International Journal of Medicine and Medical Sciences

International Journal of Medicine and Medical Sciences | Vol. 14, No. 3, March 2024 | pp. 17–24

DOI: 10.46882/2024/IJMMS/140017

Original Research Article

Prevalence of Left Ventricular Hypertrophy and Geometric Variations in Asymptomatic Hypertensive Adult Patients

Chidi O. Okafor¹, Amina J. Hassan², Samuel K. Appiah¹*

¹Department of Medicine, College of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.

²Department of Medicine and Therapeutics, Korle Bu Teaching Hospital, Accra, Ghana.

Abstract:

Left ventricular hypertrophy (LVH) is a strong independent predictor of adverse cardiovascular events in essential hypertension, often remaining asymptomatic during its early stages. This cross-sectional echocardiographic study evaluated the prevalence of LVH and specific patterns of left ventricular (LV) geometric remodeling among asymptomatic hypertensive adult patients. We evaluated 160 adults managed for essential hypertension without clinical history of heart failure or coronary disease. M-mode and two-dimensional echocardiography quantified LV mass index (LVMI) and relative wall thickness (RWT). LV geometry was classified into four groups: normal geometry, concentric remodeling, eccentric hypertrophy, and concentric hypertrophy. The mean duration of hypertension was 5.4 ± 2.8 years, and the mean blood pressure was 148.4 ± 11.5 / 94.2 ± 6.8 mmHg. The overall prevalence of echocardiographic LVH was found to be 44.3% (71/160). Geometric distribution analysis revealed that concentric hypertrophy was the most common abnormal pattern (22.5%), followed by eccentric hypertrophy (13.8%) and concentric remodeling (11.9%), leaving 51.8% with normal geometry. Multivariate logistic regression modeling demonstrated that poor blood pressure control (systolic BP ≥ 140 mmHg) (OR = 3.6, 95% CI = 1.8–7.2, p < 0.001) and concurrent obesity with a BMI ≥ 30 kg/m² (OR = 2.8, p < 0.01) were independent predictors of concentric hypertrophy. A high burden of abnormal LV geometry exists among asymptomatic hypertensive patients. Early echocardiographic screenings are important to identify high-risk geometric patterns and guide appropriate antihypertensive drug choices to promote hypertrophy regression.

Keywords: Essential Hypertension, Left Ventricular Hypertrophy, Echocardiography, Concentric Hypertrophy, Relative Wall Thickness, Cardiovascular Risk

Manuscript Timeline: Received: December 02, 2023; Revised: January 14, 2024; Accepted: February 10, 2024; Published: March 14, 2024.

Citation: Okafor CO, Hassan AJ, Appiah SK. Prevalence of Left Ventricular Hypertrophy and Geometric Variations in Asymptomatic Hypertensive Adult Patients. International Journal of Medicine and Medical Sciences, 2024, 14(3): 17–24. DOI: 10.46882/2024/IJMMS/140017

International Journal of Medicine and Medical Sciences | Vol. 14, No. 2, February 2024 | pp. 9–16

DOI: 10.46882/2024/IJMMS/140009

Original Research Article

Gastroprotective and Mucosal Restorative Actions of Ocimum gratissimum Crude Leaf Extract against Ethanol-Induced Gastric Mucosal Injury in Rats

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

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

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

Abstract:

Acute alcohol consumption induces severe gastric mucosal erosions by promoting lipid peroxidation and down-regulating mucosal defensive factors. This experimental animal study examined the gastroprotective, antioxidant, and restorative potential of an ethanolic extract of Ocimum gratissimum leaves (EEOG) against ethanol-induced gastric mucosal injury in male Wistar rats. Thirty-five adult rats were randomly assigned to 5 equal groups: Normal Control, Ulcer Control (absolute ethanol 1.0 mL orally), Cimetidine standard control (100 mg/kg), and two treatment groups receiving EEOG (200 and 400 mg/kg) orally for 14 consecutive days prior to ethanol administration. Gastric injuries were evaluated macroscopically via ulcer index scores, gastric wall mucus quantification, tissue lipid peroxidation assays, and histopathological analysis. Oral administration of absolute ethanol caused extensive mucosal lesions, indicated by a high ulcer index (5.24 ± 0.42) and a significant drop in gastric wall mucus (p < 0.01). Pre-treatment with EEOG (especially at 400 mg/kg) significantly attenuated this mucosal injury, reducing the mean ulcer index to 1.34 ± 0.18 (p < 0.01 vs. ulcer control) and preserving mucosal mucus content. Biochemical evaluations showed that EEOG significantly reduced gastric tissue malondialdehyde (MDA) levels and restored glutathione peroxidase and superoxide dismutase activities (p < 0.01). Histopathology confirmed these findings, showing minimal epithelial erosion and a substantial reduction in submucosal edema and leukocyte infiltration. Ocimum gratissimum leaf extract offers significant gastroprotection against ethanol-induced injuries by suppressing oxidative stress and maintaining mucosal barrier function.

Keywords: Ocimum gratissimum, Gastric Ulcer, Ethanol Induction, Gastroprotection, Lipid Peroxidation, Mucosal Barrier

Manuscript Timeline: Received: November 11, 2023; Revised: December 20, 2023; Accepted: January 14, 2024; Published: February 16, 2024.

Citation: Gidado MT, Obi RC, Wanjiku EW. Gastroprotective and Mucosal Restorative Actions of Ocimum gratissimum Crude Leaf Extract against Ethanol-Induced Gastric Mucosal Injury in Rats. International Journal of Medicine and Medical Sciences, 2024, 14(2): 9–16. DOI: 10.46882/2024/IJMMS/140009

International Journal of Medicine and Medical Sciences | Vol. 14, No. 1, January 2024 | pp. 1–8

DOI: 10.46882/2024/IJMMS/140001

Original Research Article

Seroprevalence, Genotypic Distribution, and Risk Factors of Human Papillomavirus Profiles among Women Attending Cervical Screening

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

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

²Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.

Abstract:

Persistent infection with high-risk human papillomavirus (HPV) genotypes is the primary driver of cervical carcinogenesis, requiring localized epidemiological mapping. This cross-sectional analytical study investigated the seroprevalence, specific sub-genotypic distributions, and socio-demographic risk factors of HPV infection among women attending routine cervical cancer screening clinics. Cervical swabs and blood samples were collected from 500 women aged 18 to 65 years. HPV DNA detection and genotypic characterization were performed using polymerase chain reaction (PCR) followed by a reverse line blot assay. The overall prevalence of cervical HPV DNA was found to be 22.4% (112/500). High-risk HPV (HR-HPV) genotypes predominated, accounting for 73.2% (82/112) of the positive cases. Genotypic mapping revealed that HPV-16 was the most common variant (42.7%), followed by HPV-18 (24.4%), HPV-35 (14.6%), and HPV-45 (9.8%). Multiple genotype infections were confirmed in 18.3% of the positive cohort. Multivariate logistic regression analysis identified several independent risk factors associated with HR-HPV infection: an age under 30 years (OR = 3.2, 95% CI = 1.8–5.8, p < 0.01), early coarche ≤ 16 years (OR = 2.4, 95% CI = 1.2–4.8, p < 0.05), and a history of smoking (OR = 2.1, p < 0.05). The burden of high-risk HPV variants, particularly types 16 and 18, is substantial in this screening population. These empirical findings support the implementation of routine primary HPV DNA screening protocols and emphasize the need to expand national adolescent HPV vaccination campaigns to reduce cervical cancer risk.

Keywords: Human Papillomavirus, Cervical Screening, High-Risk Genotypes, HPV-16, Polyacrylamide PCR, Risk Factors

Manuscript Timeline: Received: October 10, 2023; Revised: November 18, 2023; Accepted: December 08, 2023; Published: January 12, 2024.

