06/29/2017
Mini Review

Incidence of symptom-driven Coronary Angiographic procedures post-drug-eluting Balloon treatment of Coronary Artery drugeluting stent in-stent Restenosis-does it matter?

Victor Voon*, Dikshaini Gumani, Calvin Craig, Ciara Cahill, Khalid Mustafa, Terry Hennessy, Samer Arnous and Thomas Kiernan

Objectives: The clinical impact of drug-eluting balloon (DEB) coronary intervention for drug-eluting in-stent restenosis (DES-ISR) is not fully known. To further evaluate this impact, we aimed to describe the incidence of symptom-driven coronary angiography (SDCA), an under-reported but potentially informative outcome metric in this cohort of patients.

Methods: We retrospectively identified all patients (n=28) who had DEB-treated DES-ISR at University Hospital Limerick in between 2013-2015 and evaluated the incidence of subsequent SDCA as the primary endpoint. Data were expressed as mean ± SD and %.

Results: Baseline demographics demonstrate a mean age 63±9 years with 61% of DEB-treated DES-ISR presenting with acute coronary syndrome. Mean number of ISR per patient and number of DEB per lesion was 1.2±0.6 lesions and 1.2±0.6 balloons, respectively. The incidence of SDCA was 54% after mean follow-up duration of 179±241 days. 67.8% of patients had follow-up data beyond 12 months. Within the first year of follow-up, the incidence of SDCA with and without target lesion revascularization (TLR) was 11% and 36% respectively. Among patients with SDCA without TLR, 30% had an acute coronary syndrome not requiring percutaneous coronary intervention.

Conclusions: A high incidence of SDCA was observed, particularly within the first 12 months after DEB-treated DES-ISR. This under-reported metric may represent a cohort at higher cardiovascular risk but requires further confirmation in larger studies.

06/23/2017
Mini Review

Thrombolysis, the only Optimally Rapid Reperfusion Treatment

Victor Gurewich*

Thrombolysis with tissue plasminogen activator (tPA) has been plagued by inadequate efficacy and a high risk of intracranial hemorrhage (ICH), which led to its replacement by procedures like percutaneous coronary intervention (PCI) whenever possible. Since this requires hospitalization, it is time-consuming, and compromising salvage of brain tissue and myocardium. Thrombolysis is the only first-line treatment that can provide sufficiently timely treatment for optimal recovery of organ function. However, for this potential to be realized, its efficacy and safety must be significantly improved over the current method. By adopting the sequential, synergistic fibrinolytic paradigm of the endogenous system, already verified by a clinical trial, this becomes possible. The endogenous system’s function is evidenced by the fibrinolytic product D-dimer that is invariably present in blood, and which increases >20-fold in the presence of thromboembolism. This system uses tPA to initiate lysis, which is then completed by the other fibrin-specific activator prourokinase (proUK). Since tPA and proUK in combination are synergistic in fibrinolysis, it helps explain their efficacy at their low endogenous concentrations.

06/21/2017
Case Report

Spontaneous rupture of a giant Coronary Artery Aneurysm after acute Myocardial Infarction

Oguzhan Celik, Mucahit Yetim, Tolga Dogan, Lutfu Bekar, Macit Kalcık* and Yusuf Karavelioglu

Coronary artery aneurysm is commonly defined as a localized dilatation exceeding the diameter of adjacent normal coronary segments by 50% [1]. Coronary artery aneurysms may be fusiform, involving the full circumference of the coronary artery, or saccular, involving only a portion of the circumference [2].Causes of coronary artery aneurysms include atherosclerosis (accounting for 50% of cases), Kawasaki disease, polyarteritis nodosa, infection, trauma, coronary dissection, percutaneous coronary angioplasty, and congenital malformations [3]. The abnormal blood flow within the coronary artery aneurysm may lead to thrombus formation, embolization, rupture, myocardial ischemia or myocardial infarction [4]. Here we present a case of a giant fusiform coronary artery aneurysm who passed away due to coronary rupture after acute myocardial infarction.

06/23/2017
Editorial

CRISPR genome editing: A general view

Ram Mohan Ram Kumar*

CRISPR technology has presented a path forward for genomic engineering and gene modification. The framework for the use of CRISPR technology to manipulate the human genome is of great interest and the form of its development and application has excited the researchers and biotech communities as the number of ublications citing CRISPR gene targeting system has rose predominantly as indexed in PubMed.From a technical standpoint of view, most of us think that this would be relatively straightforward process, but technical feasibility is never the only consideration in doing experiments. Much of the discussion about CRISPR engineering has revolved mostly around its ability for treating disease or editing the genes of human embryos. In the real sense, what the biologists desire about CRISPR is its specificity: the ability to target and determine particular DNA sequences in the genome circuit.

