American Journal of Internal Medicine 

About: American Journal of Internal Medicine is an academic journal published by Science Publishing Group. The journal publishes majorly in the area(s): Medicine & Internal medicine. It has an ISSN identifier of 2330-4316. It is also open access. Over the lifetime, 256 publications have been published receiving 503 citations. The journal is also known as: AJIM.

Diabetic Foot Ulcer: A Review

Abstract: Diabetic foot problems are common throughout the world, resulting in major medical, social and economic consequences for the patients, their families, and society. Foot ulcers are more likely to be of neuropathic origin, and therefore eminently preventable. People at greatest risk of ulceration can easily be identified by careful clinical examination of the feet: education and frequent follow-up. Infection when complicates a foot ulcer, combination can be limb or life-threatening, and infection is defined clinically, but wound cultures assist in identifying the causative pathogens. Tissue specimens are strongly preferred to wound swabs for wound cultures. Antimicrobial therapy should be guided by culture results, and although such therapy may cure the infection, it does not heal the wound. Alleviation of the mechanical load on ulcers (offloading) should always be a part of treatment. Plantar neuropathic ulcers typically heal in 6 weeks with irremovable casting, because pressure at the ulcer site is mitigated and compliance is enforced. The success of other approaches to offloading similarly depends on the patients’ adherence to the effectiveness of pressure relief.

Prescribing Pattern and Utilization of Antihypertensive Drugs and Blood Pressure Control in Adult Patients with Systemic Hypertension in a Rural Tertiary Hospital in Nigeria

Abstract: Background: Hypertension is a major public health concern globally and is associated with high morbidity and mortality in sub-Saharan Africa. Although antihypertensive therapy is effective in lowering blood pressure, a large proportion of patients do not have optimal blood pressure control. Aims: To describe the prescribing pattern and utilization of antihypertensive drugs and assess blood pressure control in a rural reference tertiary hospital in Nigeria. Methods: We conducted a cross-sectional study of 212 adult patients with hypertension attending the cardiology clinic of the Federal Medical Centre, Ido-Ekiti, Nigeria, between February 2012 and July 2012. Anthropometric, clinical and therapeutic data were collected using a pre-tested pro forma. Data analysis was done using SPSS 16.0 software (IBM, Chicago, Il, US). P value < 0.05 (two-sided test) was considered to be statistically significant. Results: We study 212 adults with hypertension, 48.1% of whom were male and the male-to-female ratio was 0.9. The mean age (± SD) of the patients was 61.5±15.1 years. Thirty two (15.1%), 95 (44.8%), 67 (31.6%) and 18 (8.5%) patients were on mono-, dual-, triple- and quadruple therapy respectively. Diuretics (84.9%) and calcium channel blockers (56.6%) were the most frequently used antihypertensive drugs. Blood pressure was controlled in only 45.3% of patients. Dual- and triple-therapy produced more patients with controlled blood pressure (dual-therapy, p=0.30; triple-therapy, p=0.11). Conclusions: Our study showed that diuretics were the most frequently prescribed class of antihypertensive drugs in our rural tertiary hospital as in many studies from urban centres in Nigeria and sub-Saharan Africa. Consistent with the global trend, the rate of controlled blood pressure among hypertensive patients was low, with combination therapy achieving control in more patients.

Relationship Between Neutrophil-Lymphocyte Ratio and Microvascular Complications in Egyptian Patients with Type 2 Diabetes

Abstract: Several epidemiological studies have shown that chronic inflammation plays a central role in the pathogenesis of diabetes and its various complications. Neutrophil-lymphocyte ratio (NLR) is a novel potential marker in determining inflammation. The aim of this study was to evaluate the relationship between diabetic microvascular complications, namely diabetic retinopathy, nephropathy, neuropathy, and neutrophil-lymphocyte ratio in type 2 diabetic patients. The study took place in the Unit of Diabetes & Metabolism at the Faculty of Medicine, Alexandria University, Alexandria, Egypt, and included a total of 280 subjects, 200 male patients with type 2 diabetes, 108 of them having one or more microvascular complication, and a control group including 80 healthy age and sex-matched subjects. Results of our study showed that neutrophil-lymphocyte ratio (NLR) values were significantly higher in diabetic patients with retinopathy (p<0.001), neuropathy (p=0.025) and nephropathy (p<0.001) than those of diabetic patients without any microvascular complications and healthy control subjects. NLR levels correlated positively with body mass index (BMI) (r=0.436, p<0.001), glycosylated hemoglobin (HbA1c) (r=0.526, p=0.001) and erythrocyte sedimentation rate (ESR) (r=0.396, p=0.017). Based on the results of this study, we can conclude that neutrophil-lymphocyte ratio (NLR), which is an efficient, simple and stable marker of inflammation, can serve as an important predictor for the presence of microvascular complications in Egyptian patients with type 2 diabetes.

Abnormal Serum Uric Acid Levels in Health and Disease: A Double-Edged Sword

Abstract: Abnormal serum uric acid (UA) level is a highly prevalent condition worldwide and is increasing in the general population. This alarming epidemiological trend has enormous public health implications due to the central role of abnormal serum UA levels in the initiation, progression, and long-term effects of many metabolic and systemic diseases. Metabolic disorders are major causes of global morbidity and mortality. Altered serum UA level, both above and below the reference ranges for individual traits and contexts, is potentially harmful and described by many researchers as a double-edged sword. Concrete prevention plans in susceptible individuals and treatments to restore normal levels in individuals already affected are advocated. Lifestyle adjustment, including regular moderate physical activity, weight management, healthy eating, and regular serum UA screening are recommended for individuals susceptible to derangement in serum UA levels due to age, sex, genetics, and other acquired conditions. Public health efforts to create awareness about the menace of abnormal serum UA levels, particularly in susceptible individuals, should be encouraged.

Survey of Public Attitude, Awareness and Beliefs of Organ Donation in Western Region of Saudi Arabia

Abstract: Although organ transplantation is often the only preferable treatment for end-stage organ disease, there are not many organ donors in Saudi Arabia. This cross-sectional study analyzed data from 461 subjects recruited from the western region of Saudi Arabia to explore the current public awareness, attitudes and beliefs towards organ donation. The data were collected through a self-administered validated structured questionnaire. The collected data were analyzed and compared by subjects' age and sex using appropriate statistical tests with the level of statistical significance was defined as P ≤ 0.05. The mean age of the studied 461subjects was 28.3 ± 10.9 years, of them 74.0% were females and 26.0% were males. The study findings revealed that 73.5% of the studied subjects were willing to donate their organs with no significant differences between the studied males and females, although only 4.6% of them reported to have a donation card. Religion, money, and age of the recipient appeared to have no role in their willing of organ donation. The majority of the participants knew well the organ which can be donated; although 64.5% of them have no knowledge about the regulations and legislation of organ donation. The participants have also believed that governmental incentives in the form of monetary and health treatment for donor family and awards would be effective in promoting organ donation in the country. A considerable proportion of respondents in this study were willing to donate their organs, in which religion and financial reasons were not factors. The observed low level of knowledge about regulations and legislations necessitates more efforts to spread awareness about such important issues. Future representative national studies are needed before any generalization can be assumed.