this peptide in serum. The PRIDE study guidelines should be applied until presence or absence of comorbidities is diagnosed. With no comorbidities, the reference range for normal over 50 years of age remains steady at ~1000 pg/ml. The effect shown in previous papers likely is due to increasing concurrent comorbidity with age.

Key words: Congestive heart failure, natriuretic peptides, anemia, chronic renal insufficiency.
 

International Journal of Medical Advances and Discoveries ISSN 2756-3812 Vol. 15 (2), pp. 001-004, February, 2024. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Examining Hypofibronectinemia in Leprosy Patients

Ogbu ISI* and Ogalagu RO

Department of Medical Laboratory Sciences, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu State, Nigeria.

Accepted 03 October, 2023

Abstract

The aim of this study is to determine the levels of plasma fibronectin in leprosy patients of Nigerian origin. Seventy leprosy patients, 42 men and 28 women, aged 20 to 70 years, of Mile 4 Hospital Abakalilki in Ebonyi State of Nigeria and seventy age and sex-matched apparently normal subjects were used. Some (44) of the patients were on multiple drug therapy with dapsone, rifampicin, and clofazimine as the mainline drugs. The remaining 26 patients had stable treated leprosy but were living in the colony, (on-colony). Study protocol was approved by the Ethic Committee of the University of Nigeria Teaching Hospital, Enugu and informed consent was obtained from all subjects before collection of data and samples was made. Plasma fibronectin was assayed by an ELISA method. The leprosy patients had mean plasma fibronectin levels of 70.51 ± 17.83 µg/ml, men 85.39 ± 18.0 µg/ml, women 63.19 ± 3.63 µg/ml compared with the mean control value of 286.2 ± 130 µg/ml, men 395.5 ± 114.5 µg/ml, women 208.9 ± 71.69 µg/ml (p < 0.001). Peak control values were observed in the fifth decade of life, 40 to 49 years, and declined steadily thereafter. The peak values for the patients were observed in third decade of life, 20 to 29 years, and declined steadily with advancing age. Patients on drugs had lower fibronectin values, 71.32 ± 13.83 µg/ml, than those living on colony, 85.30 ± 20.50 µg/ml (p < 0.05). There is marked hypofibronectinaemia in leprosy patients that may be due to several possible causes. More work is needed to elucidate the exact cause(s) of hypofibronectinaemia in leprosy.

Key words: Leprosy, hypofibronectinaemia, plasma fibronectin, adhesion protein, Nigerian lepers.

International Journal of Medical Advances and Discoveries ISSN 2756-3812 Vol. 15 (1), pp. 001-007, January, 2024. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Assessing Iron Deficiency and Anemia in Female University Students

Fatin Al-Sayes¹*, Mamdooh Gari², Safaa Qusti³, Nadiah Bagatian³ and Adel Abuzenadah²

¹Department of Hematology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. ²Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.

³Department of Biochemistry, Faculty of Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.

Accepted 11 November, 2023

Abstract

Iron deficiency is the most prevalent nutritional problem in many parts of the world and the most common cause of anemia in Saudi Arabia especially among female. Accordingly, this study was designed to determine the prevalence of iron deficiency and iron deficiency anemia among apparently healthy Saudi young female university students studying at King Abdulaziz University in Jeddah province. Three hundred ten blood samples were collected from the students. Their ages ranged between (18 and 23) years. The data collected consisted of two sections: (A) included socio-demographic data on students such as age, height, weight, social habits, diseases symptoms, menstrual, dietary, and medical history and (B) consisted of laboratory results carried out on each subject. 50.2% of students were normal and hence considered as control group. 25.9% of students had deficient iron store and 23.9% of students had iron deficiency anemia. There was a significant correlation between iron deficiency and iron deficiency anemia with inadequate meat intake and impaired exercise capacity. Furthermore, pallor and past medical history of iron deficiency anemia were statically significant variables. Therefore, it is recommended to use screening and educational programs for iron deficiency anemia among female as high risk groups. Iron supplement and food iron fortification are required in order to overcome this simple but common health problem.

Key words: Iron deficiency anemia, deficiency, female at university stage, socio demographic data.
 

