International Journal of Medicine and Medical Sciences

International Journal of Medicine and Medical Sciences | Vol. 14, No. 9, September 2024 | pp. 65–72

DOI: 10.46882/2024/IJMMS/140065

Original Research Article

Seroprevalence, Clinical Profiles, and Risk Factors of Hepatitis B and C Virus Co-Infections among Chronic Liver Disease Patients

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

¹Department of Gastroenterology and Hepatology, Faculty of Medicine, Université Cheikh Anta Diop, Dakar, Senegal.

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

Abstract:

Dual infection with Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) accelerates the progression of liver fibrosis, increasing the risk of hepatic cirrhosis and hepatocellular carcinoma. This cross-sectional clinical study investigated the seroprevalence, specific laboratory profiles, and epidemiological risk factors of HBV/HCV co-infection among patients with established chronic liver disease (CLD). Blood samples from 350 CLD patients were screened for Hepatitis B surface Antigen (HBsAg) and anti-HCV antibodies using a third-generation Enzyme-Linked Immunosorbent Assay (ELISA), followed by quantification of viral loads using real-time PCR. The seroprevalence of isolated HBV infection was 42.9% (150/350), isolated HCV was 18.6% (65/350), and confirmed HBV/HCV co-infection was identified in 5.1% (18/350) of the patients. Patients with dual co-infection presented with significantly higher mean levels of serum alanine aminotransferase (ALT) (112.5 ± 24.6 U/L) and total bilirubin (45.8 ± 12.4 μmol/L) compared to those with monoinfections (p < 0.01). Advanced liver cirrhosis (Child-Pugh Class C) was significantly more frequent in the co-infected cohort (44.4% vs. 18.3%, p < 0.01). Multivariate logistic regression modeling demonstrated that a history of multiple blood transfusions prior to 2000 (OR = 3.4, 95% CI = 1.5–7.8, p < 0.01) and traditional scarification practices (OR = 2.8, p < 0.05) were independent risk factors for co-infection. HBV/HCV co-infection causes severe biochemical disruptions and accelerates liver injury, highlighting the importance of screening all CLD patients for both viruses to guide timely antiviral interventions.

Keywords: Chronic Liver Disease, Hepatitis B Virus, Hepatitis C Virus, Co-infection, Alanine Aminotransferase, Liver Cirrhosis

Manuscript Timeline: Received: June 15, 2024; Revised: July 22, 2024; Accepted: August 14, 2024; Published: September 13, 2024.

Citation: Diallo PO, Nwachukwu CU, Diop JPB. Seroprevalence, Clinical Profiles, and Risk Factors of Hepatitis B and C Virus Co-Infections among Chronic Liver Disease Patients. International Journal of Medicine and Medical Sciences, 2024, 14(9): 65–72. DOI: 10.46882/2024/IJMMS/140065

International Journal of Medicine and Medical Sciences | Vol. 14, No. 8, August 2024 | pp. 57–64

DOI: 10.46882/2024/IJMMS/140057

Original Research Article

Diagnostic Precision of Urinary Tissue Inhibitor of Metalloproteinases-2 versus Plasma Creatinine for the Early Detection of Cardiac Surgery-Associated Acute Kidney Injury

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

¹Department of Anesthesiology and Intensive Care, 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:

Acute kidney injury (AKI) is a severe complication following cardiac surgery with cardiopulmonary bypass, but classic plasma creatinine rises slowly. This prospective diagnostic study evaluated the accuracy of the urinary biomarker combination of tissue inhibitor of metalloproteinases-2 and insulin-like growth factor-binding protein 7 [TIMP-2]•[IGFBP7] for early detection of cardiac surgery-associated AKI (CSA-AKI). We evaluated 110 adult patients undergoing elective coronary artery bypass graft or valvular replacement surgery. Urinary [TIMP-2]•[IGFBP7] concentrations were quantified at baseline, 4, 12, and 24 hours post-bypass, while plasma creatinine was monitored daily for 5 days. AKI was defined according to the KDIGO criteria. Twenty-six patients developed confirmed AKI (23.6%) within 48 hours. In the AKI group, urinary [TIMP-2]•[IGFBP7] values rose significantly from a baseline of 0.12 ± 0.04 (ng/mL)²/1000 to 1.85 ± 0.34 (ng/mL)²/1000 at 4 hours post-bypass (p < 0.01), long before plasma creatinine variations occurred. Receiver Operating Characteristic (ROC) analysis showed that 4-hour urinary [TIMP-2]•[IGFBP7] at a cutoff value of 1.0 (ng/mL)²/1000 had a sensitivity of 88.5%, a specificity of 83.3%, and an Area Under the Curve (AUC) of 0.90 (95% CI = 0.83–0.96). In contrast, 24-hour plasma creatinine achieved an AUC of only 0.62. Urinary [TIMP-2]•[IGFBP7] serves as a sensitive and precise early diagnostic biomarker for cell cycle arrest during acute renal injury, allowing for early therapeutic optimization in postoperative intensive care settings.

