Open Access Case Study

Facial Edema that Develops with Olanzapine

Sevda Korkmaz, S. Baykara, Ömer Özer, Filiz Özsoy

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-4
DOI: 10.9734/JAMPS/2015/20492

Olanzapine is an atypical antipsychotic drug that has been approved for use in the treatment of primarily schizophrenia and bipolar disorder and various other psychiatric disorders. Olanzapine use could cause peripheral edema in 3% of the patients. There are cases in the literature where a peripheral edema occurred after olanzapine mono-therapy. In these cases, edema occurred mostly in peripheral mode, in the lower extremities such as wrists, dorsum of the feet and in the limbs up to knees. However, there are only rare cases that reported edema in the facial region. This article will scrutinize a female case where a dense edema localized in the facial region restricting the movement of facial muscles after olanzapine treatment.


Open Access Original Research Article

Investigating Associations between Parent Support Groups and Integrated Outreach Services for Maternal and Infant Survival: Experiences from a Project in Northern Uganda

Gloria K. Seruwagi, Richard Muhumuza, Geoffrey Babughirana, Anita Komukama, Andrew Tumuhameho

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-15
DOI: 10.9734/JAMPS/2015/19956

Background:  Globally various interventions have been undertaken to reduce maternal and child mortality rates. In low-income countries, outreach services are used systematically to deliver immunization and other health services to individuals with limited access to health facilities. In 2012, an Integrated Community Outreach Program (ICOP) was introduced by World Vision to provide women, children and their families with vital interventions like antenatal care, family planning services and on-spot treatment of illnesses with the aim of improving maternal, newborn and child health in Kitgum district, Uganda. To increase the appeal of these outreach services in targeted communities and facilitate compliance, parent support groups (PSGs) were also established as an intervention.

Aim: The objective of this study was to investigate whether there is an association between parent support groups (PSGs) and integrated outreach services (IOS) for maternal and infant survival in Kitgum.

Methods: We conducted a cross-sectional survey in 4 of 10 sub-counties in Kitgum where data was collected from 767 households using structured questionnaires. In addition, qualitative data was collected through in-depth interviews with key stakeholders. The association between each IOS outcome and PSGs was investigated using chi-square tests. For cross-tabulations with small counts, Fisher's exact test was used.

Results: PSGs were found to be significantly associated with most of the integrated outreach services. A strong association was observed between being in a PSG household and seeking antenatal care at least four times (chi-square=14.18, p-value=0.0002) as more likely when compared to non-PSG households. Similarly, significant associations were observed between being in a PSG household and having immunized the child for measles (chi-square=6.66, p-value=0.0099) and between being in PSG household and weighing of children (chi-square =9.59, p-value=0.002).

Conclusion: PSGs present a promising intervention for scaling up uptake of Integrated Outreach Services in remote settings which is integral to addressing the problem of maternal and infant survival.


Open Access Original Research Article

Molecular Identity and Antimicrobial Profile of Trametes species Collected from the Teaching and Research Farm of the Federal University of Technology, Akure, Nigeria

S. I. Awala, V. O. Oyetayo

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-14
DOI: 10.9734/JAMPS/2015/20059

Aims: The present study investigated the identity, antimicrobial, and secondary metabolites profile of Trametes species collected from forest near the Teaching and Research farm of the Federal University of Technology, Akure (FUTA), Ondo State.

Methodology: The Internal Transcribed Spacer (ITS 4 and ITS 5) of the mushroom nuclear ribosomal DNA (nrDNA) was used in its identification. Extracts of the mushrooms were prepared using methanol and acetone as extracting solvents. The phytochemical profile of the extracts was assessed quantitatively and qualitatively. The antimicrobial potential of the extracts on clinical and typed microbial cultures was assessed using standard microbiological techniques.

Results: The gene sequence of the Trametes species collected was observed to be 99% close to the gene sequence of Trametes lactinea from the National Center for Biotechnology Information (NCBI) GenBank. Phytochemical analysis revealed the presence of saponin, tannins, flavonoid, steroid, terpenoid, and cardiac glycosides in all the extracts. Cardiac glycoside was the most abundant in the extracts (23.183 and 19.138 mg/g in acetone and methanol extracts respectively), while flavonoid had the least content (7.008 and 7.854 mg/g in acetone and methanol extracts respectively). The extracts exhibited varying antibacterial and antifungal properties. Methanol extract of T. lactinea at concentration of 50 mg/ml exhibited a better antibacterial (28.17 mm against Staphylococcus aureus) and antifungal activity (35.33 mm against Aspergillus flavus).

