Case Report

Avoiding confusion in high flow oxygen therapy concepts

García G, Agosta M, Valencia P, Mercedes E, Sarhane Y and Díaz-Lobato S*

Oxygen therapy is the main supportive treatment in hypoxemic respiratory failure and has traditionally been delivered using low and high flow devices. However, the maximal flow rates that these devices can deliver are limited because of the insufficient heat and humidity provided to the gas administered.Low flow devices such as the nasal cannula, conventional face mask and reservoir bag deliver a flow rate of up to 15 L/min by administering more variable oxygen fractions (FiO2), depending on the patient’s respiratory pattern, peak inspiratory flow and characteristics of the devices. Conventional high flow devices, such as venturi type masks, utilize a constant flow of oxygen through precisely sized ports, entraining the ambient air, using the Bernoulli principle, providing a more constant inspired oxygen fraction. However, they are less tolerated than nasal cannulas because they are less comfortable and the insufficient humidification and heating of the gas delivered [1].

In the last two decades, new devices have been developed to administer high humidified and heated flow through a nasal cannula (HFNC) that also allows the delivery of oxygen with a known FiO2 up to 100%. In the literature, this technique has also been called mini CPAP (continuous positive airway pressure), transnasal insufflation, high nasal flow ventilation, high flow oxygen therapy, and high flow nasal cannula oxygen therapy [2].

It is considered that high flow nasal cannula has certain benefits compared to those of oxygen therapy previously detailed. HFNC manages a flow of more than 30 L/min, which is able to surpass the peak inspiratory flow of the patient, being able to reach values ​​between 60-80 L/min depending on the flow used. The gas source, which may be delivered by an air/oxygen blender, fans, or a flow generating turbine, is connected by an active humidifier to a nasal cannula and the FiO2 can be adjusted independently of the flow.

Research Article

Use of Hand Rehabilitation Board (Dominic’s Board) in Post Traumatic/Stroke Rehabilitation of the Upper Limbs

Dominic Essien and Christopher Ekpenyong*

In recent years, the increasing number of patients with upper limb musculoskeletal disorders seeking timely, intensive, prolonged and task oriented hospital- and home- based physical rehabilitation, and the decreasing numbers of trained therapist to provide the needed care, have left a palpable gab.These have resulted in several preventable deformities with associated complications leading to social and economic burdens. Although the introduction of some robotic devices has addressed some of these concerns, the shortfalls from the use of these devices limit their effectiveness. The newly introduced hand rehabilitation board (Dominic’s Board) was prospectively evaluated in 82 patients with ULMDs of different etiologies to assess its therapeutic efficacy in rehabilitation of ULMDs. Additive, but complementary effect was observed when used along with conventional hospital-based therapy and at home, suggesting the effectiveness of this device in preventing or ameliorating the complications associated with ULMDs.

Research Article

Features of Interferon and Cytokine Status in Atopic Dermatitis

Ospelnikova TP*, Gevorkyan OV, Mironova TV, Andreeva SA, Kolodyazhnaya LV and Ershov FI

The insufficiency of interferon production and the cytokine imbalance in patients with atopic dermatitis, especially in combination with persistent herpes virus infection, has been identified. The expediency of the use of interferon inducer Cycloferon in the treatment of chronic atopic dermatitis has been shown.

Mini Review

Multi-factorial Depressive Disorders Need Multi-dimensional Interventions

Mustafa Melih Bilgi*

Depressive disorders are so frequent and disabling health conditions which have been inarguably accepted to be a public health concern [1]. Many drugs have been developed to treat depression, however the efficacy of the antidepressants are inadequate particularly for mild or moderate depression [2-4].It is also mentioned that when considering the trials about the treatment effect of the antidepressants, you should be careful about the results because of reflecting a small proportion of the society [4]. Despite the methodological issues related to the controversial results about the antidepressant efficacy, a recent review showed that the antidepressant effects of the drugs persist in a six month period [5,6].

