Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52411119EnglishN2019October15HealthcareA Study Correlating the Presence of Inflammatory Marker “C-Reactive Protein” in Fracture Patients English0103Naresh KumarEnglishObjectives: The present study has been conducted to establish a relation between patient with fractures having time duration upto two weeks and presence of C-reactive protein in their serum. Materials and Methods: One hundred and three patients with fractures at different site and different time duration have been studied for the presence of inflammatory marker; C-reactive protein. The protein is detected using qualitative Slide agglutination method. Result: It has been found that out of one hundred and three patients studied, only 43.68% showed positive result and 56.31% were found negative for C-reactive protein in their serum. Conclusion: There is a poor co-relation between presence of C-reactive protein and fracture. This shows that it is not necessary that every patient with fracture will be having raised CRP level in their serum. EnglishInflammatory markers, C-reactive protein, Fracture, AgglutinationINTRODUCTION It was Tillet and Francis in 1930 established that C-reactive protein as a marker of sepsis, when they found the capacity to precipitate polysaccharide fraction designated a fraction C, from streptococcus pneumonia1 quickly disappears as patient recovery from the infection. This was not identified in healthy person studied. It was named C-reactive protein, when the reason of this reaction was identified as protein. Since 1930 many other acute phase of inflammatory has been described. C-reactive protein belongs to the Pentraxin family of protein. The other major member of this family is serum amyloid P component. These protein passes on from generations and during vertebrate evolution, indicating CRP has main role in the immune response.2 As with many acute phase protein CRP is mainly synthesized by the liver, predominantly in response to interleukin 6 ( IL-6).3 The secretion of CRP begins within 4-6 h. of stimulus and persist as long as the stimulus is present.4 In addition to the infection there are several other conditions that increases the synthesis of CRP are trauma, surgery, burns, tissue necrosis, etc. The serum concentration of CRP in the normal human being is below 10mg./L in 99% of normal human population. Level above this value is considered abnormal. Abnormal value indicates the presence of inflammation or disease process.CRP has many different functions; in conjunction with the complement component, CRP is the only acute phase protein that is directly involved in the clearing of micro-organisms. It stimulates cell mediated cytotoxicity.5,6 It also bind to the nuclear ribonucleoprotein, that shows a direct role of CRP in removal of nectrotic tissues7. There are various methods for identifying CRP in human one is qualitative while others are quantitative method. Several quantitative immunological methods has been developed for measuring C-reactive protein are: enzyme immunoassay, immunoturbidimetry and nephelometry.8,9 Nephelometry method is widely used because of its low cost and sensitivity that is within 0.04 mg/ L.10 MATERIALS AND METHODS : This study was conducted over a period of six months peroid from January 2019 to July 2019. One hundred and three patients were studied after their prior informed consent taken and permission from ethical committee given. All patients with fractures, at different sites has been studied for the presence of inflammatory marker; C-reactive protein. Those patients with duration of fracture upto two weeks have been included in this study. Out of one hundred and three patients seventy six were male and twenty seven were female. The age group of patients were between nine years to eighty years. The blood sample, 5-10 ml venous blood of the admitted patients were collected in sterile serum separating tubes without anticoagulant in the morning hours. No special preparation of patient is required prior to the collection of the sample. The test is conducted using “CRP C-Reactive Protein Latex Test Kit”.11,12 This diagnostic reagent kit is used for invitro detection of CRP in human serum by qualitative rapid Latex Slide Tests that is positive only when the CRP level is greater than 06 µg/mL.13 All the test has