International Journal of Medical Advances and Discoveries ISSN 2756-3812 Vol. 15 (1), pp. 001-004, January, 2024. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

A Comparative Study of MALDI-TOF MS and Conventional Culture Methods for Bacterial Species Identification

Iroha Ifeanyichukwu Romanus¹*, Ayogu Thomas Eze², Oji Anthonia Egwu¹, Afiukwa Felicitas Ngozi¹ and Nwuzo Agabus Chidiebube¹

¹Department of Applied Microbiology, Faculty of Biological Sciences Ebonyi State University, P.M.B. 053, Abakaliki,
Ebonyi State, Nigeria.
²Department of Food Technology, Institute of Management and technology, Enugu, P.M.B. 01079, Enugu State, Nigeria.

Accepted 28 November, 2023

Abstract

Identification of bacteria to species level is based on culturing in different media which takes 48 to 72 h from the time of isolation. Matrix-assisted desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) is a new technology in bacteria identification. We evaluated MALDI-TOF-MS system with 101 consecutively isolated bacteria colonies under routine laboratory conditions by comparing its identification efficiency with conventional culturing and biochemical tests. The MALDI-TOF MS identified bacteria colonies as Escherichia coli 44(43.5%), Klebsiella pneumoniae 56(55.4%) and Stenotrophomonas maltophila 1(1.4%) while cultural and biochemical method identified bacteria colonies as E. coli 43(42.5%), K. pneumoniae 56(55.4%) and failed to identify one bacteria colony which was identified as S. maltophila by MALDI-TOF MS. Our data suggests that although both methods are good for bacteria identification, MALDI-TOF MS is better than conventional culturing and biochemical tests because of its short turn around time with no loss of accuracy.

Key words: Bacteria identification, MALDI- TOF MS, culture, biochemical test, bacteria colony.
 

International Journal of Medical Advances and Discovery ISSN 2756-3812 Vol. 7 (3), pp. 001-003, March, 2020. © International Scholars Journals

Case Report

Transient trifascicular block in severe hyperkalemia: A case report

AGARWAL Navnit, SINGH Anurag, GABA Ripudaman*, SHUKLA Ranjeet, AGARWAL Mandavi and JAISWAL Pankaj

Department of Medicine, MLB Medical College, Jhansi Uttar Pradesh, 284128, India.

Accepted 17 October, 2019

Abstract

Hyperkalemia is a commonly encountered electrolyte abnormality that can significantly alter normal cardiac conduction. Potentially lethal dysrhythmias associated with hyperkalemia include complete heart block and Mobitz type II second-degree atrioventricular (AV) block. We report a case of trifascicular block, due to hyperkalemia. The patient's symptoms and electrocardiogram (ECG) evidence of trifascicular block resolved with lowering of serum potassium levels, with subsequent ECG showing left anterior hemiblock. This paper highlights an infrequently reported dysrhythmia associated with hyperkalemia that emergency physicians should be familiar with.

Key words: Hyperkalemia, trifascicular block, right bundle branch block, left anterior fascicular block, first degree AV block, isoprenaline, hemodialysis, emergency.

International Journal of Medical Advances and Discovery ISSN 2756-3812 Vol. 7 (2), pp. 001-005, February, 2020. © International Scholars Journals

Review

Impalement injury of the oro-pharynx with fatal consequences in a child: A case report and review of the literature

A. A. Adoga*, M. B. Sandabe, A. Bemu, E. Musa, A. A. Bakari, A. M. Kodiya and B. M. Ahmad

National Ear Care Center, No. 3 Golf/Independence Way, P. M. B. 2438, Kaduna, Nigeria.

Accepted 22 November, 2019

Abstract

Impalement injuries of the oropharynx are especially common in children. They may be innocuous injuries but can present with life threatening sequele which range from neurologic to non-neurologic sequele. Herein, we report the first of this type of injury from Nigeria and it was a 2 year old female child who presented with a rod like metallic object embedded in her oropharynx following a fall on the same object. She had surgical removal of the foreign object with seeming uneventful recovery but experienced severe hemorrhage in the 12th postoperative hour that lead to her demise. The purpose of this report is to highlight this type of injury even in our environment and to emphasize that a high index of suspicion is required in assessing the extent of injury in these patients in order to institute timely and appropriate treatment to avoid life threatening sequele.

Key words: Oropharynx, impalement injury, child, death, Nigeria.