Research Article

Differentiation of bone marrow cells in arthritic mice with decreased complement activity

Petya Ganova and Nina Ivanovska*

There is evidence that complement components induce cell migration in mesenchymal stem cells and regulate cytokine production in osteoblastic cells thus playing a regulatory role in normal bone formation. The aim of the present study was to investigate the involvement of complement system in the differentiation of bone marrow cells in complement-depleted model of rheumatoid arthritis (RA). Arthritis was induced by intraarticular injection of zymosan in cobra venom factor (CVF)-treated mice depleted of functional complement. The expression of different markers by bone marrow [1], on fibroblasts (CD29), mesenchymal cells (CD105), dendritic cells (CD14, CD86), osteoclasts (CD265), cells expressing Dectin1 (CD369) and megakaryocytes (CD62P) was determined by flowcytometry. The lack of functional complement activity at the point of arthritis initiation (day 3) lead to an increase of fibroblast and megakaryocyte populations, to a decrease of mature and dectin1 positive populations, while the number of mesenchymal cells was not changed, all compared to arthritic mice. Immunohistochemical staining showed that low complement activity diminished arthritis-induced generation of megakaryocytes and platelets in BM. Chronic inflammation during erosive conditions such as rheumatoid arthritis, leads to dysregulated differentiation and prolifеration of bone cells, inflammation of synovial membrane and bone marrow, and degradation of cartilage and bone. Present results point that the lack of functional complement changed the ratio between different cell populations that can be used for determining the development and stage of rheumatoid arthritis and can help finding of new therapeutic approaches.


What is the future for Scapholunate interosseous ligament reconstruction?

Amelia Carr, Saso Ivanovski, Randy Bindra and Cedryck Vaquette*

This opinion paper provides a summary of the current reconstructive surgical techniques for the scapholunate interosseous ligament (SLIL) and critically highlights their benefits and shortcomings. Due to limited success with direct repair of the ligament, current practice focuses on achieving biomechanical stabilization and does not allow for tissue regeneration to occur. In addition, the biomechanical behaviour of the ligament is still poorly described and understood, resulting in a very large variation in published mechanical parameters. Therefore, a thorough understanding of the biomechanics of the joint, via both experimental testing and numerical modelling is necessary for enabling the design of the next generation of implants in order to address mechanical stabilisation and regeneration.

Research Article

Peculiarities of photon emisson of whole non-diluted human blood obtained from healthy donors and patients with some diseases

Kirill N Novikov*, Vladimir L Voeikov, Ekaterina V Buravleva and Nadezhda G Berdnikova

Blood plays an important role in oxygen absorption and its transfer to organs and tissues in vertebrates, as well as in a number of invertebrate species. Numerous interactions between cellular and non-cellular blood components constantly occur. A special role in these interactions belongs to erythrocytes and leukocytes, between which oxygen is constantly exchanged and activated, which we showed directly in whole blood. Blood is a liquid tissue, which is a complex cooperative system and has many inherent functions and the most important one is the ability to maintain the homeostasis of the body. Our experience has shown that despite its high optical density, undiluted blood of humans and animals can be a source of radiation due to the transformation of the energy of electron-excited (EEE) states and secondary processes occurring in the whole blood system. Parameters of this radiation - ultra-weak photons emission (UWPE) from blood - depend upon its physiological properties and reflect the physiological state of a donor. Analysis of UWPE from non-diluted blood is a simple and sensitive method that allows to monitor the course of treatment of a patient. In spite of high opacity of non-diluted blood it may be a strong source of UWPE both in the presence and absence of UWPE enhancers. Analysis of patterns of UWPE from blood reveals its highly non-linear, stable non-equilibrium and cooperative properties. Characteristic of a living system.

Research Article

Lemongrass tea consumption and changes in Acid-Base Balance and Electrolyte homeostasis

Christopher E Ekpenyong

The consumption of dietary herbs and supplements may be associated with several physiological consequences including, but not limited to disturbances of acid-base homeostasis, minerals and electrolytes wasting, gastrointestinal disturbances as well as hemodynamic changes. Plants food based nutritional studies are important for assessing the effect of plants on human health and wellbeing. The aim of this study was to assess the changes in acid-base status and electrolyte homeostasis following the consumption of lemongrass tea. The acute and sub-chronic effects of infusions prepared from 2, 4, and 8g lemongrass leaf powder on serum and urinary pH, and electrolytes levels were assessed in 105 subjects using an interventional study design. The results post-treatment were compared with baseline values.

Plasma pH decreased from baseline value of 7.37 ± 0.02 to 7.20 ± 0.03, and 7.30 ± 0.02 at days 10 and 30 respectively for participants treated with infusion prepared from 2g of lemongrass leaf powder. For those treated with infusion prepared from 4g of lemongrass leaf powder, plasma pH decreased from baseline value of 7.35 ± 0.02 to 7.22 ± 0.02 and 7.29 ± 0.02 at days 10 and 30 respectively.

