West Indian Medical Journal

Background: Jamaica, along with the Americas, experienced major epidemics of arboviral diseases transmitted by the Aedes aegypti mosquito in recent years. These include dengue fever in 2012, Chikungunya fever in 2014 and Zika virus infection (ZIKV) in 2016. We present the emergence of the ZIKV epidemic in Jamaica and outline the national response. Methods: The Ministry of Health's preparedness included: heightened surveillance, clinical management guidance, vector control and management, laboratory capacity strengthening, training and staffing, risk communication and public education, social mobilization, inter-sectoral collaboration, resource mobilization and international cooperation...

Zika virus epidemic now involves 72 countries, worldwide. Transmission is multimodal through mosquito bites and blood and body fluids. Zika virus causes Guillain Barre Syndrome syndrome and pregnancy complications including perinatal microcephaly. Diagnosis is complicated by subclinical infection in 80%, co-circulation with dengue and chikungunya fevers with similar presentations and cross-reactivity in serological tests. There is no cure, or preventive vaccine. Large population-based studies will help to elucidate ZIKV epidemiology, vertical transmission, risks to the fetus of maternal ZIKV infection and natural history of congenital and non-congenital ZIKV infection as provided by the activities in the "ZIKAction" research consortium in Latin America, Europe and the Caribbean, which was recently funded by the European Commission...

Objective: This study aims to observe the clinical efficacy of low-dose rituximab in patients with cryoglobulinaemia secondary to connective tissue diseases. Methods: Rituximab (100 mg) was infused in patients once a week for four weeks, combined with prednisone (20 mg) once a day, and reduced regularly. Treatment effect was observed regularly. Results: Joint pain, fever, rash and fatigue symptoms in patients eased. The serology (globulin, erythrocyte sedimentation rate, C-reactive protein, lactate dehydrogenase and others) parameters returned to normal...

Medulloblastoma is one of the most common malignant tumours of the central nervous system in children. It affects two persons per million per year worldwide and is increasing. More than 70% of patients diagnosed with medulloblastoma are predominantly below age 10 years. Histological variants of medulloblastoma are recognized as classic, nodular-desmoplastic, large cell/anaplastic and medulloblastoma with extensive nodularity. Symptoms include headache, general malaise, failure to feed, vomiting, clumsiness and other presentations that mimic common and benign childhood pathologies seen in primary care...

Objectives: Thyroid disorders are highly prevalent in patients with schizophrenia. Changes in the levels of thyroid hormones cause the occurrence of psychiatric disorders and affect the response to treatment. The aim of this study was to investigate the changes in thyroid hormone levels in patients with chronic schizophrenia, and to demonstrate any association between psychiatric symptoms and hormones. Methods: Sixty-three patients with schizophrenia and 53 controls were included in this study...

Cancer is one of the leading causes of death across the world. Oral cancer is the sixth most common type of cancer in the world. The incidence of oral cancer increases with the increase in the consumption of carcinogens such as tobacco and alcohol as seen in south and southeast Asia. Oral cancer is seen to arise from pre-existing leukoplakia and oral submucous fibrosis. Antioxidants have been hypothesized to be chemopreventive agents for several cancers. Micronutrients such as zinc, copper and selenium, along with antioxidants are required for the production of various enzymes that help prevent DNA damage caused by free radicals...

Anthrax, caused by Bacillus anthracis (B anthracis), poses a potential threat as a bioterror agent because after inhalation, the spores rapidly cause bacteraemia and toxaemia. It produces a toxin consisting of three proteins ie protective antigen (PA), oedema factor (EF) and lethal factor (LF). Protective antigen plays a central role in the pathophysiology of anthrax and offers an excellent therapeutic target for treatment of anthrax. Raxibacumab is a recombinant, fully human, IgG1λ monoclonal antibody directed against PA of B anthracis...

OBJECTIVE: Appendicitis, the most common cause of abdominal pain requiring surgery in children, refers to inflammation of the vermiform appendix. The aetiology of appendicitis is multifactorial, although it is affected by several precursor factors. The purpose of this study was to investigate whether allergic diseases cause a predisposition to appendicitis. SUBJECTS AND METHODS: One hundred and sixteen patients who underwent surgery for acute appendicitis and who had a diagnosis of acute appendicitis confirmed pathologically, and a control group of 124 individuals of similar ages and genders, were enrolled...

Objective: Besides various harmful effects on the overall health, chronic consumption of psychoactive substances has different consequences on oral health. The goal of this paper was to examine the condition of oral health in psychoactive substance users during the healing process and to do a comparative analysis of maintaining oral hygiene before and during the substance abuse treatment. Subjects and Methods: The study included 26 regular users of psychoactive substance...