Short Communication

Cardiac Autonomic Modulation in children and Preadolescents obese

Mario Augusto Paschoal*

Alterations in cardiac autonomic modulation of children and obese preadolescents have attracted the attention of researchers around the world. These alterations cause disorders in the cardiac autonomic control and can interfere in cardiac output and in the homeostatic actions that depends of the cardiovascular system action.

Research Article

Photocatalytic Degradation of Microcystins-LR over Mesoporous graphitic Carbon Nitride (mpg-CN)

Laiyan Wu, Jirong Lan, Anping Yang, Yanxi Zhao, Songbo Wang and Junjiang Zhu*

Mesoporous graphitic carbon nitrides (mpg-CN) were synthesized by a templating method using Ludox (SiO2) as hard template and guanidine hydrochloride (GndCl) as precursor, and were used as metal-free photocatalysts for microcystin-LR (MC-LR) degradation in aqueous solution. By tuning the mass ratio of SiO2 to GndCl, mpg-CN with varied surface areas and condensation degrees were obtained. Catalytic results showed that sample prepared at mass ratio equals 0.4, i.e., mpg-CN(0.4), exhibits the best activity, with above 98% MC-LR conversion obtained at 120 min. Mechanism studies suggested that the reaction obeys the pseudo first-order equation and the produced superoxide anion radicals (•O2−) is the major reactive intermediates contributing to the reaction. Stability tests showed that no appreciable loss of activity is observed even the catalyst is recycled for five times, indicating that the material is stable in the reaction.

Research Article

Phytochemical content of leaf and stem of Marsilea quadrifolia (L.)

Karikalan Gopalakrishnan and Rajangam Udayakumar*

The present study was aimed to screen and quantify the phytochemicals by qualitative and quantitative analysis in methanol and aqueous leaf and stem extracts of Marsilea quadrifolia (L.). In qualitative analysis, the phytochemical compounds such as tannins, saponins, flavonoids, steroids, terpenoids, triterpenoids, alkaloids, carbohydrates, proteins, anthroquinones, phenolic compounds and phytosterol were screened. Among these phytocompounds tannins, saponins, flavonoids, steroids, alkaloids, carbohydrates, proteins and phenolic compounds were observed in methanol and aqueous leaf and stem extracts of M. quadrifolia. Anthroquinones were absent in both leaf and stem extracts of M. quadrifolia. The content of phenolic compounds 8.34±0.92 mg/g and 7.31±0.46 mg/g, flavonoids 7.46±0.64 mg/g and 6.45±0.68 mg/g, alkaloids 6.12±0.51 mg/g and 5.89±0.61 mg/g, tannins 6.58±0.72 mg/g and 6.07±0.56 mg/g and saponins 5.32±0.48 mg/g and 6.30±0.58 mg/g were determined in leaf and stem of M. quadrifolia, respectively. So, the present study confirmed that the presence of phytocompounds in leaf and stem of M. quadrifolia.

Review Article

Caring Difficulties of Parents’ Towards Children with Cerebral Palsy

Melike Ertem*

Children with cerebral palsy may have one or more of mental, psychomotor, visual, audio or speech problems. Not being a well-defined disease with clear boundaries, it is regarded as a set of conditions caused by various reasons. In this regard, children with CP have to depend on their families or caregivers and cope with physical, mental, social and economic problems due to their condition. Therefore, it turns out to be crucial to determine the needs of the family with children with CP so that the programs that will assist them during this process can be developed. The study further revealed that the parents of the children with cerebral palsy needed information about controlling their children’s behaviors and teaching them certain behaviors; they needed to talk to the teacher and/or therapist of the child; they needed support about making time for themselves; they needed community services about finding a care center or a nursery suitable for their children’s needs.