Treatment with infusion prepared from 8g of lemongrass leaf powder caused a decrease in plasma pH from baseline value of 7.38 ± 0.02 to 7.15 ± 0.02 and 7.18 ± 0.02 at days 10 and 30 respectively. Corresponding changes in urinary pH were also observed. Furthermore, at days 10 and 30, plasma protein concentrations increased significantly (p < 0.05) in subjects treated with infusion prepared from 8g lemongrass leaf extract. There were also significant increases (p < 0.05) in urinary volume, urination frequency, and urinary electrolytes levels within the same period.

The consumption of lemongrass tea may be associated with changes in acid-base balance and electrolyte homeostasis due to its varied biological constituents and their activities.

Short Communication

How Condylar modifications occurs

Rohit Kulshrestha*

Functional appliances used in correction of class II malocclusions are shown to modify the neuromuscular environment of dentition & associated bones. There are many studies related to the skeletal, dental and neuromuscular changes which are evaluated cephalometrically, clinically as well as with the recent diagnostic aids like MRI. The aim of this short communication was to highlight and discuss the different aspects of condylar modifications and its role in its growth.

The Twin Block has higher effectiveness & comfort as compared to other removable functional appliances [1.2]. The action of Twin Block & Bionator is for 24 hours so effects are more with these appliances. Over the years, several theories have emerged attempting to shed light on condylar growth. One of the earliest theories, the genetic theory, suggests the condyle is under strong genetic control like an epiphysis that causes the entire mandible to grow downward and forward. Although this may be related more to development of the prenatal than postnatal condyle, the theory does indirectly question the effectiveness of orthopedic appliances in condylar growth as proposed by Brodie [3,4]. Several long-term investigations actually showed clinically insignificant condylar growth modification after continuous mandibular advancement with a reasonable retention period in human beings although the initial treatment results appeared encouraging. This leads to the conclusion that the general growth of the condyle appears relatively unalterable in long-term studies.

A second hypothesis based on the earliest available acute and blind EMG monitoring technique, suggests that hyperactivity of the lateral pterygoid muscles (LPM) promotes condylar growth. Rees reported that other muscles and tendons, including those of the deep masseter and temporalis, also attach to the articular disk region. Attachments of the LPM to the condylar head or articular disk may be expected to cause condylar growth, but anatomic research has not found evidence that significant attachments actually exist [5,6]. The LPM tendon is observed attaching, however, to the anterior border of the fibrous capsule that in turn attaches to the fibrocartilage of the condylar head and neck anteriorly. At the same time, it is doubtful that initial hyperactivity could occur where the LPM muscle has been shortened by continuous mandibular displacement therapy. By using LPM myectomy in rats, which may have disrupted condylar blood supply, Whetten and Johnston found little evidence that LPM traction had any pronounced effect on condylar growth. More recently, permanently implanted longitudinal muscle monitoring techniques have found that the condylar growth is actually related to decrease postural and functional LPM activity. This notion was also supported in human studies by Auf der Maur, Pancherz and Anehus- Pancherz, and Ingervall and Bitsanis that reported decreased muscle activity. The LPM hyperactivity theory brought forward by Charlier et al. Petrovic, and later espoused by McNamara however, was important in prompting further investigations in muscle-bone interactions [7,8].

A third hypothesis, the functional matrix theory, postulates the principal control of bone growth is not the bone itself, but rather the growth of soft tissues directly associated with it. Although this was supported in part by investigations testing the different growth and developmental responses between the condyle and epiphysis, there has been no explanation as to exactly how condylar growth would be stimulated. Thus, this theory’s validity has been questioned. One of the reasons was that there was little explanation of the specific mechanism by which the condyle was stimulated to grow. Endow and Hans presented an excellent overall perspective suggesting that mandibular growth is a composite of regional forces and functional agents of growth control that interact in response to specific extra-condylar activating signals [9,10].

Case Report

A Three approach at one stage to surgical management of Cervical Spondyloptosis after Failed Primary anterior fusion

Saeed Oraee-Yazdani*, Maryam Golmohammadi, Mohammadhosein Akhlaghpasand and Maryam Oraee-Yazdani

A 35-year-old female, known case of complete spinal cord injury, presented with cervical pain and neck deformity that interfere with her physiotherapy and occupational therapy. Two years before admission, she had a car accident which result in a complete quadriplegia. That time at another center, she underwent surgery to anterior cervical fixation of C6-C7 through insertion of cage and plate without corpectomy. Based on current radiologic images, spondyloptosis was detected at the C6-C7 with bilateral locked facet, due to hardware failure. A three approaches in one stage was performed to maintain cervical alignment that includes posterior, anterior and again posterior approach. With this manner, anterior fusion through corpectomy and insertion of expandable cage and plate as same as instrumental posterolateral fusion were done. After surgery, she was pain free and the alignment of cervical spine was maintained so she could come back to ordinary rehabilitation programs.