Citation: Diallo PO, Nwachukwu CU, Diop JPB. Seroprevalence, Genotypic Distribution, and Risk Factors of Human Papillomavirus Profiles among Women Attending Cervical Screening. International Journal of Medicine and Medical Sciences, 2024, 14(1): 1–8. DOI: 10.46882/2024/IJMMS/140001

International Journal of Medicine and Medical Sciences | Vol. 13, No. 12, December 2023 | pp. 89–96

DOI: 10.46882/2023/IJMMS/130089

Original Research Article

Diagnostic Utility of Serum Soluble ST2 versus N-Terminal Pro-Brain Natriuretic Peptide for Predicting Mortality in Acute Decompensated Heart Failure

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

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

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

Abstract:

Risk stratification in acute decompensated heart failure (ADHF) remains challenging, necessitating the evaluation of novel biomarkers that reflect myocardial stretch and fibrosis. This prospective cohort study evaluated the diagnostic accuracy of serum soluble ST2 (sST2) compared to N-terminal pro-brain natriuretic peptide (NT-proBNP) for predicting 90-day all-cause mortality in ADHF. We evaluated 130 adult patients admitted to cardiac wards with a confirmed diagnosis of ADHF. Serum sST2 was quantified using an enzyme-linked immunosorbent assay (ELISA) and NT-proBNP via electrochemiluminescence at admission, and patients were tracked for 90 days. A total of 22 deaths occurred during the follow-up period, representing a mortality rate of 16.9%. Deceased patients exhibited significantly higher mean baseline sST2 levels (78.5 ± 14.2 ng/mL) compared to survivors (34.2 ± 6.8 ng/mL, p < 0.001). Receiver Operating Characteristic (ROC) analysis showed that a baseline sST2 cutoff value of 45 ng/mL predicted 90-day mortality with a sensitivity of 86.4%, a specificity of 81.5%, and an Area Under the Curve (AUC) of 0.89 (95% CI = 0.82–0.95). In comparison, NT-proBNP achieved an AUC of 0.78 (p < 0.05). Multivariate Cox proportional hazards regression demonstrated that elevated sST2 remained an independent predictor of mortality (HR = 3.4, 95% CI = 1.6–7.2, p < 0.01) after adjusting for left ventricular ejection fraction and renal function. Serum sST2 offers superior predictive precision for short-term mortality in ADHF compared to NT-proBNP, serving as a valuable tool to guide intensive post-discharge clinical monitoring.

Keywords: Acute Decompensated Heart Failure, Soluble ST2, NT-proBNP, Biomarkers, Mortality Predictors, Myocardial Fibrosis

Manuscript Timeline: Received: September 14, 2023; Revised: October 22, 2023; Accepted: November 11, 2023; Published: December 14, 2023.

Citation: Igwe CO, Sanon RL, Boateng AD. Diagnostic Utility of Serum Soluble ST2 versus N-Terminal Pro-Brain Natriuretic Peptide for Predicting Mortality in Acute Decompensated Heart Failure. International Journal of Medicine and Medical Sciences, 2023, 13(12): 89–96. DOI: 10.46882/2023/IJMMS/130089

International Journal of Medicine and Medical Sciences | Vol. 13, No. 11, November 2023 | pp. 81–88

DOI: 10.46882/2023/IJMMS/130081

Original Research Article

Bacterial Pathogens and Antimicrobial Susceptibility Trends in Wound Infections among Diabetic Foot Ulcer Patients

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:

Diabetic foot ulcers (DFUs) are prone to polymicrobial infections, which can lead to osteomyelitis and lower limb amputation if treated with ineffective antibiotics. This prospective cross-sectional study identified the predominant bacterial pathogens and mapped their antimicrobial resistance trends in patients presenting with infected DFUs. Deep tissue biopsies or wound swabs were collected from 140 diabetic patients presenting with Wagner grade 2 to 4 foot ulcers. Bacterial isolation was achieved using standard microbiological criteria, and antimicrobial susceptibility testing was performed using the disk diffusion technique. A total of 185 bacterial isolates were recovered, showing a polymicrobial infection rate of 32.1%. Gram-negative bacilli predominated at 58.4%, with Pseudomonas aeruginosa (24.3%) and Escherichia coli (18.9%) being the most frequent, while Staphylococcus aureus was the most common Gram-positive isolate (35.1%). Antibiogram mapping revealed alarming resistance rates among S. aureus isolates to erythromycin (75.4%) and clindamycin (41.5%), with 38.5% confirmed as Methicillin-Resistant Staphylococcus aureus (MRSA). Gram-negative bacilli showed high resistance to ciprofloxacin (62.8%) and ceftazidime (58.3%), while remaining highly susceptible to amikacin (91.6%) and imipenem (94.4%). Logistic regression showed that a duration of diabetes > 10 years was strongly associated with MRSA infection (OR = 3.2, 95% CI = 1.5–6.8, p < 0.01). Infected DFUs in this region show high rates of multi-drug resistant pathogens. Treatment should be guided by wound culture results rather than empirical protocols to improve healing outcomes and reduce amputation rates.

Keywords: Diabetic Foot Ulcer, Pseudomonas aeruginosa, Staphylococcus aureus, MRSA, Antimicrobial Resistance, Wound Biopsy

Manuscript Timeline: Received: August 18, 2023; Revised: September 25, 2023; Accepted: October 12, 2023; Published: November 15, 2023.

Citation: Cole EA, Tarawallie MZ, Okoye VN. Bacterial Pathogens and Antimicrobial Susceptibility Trends in Wound Infections among Diabetic Foot Ulcer Patients. International Journal of Medicine and Medical Sciences, 2023, 13(11): 81–88. DOI: 10.46882/2023/IJMMS/130081

International Journal of Medicine and Medical Sciences | Vol. 13, No. 10, October 2023 | pp. 73–80

DOI: 10.46882/2023/IJMMS/130073

Original Research Article

Evaluation of Spirometric Parameters and Chronic Airway Symptoms among Commercial Flour Mill Workers

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:

Occupational inhalation of respirable organic flour dust induces chronic airway inflammation, leading to progressive ventilatory changes. This cross-sectional analytical study evaluated the prevalence of respiratory symptoms and alterations in pulmonary function indices among commercial flour mill workers. We matched 150 male flour millers exposed to organic dust for at least 2 years with 150 unexposed healthy male control subjects based on age, height, and body mass index. Respiratory symptom profiles were captured using a standardized questionnaire, and lung parameters were measured via computerized spirometry. Flour millers demonstrated a significantly higher prevalence of chronic productive cough (36.7% vs. 9.3%, p < 0.01), persistent wheezing (22.7% vs. 4.7%, p < 0.01), and exertional dyspnea (28.0% vs. 6.7%, p < 0.01) than the control group. Spirometric evaluation showed significant reductions in Forced Vital Capacity (FVC) (3.28 ± 0.38 L vs. 3.88 ± 0.42 L, p < 0.01) and Forced Expiratory Volume in 1 second (FEV1) (2.38 ± 0.31 L vs. 3.21 ± 0.35 L, p < 0.01) in the exposed group. The FEV1/FVC ratio was also significantly lower in flour millers (72.56 ± 4.8% vs. 82.73 ± 3.4%, p < 0.05), indicating an obstructive pattern of respiratory impairment. Stratified analysis revealed a significant inverse correlation between the duration of occupational exposure and FEV1 reductions (r = -0.55, p < 0.01). Occupational exposure to flour dust significantly impairs lung indices and increases respiratory symptoms. Implementing engineering controls such as local dust extraction systems and requiring personal protective respirators are necessary to protect worker health.

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

Manuscript Timeline: Received: July 14, 2023; Revised: August 22, 2023; Accepted: September 10, 2023; Published: October 13, 2023.

Citation: Tetteh FM, Amadi KC, Bond AJ. Evaluation of Spirometric Parameters and Chronic Airway Symptoms among Commercial Flour Mill Workers. International Journal of Medicine and Medical Sciences, 2023, 13(10): 73–80. DOI: 10.46882/2023/IJMMS/130073