Research Article

The lifestyle modification effectiveness in reducing Hypertension in a Brazilian Community: From the epigenetic basis of Ancestral Survival to the Contemporary Lifestyle and Public Health Initiatives

Roberto Carlos Burini*, Hugo Tadashi Kano, Mariana Santoro Nakagaki, Caroline das Neves Mendes Nunes and Franz Homero Paganini Burini

High blood pressure (HBP) is a strong, independent and etiologically relevant risk factor for cardiovascular and therefore, the leading cause of preventable deaths worldwide. Hypertension has high medical and social costs. Due to its many associated complications, the use of medical services create high costs with medications which represent almost half of the estimated direct expenses. Free distribution of more than 15 medications for HyPERtension and DIAbetes (HIPERDIA program) clearly shows the important role of drugs in the Brazilian Government’s effort to tackle these two diseases. Notwithstanding, the prevalence of HBP is rising in parallel with other NCDs. It is known that HBP results from environmental and genetic factors, and interactions among them. Our ancestors were often faced with survival stresses, including famine, water and sodium deprivation. As results of natural selection, the survival pressures drove our evolution to shape a thrifty genotype, which favored/promoted energy-saving and sodium/water preservation. However, with the switch to a sodium- and energy-rich diets and sedentary lifestyle, the thrifty genotype and ancient frugal alleles, are no longer advantageous, and may be maladaptive to disease phenotype, resulting in hypertension, obesity and insulin resistance syndrome. Low-grade chronic inflammation and oxidative stress would be the underlying mechanisms for these diseases. HBP is often associated with unhealthy lifestyles such as consumption of high fat and/or high-salt diets and physical inactivity. Therefore, alternatively to medicine drugs, lifestyle and behavioral modifications are stressed for the prevention, treatment, and control of hypertension. A lifestyle modification program (LSM) involving dietary counseling and regularly supervised physical activity (“Move for Health”) has been used for decades, in our group, for NCDs primary care. Retrospective (2006-2016) data from 1317 subjects have shown the top quartile of blood pressure(142.2/88.5mmHg) differing from the lower quartile (120.6/69.2mmHg) by being older, with lower schooling, lower income and, lower physical activity and aerobic capacity. Additionally, the P75 showed higher intake of CHO, saturated fat and sodium along with lower-diet quality score with a more processed foods. They showed higher body fatness and prevalence of metabolic syndrome along with higher pro-inflammatory and peroxidative activities and insulin resistance. In this free-demand sample, the HBP rate was 51.2% for SBP and 42.7% for DBP. The rate of undiagnosed HBP was 9.8% and only 1/3 of medicated patients were controlled for HBP. After 10 weeks of LSM the HBP normalization achieved 17.8% for SBP and 9.3% for DBP with a net effectiveness of 8.5% and 2.4%, respectively. The reduction of HBP by LSM was followed by increased aerobic conditioning and reduced intake of processed foods along with decreased values of BMI, abdominal fatness, insulin resistance, pro-inflammatory and peroxydative activities. Importantly, once applied nationwide this LSM would save HBP medication for 3.1 million of hypertensives at an economic saving costs of US$ 1.47 billion a year!

Research Article

Procedure utilization, latency and mortality: Weekend versus Weekday admission for Myocardial Infarction

Nader Makki, David M Kline, Arun Kanmanthareddy, Hansie Mathelier, Satya Shreenivas and Scott M Lilly*

Background: Due to variations in hospital protocols and personnel availability, individuals with myocardial infarction admitted on the weekend may be less likely to receive invasive procedures, or may receive them with a greater latency than those admitted during the week. Whether or not this occurs, and translates into a difference in outcomes is not established.

Method: Using the Nationwide Inpatient Sample (2008-2011) database, we identified all patients admitted with a principle diagnosis of acute myocardial infarction. They were stratified by weekend or weekday admission. Baseline clinical characteristics, procedure utilization and latency to procedure were compared, and logistic regression models were constructed to assess the relationship between these variables and in-hospital mortality.