Case Report

McArdle’s Disease (Glycogen Storage Disease type V): A Clinical Case

Calheiros-Cruz T, Caamaño-Vara MP, Villar-Fernandez B, Ruibal-Azevedo J, Cameselle-Cortizo L1, Cameselle-Arias M, Charro Gamallo ME, Turienzo-Pacho F, Yera Acosta A and Cameselle-Teijeiro JF*

McArdle’s Disease, or Glycogen Storage Disease Type V, is the result of a deficiency in one of the enzymes responsible for the metabolism of glycogen in the body. Individuals with this disease, lack or produce very small concentrations of the myophosphorylase or glycogen phosphorylase enzyme.

McArdle’s disease is a metabolic and recessive genetic disease caused by a mutation on the PYGM gene located on chromosome 11q13. This gene is responsible for the synthesis of the myophosphorylase (or glycogen phosphorylase) enzyme. It is the most common form of muscular glycogenesis. We present here the clinical case of a 35 years old woman diagnosed with McArdle’s disease at the age of 21 after a visit to a Neurologist. It was confirmed that the patient had shown symptoms of this disease at least 10 years before definitive diagnosis: intolerance to exercise, asthenia and muscular weakness. In this report we describe the different signs and symptoms of the disease, as well as the tests performed to confirm the diagnosis by muscle biopsy and genetic analysis. McArdle’s disease is classified as a rare disease and often its diagnosis is delayed due to a lack of knowledge about its symptoms and signs. Our intention is to make, with the description of our clinical case, the information about this disease more available to physicians to prevent future misinterpretations and delayed diagnosis. A medical documentary we have created on “McArdle’s Disease” can be seen in YouTube using the following links: https://youtu.be/HAhoZ7jxz7Q (English version) and https://youtu.be/uZopzSHOl20 (Spanish version).

Research Article

Knowledge, attitudes and skills of doctors, nurses and emergency medical technicians in pre-hospital care and emergency medicine who accompany patients in ambulances which arrive at the National Hospital of Sri Lanka

Gangadevi Nandasena and Chrishantha Abeysena*

Objective: To assess the knowledge, attitudes, and skills in pre-hospital care and emergency medicine of doctors, nurses and Emergency Medical Technicians (EMT), who accompanied emergency patients in ambulances?

Methods: A descriptive cross-sectional study was conducted among the doctors, nurses, and EMT who accompanied emergency patients in ambulances to the National Hospital. All ambulances arriving from August to October 2008 (n=409) were screened. A self-administered questionnaire with 30 items was used to assess knowledge, attitudes, and skills. The knowledge was categorized into three levels, EMT-basic level, EMT-intermediate level, and EMT-paramedic level and the scores were converted into the percentages.

Results: The overall knowledge score on basic, intermediate and paramedic level were 57.5%, 42.9%, and 33.9% respectively. The knowledge on airway management (84.3%), bleeding control (82.9%), patient transport (71%) and first aids (61%) at the EMT-basic level were higher, however oxygen administration (37.1%) and basic life support (38.6%), spinal immobilization (45.7%), traction splinting (47%) and triage (48.6%) were lower. For the EMT-intermediate level, knowledge on endotracheal intubation (41.4%) and initial cardiac drug therapy (44.3%) were low. For the EMT-paramedic level, the knowledge on the advanced respiratory support (53%), ECG interpretation (37%), pharmacology (13%) and paediatric life support (20%) were lower.

Most staff showed positive attitudes towards the need of basic knowledge in pre-hospital care (97.1%, n=34), need for proper training (97.1%, n=34) and cost for pre-hospital care (77.1%, n=27), while they showed relatively negative attitudes towards the outcome of pre-hospital care (74.3%, n=26).

For the required skills for advanced life support, most of the staff showed skills in IV cannulation (71.4%, n=25) and IV drug administration (71.4%, n=25) however less skills were shown cricothyroidotomy (22.9%, n=8), pleural drainage (25.7%, n=9) and laryngoscopy and intubation (31.4%, n=11).

Conclusion: The knowledge at the EMT-basic level was average and intermediate and paramedic levels were lower than average. The attitudes were generally positive. However they lacked some specific skills.

Research Article

Best and effective practices of wound care and healing among patients with Diabetes Mellitus

Jefferson Garcia Guerrero*

Aim: With the continuing trend in the incidence of diabetic ulcer, the current researches on wound care and healing will bring best and effective practices on wound care and healing among patients suffering from diabetes mellitus.