Even though CRISPR has emerged as a revolution in genome editing within the scientific community, it has undergone a close scrutiny even within the non- scientific community. The thought of using CRISPR system for curing genetic diseases have gained support but a fewer does not support the use of this technology for editing the human germline cells which has the potential to transfer on their genetic information, has sparked a question about the role we are tempted to play in our own evolution. Interestingly, in an editorial that appeared on Science, it mentioned about a call for a moratorium on germline genome modification by discovers of CRISPR, scientists, ethicists and policymakers on using CRISPR in human subjects and cited a need for greater transparency in the CRISPR system. It also emphasised the need for optimised benchmarking and determination of off-target modifications made by the CRISPR system, the effects of which are largely unknown [1]. However, tremendous potential of CRISPR system for curing genetic diseases have been highlighted inspite of all the concerns.

06/28/2017
Review Article

Mitomycin-C Use and Complications in Ophthalmology

Tongabay Cumurcu*

Mitomycin-C, First found its way into ophthalmic use in 1969, in Japan, where recurrent pterygia were successfully treated with the drug which is an antineoplastic / antibiotic agent isolated from the soil bacterium Streptomyces caespitosus [1]. It is an anti-metabolite with anti-proliferative effect on cells showing the highest rate of mitosis by inhibiting DNA synthesis and interferes with RNA transcription and protein synthesis [2].

06/20/2017
Short Communication

The interaction between photonic technology and physical exercise: The action of low-level laser therapy

Antonio Eduardo de Aquino Jr* and Fernanda Mansano Carbinatto

Introduction: Obesity is a global-level epidemic. Together with this disease, called chronic subclinical inflammatory disease, many other diseases, known as comorbidities, arise.

Objective: To show that the association between low-level laser therapy and physical exercise is supported, by experimental and clinical studies, being an instrument that maximizes the treatment of obesity as well as its comorbidities.

Conclusion: This manuscript brings a compendium of accomplished work by our group that allows understand the mechanism base of interaction between the photonic technology and the physical exercise, allowing to potentiate the treatment of the obesity.

06/30/2017
Research Article

The impact of geographical origin on specific properties of pine honey

Ioannis K. Karabagias*, Christos Nikolaou and Ilias Gatzias

Pine honey represents the major type of honey produced in Greece. In that sense, the aim of the present study was to investigate if specific physicochemical and bioactive properties could serve as markers of its geographical origin. For this purpose, forty pine honey samples were collected during harvesting years 2011 and 2012 from Halkidiki and Thassos, the well-known pine honey producing areas in Greece. Physicochemical parameters taken into account, using conventional and literature cited methods, were: pH, CIE colour parameters L*,a*,b*, and browning index. Furthermore, colour intensity and the in vitro radical scavenging activity were estimated by the application of spectrometric assays. Results showed that, pine honeys exhibited statistically significant differences (p<0.05) in pH, colour intensity, and radical scavenging activity, depending on geographical origin. On the basis of radical scavenging activity results obtained, pine honeys proved to have a high in vitro antioxidant “character’’. Finally, perfect Pearson’s correlations (r=1) at the confidence level p<0.01 were obtained for the sets: pH-browning index, pH-radical scavenging activity, and browning index -radical scavenging activity, with respect to geographical origin.

06/21/2017
Research Article

Endovascular treatment of complex cerebral arterial saccular aneurysms with different methods of coiling: 14 years of experience review

Dmytro V Scheglov*, Stanislav V Konotopchik, Maryna Y Mamonova and Oleg E Sviridyuk

The Objective: to improve the treatment results for patients with cerebral arterial saccular aneurysms by optimizing of differentiated approach to the using of endovascular assisting occlusion techniques.
The Objective: to improve the treatment results for patients with cerebral arterial saccular aneurysms by optimizing of differentiated approach to the using of endovascular assisting occlusion techniques.The Objective: to improve the treatment results for patients with cerebral arterial saccular aneurysms by optimizing of differentiated approach to the using of endovascular assisting occlusion techniques.
The Objective: to improve the treatment results for patients with cerebral arterial saccular aneurysms by optimizing of differentiated approach to the using of endovascular assisting occlusion techniques.
Materials and Methods: The work is based on the comprehensive survey and treatment of 1345 patients with cerebral saccular arterial aneurysms (AA), who were treated at the SO “Scientific-Practical Center of endovascular neuroradiology of NAMS of Ukraine” from 2002 to 2016. 214 cases were selected for further clinical-instrumental dynamic observation in follow-up period. All patients were operated by endovascular approach in “before hemorrhage” period, in acute or “cold” period of the disease on for symptomatic or asymptomatic intracranial saccular AA in both vascular pools with balloon-remodeling or stent-assisting techniques using with the coiling or just detachable coils (DC) using-mono-coils occlusion technique. Depending on the initial endovascular occlusion method, the patients were divided into three groups for observation: I group (mono-coils occlusion)-82 (38.3%) patients, II group (balloon-remodeling technique using)-68 (31.8%) patients, group III (stent-assisting technique occlusion)-64 (29.9%) patients. The life quality and the level of social adaptation were evaluated before hospital discharge and at the follow-up control examinations by Glasgow Outcome Scale (GOS) and by the modified Rankine scale (mRS). AA radicalism occlusion was assessed by Modified Raymond-Roy Scale (MRRS) (Mascitelli JR, et al., 2015). AA occlusion I and II by MRRS was considered as “Effective”.
Results: 9 criteria of cerebral saccular AA complexity inherent in endovascular surgery have been developed based on the technical and surgical features of endovascular methods of the cerebral AA occlusion and X-ray-anatomical characteristics of aneurysms, which complicated the “effective” reconstructive occlusion of AA cavity.
The evaluation of the AA complexity criteria prognostic significance to achieve the “effective” primary occlusion, shown different results in different groups: high prognostic significance of 4 criteria was shown in group I, of 2 criteria - in group III, and no any criteria significance in group II.
There was no statistically significant difference between groups in the primary AA occlusion efficacy and initial good results by GOS and mRS.
It was proved that endovascular occlusion of complex cerebral AA with the assisting methods using has high efficiency in all periods of the disease, unlike the method of mono-coils occlusion, which is most effective in acute and “cold” periods.
There was no statistically significant difference between the number of intraoperative, postoperative and non-surgical complications (p>0.05).
It was found that all methods of complex AA endovascular occlusion can effectively prevent the disease recurrence despite the differences between them in the stability of the AA cavity occlusion.
Conclusions: Consideration of developed AA complexity criteria during endovascular surgery planning allows to choose the most optimal and safe individual method of primary or phased AA occlusion and helps to reduce the frequency of AA recanalization in follow-up period. The choice of the complex AA occlusion method doesn’t effect on result of primary treatment, the number of intraoperative complications and the quality of primary occlusion. However, an analysis of the long-term treatment results indicates that the assisting techniques have proven advantages according to the occlusion stability.
06/27/2017
Research Article