Results: Patient demographics and provider-related characteristics (hospital type, geography) were similar between weekend and weekday admission for myocardial infarction. Adjusted for covariates, we found that the odds of mortality for a weekend admission are 5% greater than for a weekday admission (OR: 1.05; 95% CI: 1.01, 1.09, p=0.009). For the utilization of an invasive procedure, we found that the odds of receiving a procedure for a weekend admission were 12% less than the odds for a weekday admission, adjusted for the other covariates (OR: 0.88; 95% CI: 0.86, 0.91, p<0.001). In addition, we found that the time to procedure was an average of 0.18 days (4.32 hours) longer for weekend admissions compared to weekday admissions (95% CI: 0.16, 0.20, p<0.001). However, we did not observe a significant difference in the overall length of stay for weekend and weekday admissions (0.004 days; 95% CI: -0.04, 0.05, p=0.87).

Conclusion: In a large and diverse subset of patients admitted with myocardial infarction, weekend admission was associated with fewer procedures, increased latency to those procedures, and a non-significant trend towards greater in adjusted in-hospital mortality.

Review Article

Heat transfer investigation of Non- Newtonian Fluid between two vertically infinite fl at plates by numerical and analytical solutions

Pourmehran O*, Rahimi-Gorji M, Tavana M, Gorji-Bandpy M and Ganji DD

In natural convection, the fluid motion occurs by natural means such as buoyancy. Heat transfer by natural convection happens in many physical problems and engineering applications such as geothermal systems, heat exchangers, petroleum reservoirs and nuclear waste repositories. These problems and phenomena are modeled by ordinary or partial differential equations. In most cases, experimental solutions cannot be applied to these problems, so these equations should be solved using special techniques. In this paper, natural convection of a non-Newtonian fluid flow between two vertical flat plates is investigated analytically and numerically. Collocation Method (CM) and fourth-order Runge -Kutta numerical method (NUM) are used to solve the present problem. These methods are powerful and convenient algorithms in finding the solutions for the equations. While these are capable of reducing the size of calculations. In order to compare with exact solution, velocity and temperature profiles are shown graphically. The obtained results are valid with significant accuracy.

Research Article

A Preliminary Laboratory Investigation of Methane Generation Potential from Brewery Wastewater using UASB Reactor

MA Karim* and Benjamin L Moss

A preliminary laboratory study was conducted using upflow anaerobic sludge blanket (UASB) reactor to investigate the potential of methane generation from brewery wastewater. Brewery wastewater from a local brewery company was collected and used in the experiments. The experiments were run for 15 days. The rate of methane production was about 5.32 L per kg of chemical oxygen demand (COD) removed per day. The pH reduction in the experimental reactor limited the ability of gas production and is likely the result of the temperature at which the experiments were conducted.

Review Article

Bruxism: Its multiple causes and its effects on Dental Implants: A Review

Sameera Singh Deo, Devinder Preet Singh* and Nitya Dogra

The rehabilitation of partially or completely edentulous patients with implant supported prostheses has been widely used, achieving high success rates. However, many studies consider the presence of bruxism as a contraindication for this treatment modality. The purpose of this study was to review the literature and identify risk factors in implant supported rehabilitation planning in subjects with bruxism.The rehabilitation of bruxers using implant supported prostheses, using implants with adequate length and diameter, as well as proper positioning, seems to be a reliable treatment with reduced risks of failure. Bruxism control through the use of a night guard by rigid occlusal stabilization appliance, relieved in the region of implants, is highly indicated. Although it is clear that implant supported rehabilitation of patients with bruxism requires adequate planning and follow-up, well-designed randomized controlled trials are needed to provide reliable evidence on the long-term success of this treatment modality.

Research Article

Effects of a short Cardiovascular Rehabilitation program in Hypertensive subjects: A Pilot Study

Juliana Bassalobre Carvalho Borges, Debora Tazinaffo Bueno, Monique Fernandes Peres, Ana Paula Aparecida Mantuani, Andreia Maria Silva and Giovane Galdino*