Conclusion: Findings from this study show that extracts of Trametes lactinea indigenous to Akure is a potential source of natural antibacterial and antifungal agents which could be very useful in the treatment of infectious disease.


Open Access Original Research Article

Non-steroidal Anti-inflammatory Drugs Misuse among Newly Diagnosed and Resurged Peptic Ulcer Patients in Maiduguri-City, Nigeria

John David Ohieku, Thlama Stephen Jasini

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-10
DOI: 10.9734/JAMPS/2015/19213

Background: Many patients are often unaware of the risks posed by indiscriminate use of non-steroidal anti-inflammatory drugs (NSAIDs) in aggravating peptic ulcer disease (PUD) related discomfort or delaying its healing.

Aim: The objectives of the study are to investigate the extent of NSAIDs consumption among newly diagnosed and resurged ulcer cases, identify the various types and forms of NSAIDs commonly misuse as well as evaluate their possible potentials risks in patients with fresh and resurged ulcer pains.

Methods: NSAIDs use were assessed through prospective study in 237 patients (114 males and 123 females) using questionnaire. All patients were assessed for NSAIDs consumption, duration of use, types of NSAIDs, their combinations and ulcerogenic potentials.

Results: The proportions of NSAIDs users were 0.52 (n=123; 95% CI=0.46-0.58) comprising 45.6% (proportion=0.47, 95% CI= 0.41-0.53) and 55.1% (proportion= 0.55; 95% CI= 0.49-0.61) of new and resurged PUD respectively. There was no gender variation in NSAIDs consumption in the two groups. However, NSAIDs use was higher in female below 30 years than men though this trend was reversed in those above 50 years. Also, 43.0% (n=104) used NSAIDs containing single agents while 8.0% (n=19) used combinations of NSAIDs. Misused NSAIDs in their various formulated oral dosage forms are ibuprofen (19.0%), piroxicam (3.4%), diclofenac (14.8%), naproxen (1.11%), acetylsalicylic acid (3.0%), and ketoprofen (1.3%). The duration of NSAID used ranged below 1year (8.9%) to >10years (1.9%) with the result being skewed toward low frequency of higher duration in year.

Conclusion: Several PUD patients were using NSAIDs indiscriminately and lacking the knowledge of their ulcerogenic potentials. This underscores the need for patients’ drug therapy care, education and counseling, and monitoring in order to limit hospitalization or physician visits, morbidity or mortality and drug therapy problems while adherence with therapeutic guiding principles for NSAIDs use in PUD patients is to be encouraged.


Open Access Original Research Article

Comparative Study on Efficacy of Intrathecal Injection Midazolam (2 mg) Versus Injection Metoclopramide IV in Prevention or Reduction of Nausea and Vomiting in Women during Caesarean Delivery under Spinal Anaesthesia

Vijay Jalaki, Pavan P. Havaldar, Shaik Hussain Saheb

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-6
DOI: 10.9734/JAMPS/2015/19747

Background: Nausea and vomiting after spinal anaesthesia in caesarean are frequent causing distress to the patient and surgeon. To diminish the incidence various pharmacological agents were used with their limitations. This study compares intrathecal midazolam with intravenous metoclopramide for prevention of nausea and vomiting during surgery and in the early postoperative period after caesarean delivery performed with spinal anaesthesia.

Materials and Methods: In a randomized single blind manner, 100 women (ASA Grade I and II) undergoing elective caesarean delivery were enrolled for the study with 0.5% hyperbaric  bupivacaine 2 ml (10 mg)  spinal anaesthesia were randomly allocated in to two groups. Group I received intravenous metoclopramide 10 mg (n = 50 in each group). Group II received intrathecal midazolam preservative free 2 mg (n = 50). Emetic episodes were recorded during anaesthesia and in the initial period after caesarean delivery (0 – 6 hrs) and compared between two groups by using Chi – square test. P value of <0.05 was taken to be significant.

Results: The incidence of patients who were emesis – free in the intraoperative and postoperative period was 39 (78%) with intravenous metoclopramide and 49 (98%) with intrathecal midazolam, respectively (p< 0.001). No clinically important adverse events were observed in either group.

Conclusion: We conclude that use of intrathecal midazolam (2 mg) is more effective than intravenous metoclopramide (10 mg) for preventing nausea and vomiting in women undergoing caesarean delivery under spinal anaesthesia with bupivacaine (0.5%) hyperbaric.