Clinical significance of Urinary Amylase in Acute Pancreatitis

Mumtaz Din Wani, Mushtaq Chalkoo*, Zaheer Ahmed, Awhad Mueed Yousuf, Yassar Arafat, Syed Shakeeb Arsalan and Jaffar Hussain

Acute pancreatitis forms a major bulk of our inpatient admission due to gall stone disease. Diagnosis of acute pancreatitis remains a challenge even now. Serum amylase remains the most commonly used biochemical marker for its diagnosis but its sensitivity can be reduced by late presentation, hyper-triglyceridemia and chronic alcoholism. We conducted a study to determine the levels of serum and urinary amylase in patients with acute pancreatitis and compared their sensitivity and correlation with CT findings vis-à-vis the severity of the disease. The study was taken as a post graduate research model in the Post graduate Department of General and Minimal Access Surgery, Govt. Medical College Srinagar, J&K, India 2014-2016 and submitted for the award of masters in General Surgery. A total number of 150 patients were enrolled in the studies which were admitted in our unit as acute pancreatitis. 73 (48.7%) belonged to the age group of 30-44 years, 15(10%) patients aged >60 years with 86 (57.3%) males and 64 (42.7%) females. We had 81 (54%) patients with biliary tract diseases, followed by 21 (14%) patients with worm induced, 20 (13.3%) had hyperlipidaemia and only 4 (2.7%) patients had post ERCP etiology. Tenderness in epigastrium was the presenting sign in 111 (74%), followed by chest signs in 25 (16.7%) patients, diffuse tenderness in 19 (12.7%), icterus in 11 (7.3%), low grade fever in 9 (6%) patients, shock in 5 (3.3%). Diabetes mellitus as a comorbidity was observed in 48 (32%) patients followed by hypothyroidism 37 (24.7%) patients. Hypertension was seen in 31 (20.7%) patients, COPD in 19 (12.7%) patients and obesity in 13 (8.7%) patients. Twenty two (14.7%) needed ICU admission; while as 128 (85.3%) were managed in the general ward. All the enrolled patients in our study were managed conservatively. Out of a total of 150 patients, 148 (98.7%) survived while as only 2 (1.3%) of our patients expired. At the time of admission in the hospital, 120 (80%) patients had serum amylase level of >450 U/L, 19 (12.7%) patients had 150-450 U/L levels while as 11 (7.3%) patients had <150 U/L serum amylase levels. CT has been shown to yield an early overall detection rate of 90% with close to 100% sensitivity after 4 days for pancreatic gland necrosis. The correlation of urinary amylase with the CECT Severity Scoring in a patient of acute pancreatitis is still ambiguous.

06/23/2017
Short Communication

Function Prediction of Proteins from their Sequences with BAR 3.0

Giuseppe Profiti, Pier Luigi Martelli and Rita Casadio*

Protein functional annotation requires time and effort, while sequencing technologies are fast and cheap. For this reason, the development of software tools aimed at predicting protein function from sequences can help in protein annotation.
In this paper, we describe how to use our recently implemented Bologna Annotation Resource (BAR) version 3.0, a tool based on over 30 million protein sequences for protein structural and functional annotation. In BAR 3.0, sequences are arranged in a similarity graph and then clustered together when they share at least 40% sequence identity over 90% of sequence alignment, for a total of 1,361,773 clusters.