been done in the department of pathology, SSIMS. KIT CONTENTS REAGENTS Reagent 1 :  CRP Latex Reagent Reagent 2 :  Positive Control Serum Reagent 3 :  Negative Control Serum ACCESSORIES Glass Slide Disposable Applicator Sticks Disposable Plastic Droppers Rubber Teats RESULT : In my study out of 103 patients, it has been found that only 45 (43.68%) showed positive result and 58 (56.31%) were found negative for C-reactive protein. Out of 27 female,11(10.67%) were positive for CRP and 14 (13.59%) were negative. Whereas out of 76 male, 34 (44.73%) were positive and 42(55.26%) were negative. DISCUSSION It has been reported that C- reactive protein is elevated till the stimulus is present.14,15 In present series, irrespective of patient age (youngest patient 09 year male and eldest one 80 years male) and fracture duration upto two weeks, no correlation was established between fracture and presence of CRP in patient’s serum inspite of continuous stimulus created by the fracture. In fact there were 56.31% of them who had negative CRP in their serum. There are many other inflammatory marker those are base excess(BE), prothombin time(PT), procalcitonin(PCT), Lipopolysaccharides-binding protein(LBP) and many other marker that are released in blood after trauma. There is no single marker that can decide the outcome in polytrauma patients.16 It has been noticed that in the first 24hr of insult ESR may be normal but CRP remains elevated.17 CONCLUSION There is a poor co-relation between presence C-reactive protein and fracture. Only 43.68% showed the presence of C-reactive protein and 56.31% showed negative result. The presence of CRP does not help to make a diagnosis of visible fractures and invisible fracture on X-rays irrespective of age, gender or fracture duration.CRP levels in serum appears to be a nonspecific phenomenon but the change can be used to monitor the course of certain disease and their treatment and not for fracture diagnosis. ACKNOWLEDGEMENT: I acknowledge the immense help I got from the articles of the scholars whose articles has been cited and included in the reference of this manuscript. I am grateful to the authors, editors and the publishers of all those articles, journals and books from where the literature of my article has been reviewed and discussed. I declared that all the funding to create this manuscript has been done solely by me. Englishhttp://ijcrr.com/abstract.php?article_id=2634http://ijcrr.com/article_html.php?did=2634 Tillet WS, Francis T( Sep1930) Serological reactions in pneumonia with non-protein somatic fraction of pneumococcus. J Exp. Med 52(4):561-571.  Vigushin DM, Pepys MB, Hawkins PN(1993) Metabolic and scintigraphic studies of radiodinated human C –reactive protein in health and disease. J Clin Invest 91:1351—1357. Gabay C, Kushner I (1999) Acute phase proteins and other systemic responses to inflammation. N Engl J Med 340:448—454.  P.V. Giannoudis, F. Hilderbrand, H.C.Pape, Inflammatory serum markers in patients with multiple trauma. J Bone Joint Surg (Br) 2004;56-B:313-23. Pepys MB, Baltz ML (1983) Acute phase proteins with special reference to C-reactive protein and related proteins9pentraxins) and serum amyloid A protein. Adv Immunol 34:-B141—212. Pepys MB (1981) C-reactive protein fifty years on. Lancet i:653—657. Pepys MB, Booth SE, Tennent GA, Buttler PJ, Williams DG (1994) Binding apentraxins to different nuclear structures: C-reactive proteins binds to small nuclear ribonucleoproteins particles, serum amyloid P component binding to chromatin and nucleoli. Clin Exp Immunol 97:152—157. Maekawa K. Futami S, Nishida M et al. Effects of trauma and sepsis on soluble L-selectin and cell surface expression of L-selectin and CD11b. J Trauma 1998;44:460-8. Pape HC, Schmidt RE, Rice J, et al. Biochemical changes following trauma and skeletal surgery of the lower extremity: quantification of the operative burden. Crit Care Med2000;28:3441-8.  Schumann RR,Leong SR, Flagge GW, et al. Structure and function of Lipopolysaccharide binding protein. Science 1990;249:1429-3.  Singer, J.M, and C.M. Piotz, Amer, J. Med 21,888,(1956).  Hyde, R.M. and S.Garb, Amer. J. Clin.Path,  44, 436,(1965).  Scherttarth, F.M.Perez-Miranda and H.Goetz.,Blut,20,296,(1970).  Qrrego LM, Perez CM, Perez YM, Cheyre EJ, Mardones PR,Plasma C-reactive protein in elective orthopaedic surgery Rev. Med Chil. 2005 Nov.133(11):1341 -8.  Gosling P, Dikson GR. Serum C- reactive protein in patient with serious trauma. Injury 1992;23:483-86.  Pedro Povoa Intensive Care Med(2002) 28:235-243,DOI 10.1007/s00134-002-1209-6.