Keywords: Acute Kidney Injury, Cardiac Surgery, Cardiopulmonary Bypass, Biomarkers, [TIMP-2]•[IGFBP7], Diagnostic Accuracy

Manuscript Timeline: Received: May 12, 2024; Revised: June 18, 2024; Accepted: July 11, 2024; Published: August 14, 2024.

Citation: Igwe CO, Sanon RL, Boateng AD. Diagnostic Precision of Urinary Tissue Inhibitor of Metalloproteinases-2 versus Plasma Creatinine for the Early Detection of Cardiac Surgery-Associated Acute Kidney Injury. International Journal of Medicine and Medical Sciences, 2024, 14(8): 57–64. DOI: 10.46882/2024/IJMMS/140057

International Journal of Medicine and Medical Sciences | Vol. 14, No. 7, July 2024 | pp. 49–56

DOI: 10.46882/2024/IJMMS/140049

Original Research Article

Bacterial Uropathogens and Antimicrobial Susceptibility Mapping among Geriatric Patients with Catheter-Associated Urinary Tract Infections

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 Medicine, Connaught Hospital, Freetown, Sierra Leone.

Abstract:

Catheter-associated urinary tract infections (CAUTIs) in geriatric patients are often caused by multidrug-resistant bio-film-forming pathogens, leading to limited options for empiric therapy. This prospective cross-sectional study identified the predominant bacterial uropathogens and mapped their antimicrobial resistance profiles among hospitalized geriatric patients presenting with signs of CAUTI. Urine samples collected from 150 catheterized patients aged ≥ 65 years were cultured. Bacterial confirmation was achieved using automated systems, and antimicrobial susceptibility testing was performed using the disk diffusion technique. Significant bacteriuria was confirmed in 58.7% (88/150) of the symptomatic participants. Pseudomonas aeruginosa was the most common isolate (31.8%), followed by Escherichia coli (27.3%), Klebsiella pneumoniae (20.5%), and Enterococcus faecalis (13.6%). Antibiogram mapping revealed high resistance rates among Gram-negative bacilli to ciprofloxacin (74.2%) and ceftazidime (68.5%). Resistance to imipenem was detected in 18.2% of the P. aeruginosa isolates. Conversely, high susceptibility rates were maintained for amikacin (88.6%) and piperacillin-tazobactam (85.2%). Extended-Spectrum Beta-Lactamase (ESBL) production was confirmed in 33.3% of the E. coli strains. Logistic regression analysis demonstrated that a catheterization duration > 7 days was strongly associated with a multidrug-resistant infection (OR = 3.8, 95% CI = 1.9–7.6, p < 0.01). CAUTIs in geriatric patients show high resistance to common oral and parenteral antibiotics. Minimizing the duration of catheter usage, practicing sterile insertion techniques, and guiding therapies by culture results are essential strategies to reduce resistance.

Keywords: Catheter-Associated Urinary Tract Infection, Geriatric Patients, Pseudomonas aeruginosa, Escherichia coli, Antimicrobial Resistance, Catheterization Duration

Manuscript Timeline: Received: April 02, 2024; Revised: May 11, 2024; Accepted: June 05, 2024; Published: July 12, 2024.