Protein sequences with known function transfer their annotation to other sequences in the same cluster after statistical validation. Sequences with unknown function and new sequences entering in a cluster inherit its statistically validated annotations.

The method well compares to other techniques in the Critical Assessment of protein Function Annotation algorithms (CAFA). The CAFA experiment tests the performances of different predictors on a dataset that accumulates annotations over time. BAR predictions have been submitted to all the instances of CAFA through the years (BAR Plus in CAFA, BAR++ in CAFA2 and BAR 3.0 in CAFA3). The benchmarking indicates that in the field improvement is still possible and that our BAR scores among the top performing methods.

This work focuses on how the tool can transfer statistically significant features to poorly annotated or new sequences derived from transcrptomics or proteomics experiments.

06/26/2017
Research Article

Chemotherapy Exposure and outcomes of Chronic Lymphoid Leukemia Patients

Josephina G Kuiper*, Patience Musingarimi, Christoph Tapprich, Fernie JA Penning-van Beest and Maren Gaudig

This study describes chemotherapy exposure, healthcare utilization, overall survival (OS) and progression-free survival (PFS) among patients diagnosed with chronic lymphoid leukemia (CLL). Newly diagnosed CLL patients who received chemotherapy were selected from the Eindhoven Cancer Registry between 1998-2011, linked on a patient-level to the PHARMO Database Network including data on in- and out-patient drug dispensings, hospitalizations and clinical laboratory measurements. Chemotherapy was classified in regimens of use based on chemotherapy combinations. OS and PFS were determined after diagnosis and after chemotherapy. Healthcare utilization was assessed in the year before diagnosis and in the year after chemotherapy.

In total, 125 CLL patients received chemotherapy: 52 patients (42%) started chemotherapy within 6 months and 73 patients (58%) started chemotherapy ≥6 months after diagnosis. Mean (±SD) age was 67(±10) years and 68% was male. About 50% had one treatment line and about 25% two lines of treatment. Chlorambucil was the most common type of first line chemotherapy. Prior diagnosis, 44% were hospitalized for any cause and 94% had at least one drug dispensing. After chemotherapy, this was 43% and 98%, respectively. One-year survival rate after diagnosis was 94%. Median PFS after first treatment line was 17 months for patients starting within 6 months and 27 months for patients starting ≥6 months after diagnosis. In conclusion, most CLL patients receiving chemotherapy were treated with chlorambucil. One-year after initial diagnosis, 94% were still alive. Median PFS after first line chemotherapy ranged from 17 to 27 months, depending on the timing of chemotherapy.

06/26/2017
Case Report

Time to Terminate LNT: Radiation Regulators Should Adopt LT

Jeffry A Siegel*, Bill Sacks and James S Welsh

The linear no-threshold hypothesis (LNT)-the basis of radiation regulatory policy-extrapolates from observed high-dose harm to assumed low-dose harm, entailing that all ionizing radiation is harmful, by denying any biological response to damage and asserting cumulative lifetime harm, regardless of dose or dose rate.All aspects of LNT are demonstrably false. There are evolved biological responses that repair or remove radiogenic damage from low doses and dose rates, thereby averting acute harm and precluding the alleged cumulative damage. LNT and its offspring, the “as low as reasonably achievable” principle, do not err on the side of caution; neither is truly conservative. The public needs protection from radiophobia, rather than from low-dose radiation exposure. Neither radiation regulations nor medical practice should be based on LNT, but rather, at least as a first step, on a linear (down to a) threshold (LT) model.

06/23/2017
Research Article

Reliability and validity of the Sit-To-Stand Test to assess Global Foot Mobility

Mark W Cornwall*, Carissa Lane, Jennifer Norwood, Sara Patterson and Daniel Strauss

The Sit-to-Stand test (STST) involves comparing the change in a person’s non-weight-bearing and weight-bearing foot posture to quickly classify a person’s overall foot mobility. Despite the simplicity of the test, its reliability and validity has not been established. The purpose of this study is to determine the intra-rater and inter-rater reliability of the STST as well as its validity.Ninety-seven subjects with a mean age of 25 years (±3.7) participated in the study. Each subject’s foot posture from non-weight-bearing to weight-bearing was evaluated by two different raters. Each rater classified each subject’s change in foot posture as “Hypomobile”, “Normal” or “Hypermobile”. This same procedure was repeated approximately one week later without the raters being able to review what their original classification for that subject had been. The subjects also had their foot mobility quantified by measuring the height and width of their dorsal arch in both non-weight-bearing and weight-bearing. These quantitative measures of foot mobility were then classified as “Hypomobile”, “Normal”, or “Hypermobile” using quartiles. A series of Cohen’s Kappa coefficients were used to assess the amount of agreement between the visual classifications by each rater as well as the classification between the observational and objective classifications. The between-day Kappa coefficients ranged from 0.613 to 0.719 and the inter-rater Kappa coefficients ranged from 0.473 to 0.531. The Kappa coefficients between the visual and quantitative classifications ranged from 0.281 to 0.436. The STST should therefore be used with caution because of its moderate between-rater reliability and validity.