Methods: This study utilized a systematic review of literatures in light of wound care through Pub Med database with the key words “Diabetes Mellitus,” “wound practices,” “wound healing,” and “systematic review.” The searched literatures were of case reports, interventional studies, and review papers whose main texts were in English.

Results: There were 7,988 published articles yielded from the keywords used and 16 were included in this study. The practiced management and techniques in these literatures focused on comfortable and cost efficient means of wound care and healing with the involvement of group participation than individual plan of care.

Conclusions: There are meager evidences of feasible wound and healing options that needs further studies in resolving wound issues among patients with Diabetes Mellitus. This systematic review establishes the insufficiency of high level of evidence based studies on wound healing in DM patients and brings a track for continuity of rigid studies concerning this topic.

Research Article

Endogenous archeological sciences: Physiology, Neuroscience, Biochemistry, Immunology, Pharmacology, Oncology and Genetics as instrument for a new field of investigation? Modern global aspects for a new discipline

Luisetto M*, Naseer Almukhtar, Ghulam Rasool Mashori, Ahmed Yesvi Rafa, Farhan Ahmad Khan, Gamal Abdul Hamid, Luca Cabianca and Behzad Nili-Ahmadabadi

In this work is analyzed scientific literature involved in human evolution to be used as an archeological Pathway to link different sciences in an overall new discipline.

A rational classification of single evidence make possible to better understand under new light some Physiological process.

The archeological instrument to be applied in other field like biology or other sciences.

ational classification of single evidence make possible to better understand under new light some Physiological process.
The archeological instrument to be applied in other field like biology or other sciences.

Case Report

Lessons from the success and failures of peritoneal Dialysis-Related Brucella Peritonitis in the last 16 years: Case report and Literature review

Muhammad Bukhari1*, Azharuddin Mohammed, Abdullah Al-Guraibi, Ahmed Shahata and Mansour Al-Ghamdi

Brucellosis is a zoonotic infection that is endemic in some Mediterranean countries, North Africa and the Middle East. Brucella is a rare cause of peritonitis in Peritoneal Dialysis (PD) population and in non-dialysis patients alike. We report here a challenging case of PD-related Brucella peritonitis in a 45-year-old Saudi male with late peritonitis that delivered some key learning throughout its course from presentation, diagnosis and treatment to catheter salvage attempts so as to circumvent PD failure. We provide an in-depth review of limited published literature on PD-related Brucella peritonitis (seven cases, and present case) and summarized the data on key clinical characteristics, management and PD technique outcome to benefit nephrologists when encountered with this rare presentation.

Case Report

Liver cyst infection in kidney transplant patient with autosomal dominant polycystic kidney disease: Interest of PET/CT in diagnosis and treatment

Georgery H*, Migali G, Pochet JM, Tintillier M, Van Ende C and Cuvelier C

Liver cyst infection in patients with autosomal dominant polycystic kidney disease (ADPKD) is a rare but life-threatening complication. Diagnosis and treatment remain challenging. We report the case of a 64-year-old kidney transplant patient presenting with fever and abdominal pain. The diagnosis of liver cyst infection was made by positron emission tomography scan (PET/CT). Moreover, the course of our patient illustrates the interest of subsequent PET/CT during follow-up as our patient failed on antibiotherapy and required liver cyst drainage.

Research Article

Outcome of Trabeculectomy in Advanced Glaucoma in a tertiary hospital in Rivers State, Nigeria

Awoyesuku EA* and Fiebai B

Aim: To evaluate the outcome of Trabeculectomy in advanced glaucoma in a hospital in Rivers State, Nigeria.

Methods: This was a non-randomized interventional study in which each patient served as its own control. Patients with advanced glaucoma and demonstrable field defects and Mean defect ≥-12 were included. The intervention employed was Trabeculectomy and IOP and visual acuity pre operative, as well as post op were collected and compared at pre- op, post -op day 1, one week, one month, 6 months. Data was analyzed using SPSS version 20.

Results: Thirteen (13) eyes from ten (10) patients with advanced glaucoma were involved in the study. Mean age of study population was 53±19.62 years. Mean of mean defect was -19.05±5.23dB while mean of vertical cup disc ratio (VCDR) was 0.88±0.04.

Mean of Pre- op Visual acuity (log MAR) was 0.46 and dropped to 0.72 first day post-op but improved over 6 months to 0.42. The mean of IOP pre-op was 24.15mmHg and dropped to 11.23mmHg (58.24%) over 6 months (p=0.001).

Conclusion: Trabeculectomy still remains the gold standard surgical treatment for glaucoma. In our study it resulted in a 58.24% drop in IOP over 6 months with mean visual acuity maintained at pre-op levels after 6 months follow up. It therefore is effective and safe surgical intervention in advanced glaucoma.