Citation: Cole EA, Tarawallie MZ, Okoye VN. Bacterial Uropathogens and Antimicrobial Susceptibility Mapping among Geriatric Patients with Catheter-Associated Urinary Tract Infections. International Journal of Medicine and Medical Sciences, 2024, 14(7): 49–56. DOI: 10.46882/2024/IJMMS/140049

International Journal of Medicine and Medical Sciences | Vol. 14, No. 6, June 2024 | pp. 41–48

DOI: 10.46882/2024/IJMMS/140041

Original Research Article

Evaluation of Lung Function Alternations and Airway Symptoms among Bakery Food Handlers Exposed to Flour Dust

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 occupational exposure to airborne organic wheat flour dust can cause progressive respiratory sensitisation and compromise ventilatory mechanics. This cross-sectional analytical study evaluated the prevalence of respiratory symptoms and alterations in pulmonary function indices among commercial bakery food handlers. We matched 140 male bakery workers exposed to flour dust for at least 3 years with 140 unexposed healthy male control subjects based on age, height, and body mass index. Respiratory symptom profiles were evaluated using a standardized British Medical Research Council questionnaire, and lung function indices were quantified via computerized spirometry. Bakery workers demonstrated a significantly higher prevalence of chronic dry cough (38.6% vs. 10.0%, p < 0.01), morning wheezing (21.4% vs. 4.3%, p < 0.01), and exertional dyspnea (25.7% vs. 7.1%, p < 0.01) compared to the control cohort. Spirometric evaluation showed significant reductions in Forced Vital Capacity (FVC) (3.32 ± 0.35 L vs. 3.92 ± 0.41 L, p < 0.01) and Forced Expiratory Volume in 1 second (FEV1) (2.42 ± 0.28 L vs. 3.24 ± 0.32 L, p < 0.01) in the exposed group. The FEV1/FVC ratio was also significantly lower in the bakery worker cohort (72.89 ± 4.5% vs. 82.65 ± 3.1%, p < 0.05), indicating an obstructive pattern of airway impairment. Regression modeling confirmed a significant inverse correlation between the duration of bakery employment and FEV1 values (r = -0.52, p < 0.01). Occupational exposure to flour dust in bakeries significantly increases respiratory symptoms and impairs lung indices. Stricter enforcement of workplace ventilation standards and the mandatory use of protective respiratory masks are recommended.

Keywords: Flour Dust, Occupational Health, Spirometry, Forced Expiratory Volume, Airway Obstruction, Respiratory Symptoms

Manuscript Timeline: Received: March 11, 2024; Revised: April 19, 2024; Accepted: May 12, 2024; Published: June 14, 2024.

Citation: Tetteh FM, Amadi KC, Bond AJ. Evaluation of Lung Function Alternations and Airway Symptoms among Bakery Food Handlers Exposed to Flour Dust. International Journal of Medicine and Medical Sciences, 2024, 14(6): 41–48. DOI: 10.46882/2024/IJMMS/140041

International Journal of Medicine and Medical Sciences | Vol. 14, No. 5, May 2024 | pp. 33–40

DOI: 10.46882/2024/IJMMS/140033

Original Research Article

A Retrospective Institutional Review of Surgical Site Infection Prevalence and Microbiological Proportions in Major Gynecological Surgeries

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

¹Department of Obstetrics and Gynaecology, 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) are common complications following major gynecological procedures, extending hospital stay and driving antimicrobial use. This retrospective clinical study evaluated the overall prevalence, specific risk factors, and microbiological susceptibility patterns of SSIs following elective and emergency gynecological laparotomies (hysterectomies and myomectomies) over a five-year period (2019–2023). Data from 750 patient files were extracted and analyzed using the Centers for Disease Control and Prevention (CDC) grading criteria for wounds. Out of the 750 procedures reviewed, 46 cases of confirmed SSIs were identified, resulting in an overall prevalence rate of 6.13%. The infection rate was significantly higher in emergency surgeries (11.4%) compared to elective interventions (3.4%, p < 0.01). Microbiological cultures from wound site swabs showed that Staphylococcus aureus was the most common pathogen (34.8%), followed by Escherichia coli (28.3%) and Klebsiella pneumoniae (19.6%). Antibiogram mapping revealed high resistance rates among Gram-negative isolates to amoxicillin-clavulanic acid (72.4%) and ceftriaxone (58.3%), while all isolates remained completely susceptible to imipenem and amikacin (100%). Methicillin resistance was confirmed in 31.3% of the S. aureus strains. Multivariate logistic regression analysis demonstrated that an operative duration > 120 minutes (OR = 2.9, 95% CI = 1.4–5.8, p < 0.01) and a high body mass index ≥ 30 kg/m² (OR = 2.4, p < 0.05) were independent predictors of infection. Post-gynecological SSIs represent a notable clinical challenge, highlighting the need to optimize perioperative glycemic control and strictly enforce antiseptic skin preparation protocols.