06/23/2017
Case Report

Successful Therapy with intravenous gamma globulin in two children with postinfectious bronchiolitis obliterans

Sevgi Pekcan , Bahar Gökturk* and Ismail Reisli

Bronchiolitis obliterans (BO) is an infrequent clinical syndrome characterized by the chronic obstruction of small airways due to fibrosis [1]. Intravenous immunoglobulin (IVIG) could be used for treatment while underlying immune mechanisms in the pathogenesis of BO exist [2]. Here, we present two children with BO due to adenovirus infection whose complaints resolved after IVIG replacement.

06/19/2017
Case Report

Acute and chronic changes in massive Barium Sulfate aspiration in an infant who subsequently was diagnosed with severe Gastro-esophageal Reflux

Sevgi Pekcan*

The barium is often used in radiocontrast examinations of the digestive system because of mucosal absorption is limited. Massive barium aspiration is a rare complication, especially when there is no anatomic or neurological deficit. The depending on barium concentration can cause various lung effects.When the literature is reviewed, barium aspiration may be asymptomatic or lethal in massive amounts. Rarely, large amounts of barium sulphate are aspirated into the lung, there is no literature study how often this is happening.

We present a case of massive barium aspiration in this subject. The case is related to a patient’s diagnostic esophagography who complaints swallowing problems. The massive barium aspiration couldn’t notice because of the absence of acute symptoms and surgical operation of gastrointestinal tract which the patient had undergone previously. When the patient applied our Pediatric Chest Diseases Polyclinic after three months, as a result of the examinations and deep research it was understood that the case was about massive barium aspiration. The patient was directed to our center because there was a radiological appearance of bone density signs on chest X-ray. Such a complaint was not reported by the family neighter in his biography, nor was written in the epicrisis. We will share acute and chronic changes in the lungs, diagnosis and treatment approaches of this case. The infant who has ileostomy was previously operated because of necrotizing enterocolitis. And also still has severe gastro-esophageal reflux and under conservative and medical treatment, a possible fundoplication surgery is planning.

06/30/2017
Case Report

Direct Carotid Puncture for Flow Diverter Stent Insertion

Bhogal P*, Phillips TJ and Makalanda HLD

Objective: To report our experience of direct carotid puncture and its use in the management of a large and rapidly expanding cavernous aneurysm.

Methods: A patient with a cavernous aneurysm that measured 25mm in maximum diameter underwent treatment with flow diversion. The initial treatment strategy was parent vessel occlusion however she failed the balloon occlusion test at 3 minutes. Due to extremely tortuous vessels stable access via a common femoral artery approach was impossible to achieve. We present our strategy, the post-operative management and long term results.

Results: Using a direct carotid puncture three telescoped Pipeline embolisation devices were successfully deployed across the neck of the cavernous aneurysm without complication. The puncture site formed a stable platelet plug after direct compression with an ultrasound probe for 90 minutes with no post-operative complications either intracranially or at the neck puncture site. At 2 year follow-up the aneurysm is completely excluded from the circulation.

Conclusion: Direct carotid puncture can be used as access for intracranial interventional procedures even if patients are on dual anti-platelet medication.

Methods: A patient with a cavernous aneurysm that measured 25mm in maximum diameter underwent treatment with flow diversion. The initial treatment strategy was parent vessel occlusion however she failed the balloon occlusion test at 3 minutes. Due to extremely tortuous vessels stable access via a common femoral artery approach was impossible to achieve. We present our strategy, the post-operative management and long term results.
 
06/29/2017
Review Article

Natural and effective ways of purifying lake water

Swapnil Lokhande and Savita Dixit*

Water resources play an integral part in the life of a living being. The various water resources that are present on the earth’s surface are in the form of oceans, seas, lakes, rivers, ponds, waterfalls etc. Among these water resources Lakes and reservoirs are vital for people’s life, industrial activities and many other day to day activities. These water resources help in obtaining water for drinking after being treated. They also provide water for agriculture and industrial usage, fishery resource, flood control functions and many other activities. Due to the closed nature of lakes’, the waste material from sewage, agricultural effluents, domestic and industrial fields, gets accumulated around the surface of these water resources and once the water gets polluted, it gets strenuous to improve the quality of the water. In the study, the authors have examined different effective ways by which the quality of lake water can be improved.

06/29/2017
Research Article

Hydraulic jump experiment in a rectangular open channel flume

Mostafa M El-Seddik*

This paper presents a laboratory experiment for the formation of hydraulic jump in a rectangular open channel flume to accurately explore the effect of flow structures on water resources. This experiment illustrates the behavior of super-critical flow under sluice gate for various flow rates and downstream depths. Several runs are carried out using Armfield Model No. C4-MKII-5.0-11 to investigate the former computations concerning both the downstream conjugate depth and the critical depth resulting within the jump. Moreover, the model is examined to explore the sensitivity of Froude number by adjusting the flow-meter and over-shot weir in the flume. Also, the type of jump attributed to flow velocity can thus be obtained. Furthermore, both location of hydraulic jump and energy dissipated are discussed under the influence of different gate openings.