Systemic arterial hypertension (SAH) is considered an important risk factor for the development of cardiovascular diseases. The aim of the present study was to verify the effects of a short cardiovascular rehabilitation program (CR) in hypertensive subjects. The clinical pilot study involved a sample composed of 11 hypertensive subjects. It was evaluated the weight, height, body mass index (BMI), waist and hip circumference, waist hip ratio, systolic blood pressure (SBP), diastolic blood pressure (DBP) and six-minute walk test (6-MWT) before and after CR. CR was performed twice a week for 60 minutes. The results shown that after CR occurred a reduction of waist circumference (99.86±8.7 to 95.2±8.6 cm, p=0.0002) and hip circumference (110.18±14.75 to 105.00±12.7 cm p=0.01) values. About the mean distance walked in the 6-MWT there was an increase after the CR program (335.9±123.5 m to 554.56±87.9 m, p=0.000). In conclusion, the results suggest that a short CR is an effective for the treatment of hypertensive subjects. After 16 CR sessions, functional and musculoskeletal capacity was improved, evaluated by 6-MWT. Furthermore, the short CR program decreased waist and hip circumferences, being an important option for these subjects. Although. There were no changes in baseline blood pressure levels.

Research Article

Changes in Serum Markers of Atherogenesis and Hematological Profile after the consumption of Quail eggs

Ekpenyong CE*, Patrick ES and Akpan KS

Previous studies suggest that diets with more eggs than is recommended may be used as part of a healthy diet in some countries. However, whether quail egg diets could form part of such diet has not been explored. The aim of the present study is to evaluate the effect of quail egg consumption on serum markers of atherogenesis and hematological parameters in healthy volunteers. Thirty adult subjects participated in this study after ascertaining their baseline health status. They were fed 3 eggs per day and 8hourlyfor 30 days. They were evaluated for serum levels of cholesterol sub-fractions, AIP and hematological parameters at days 0, 10 and 30 after the consumption of quail eggs. At day10, serum levels of cholesterol sub-fractions (TG, HDL-C and LDL-C) were not significantly (p>0.05) different from the corresponding values at baseline. Serum levels of VLDL-C and calculated AIP significantly (p<0.05) decreased compared to the levels at baseline. At day 30, serum levels of HDL-C, TG and VLDL-C significantly (p<0.05) increased, while LDL-C and AIP significantly decreased. Also, total RBC, HB, PCV, MCV, MCH and MCHC were not significantly different from the levels at baseline. At day 30, RBC, PCV and HB significantly (p<0.05) increased compared to the levels at baseline, while MCV, MCH and MCHC were not significantly (p>0.05) different from the baseline values.

Indeed, long-term consumption of quail egg may be associated with improvement in serum markers of atherogenesis and hematological parameters due to its varied nutrient constituents and their activities.

Review Article

Clown language training in Dental education: Dental Student’s Perspective

Siddharth Tevatia*, Richa Dua, Vinita Dahiya, Nikhil Sharma, Rahul Chopra and Vidya Dodwad

Clowning is a form of humour. It is an art form that invites play, interaction, and laughter. Clown Care is a programme in hospitals and medical centres involving visits from specially trained hospital clowns. Clowning helps patients to focus on something other than their illness. Olsson et al. and Spitzer suggested that clown care could create a warm climate, promote good interpersonal relationships, and relieve feelings of frustration, anxiety, or hostility.Hospital clowns work worldwide as a health humanization resort, providing interplay with patients, family and staff creating a positive emotional state that fosters affirmative environmental conditions. This type of activity varies greatly in terms of professionalism, accountability and artistic methods. Promotion of emotional and psychosocial well-being of patients transcends opportunities for oral health promotion activities in hospitals, schools and community. Previous research reports on clown training reflects attitude-building potential for the healthcare students provided that it is performed in a deep, essential, strict and continuous fashion in a facultative manner rather than mandatory allowing the student to build his own artistic, professional and personal path. Thus, the prospect of introducing training curriculum of this underrated non-technical skill for dental students in Indian dental education system needs to be harnessed.


