Open Access Original Research Article

Patient Satisfaction with Colorectal Rapid Access Clinic

Kirsty Cattle, Thomas Athisayaraj, Neil Keeling, Ami Mishra

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-8
DOI: 10.9734/jamps/2020/v22i1230205

Aims: Patients referred with red flag colorectal cancer symptoms are seen within 2 weeks of referral and require completion of treatment within 62 days of referral.  The demand on resources is such that the remit of this rapid access pathway (RAP) is to diagnose or exclude cancer quickly.  It is hypothesised that patients on these pathways are less likely to have their symptoms addressed and more likely to be dissatisfied with the service received.

Study Design: Questionnaire based study of all patients attending new colorectal outpatient appointments, both routine and RAP.

Place and Duration of Study: All patients referred the colorectal department at West Suffolk Hospital, a district general hospital, during January 2018 were sent a questionnaire 6 months later.

Methodology: Results were analysed for statistically significant differences between the two groups in relation to patient satisfaction.

Results: Of 273 new patients, questionnaires were returned by 78 patients attending rapid access clinics and 61 attending routine new appointments. There was no significant difference in the overall level of satisfaction with the overall investigation and management process between patients seen in rapid access clinics or routine new appointments (P = 0.867). Patients on the RAP were less likely to have been given a diagnosis (p = 0.001) or advice on managing their symptoms (P = 0.002). When assessing a number of variables, only patients whose symptoms had resolved were significantly more satisfied with the overall care pathway (P = 0.037).

Conclusion:  Patients seen on the RAP are not less satisfied with their care.

Open Access Original Research Article

Does Allergic Rhinitis have any Effect on Choroidal Thickness?

Raşit Kiliç, Harun Soyaliç

Journal of Advances in Medical and Pharmaceutical Sciences, Page 9-13
DOI: 10.9734/jamps/2020/v22i1230206

Aim: The aim of this study is to compare the choroidal thickness between patients with allergic rhinitis (AR) and healthy controls.

Study Design: Prospective case-control study.

Methodology: This cross sectional case control study consisted of 52 patients with AR and 52 healthy subjects. The choroidal thicknesses were measured horizontally with the digital calipers provided by the Heidelberg Spectralis software. The points of measurements were at the subfovea, 1500 µm nasal and 1500 µm temporal to the center of the fovea. The right eye was assessed in all participants.

Results: There was no statistically significant difference between the groups for age and gender distribution, intraocular pressure and spherical equivalent. Mean subfoveal choroidal thickness, nasal choroidal thickness and temporal choroidal thickness were 382.1±121.7, 328.6±111.8 and 368.1±98.2 in AR patients and 378.5±87, 309±77 and 354.2±94.2 in healthy subjects respectively. These differences were not found statistically significant (P˃0.05).

Conclusion: Choroidal thickness in AR patients was found to be thicker, but not statistically significant.

Open Access Original Research Article

Anthill Inhibiting Bacteria, a Promising Source of Bio Efficacy

A. A. Katun, A. R. Abdulmumin, M. U. Yahaya, N. K. Habeeb, A. Bala

Journal of Advances in Medical and Pharmaceutical Sciences, Page 14-21
DOI: 10.9734/jamps/2020/v22i1230207

The investigation into soil bacteria has been widely studied and becoming increasingly appreciated as an exceptional reservoir of unique naturally occurring biologically active metabolites with pharmaceutical applications. This article aimed to isolate, identify and biochemically characterize antibiotic-producing bacteria from anthill soils in the permanent site of Ibrahim Badamasi Babangida University, Lapai (IBBUL), Niger State, Nigeria. The sum of ten samples were collected from five sampling sites, the sampling was done in threefold (morning, noon and evening) and analyzed adopting standard microbiological protocols. The obtained result revealed that the total bacteria count in the morning ranges from 2.1×107 cfu/mL to 1.4×106 cfu/mL, noon count ranges from 3.1×107 to 2.6×106 cfu/mL while evening count was in the range of 2.1×107 cfu/mL to 1.7×106 cfu/mL. A total number of five (5) bacteria were isolated as Staphylococcus aureus, Staphylococcus epidermidis, Bacillus subtilis, Bacillus lentus and Micrococcus reseus. The total prevalence of the bacterial isolates in the morning, noon and evening were calculated as B. subtilis (109.08%), S. epidermidis (36.36%), M. reseus (36.36%), B. lentus (63.63%), and S. aureus (54.54%) respectively. These isolates were further assayed against Escherichia coli, Salmonella typhi, Klebsiella sp. and Staphylococcus aureus. The antibacterial outcome showed that two (2) (40%) anthill isolates exhibited antibacterial activity against three (3) tested bacteria (Escherichia coli, Salmonella typhi and Staphylococcus aureus). This research study has showcased that the production of inhibitory substances are common among some of the bacterial strains isolated from anthills.