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52411119EnglishN2019October15HealthcareThe Impact of Blindness on the Socio Economic Lives of Young Adults in South Western Nigeria English0408Onabolu Oluwatoni OEnglish Jagun Omodele OEnglish Ebonhor MichaelEnglishBackground: Rehabilitation of the blind in developing countries is usually focused on education for employment purposes with little attention to social life. Yet it is known that the blind have dreams and aspiration that are dampened by their disability. This study examined how rehabilitated blind adults cope socially with their disability. Methods: This was a cross sectional observational study amongst registered members of the Nigerian Association of the Blind, Ogun State Chapter. Sixty-six adults were recruited and subjected to a validated interviewer administered questionnaire. Results: Age range was 17-68 years with mean of 38.51±11.97 years. There were 42 (63.7%) males and 36 (54.5%) were married. Majority of those that were married 29 (80%) had 3 children each and 35(53%) lived in rented/institutional apartments where they either partially or fully paid for rent. 25(37.88%) participants had attained tertiary education. 50% were self-employed and 19(28.8%) were engaged in competitive employment. 44.8% of the self- employed earned less than 19000 naira per month ($52.6) while those in paid employment earned up to 72000 Naira per month ($193.9). Conclusion: Despite rehabilitation, the earning capacity of the blind adult is low. Blindness has a negative impact on social lives even after rehabilitation. EnglishBlind, Marriage, Social life, Economic ChallengesINTRODUCTION Young adults with visual impairment wish for a bright and productive future but this dream is  dampened by difficulties resulting from their visual disabilities1. One important barrier is the  rate of competitive employment of the visually impaired and blind which had been found to be  considerably lower than their sighted peers2. In Europe the visually impaired were at higher risk  of not having a paid job, being unemployed, belonging to a manual social class, having less job satisfaction, and getting inadequate salary3,4. Researchers have also shown that persons with visual impairment have distinct challenges  Regarding relating with other people, mobility, mental and social wellbeing5. In Nigeria, most  blind adults are seen as illiterate street beggars while others become dependent on sighted family  members for daily living6. However a few get educated even up to tertiary level and become fully rehabilitated but they still have difficulty in securing paid employment7,8. A longitudinal study on blind adolescents revealed that they have a small social network with  fewer friends and are more likely to stay in familiar surroundings like their homes because of  socializing difficulties9. Therefore dating the opposite sex is uncommon leading to late starting  of a family9. The prevalence of blindness in Ogun State of Nigeria was 2.8 % (Nigeria National Blindness  Survey 2005-2007)10. There are two primary schools for the blind and three integrated  secondary schools. Ogun state has a literacy rate of 78.8% amongst adults and has a high  concentration of industries11. The minimum civil service salary per month is N18000 (US $50)12. Transportation within the towns and villages is by road. Majority of the roads lack pedestrian  pathways which makes mobility difficult for the visually impaired even with their canes. The purpose of this communication is to give information on the socioeconomic life of the rehabilitated blind and visually impaired in South West Nigeria so that special schools for  rehabilitation can include mentorship, job placement and social interactions in their curriculum. Materials and methods: Study design. This was a cross sectional observational study of the registered members of the Nigerian Association of the Blind (NAB), Ogun State chapter. Sample size consisted of 66  consenting participants from a sample frame of 206 registered members. Each participant was subjected to an interviewer administered