International Journal of Medicine and Medical Sciences

International Journal of Medicine and Medical Sciences | Vol. 12, No. 9, September 2022 | pp. 65–72

DOI: 10.46882/2022/IJMMS/120065

Original Research Article

Hypoglycemic and Pancreatoprotective Potentials of Phyllanthus amarus Methanolic Extract in Alloxan-Induced Diabetic Rats

Mustapha T. Gidado¹, Rose C. Obi², Elizabeth W. Wanjiku¹*

¹Department of Pharmacology, Faculty of Pharmaceutical Sciences, University of Maiduguri, Maiduguri, Nigeria.

²Department of Pharmacology and Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi, Kenya.

Abstract:

Pancreatic islet cell damage caused by chronic oxidative stress is a hallmark of experimental and clinical diabetes mellitus. This animal study investigated the hypoglycemic, antioxidant, and pancreatoprotective effects of a crude methanolic extract of Phyllanthus amarus leaves (MEPA) in alloxan-induced diabetic Wistar rats. Hyperglycemia was induced via a single intraperitoneal injection of alloxan (150 mg/kg). Thirty-five rats were allocated to 5 groups: Normal Control, Diabetic Control, Glibenclamide group (2 mg/kg), and two diabetic groups treated orally with MEPA at 200 mg/kg and 400 mg/kg body weight daily for 21 days. Fasting blood glucose (FBG) levels were evaluated weekly, and serum insulin and lipid markers were quantified at study termination. Oral administration of 400 mg/kg MEPA for 21 days resulted in a significant reduction in mean FBG from 17.42 ± 1.35 mmol/L to 5.92 ± 0.42 mmol/L (p < 0.01), showing comparable efficacy to the glibenclamide group (5.54 ± 0.38 mmol/L). MEPA significantly increased serum insulin concentrations (from 3.8 ± 0.5 μIU/mL to 12.4 ± 1.2 μIU/mL, p < 0.01 vs. diabetic control). Tissue analysis showed that MEPA lowered pancreatic malondialdehyde (MDA) levels and significantly restored catalase and glutathione peroxidase activities (p < 0.01). Histopathological analysis confirmed these biochemical findings, showing marked restoration of pancreatic islet volume and reduced cellular necrosis. Phyllanthus amarus leaves possess potent hypoglycemic and antioxidant properties that protect pancreatic tissue and enhance insulin secretion.

Keywords: Phyllanthus amarus, Diabetes Mellitus, Alloxan, Hypoglycemic, Oxidative Stress, Pancreatoprotection

Manuscript Timeline: Received: June 15, 2022; Revised: July 22, 2022; Accepted: August 14, 2022; Published: September 14, 2022.

Citation: Gidado MT, Obi RC, Wanjiku EW. Hypoglycemic and Pancreatoprotective Potentials of Phyllanthus amarus Methanolic Extract in Alloxan-Induced Diabetic Rats. International Journal of Medicine and Medical Sciences, 2022, 12(9): 65–72. DOI: 10.46882/2022/IJMMS/120065

International Journal of Medicine and Medical Sciences | Vol. 12, No. 8, August 2022 | pp. 57–64

DOI: 10.46882/2022/IJMMS/120057

Original Research Article

Seroprevalence and Molecular Genotypes of Human Immunodeficiency Virus Co-Infections among Patients with Active Pulmonary Tuberculosis

Patrick O. Diallo¹, Cynthia U. Nwachukwu², Jean-Pierre B. Diop¹*

¹Department of Infectious Diseases, Faculty of Medicine, Université Cheikh Anta Diop, Dakar, Senegal.

²Department of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.

Abstract:

Human Immunodeficiency Virus (HIV) co-infection worsens the pathology of pulmonary tuberculosis (TB) and increases the complexity of treatment. This cross-sectional study determined the seroprevalence and distribution of specific HIV strains and genotypes among patients presenting with active, sputum-smear-positive pulmonary TB. Blood samples from 400 newly diagnosed TB patients were screened for HIV-1 and HIV-2 antibodies using rapid test algorithms and confirmed via Western Blot. Viral RNA extraction and subsequent sequencing were performed on dual-positive specimens to determine specific sub-genotypic distributions. The overall seroprevalence of HIV co-infection among the TB patients was 16.5% (66/400). Out of the 66 co-infected patients, HIV-1 infection predominated at 89.4% (59/66), HIV-2 accounted for 7.6% (5/66), and dual HIV-1/HIV-2 infection was confirmed in 3.0% (2/66). Molecular genotypic mapping of HIV-1 isolates revealed that the CRF02_AG circulating recombinant form was the most prevalent variant (64.4%), followed by subtype G (18.6%) and subtype A (10.2%). CD4+ T-cell count distribution showed that 54.5% of co-infected individuals had severe immunosuppression with a CD4+ count < 200 cells/μL. Logistic regression demonstrated that an age between 25 and 35 years (OR = 2.9, p < 0.05) and a history of previous incarceration (OR = 3.4, 95% CI = 1.7–6.8, p < 0.01) were significant risk factors. The high prevalence of HIV-1 CRF02_AG co-infections among TB patients emphasizes the need for universal, integrated TB-HIV clinic systems to ensure early initiation of antiretroviral and antitubercular therapies.

Keywords: Pulmonary Tuberculosis, HIV Co-infection, Seroprevalence, Molecular Genotypes, CRF02_AG, Immunosuppression

Manuscript Timeline: Received: May 14, 2022; Revised: June 20, 2022; Accepted: July 12, 2022; Published: August 16, 2022.

Citation: Diallo PO, Nwachukwu CU, Diop JPB. Seroprevalence and Molecular Genotypes of Human Immunodeficiency Virus Co-Infections among Patients with Active Pulmonary Tuberculosis. International Journal of Medicine and Medical Sciences, 2022, 12(8): 57–64. DOI: 10.46882/2022/IJMMS/120057

International Journal of Medicine and Medical Sciences | Vol. 12, No. 7, July 2022 | pp. 49–56

DOI: 10.46882/2022/IJMMS/120049

Original Research Article

Diagnostic Precision of Serum Neutrophil Gelatinase-Associated Lipocalin versus Serum Creatinine for the Early Detection of Contrast-Induced Acute Kidney Injury

Charles O. Igwe¹, Rachel L. Sanon², Anthony D. Boateng¹*

¹Department of Radiology, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria.

²Department of Nephrology, Faculty of Health Sciences, Université de Ouagadougou, Ouagadougou, Burkina Faso.

Abstract:

Contrast-induced acute kidney injury (CI-AKI) elevates cardiovascular mortality following coronary angiography, but conventional serum creatinine is a slow diagnostic marker. This prospective cohort study evaluated the diagnostic accuracy of serum neutrophil gelatinase-associated lipocalin (sNGAL) compared to serum creatinine for the early detection of CI-AKI. We evaluated 140 adult patients with chronic kidney disease (baseline eGFR between 30 and 59 mL/min/1.73m²) undergoing elective coronary angiographic procedures. Serum NGAL was measured via chemiluminescent immunoassay at baseline, 4, 12, and 24 hours post-procedure, while serum creatinine was monitored daily for 3 days. CI-AKI was defined as a ≥ 25% or ≥ 44.2 μmol/L increase in serum creatinine from baseline within 48 hours. Twenty-four patients developed confirmed CI-AKI (17.1%). In the CI-AKI group, sNGAL levels rose significantly from a baseline of 84.5 ± 12.4 ng/mL to 185.4 ± 24.6 ng/mL at 4 hours post-procedure (p < 0.01), whereas serum creatinine variations were non-significant at this time point. Receiver Operating Characteristic (ROC) analysis showed that 4-hour sNGAL at a cutoff value of 140 ng/mL had a sensitivity of 91.7%, specificity of 86.2%, and an Area Under the Curve (AUC) of 0.92 (95% CI = 0.85–0.97). In contrast, 24-hour serum creatinine achieved an AUC of only 0.68. Serum NGAL serves as a highly sensitive and precise early diagnostic biomarker for contrast-induced renal injury, allowing for timely protective renal interventions long before creatinine clearance falls.

Keywords: Contrast-Induced Nephropathy, Acute Kidney Injury, Neutrophil Gelatinase-Associated Lipocalin, Biomarkers, Coronary Angiography, Renal Function

Manuscript Timeline: Received: April 02, 2022; Revised: May 11, 2022; Accepted: June 05, 2022; Published: July 12, 2022.