Open Access Original Research Article

L-Citrulline Supplementation Enhances Reproductive Functions of Lead Acetate Induced Testicular Toxicity in Male Sprague Dawley Rats

Tolunigba Abisola Kolawole, Beatrice Olatundun Oluwatayo, Ogadinma Ilochi, Elizabeth Umoren, Datonye Victor Dapper

Journal of Advances in Medical and Pharmaceutical Sciences, Page 22-35
DOI: 10.9734/jamps/2020/v22i1230208

Introduction: Lead (Pb) is a transition metal and a known male reproductive toxicant that induces its effects mainly through oxidative stress. This study investigated the effects of L-Citrulline (Cit) supplement on reproductive functions and antioxidant activities in Lead acetate treated male rats. Materials and Methods: Twenty  male rats (180-200 g) were grouped into four  and treated as follows; Group 1 (Control), given distilled water, Group 2 was given Pb acetate (2.25mg/kg), Group 3 was co-treated with Pb acetate (2.25mg/kg) and Cit (900mg/kg) and Group 4 was given Cit (900mg/kg) only. All administrations were done orally for thirty days. Caudal sperm, serum hormone levels and testicular antioxidant activities and Nitric oxide levels were evaluated at the end administrations.

Results: Results showed decrease (p<0.05) in sperm morphology, count, viability, motility, FSH, LH, Testosterone, Catalase, Nitric Oxide and Super oxide dismutase in Group 2(Pb treated rats), when compared to Group 1(Control).However, in Group 3 (Pb acetate co-administered with Cit) the effect was significantly reversed (p<0.05) compared with Group 2 and significant increase was observed in Group 4 (Cit only group) compared with Group 2.

There was an increase (p<0.05) in Malondialdehyde level in Group 2 compared with (Group 1) Control while a significant decrease (p<0.05) was observed in Groups 3 and 4 compared with Group 2.

Conclusion: The results of this study suggest that L- Citrulline supplement has ameliorating capacity on the toxic effect of Lead acetate on sperm parameters.

Open Access Original Research Article

Genotoxic Effect of Arsenate and Arsenite in Human HaCat Cells in Culture Using Comet Assay

Ghazalla Benhusein, Elaine Mutch, Faith M. Williams

Journal of Advances in Medical and Pharmaceutical Sciences, Page 36-44
DOI: 10.9734/jamps/2020/v22i1230211

Arsenic is an environmental chemical of toxicological concern today since it is a human genotoxin and chronic exposure is associated with development of cancers, including skin. Inorganic arsenate is metabolically reduced to arsenite by glutathione (GSH) prior to methylation. The aim of this study was to determine the relative toxic effects of arsenate and arsenite in HaCat cells (immortalized human keratinocytes) in vitro by measuring cytotoxicity, DNA damage, depletion of glutathione and apoptotic and necrotic events. HaCat cells were treated with arsenate and arsenite (10 μM) for DNA damage detection using Comet assay and cytotoxicity (10, 60 and 100 μM) all measured at 24 hr. In some experiment arsenate or arsenite (10 μM) was added at the same time as BSO 10 μM for 24 hr, and GSH levels were measured by HPLC with fluorescence detection. Flow cytometry was used to investigate apoptotic and necrotic events following arsenate and arsenite (10 μM) treatment for 24 hr. Arsenate and arsenite at 60 and 100 μM, but not 10 μM, reduced the number of adherent viable cells with time. Therefore, DNA damage could only be measured at 10 μM as at higher concentrations the cells did not produce classical Comets but showed fragmentation. DNA damage was significantly (p < 0.001) increased in cells treated for 24 hr with 10 μM arsenate and arsenite compared to control. GSH levels were significantly increased in HaCat cells treated with10 μM arsenate and arsenite (p < 0.05, p < 0.001, respectively) compared to control. Cells treated with buthionine sulphoximine (BSO) at the same time as arsenate had increased GSH levels (p < 0.001), but arsenite and BSO did not increase cellular GSH. Arsenate and arsenite increased apoptosis, and arsenate increased necrosis, although none of the values reached statistical significance. Arsenite was more cytotoxic than arsenate. Arsenate and arsenite are known to produce oxidative stress involving ROS formation and depletion of glutathione. The increase in GSH levels at low doses of arsenate and arsenite, and by arsenate even in the presence of BSO.