Recent findings related to Nutrition and Diabetes Mellitus

Motahar Heidari-Beni* and Seyedeh-Masomeh Derakhshandeh-Rishehri

Roux-en-Y Gastric Bypass surgery is superior to medical treatment for short- to medium-term remission of Type 2 diabetes (T2DM) [1]. Recent research indicates that the improvements in insulin sensitivity following bariatric surgery are associated with elevated circulating bile acid concentration and remodeling of gut microbiota [2].


Psychosocial care is necessary in supporting refugees

Gudrun Widders* and Ute Teichert

Between 2013 and 2016 the main tasks for the German public health care
departments were mainly related to medical support in terms of the management of outbreaks of infectious diseases, physical examinations of children and adults to exclude tuberculosis ore other infectious diseases, the administration of vaccinations and medical acute care.

Research Article

Immediate postplacental insertion of intrauterine contraceptive device (copper 375) and its complications in term of expulsion, infection and perforation

Benish Khanzada*, Mala Jitendra Shahani and Areesha Kamran Khanzada

Objective: To determine the complications (infection, perforation and expulsion rate) of immediate postplacental insertion of intrauterine contraceptive device (Multiload Copper375) in postnatal patients.

Methods: A case series study was conducted between October 28, 2014 to April 30, 2018 in obstetrics and gynaecology department, Civil Hospital Karachi,-+ Informed consent was taken. Intrauterine contraceptive device (Multiload) was inserted immediately within 10 min after delivery of placenta. These women were observed to determine outcome (infection, perforation and expulsion) at the time of discharge and 6 weeks postpartum. Absence of all these were taken as satisfactory outcome.

Results: A total of 435 women were included in this study. 165 (38%) were delivered through cesarean section and 270 (62%) were delivered through vaginally. There were 36 (8.3%) cases of infection. The cumulative rate of expulsion and perforation at the end of sixth week of post insertion was 39 (9%) and 0% respectively and 360 (82.8%) had satisfactory outcome. Post-placental placements during cesarean delivery are associated with lower expulsion rates than post-placental vaginal insertions without increasing rates of postoperative complications like perforation, slightly increase infection rate following vaginal delivery.

Conclusions: Immediate postpartum insertion of IUCD is an effective, safe and easily reversible method of contraception. Rates of the complications (Infection, expulsion and perforation) are remarkably low.

Research Article

The predictive value of the preoperative diagnostic tests in mature cystic teratomas of the ovary

Hanife Saglam, Funda Atalay*, Ayse Filiz Avsar and Hüseyin Levent Keskin

Aim: The aim of this study was to determine the sensitivity of the tumor markers and diagnostic methods used in the preoperative period for dermoid cysts, the most common benign neoplasm of the ovary.

Material and Methods: 136 patients who were operated for any reason and reported as ovarian dermoid cyst in the Department of Obstetrics and Gynecology, Ankara Atatürk Training and Research Hospital between January 2004 and September 2005 were included in the study. The medical records of the cases were obtained retrospectively from Ankara-Atatürk Training and Research Hospital, HIS, archive files and patient numbers where necessary.

Results: In the preoperative period, 119 patients underwent ultrasonographic examination, 33 underwent Computed Tomography, and 17 underwent Magnetic Resonance Imaging.10 of the cases only underwent CT, while 3 of the cases underwent only MRI 22 of them underwent both USG and CT, USG and MRI were performed on 13 cases and only 1 case underwent all three of the imaging methods. Tumor markers were CEA, CA 125, CA 19-9, CA 15-3 and AFP.

Conclusions: The reviews of ultrasonography and / or computed tomography and / or magnetic resonance imaging (n = 132) revealed that 103 of the cases were put into operation and the sensitivity of the preoperative screening methods were calculated to be 75.5%. The sensitivity of the tumor marker CA 19-9 was calculated to be 31%.


Navigation in the land of Scarcity

Awad Magbri* and Mariam El-Magbri

Delivering health care is a complex task that marginalized a portion of the population intentionally or unintentionally. Discrepancy in health care providing to the intended patients is sometimes accompanied by unintended collateral damage to the bystanders who desperately needing our help and assistance.

I was called to help in the management of a 75-year old Caucasian male with history of ischemic heart disease requiring percutaneous coronary intervention (PCI) for 2-vessel disease treated with stent placement, hyperlipidemia, chronic obstructive pulmonary disease, peripheral vascular disease, and diastolic heart failure with preserved ejection fraction of 50-55%. The patient was admitted this time with community acquired pneumonia resulting in hypoxemic respiratory failure demanding initiation of mechanical ventilation and tracheostomy placement.