Citation: Igwe CO, Sanon RL, Boateng AD. Diagnostic Precision of Serum Neutrophil Gelatinase-Associated Lipocalin versus Serum Creatinine for the Early Detection of Contrast-Induced Acute Kidney Injury. International Journal of Medicine and Medical Sciences, 2022, 12(7): 49–56. DOI: 10.46882/2022/IJMMS/120049

International Journal of Medicine and Medical Sciences | Vol. 12, No. 6, June 2022 | pp. 41–48

DOI: 10.46882/2022/IJMMS/120041

Original Research Article

Bacterial Uropathogens and Antimicrobial Susceptibility Profiles in Female Patients with Uncomplicated Cystitis

Elizabeth A. Cole¹, Moses Z. Tarawallie², Victoria N. Okoye¹*

¹Department of Medical Microbiology, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.

²Department of Obstetrics and Gynaecology, Connaught Hospital, Freetown, Sierra Leone.

Abstract:

Uncomplicated acute cystitis is a frequent cause of antibiotic prescriptions in women, but empirical therapy is increasingly limited by rising antimicrobial resistance. This prospective cross-sectional study identified the predominant bacterial uropathogens and mapped their resistance profiles among non-pregnant female outpatients presenting with signs of uncomplicated cystitis. Mid-stream urine specimens from 350 women aged 18 to 45 years were cultured. Bacterial confirmation was achieved through standard automated methods, and susceptibility profiles were assessed using the disk diffusion technique. Significant bacteriuria (≥ 10⁵ CFU/mL) was confirmed in 44.3% (155/350) of the participants. Escherichia coli was the most common isolate (61.3%), followed by Klebsiella pneumoniae (15.5%) and Staphylococcus saprophyticus (11.6%). Antibiogram mapping revealed high resistance rates among Gram-negative isolates to cotrimoxazole (74.2%) and ampicillin (81.9%). Resistance to ciprofloxacin was also high at 28.4%. Conversely, excellent susceptibility rates were observed for nitrofurantoin (91.6%) and fosfomycin (94.8%). Phenotypic screening for Extended-Spectrum Beta-Lactamase (ESBL) production was positive in 12.6% of the E. coli strains. Logistic regression showed that a history of prior UTI within the past 12 months was strongly linked to an ESBL-producing strain (OR = 3.2, 95% CI = 1.5–6.8, p < 0.01). Due to extensive resistance to cotrimoxazole and fluoroquinolones, these agents should be avoided for empirical use. Nitrofurantoin and fosfomycin should be prioritized as first-line agents for uncomplicated acute cystitis in this outpatient setting.

Keywords: Acute Cystitis, Escherichia coli, Antimicrobial Resistance, Nitrofurantoin, Fosfomycin, Empirical Therapy

Manuscript Timeline: Received: March 11, 2022; Revised: April 19, 2022; Accepted: May 15, 2022; Published: June 15, 2022.

Citation: Cole EA, Tarawallie MZ, Okoye VN. Bacterial Uropathogens and Antimicrobial Susceptibility Profiles in Female Patients with Uncomplicated Cystitis. International Journal of Medicine and Medical Sciences, 2022, 12(6): 41–48. DOI: 10.46882/2022/IJMMS/120041

International Journal of Medicine and Medical Sciences | Vol. 12, No. 5, May 2022 | pp. 33–40

DOI: 10.46882/2022/IJMMS/120033

Original Research Article

Evaluation of Cardiopulmonary Fitness and Autonomic Function Indices among Chronic Heavy Cigarette Smokers

Festus M. Tetteh¹, Kingsley C. Amadi², Arthur J. Bond¹*

¹Department of Physiology, School of Biomedical Sciences, University of Ghana, Accra, Ghana.

²Department of Medicine, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.

Abstract:

Chronic tobacco smoking impairs respiratory mechanics and disrupts autonomic cardiovascular regulation, elevating long-term cardiac mortality risks. This cross-sectional analytical study evaluated cardiopulmonary fitness indices and heart rate variability (HRV) parameters among chronic heavy cigarette smokers. We enrolled 120 male heavy smokers (smoking ≥ 20 cigarettes/day for ≥ 5 years) and 120 age- and body mass index-matched healthy non-smoking controls. Pulmonary function was measured via spirometry, and aerobic capacity (VO₂ max) was evaluated using a standardized treadmill exercise protocol. Autonomic function was determined through short-term resting electrocardiographic HRV parameters. Smokers demonstrated significant reductions in Forced Expiratory Volume in 1 second (FEV1) (2.45 ± 0.34 L vs. 3.22 ± 0.38 L in controls, p < 0.01) and FEV1/FVC ratio (72.4 ± 4.5% vs. 82.8 ± 3.2%, p < 0.01). The mean aerobic capacity (VO₂ max) was also significantly lower in the smoking cohort (32.4 ± 4.2 mL/kg/min vs. 41.8 ± 5.1 mL/kg/min, p < 0.01). HRV analysis revealed marked autonomic imbalance in smokers, characterized by decreased root mean square of successive differences (RMSSD) (21.4 ± 3.5 ms vs. 36.8 ± 5.2 ms, p < 0.01) and elevated low-frequency to high-frequency (LF/HF) ratios (2.45 ± 0.42 vs. 1.22 ± 0.25, p < 0.001), indicating sympathetic overactivity. Chronic heavy smoking induces significant ventilatory impairment, reduces physical endurance, and triggers autonomic dysregulation. Public health anti-smoking campaigns and smoking cessation programs are vital to lower cardiorespiratory risks. [1]

Keywords: Cigarette Smoking, Spirometry, Aerobic Capacity, Heart Rate Variability, Autonomic Dysregulation, Pulmonary Function

Manuscript Timeline: Received: February 10, 2022; Revised: March 18, 2022; Accepted: April 12, 2022; Published: May 13, 2022.

Citation: Tetteh FM, Amadi KC, Bond AJ. Evaluation of Cardiopulmonary Fitness and Autonomic Function Indices among Chronic Heavy Cigarette Smokers. International Journal of Medicine and Medical Sciences, 2022, 12(5): 33–40. DOI: 10.46882/2022/IJMMS/120033

International Journal of Medicine and Medical Sciences | Vol. 12, No. 4, April 2022 | pp. 25–32

DOI: 10.46882/2022/IJMMS/120025

Original Research Article

A Five-Year Trend Assessment of Surgical Site Infections and Risk Factors in a Tertiary Orthopedic Center

Blessing N. Chukwu¹, Patrick E. Lawson², Evelyn M. Kamau¹*

¹Department of Surgery, Faculty of Clinical Sciences, University of Port Harcourt, Port Harcourt, Nigeria.

²Department of Community Health, College of Health Sciences, Moi University, Eldoret, Kenya.

Abstract:

Surgical site infections (SSIs) significantly increase morbidity, healthcare costs, and duration of hospital stay in orthopedic surgery. This retrospective institutional study analyzed the five-year trend (2017–2021) and specific clinical risk factors associated with SSIs following major open orthopedic procedures. Data from 1,120 patient files were extracted and evaluated according to the Centers for Disease Control and Prevention (CDC) criteria for SSIs. Out of the 1,120 surgical procedures reviewed, 68 cases of confirmed SSIs were identified, yielding an overall incidence rate of 6.07%. The annual trend showed a progressive rise from 4.8% in 2017 to 7.4% in 2021. Superficial incisional SSIs were the most frequent (52.9%), followed by deep incisional (32.4%) and organ/space infections (14.7%). Staphylococcus aureus was the predominant bacterial pathogen isolated (41.2%), with 35.7% of these strains confirmed as methicillin-resistant (MRSA). Multivariate logistic regression modeling demonstrated that an operative duration > 180 minutes (OR = 3.4, 95% CI = 1.8–6.4, p < 0.01), pre-existing diabetes mellitus (OR = 2.8, 95% CI = 1.3–5.9, p < 0.01), and a preoperative hospital stay > 5 days (OR = 2.1, p < 0.05) were independent predictors of SSI development. The rising trend of SSIs in orthopedic procedures highlights the need for strict adherence to perioperative preventive bundles. Optimizing operating room traffic, minimizing surgical duration, and ensuring timely administration of prophylactic antibiotics are crucial clinical interventions.

Keywords: Surgical Site Infection, Orthopedic Surgery, Staphylococcus aureus, Risk Factors, Retrospective Study, Operating Room

Manuscript Timeline: Received: January 08, 2022; Revised: February 14, 2022; Accepted: March 10, 2022; Published: April 14, 2022.

Citation: Chukwu BN, Lawson PE, Kamau EM. A Five-Year Trend Assessment of Surgical Site Infections and Risk Factors in a Tertiary Orthopedic Center. International Journal of Medicine and Medical Sciences, 2022, 12(4): 25–32. DOI: 10.46882/2022/IJMMS/120025