06/22/2017
Case Report

Esthetic recovery of permanent Mandibular Lateral Incisor using biological post after non-surgical healing of Periradicular Lesion: A Case Report

Amit Kumar Garg, Neha Agrawal* and Rajendra Kumar Tewari and Surendra Kumar Mishra

Statement of the problem: Anterior tooth fracture, as a result of traumatic injuries, frequently occurs in dentistry. This leads to necrosis of pulp and periapical pathology. The goal of endodontic and restorative dentistry is to retain natural teeth with maximum function and pleasing esthetics.

Purpose of the study: This study aimed at proper reconstruction of extensively damaged teeth through the procedure known as “Biological Restoration.”

Materials and methods: Biological post obtained through natural, extracted teeth from another individual represents a low-cost option and alternative technique for the morphofunctional recovery of damaged anterior teeth that provides highly functional and esthetic outcomes.

Conclusions: This case report refers to the esthetics and functional recovery of mandibular left lateral incisor after non-surgical healing of periradicular lesion.

 
Conclusions: This case report refers to the esthetics and functional recovery of mandibular left lateral incisor after non-surgical healing of periradicular lesion.
 
Materials and methods: Biological post obtained through natural, extracted teeth from another individual represents a low-cost option and alternative technique for the morphofunctional recovery of damaged anterior teeth that provides highly functional and esthetic outcomes.
 
Conclusions: This case report refers to the esthetics and functional recovery of mandibular left lateral incisor after non-surgical healing of periradicular lesion.
 
Materials and methods: Biological post obtained through natural, extracted teeth from another individual represents a low-cost option and alternative technique for the morphofunctional recovery of damaged anterior teeth that provides highly functional and esthetic outcomes.
06/20/2017
Case Report

Efficacy of early Hyperbaric Oxygen Therapy in Central Retinal Artery Occlusion

Ayse Gul Kocak Altintas* and Mehmet Citirik

A 60-year-old woman had central retinal artery occlusion (CRAO) presented to the ophthalmology department with a sudden, painless loss of vision. Her initial visual acuity was light perception and she treated with hyperbaric oxygen therapy (HBOT) 4 hours after the development of visual symptoms. Systemic risk factors were not found so she was diagnosed as having idiopathic CRAO. Her vision improved from light perception to 20/50 after the HBOT. Any complications such as neovascularization were not developed until the last follow up visit of 8th months.

06/28/2017
Review Article

Concise Review: Considerations for the Formulation, Delivery and Administration Routes of Biopharmaceuticals

Amir Mohammed Alsharabasy*

The drugs of biological origins have attracted the attention of many pharmaceutical companies where it is essential to protect the heterogeneous nature and the optimal three dimensional structures of the different macromolecules. These molecules are used in both the investigation and therapy purposes, so their maximum activities should be maintained. This requires the designing of certain delivery formulations that suits the macromolecule nature, its target organ, the required dose and delivery route, and that’s why the biotech companies invest millions of dollars towards achieving that. The first main focal point of this article includes the recent developments in the formulation technologies for several biomacromolecule classes. The second focal point concentrates on the current considerations for optimizing their delivery for a maximum performance in the body.

06/27/2017
Research Article

A possible Etiology and new treatment of Burning Mouth Syndrome and allied condition

Sudhakar Pattanaik*

Introduction: Burning mouth syndrome, oral sub mucous fibrosis, leukoplakia, etc are the different manifestations of a common disease as per the surmise of various authors. There is no known cause and no specific treatment. Attempt is made in this study to find a cause and if possible, a treatment.

Materials and methods: 38 such cases were taken up in this study. It was found, that the cardinal signs of paucibacillar indeterminate form of Hanseniasis, as per the definition of WHO, are present in all these cases. Also they are found to respond well to the anti-leprotic drugs prescribed by WHO for the Hanseniasis.

Conclusion: It is recommended for multicentre trial and further research on this score which would relieve the suffering millions of the world populations.

06/27/2017
Review Article

MicroRNA Therapeutics in Triple Negative Breast Cancer

Sarmistha Mitra*

Breast cancer is a complex disease and one of the main causes of cancer-related mortality in women worldwide. In case of approximately 15% of all breast cancers, three markers i.e. estrogen receptors (ER), progesterone receptors (PR) and human epidermal growth factor receptors-2 (HER2) are not expressed, and is commonly termed as triple-negative breast cancer (TNBC). Particularly, TNBC is associated with a higher percentage of breast cancer related mortality, which is often aggressive and most frequently found with a BRCA1 mutation or increased basal marker expression. However, due to the limitations of chemotherapy and radiation based treatment; the current challenge is to establish a new strategy of diagnosis and treatment of TNBC. The deregulation of a number of microRNAs (miRNAs) in breast cancer has been widely reported. Therefore, this review is directed towards enhancing our understanding of the involvement of various miRNAs in the pathology of TNBC, their upregulations and downregulations and the effects on various factors. From recent studies a number of miRNAs are found to be related with TNBC, which have great potential to be used as a biomarker to determine the disease prognosis and predict the fate of disease. Again miRNA can be targeted to be applied as a therapeutic to provide a great benefit to the patients of TNBC by finding a new, safe, and effective treatment strategy.