Mini Review

Severe aorto-iliac occlusive disease: Options beyond standard aortobifemoral bypass

Konstantinos Filis*, Constantinos Zarmakoupis, Fragiska Sigala and George Galyfos

According to recent guidelines, endovascular angioplasty is the standard treatment for TASC A and B primary aorto-iliac occlusive (AIOD) disease, and the first-line approach for TASC C lesions [1,2].Extended TASC D occlusive disease is usually treated by open surgery yielding excellent patency rates at a cost of a higher mortality (2%-4%) and a severe morbidity (up to 10%) [3]. However, several studies have reported promising results after endovascular treatment of extensive AIOD and full reconstruction of the aortic bifurcation [4,5]. In a recent meta-analysis, Jongkind et al., concluded that endovascular treatment of extensive AIOD can be performed successfully by experienced interventionists in selected patients [6]. Although primary patency rates seem to be lower than those reported for surgical revascularization, reinterventions can often be performed percutaneously yielding a secondary patency comparable to surgical repair.

Common causes of chronic infrarenal aortic occlusion (CIAO) include: i) atherosclerotic occlusive disease; ii) middle aortic syndrome; iii) Takayasu arteritis; iv) fibromuscular dysplasia; v) neurofibromatosis; and vi) coral reef aorta [3,7-9]. Although standardized infrarenal aorto-bifemoral bypass (AoBFB) remains the surgical procedure of choice for CIAO, operative decisions may proceed beyond AoBFB in complicated cases. Different therapeutic strategies include axillo-(bi)femoral bypass (AxBFB), aortoiliac endarterectomy (AIE) or hybrid procedures. AxBFB grafting usually refers to patients of high risk for aortic clamping or patients with many comorbidities that prohibit an extensive transperitoneal procedure [10]. However, its primary patency is usually inferior compared to classic aortofemoral bypass surgery and AxBFB is associated with an increased risk for infections. In a recent systematic review, anatomical open procedures such as AIE showed very low perioperative mortality, with 5-year primary patency rates of over 80% [11]. Finally, hybrid procedures show equivalent midterm primary patency rates with the open procedures even for TASC D lesions while reducing perioperative mortality rates [12]. Hybrid procedures for aortoiliac disease usually include iliac stenting plus femoral endarterectomy or femorofemoral bypass.

Research Article

The effects of physiotherapy and rehabilitation on Pallister-Killian Syndrome: A case report

Zehra Guchan Topcu* and Selma Uzuner

The aim of the paper is to determine the effects of physiotherapy and rehabilitation (PHTR) on a child with Pallister-Killian Syndrome (PKS). Gross Motor Function Measure (GMFM) and duration of grasping ping pong ball were the primary outcome measures which were conducted at the beginning, 12th, and 24th month.Neurodevelopmental Therapy and Sensory Integration Therapy were used as intervention methods. The most increase with around 50% was acquired in Section A of the GMFM. Duration of holding a ping pong ball gradually increased. As a result, this is the first paper presenting a PHTR shedule and its results in a child with PKS.

Review Article

Role of physical activity in cancer survival and recurrence: A narrative review from relationship evidence to crucial research perspectives

J Maury, P Senesse and G Ninot*

Purpose: The benefits of Physical Activity (PA) considered as a major supportive care in cancer patients, on survival, and recurrence risk is largely disseminated in public communication. However, these data must be taken with caution.The main objectives were to review the evidence and limits of studies reported regarding the post-diagnosis PA role on cancer survival and recurrence risk to secondly discuss of research perspectives on PA programs.

Method: The narrative review included all published or ongoing studies in English during the last 20 years related to PA, survival and recurrence risk with a systematic search on main databases.

Results and discussion: The current evidences regarding the PA role on survival and recurrence risk were only based on cohort studies, mainly in breast cancer. The major methodological limits identified as the lack of PA change assessment, PA level assessed largely by self-reported methods and the significant inter- but also intra- variability make the interpretation of data very. Beyond the use of rigorous RCT, the major issue is to develop adapted and personalized interventions to progressively increase PA level overtime in cancer survivors.

Conclusion: Despite the lack of causal relationship between post-diagnosis PA, survival and recurrence risk, the review underlines several interesting research perspectives. The future PA interventions, using innovative tools and integrated to the “real-life” will argued for the potential antitumoral PA role growing in literature.

Research Article

Receptor pharmacology and other relevant factors in lower urinary tract pathology under a functional and toxicological approach: Instrument to better manage antimicrobials therapy

Mauro Luisetto*, Naseer Almukhtar, Behzad Nili-Ahmadabadi, Ghulam Rasool Mashori, Kausar Rehman Khan, Ram Kumar Sahu, Farhan Ahmad Khan, Gamal Abdul Hamid and Luca Cabianca

In various patients conditions involved in lower urinary tract disease LUT (like overactive bladder, bladder neck sclerosis, dis –synergy (with our synenrgic contraction between bladder detrusor and bladder neck, BPH, recurrent cysytitis, interstitial cystitis, chronic prostatitis, uretral stenosys, loss of sfinteric coordination.

Prostatic cancer, anatomic abnormalities and other the receptor status play relevant role to reduce effect of vicious clycle that can be responsible in progression of the pathologic process.