Objective: Geriatric dentistry refers to dealing with oral diseases including prevention and treatment in old individuals. The aim of this investigation was to examine the types and frequency of oral lesions in the elderly. Subjects and Methods: The study involved 75 elderly persons. The clinical diagnosis was established by correlating the aetiological factor associated with the lesion and by systematic examination of the oral mucosa and classifying those alterations according to the epidemiological guidelines for the diagnosis of oral mucosal diseases...

Melanoma is the most serious form of skin cancers and life-time risk of melanoma is increasing rapidly both in men and women. Melanoma in the parotid gland is seen rarely and it is more likely to be metastatic disease. We present here a rare case of metastatic malignant melanoma from the forehead skin to the parotid glands bilaterally.

Objective: Typhoid fever can involve various organs, leading to a wide range of presentations: from uncomplicated to complicated typhoid fever. The haematological changes are common in typhoid fever and include anaemia, leucopaenia, thrombocytopaenia and bleeding diathesis. This study was undertaken in order to determine the clinical and haematological presentation of typhoid fever in children. Methods: In this study, records of children and adolescents with typhoid fever aged under or equal to 16 years, admitted to Yuzuncu Yil University Hospital between 2010 and 2014, were analysed retrospectively...

Ischaemic colitis results from a chronic or acute drop in the blood supply to the bowel and accounts for 6‒18% of the causes of acute lower gastrointestinal bleeding. Diabetes mellitus, hypotension, advanced age, aortic surgery and peripheral vascular disease have also been suggested to be predisposing factors for ischaemic colitis (1). In this report, we present a case of ischaemic colitis in haemodialysis with a good response to conservative treatment.

Patients with systemic lupus erythematosus (SLE) have an increased susceptibility to bacterial, viral, fungal and parasitic infections. Cryptococcal infection of the central nervous system (CNS) is a rare but often fatal complication of SLE. Here, we describe a case of cryptococcal meningitis in a female patient with active SLE, who was successfully treated with amphotericin B. This case suggests that the clinical findings of SLE patients with cryptococcal meningitis are non-specific and misleading, and early use of amphotericin B has a good response...

Objective: The aim of this study was to evaluate whether combining diffusion tensor magnetic resonance imaging (DTI) and susceptibility weighted imaging (SWI) techniques would provide a sensitive method for differentiating between 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced rhesus monkey model of Parkinson's disease (PD) and wild-type controls. Subjects and Methods: Seventeen rhesus monkeys were divided into two groups. A series of intramuscular injections of either saline (control group, n = 8) or MPTP (0...

Background: The main reason for biomaterial related refractory infections is biofilm formation caused by bacterial adhesion on the surface of materials. Silver-hydroxyapatite (Ag/HA) nanocomposite coating can inhibit the formation of biofilm, but its mechanism is not clear. Material and method: In order to clarify the mechanism, the amounts of biofilm on the Ag/HA composite coating and HA coating were determined, the release rates of silver nanoparticles in simulated body fluid (SBF) were detected by atomic absorption spectrometry, and the expression values of atlE, fbe, sap, iapB genes of Staphylococcus aureus were studied when they grew on Ag/HA composite coating and HA coating...

Objective: To study clinical semi-permeability tolerance level in the field of dental restoration. Method: Vita 95 enamel porcelain powder was adopted and 6.0% used as the control transmissivity. Discoid porcelain plates with different transmissivity, namely increasing transmissivity (0.25%, 0.5%, 1.0%, 1.5%, 2%, 2.5%, 3%, 3.5%, 4% and 4.5%) and decreasing transmissivity (-0.25%, -0.5%, -1.0%, -1.5%, -2%, -2.5%, -3% and -3.5%) were made. Forty observers judged these according to six grades: same, similar, slightly different, visibly different, recognizable and significantly different, and under the observation conditions of a neutral grey background and 45(°)/0(°) lighting...

Background: The study of the effect of different dialysis methods on cellular immune function of maintenance haemodialysis (MHD) patients should provide theoretical support for deciding on the best method of blood purification that effectively improves cellular immune function of haemodialysis patients. Subjects and Method: Sixty MHD patients were randomly divided into three groups that respectively received treatment of haemodialysis (HD), high flux haemodialysis (HFHD) and haemodiafiltration (HDF)...

Background: Diabetes mellitus is an important human disease afflicting many from various walks of life in different countries. Even though modern medicines contribute a variety of effective treatment options, they can have several unfavourable effects. The intention of this review is to organize and discuss various studies that have been previously conducted on the effectiveness of these herbal plants in diabetes. Method: By using various electronic search databases, a comprehensive English literature search was conducted...

Background: The use of chemotherapy for the treatment of cancer began at the start of the 20(th) century in an attempt to narrow the universe of chemicals that affect the disease. Metastatic testicular cancer has always been sensitive to chemotherapy. Subjects and Method: A retrospective and prospective study was performed of patients who had undergone testicular cancer from 2011-2013. The overall age of the testicular cancer patients at the time of diagnosis, their marital status, stage of disease and treatment strategies, testosterone level etc were analysed using linear regression and t-test...