06/13/2017
Case Report

Acute Tubulointerstitial Nephritis due to Phenytoin: Case Report

Nilzete Liberato Bresolin*, Pedro Docusse Junior, Maria Beatriz Cacese Shiozawa, Marina Ratier de Brito Moreira and Natalia Galbiatti Silveira

Introduction: Acute tubulointerstitial nephritis (ATIN) is an acute kidney injury (AKI) resulting from damage to the tubulointerstitial tissue due to infection, trauma, or use of medication. It is clinically non-specific.

Case: A teenager with multiple trauma, hospitalised after lowering of level of conscience, and convulsion fits. While in the emergency ward, he received: midazolam, fentanyl and phenytoin. The cranial and abdominal CT scans were normal. He was stable with no signs of shock, trauma or infection; he developed oliguria and serum creatinine (Scr) 1.7mg/dL), 12 hours after the admission. After 36 hours, Scr levels were at 3.4mg/dL and urea at 55mg/dL. He had AKI according to pRIFLE (66.2% reduction in clearance). After other causes of AKI had been ruled out, the possibility of ATIN was raised; the phenytoin was suspended and pulse therapy, with methylprednisolone, was promptly initiated. After the first pulse, there was already a decline in the creatinine and urea readings; 48 hours later: Scr at 2.2mg/dL and urea at 86mg/dL. Thirty days after being discharged from hospital, the patient was in good health and had full restoration of kidney function.

Discussion: The singularity of this report relies on the rarity of ATIN secondary to the use of phenytoin and also in the importance of recognizing this aetiology as being one of the origins of AKI.

Conclusion: Early diagnosis allows the reversal of AKI through suppression of treatment with phenytoin and introduction of corticosteroid therapy, when necessary.

06/16/2017
Case Report

Recurrent Mucoepidermoid Carcinoma of Parotid with Facial Tics - Report of an unusual case

Pirabu Sakthivel*, Chirom Amit Singh, Smriti Panda, Suresh Chandra Sharma, Konki Malla Abhilash and Milind Sagar

We report an interesting case of a 21 year old male who presented with recurrent mucoepidermoid carcinoma of parotid with facial nerve involvement as facial tics. Intraoperatively, the tumour was noted to be firm, irregular and adherent to the underlying structures. The patient underwent extended total parotidectomy, division of buccal branch of facial nerve, selective neck dissection with cervical local rotational flap repair and post-operative radiotherapy. This presentation of Mucoepidermoid carcinoma with involvement of facial nerve as facial tics is one of the rare unique reported cases.

06/12/2017
Research Article

Wild-type Agrobacterium rhizogenesmediated gene transfer in plants: Agrobacterium virulence and selection of transformants

Mohammad M Rana, Muhammad Abdullah, Ferdinand L Shamalla and Shu Wei*

Agrobacterium rhizogenesATCC 15834 wild type strain was transformed with the binary vector pBI121 using the heat shock method. The transformed Agrobacterium was then tested for virulence through tobacco leaf explant transformation. Compared to the non-transformed Agrobacterium, the transformed Agrobacterium showed reduced virulence, producing significantly lower number of hairy roots in tobacco leaf explants. Although the transformed Agrobacterium showed reduced virulence, it was able to transfer the T-DNA of the binary vector into the plant genome, resulting in stable GUS expression in the generated hairy roots. This indicated that in addition to the transfer DNA (T-DNA) from its root inducing (Ri) plasmid, the transformed Agrobacterium is also capable of transferring the binary vector T-DNA and allowing the integration of a foreign gene. Results also showed that hairy root generation efficiency of the transformed Agrobacterium varied with the concentration of the selection agent (kanamycin). Hairy root generation efficiency (hairy roots·explant-1) progressively increased with decreasing concentrations of kanamycin; and the efficiency was highest in the absence of kanamycin. Generated hairy roots showed very strong to tiny GUS expression even those that grew under the highest concentration of the kanamycin (50 mg·L-1). This indicated that co-transformation and efficient transgene expression does not always occur.

06/12/2017
Case Report

Hypernatremia and central Diabetes Insipidus following Neurosurgical procedure of Trauma

Awad Magbri*, Eussera El-Magbri and Seth Hershit

The greater risk of hypernatremia in patients over 65 years old are associated with impaired mental status and physical disability which may result in impaired sensation to thirst, impaired ability to express thirst, and/or decrease access to water [1,2].