In this work the complex receptorial status is analyzed to verify new therapeutic strategies.

Starting from the observation that various irritant substanties produce irritant stimulus in Prostatic Patients or in bladder neck condition is interesting to deep understand the etio-patogenesys and Functional results.

In Various prostatic, bladder neck or ureteral condition a reduced urinary fluss can produce infectious.

Conditions like acute or chronic prostatitis.

Irritants sustanties in diet (in example etilic alcohol drink, hot spices, crud meats, carbonate drinks, caffeine and other) can produce Painful stimulus in innervations of vecical trigonous, bladder neck and prostatic urethra.

The same recurrent cystitis and Bph contribute in a complex situation.

This stimulus produce ipertonus of bladder muscle involved in the expulsion of urine.

The event related inflamation and edema (bladder, prostatic uretra, trigonus) contribute to the global effect.

So conditions like bladder neck sclerosys IPB, recurrent prostatitis and cistitys in acts in a vicious circle. (Also immunomediated: Bph and cronic prostatitis with linfocite infiltration and tissue remodeling).

The ormonal status check the systems (see 5-ARI efficacy in Bph).

Simpatic, parasimpatic and other system are deeply involved.

Also behavioral habits or diet can influence in example urinary flux in a complex system like LUT. (Bladder and prostatic irritants that can produce edema and acute inflamation).

Other behavior habits are deeply involved as too much sedentary, water intake, coffee, pee modality and also psychological profile and stressing conditions.

Some disease like diabetes produce high consequences in all this systems due to

Bladder modification, oxidative stress, osmotic movens, and increase susceptibility of urinary infections.

This article are verified this kind of movens that contribute in physio -pathology of some low urinary tract conditions.

The anatomic abnormalities produces, obviously, physiological disfuntions.

Recurrent urinary tract infections, inadequate antimicrobial therapy:

Profile of resistance, duration of therapy, kind of antimicrobials, posology,

Pk. Kinetics, associations, compliance, biofilms, micro calcifications (recurrent chronic prostatitis) contribute to a progression of the condition.

Research Article

Influence of an integrated rehabilitative treatment on the modification of body representation in patients affected by Unilateral Spatial Neglect

Maurizio Falso*, Michela Delpero and Eleonora Cattaneo

Background: In line with the so-called “embodiment concept”, human bodily experience is characterized by the immediate feeling that our body is localized in a certain position in space and that the self is localized within these body limits.

Aim: To verify in a cohort of patients affected by unilateral spatial neglect (NSU) secondary to cerebrovascular damage the possible correlation between a comprehensive neuromotor/neuropsychological rehabilitative treatment and the modification of body representation.

Setting: A rehabilitation institute for the treatment of neurological gait disorders and neuropsychological failures.

Methods: 12 patients (7 males, 5 females; mean age 60 ± 2yy) affected by NSU secondary to cerebral stroke and recovered in the Neurological Rehabilitation Section of the Clinical Institute Città di Brescia were recruited for the aim of this study. In accordance with our inclusion criteria we recruited 4 patients affected by ischemic stroke and 8 patients affected by haemorragic stroke; 9 patients of our study group arrived from a coma state period. Recruited patients underwent at time T0 (hospitalization day) to a functional impairment evaluation (Motricity Index = MI; Trunk Control Test = TCT; Functional Ambulation Category = FAC) and to a neuropsychological evaluation (Behavioural Inattention Test = BIT; Representional drawing; Personal Neglect evaluation scale); each evaluation was repeated in the same way at time T1 (intertime between 2 and 4 months after hospitalization) and time T2 (inter time between 5 and 6 months after hospitalization). At time T0 each patient began an individualized integrated (motor and neuropsychological) rehabilitative treatment course.

Results: In all patients recruited a statistical significant modification was observed for the MI LL left, the TCT and the FAC; no significant statistical modification was observed for the MI UL left, the MI UL and the MI LL right. The t-test showed a significant statistical modification of the personal neglect evaluation scale while no significant statistical modification was defined for the spontaneous human figure drawing test proceeding from time T0 to time T1. The spontaneous drawing of the human figure showed an individual different trend and modification in all patients recruited. A correlation analysis was made comparing the mean value of all motor scales (G1) with the mean value of all neuropsychological scales (G2) and no statistical significant correlation was observed between G1 (T0) and G1 (T1), G1 (T0) and G2 (T0), G1 (T0) and G2 (T1), G2 (T0) and G1 (T1), G2 (T0) and G2 (T1), G1 (T1) and G2 (T1). A second correlation analysis was made comparing all single motor scales with the neuropsychological scales, for the group made by 12 patients and the group made by 5 patients. For the group made by 12 patients, we observed the subsequently significant correlations: MI UL left (T0) correlates with MI LL left (T0); MI LL left (T0) correlates with MI LL left (T1); MI UL left (T1) correlates with MI LL left (T1); MI LL left (T1) correlates with FAC (T1); TCT (T1) correlates with FAC (T1). For the group made by 5 patients, we observed the subsequently significant correlation: TCT (T2) correlates with FAC (T2). In the group made by 12 patients, the mean amelioration of the time related normalized (T0-T1) motor scales is equal to 49% while to 63% was observed for the neuropsychological scales. The mean amelioration of the neuropsychological scale proceeding from time T0 to T1 is equal to 26% with an increase equal to 57% proceeding from time T1 to T2. The neurocognitive amelioration can be observed especially between the 5th and 6th month from the ischemic cerebral damage with a mean increase from 26% to 57%.