Metallic Ureteric Stents a cost-effective alternative in the management of Obstructed Distal Ureters

Erich K Lang*

Management of obstruction of the distal-pelvic ureters by minimally invasive procedures such as antigrade or retrograde double “J” stents has generally been unsatisfactory. Corrective surgical procedures mandate long hospitalization, hence high cost, and have a moderate incidence of complications.
Management of obstruction of the distal-pelvic ureters by minimally invasive procedures such as antigrade or retrograde double “J” stents has generally been unsatisfactory. Corrective surgical procedures mandate long hospitalization, hence high cost, and have a moderate incidence of complications.
Management of obstruction of the distal-pelvic ureters by minimally invasive
procedures such as antigrade or retrograde double “J” stents has generally been
unsatisfactory. Corrective surgical procedures mandate long hospitalization, hence
high cost, and have a moderate incidence of complications.Management of obstruction of the distal-pelvic ureters by minimally invasive
procedures such as antigrade or retrograde double “J” stents has generally been
unsatisfactory. Corrective surgical procedures mandate long hospitalization, hence
high cost, and have a moderate incidence of complications.
Short Communication

The effects of EMF (ELECTROMAGNETIC FIELDS) on the Bone and Cartilage Tissue

Cemil Sert*

Environmental electromagnetic fields are nowadays available in all environments today. These areas affect the biological system. Controlled interactions with elecrtomagnetic fields can have positive effects when unrestricted interactions have negative effects.Uncontrolled exposure to low-frequency electromagnetic fields can cause adverse effects such as signal transduction in cells and tissues, cell membrane structure, ion channels, molecular interactions, DNA damage. But contrary to controlled exposure, it positively affects tissues. The most obvious example of this is seen in the bone and cartilaginous tissue. Repairing fractures and damage in bone and cartilage. This has been shown in many studies. Below is a summary of the relevant information.

Review Article

The Bacterial Heterotrimeric Amidotransferase GatCAB: functions, structures and mechanism-based inhibitors

Van Hau Pham* and Jacques Lapointe

tRNA-dependent amidotransferases (AdT) are essential enzymes for protein biosynthesis in many bacteria and in all archaea. As AdT is essential for a number of pathogenic bacteria, and it is absent from mammalian cytoplasm, it is considered as a putative target for novel inhibitors that could be lead compounds to develop a new class of antibiotics. Besides GatFAB of Saccharomyces cerevisiae mitochondria and GatAB of Plasmodium falciparum apicoplast, all reported AdT can be divided into two groups: heterodimeric GatDE and heterotrimeric GatCAB. The latter is required to catalyze the conversion of Glu-tRNAGln and/or Asp-tRNAAsn into Gln-tRNAGln and/or Asn-tRNAAsn in many pathogenic bacteria. Recently determined high resolution crystal structures of several GatCAB could be used to design new inhibitors. In this review, we highlight the essential role of AdT for the faithful translation of glutamine and/or asparagine codons, we describe important features of the crystal structures of several GatCAB as well as tRNA/AdT/aaRS complexes for the formation of Gln-tRNAAsn and Asn-tRNAAsn, we finally summarize discoveries of AdT inhibitors based on their analogy to glutamine, adesosine tripoliphosphate and 3’-end of tRNA.

Letter to the Editor

The Daring of Biosimilars

Nuris Ledon* and Agustin Lage

The so-called “biotechnological revolution” is changing the structure of the Pharmacopoeia [1]. The space of biological products, previously limited to blood products and vaccines, grew from the introduction of first recombinant therapeutics in the 1980s until attaining a 25% by value of the pharmaceutical market. This share is expected to reach 50% in the coming years. More than 80 biotechnology drugs have entered the market in the last ten years. It is estimated that there are more than 900 biological products on development for more than 100 diseases [2].

Biopharmaceuticals have been used especially in the treatment of chronic diseases such as autoimmunities and cancer, which require long term treatments. Biologicals have an average cost 22 times higher than chemical drugs [3]. The appearance of effective but costly drugs for long treatments is contrary to the goal of gaining access to the best treatments and the goal of achieving wide population coverage. This conflict was already faced 30 years ago with synthetic drugs, and the solution was the introduction of generic drugs, at the moment when the patents of innovators expire.