questionnaire (during their monthly meetings until all consenting members were covered) consisting of their bio-data, education, occupation, income per month, accommodation, marital status and number of children. The questionnaire was initially validated amongst members of another branch of NAB in the adjacent State (Lagos) and adjusted accordingly. Ethical approval was obtained from The Olabisi Onabanjo University Teaching Hospital review committee. All participants gave Verbal consent and the Chairman of the NAB provided a written consent prior to the study. Statistics: The result was recorded in a personal computer using Statistical Package for Social  Sciences IBM version 21 spread sheets. Discrete variables were compared by means and  percentages while continuous variables were compared using Pearson’s chi- square with valuesEnglishhttp://ijcrr.com/abstract.php?article_id=2635http://ijcrr.com/article_html.php?did=26351. Heppe EC, Kef S, Schuengel C. Testing the effectiveness of a mentoring intervention to  improve social participation of adolescents with visual impairments?: study protocol for a  randomized controlled trial.  Trials 2015;16:1–11. 2. Bell E. Competitive employment for consumers who are legally blind: A 10-year  retrospective study. J Rehabil Res Dev [Internet] 2010; 47(2):109–16. 3. Mojon-azzi SM, Sousa-poza A, Mojon DS. Impact of Low Vision on Employment  2010;381–8. 4. Ulldemolins AR, Lansingh VC, Valencia LG, Carter MJ, Eckert KA. Review Article Social  inequalities in blindness and visual impairment?: A review of social determinants. Indian Journal  Ophthalmol 2012;60(5):368-375 5. Elsman EBM, Van Rens GHMB , Van Nispen RMA. Impact of visual impairment on the  lives of young adults in the Netherlands?: a concept-mapping approach. Disability and  Rehabilitation 2017; 39(26):2607-18. 6. Ademola-Popoola D, Tunde-Ayinmode M, Akande T. Psychosocial characteristics of  totally blind people in a Nigerian city. Middle East Afr J Ophthalmol [Internet]. 2010;17(4):335. 7. Onabolu OO, Bodunde OT,  Ajibode HA, Otulana TO, Daniel OJ, Ebonhor ME.  Rehabilitation and Paid Employment for Blind People in a Low Income Country. J Adv Med Med Res. 2018;25(8):1–9. 8.  Wolffe  KE, Ajuwon  PM, Kelly SM. Working with Visual Impairment in Nigeria: A  Qualitative Look at Employment Status. J Vis Impair Blind [Internet]. 2013;107(6):425–36. 9. Gold D, Shaw A, Wolffe K. The social lives of Canadian youths with visual impairments.  J Vis Impair Blind. 2010;104(7):431–43. 10. Rabiu MM, Kyari F,  Ezelum C, Elhassan E, Sanda S, Gudlavalleti V. S  et al.  Review of the publications of the Nigeria national blindness survey: Methodology, prevalence,  causes of blindness and visual impairment and outcome of cataract surgery. Ann Afr Med. 2012;11(3):125–30. 11. Ogun State : Ogun State.gov.ng/ogun state 2018. (Accessed 30/04/2019) 12. Nigeria: Minimum wage https://nass.gov.ng/document/download/. (Accessed 30/04/2019). 13. Lindsay S, McDougalL C, Menna-Dack D., Sandford R. An ecological approach to  understanding barriers to employment for youth with disabilities compared to their typically  developing peers?: Views of youth, employers, and job counselors. Disabil Rehabil. 2015;37 (8):701–11. 14. Lee IS, Park SK. Employment Status and Predictors among People with Visual  Impairments in South Korea: Results of a National Survey. Journal of Visual impairment & Blindness 2008; 102(3):147-159. 15. Harrabi H, Aubin M, Zunzunegui MV, Haddad S, Freeman EE. Visual Difficulty and  Employment Status in the World. 2014;9(2):1–6. 16. Grow SJ, Daye P. Barriers to Employment Identified by Blind and Vision-Impaired  Persons in New Zealand. Soc Policy J New Zeal. 2005;(26):173–85. 17. Pfeiffer JP and Pinquart M. Attainment of developmental tasks by adolescents with visual  impairment Journal ofVisual Impairment & Blindness 2011;3:3-44. 18. Law M. Participation in the occupation of everyday life. Am J Occup Ther 2002;56(6):640-9 19. Salehi M, Azarbevejani A, Shafiei K, Ziaei T, Shayegh B. Self-esteem, general and sexual  concepts in blind people. J. Res Med Sci 2015;20(10):930-60 20. Van LL, Rainey L, Kef S, Van RG, Van NR. Investigating rehabilitation needsof visually  impaired young adults according to the international classification of functioning disability and health. Acta Ophthalmologica 2015;93(7)