06/08/2017
Case Report

The Neuromuscular diseases in Pediatric Dental Office

Ambarkova Vesna*

The neuromuscular disorders may be hereditary, autoimmune, and in some cases with unknown etiology. These diseases are characterized by progressive course, muscle weakness, and in an advanced stage with binding the patient to a wheelchair. This group includes a number of diseases, but from the dental perspective, the most interesting are muscular dystrophy, multiple sclerosis and myasthenia gravis. Neuromuscular disorders affect the oral cavity and the impact on oral hygiene procedures should be monitored with great attention.

06/06/2017
Mini Review

Fungi present in home and their impact on human health-A short review

Mariusz Dylag*

It is estimated that even up to 30% of buildings worldwide may be the subject of complaints connected with the quality of indoor air. Potential sources of air pollution can be both organic and inorganic particles. This article focuses on biological air pollutants from living and dead biological sources, especially those connected with fungi. Fungi found in the indoor air of domestic dwellings in a large extent are similar in their species composition to those found on the outside of the building. Microorganisms enters into the buildings during the airing of rooms or through the different slots and can develop on the surfaces of various materials. Intensively develops in a poorly ventilated, damp and dusty environments. For this reason the exposure to the indoor air pollution might be stranger for inhabitants than the expose to the impurities of the outdoor air. Presence of fungi in domestic dwellings can be very danger because of most often is associated with allergic reactions, mycotoxins, volatile organic compounds or even with fungal infections.

06/06/2017
Research Article

Protective functions of AEURA in Cell Based Model of Stroke and Alzheimer disease

Jigar Modi Ahmed Altamimi, Ashleigh Morrell, Hongyuan Chou, Janet Menzie, Andrew Weiss, Michael L Marshall, Andrew Li, Howard Prentice* and Jang-Yen Wu*

Stroke and neurodegenerative diseases including Alzheimer’s disease (AD) are responsible for a major proportion of mortalities in the elderly. We have previously investigated novel mechanism-based therapies of AEURA in cell culture models against viral infection and in glutamate excitotoxity. In our new studies, we propose that the homeopathic formula AEURA could serve as a potential therapeutic agent for stroke & for AD.In examining AEURA treatment of PC12 cells exposed to glutamate excitotoxicity, hypoxia /re-oxygenation injury and A-Beta toxicity. We demonstrated an increased survival rate in AEURA treated cells by comparison to control cells. In examining the therapeutic potential of AEURA in PC12 cells this homeopathic agent was found to be neuroprotective against either glutamate induced toxicity, hypoxia /re-oxygenation stress or cell stress resulting from viral infection (with either HSV-1 or rhinovirus). Our ongoing studies involve examining the neuroprotective potential AEURA in vivo using rodent models of stroke & AD.

06/06/2017
Research Article

Comparison of Vitreous Protein Profiles of Rabbits subjected to Acute Carbon Monoxide poisoning and normal animal after death

Agoro ES*, Akubugwo EI, Chinyere GC and Samuel R

Acute carbon monoxide (CO) poisoning is caused by the inhalation of large quantity of CO within short time leading to morbidity and mortality. In this study, a total of eighteen (18) rabbits were divided into three (3) groups of six (6) animals each. The first group first group was poisoned with CO and labelled carbon monoxide death (CD). The second group of animals was killed prior to exposure to CO and labelled disguised death (DD), while the third was the control group (CG). The vitreous humour samples were collected from all the animals using standard methodologies. The vitreous humour total protein and albumin were estimated while its globulin content and albumin/globulin ratio were derived mathematically. Pearson correlation analyses were used to establish relationships between vitreous protein profile components and the acute graded carbon monoxide concentrations. Results indicated a significant increase (P<0.05) in vitreous total protein and globulin of the studied groups. This observation was more pronounced in the CD group of animals. Therefore the marked elevation of vitreous total protein and globulin may serve as a useful tool in the confirmation of death due to carbon monoxide poisoning.

06/02/2017
Mini Review

Antagonistic features displayed by Plant Growth Promoting Rhizobacteria (PGPR): A Review

Mohsin Tariq*, Muhammad Noman, Temoor Ahmed, Amir Hameed, Natasha Manzoor and Marriam Zafar

Soil dwelling bacteria able to colonize plant roots and closely associated soil are referred to as rhizobacteria. A wide range of rhizobacteria has the ability to promote plant growth directly by producing phytohormone and nutrients; and indirectly by controlling plant pathogen.These beneficial bacteria are known as plant growth promoting rhizobacteria (PGPR). PGPR control phytopathogens by producing chemicals that could damage pathogen cells, removing pathogen specific nutrients from the environment, or inducing resistance against pathogen in plant body. Antagonistic bacteria specifically damage pathogens by producing lytic enzymes, antibiotics and bacteriocins; and excluding pathogen from plant environment by siderophores oriented iron chelation. This review highlights the antagonistic feature of PGPR. Application of antagonistic bacteria as biopesticides is an attractive alternate of chemical pesticides. Chemical pesticides are non-targeted and cause pollution during its synthesis as well as at the site of application. Antagonistic bacteria could be used as biopesticides and biofertilizers for better plant health and growth improvement.