Keywords: Surgical Site Infection, Gynecological Surgery, Hysterectomy, Staphylococcus aureus, Antibiotic Resistance, Risk Factors

Manuscript Timeline: Received: February 14, 2024; Revised: March 22, 2024; Accepted: April 11, 2024; Published: May 15, 2024.

Citation: Chukwu BN, Lawson PE, Kamau EM. A Retrospective Institutional Review of Surgical Site Infection Prevalence and Microbiological Proportions in Major Gynecological Surgeries. International Journal of Medicine and Medical Sciences, 2024, 14(5): 33–40. DOI: 10.46882/2024/IJMMS/140033

International Journal of Medicine and Medical Sciences | Vol. 14, No. 4, April 2024 | pp. 25–32

DOI: 10.46882/2024/IJMMS/140025

Original Research Article

Therapeutic Efficacy and Glycemic Outcomes of Sitagliptin versus Pioglitazone as Add-on Therapies in Type 2 Diabetes Mellitus

Fatima Z. Bello¹, Kwaku A. Mensah², Grace N. Ojo¹*

¹Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, Bayero University, Kano, Nigeria.

²Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Abstract:

When metformin monotherapy fails to maintain glycemic targets in type 2 diabetes mellitus (T2DM), selecting an appropriate second-line agent is necessary to optimize clinical outcomes. This randomized, open-label, comparative clinical trial evaluated the therapeutic efficacy, safety, and metabolic profiles of sitagliptin versus pioglitazone as add-on therapies in patients with inadequately controlled T2DM. A total of 150 adult patients with baseline Glycated Hemoglobin (HbA1c) between 7.5% and 9.5% despite optimal metformin therapy were randomized to receive either sitagliptin (100 mg daily, n = 75) or pioglitazone (30 mg daily, n = 75) for 24 weeks. The primary outcome was the mean reduction in HbA1c at week 24, while secondary outcomes tracked fasting plasma glucose (FPG), lipid parameters, and body weight variations. At the completion of 24 weeks, both treatment arms demonstrated significant reductions in HbA1c from baseline markers (p < 0.01). The mean decrease in HbA1c was comparable between the sitagliptin group (-0.84 ± 0.15%) and the pioglitazone cohort (-0.92 ± 0.18%, p = 0.42). Pioglitazone achieved a significantly greater reduction in mean FPG and a significant increase in HDL-cholesterol levels compared to sitagliptin (p < 0.05). However, sitagliptin demonstrated superior safety regarding body weight modifications, showing a slight mean weight reduction (-0.48 ± 0.22 kg) compared to a significant weight gain in the pioglitazone arm (+2.45 ± 0.64 kg, p < 0.001). Mild peripheral edema was reported exclusively in the pioglitazone cohort (10.7%). Both options offer similar glycemic efficacy, but sitagliptin provides advantages for weight management, whereas pioglitazone offers specific lipid benefits.

Keywords: Type 2 Diabetes Mellitus, Sitagliptin, Pioglitazone, HbA1c, Weight Modification, Metabolic Profiles

Manuscript Timeline: Received: January 12, 2024; Revised: February 20, 2024; Accepted: March 15, 2024; Published: April 16, 2024.

Citation: Bello FZ, Mensah KA, Ojo GN. Therapeutic Efficacy and Glycemic Outcomes of Sitagliptin versus Pioglitazone as Add-on Therapies in Type 2 Diabetes Mellitus. International Journal of Medicine and Medical Sciences, 2024, 14(4): 25–32. DOI: 10.46882/2024/IJMMS/140025