Conclusions: It would certainly make sense to treat patients with NSU from the neuropsychological point of view in the long term and from the neuro-motor point of view in the first 3-4 months after stroke; in all this, we cannot exclude that an improvement of the visuo-spatial exploration, emphasized by the neuropsychological treatment, can positively influence also patient’s motor outcome.

Aim: To verify in a cohort of patients affected by unilateral spatial neglect (NSU) secondary to cerebrovascular damage the possible correlation between a comprehensive neuromotor/neuropsychological rehabilitative treatment and the modification of body representation.

Research Article

Canine Distemper Virus detection based in Hemaglutinine Gene as target in Reverse Transcriptase- Polymerase Chain Reaction

Jara P, Cespedes P and Navarro C

Canine Distemper have become a major concern within the veterinary clinical work. Thus, the appearance of many cases of canine distemper in adult animals with their vaccination plan up to date has alarmed veterinarians. Many cases of canine distemper have become a major concern within the clinical veterinary task. The purpose of this work was to detect the gene of hemagglutinin of the virus canine distemper, by using the Polymerase Chain Reaction associated with Reverse transcription (RT-PCR), as confirmation of the clinical diagnosis of disease. For this, peripheral blood samples of animals were used clinically patients and were grouped according to their date of extraction and using vaccines commercial as control.

The results allow to demonstrate a high sensitivity of the technique, besides allowing the use of samples up to seven days of storage at 4°C, despite the fragility of RNA viral.

Detection of canine distemper virus haemagglutinin gene in field samples and its high sensitivity, suggests studying its use as a diagnostic tool complementary to the clinical diagnosis of canine distemper in our country.


Pneumothorax, pneumomediastinum, subcutaneous emphysema: serious complications of asthma

Yiannakopoulou E

Bronchial asthma, is a quite common disease characterized by the chronic
inflammation of the airways. It is due to the interaction of genetic with environmental factors. Currently, bronchial asthma is regarded as a public health problem, since its prevalence is constantly increasing worldwide.

Mini Review

HIV-1 Immune evasion: The main obstacle toward a successful vaccine

Mona Sadat Larijani, Seyed Mehdi Sadat and Amitis Ramezani*

It is estimated that there are 36.9 million individuals living with HIV-1 from who 21.7 million patients receiving antiretroviral therapy (ART) [1,2]. ART has had a significant effect on the patients’ quality of life recently, however, its global coverage declines to 16-35% in low or middle income parts of Africa [3].

Research Article

Peaceful Bridging

RS Carlson*

In our past 200 years we have seen the advancing development of Dental Arts and Science though discoveries by its practitioners. Perhaps it will do some good to review the basis upon which fixed tooth replacement has evolved—that is the prosthetic crown.

Prior to 1871, before the first manufactured foot-treadle dental engine was introduced in America, the restoration of structurally compromised teeth was with hand cutting instruments and bands of metal or wires that were place about the tooth remanents. Although crude and only for the very wealthy, they seemed to be secure enough to last sometime—temporarily or permanently depending upon the time in service. Since life expectancy at this time was less than 35 years, even “temporary”—a year or more—would work well.

We show here in our graphic figure 1, a page from the Dental Cosmos. In it we see the art of “engrafting” a metal crown about a tooth with minimal reduction/preparation.

e show here in our graphic figure 1, a page from the Dental Cosmos. In it we see the art of “engrafting” a metal crown about a tooth with minimal reduction/preparation.

Research Article

Dietary and Lifestyles assessment among Obese Women in Gaza City, Palestine

Marwan O Jalambo*, Basil Kanoa, Mohammed S Ellulu, Smaher Younis and Mueen El-Kariri

Background: The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended.
Aim: To clarify and figure out food habits and different lifestyle pattern among a sample of Palestinian women attending the nutrition center in the Gaza Strip.

Methods: A cross-sectional study involved 116 women were randomly chosen by purposive census sampling. They aged 25 to 60 years with a diagnosis of obesity. The data collected by interview questionnaire that included social factors, lifestyle habits, and health/disease history.

Results: Age group variable has distributed significantly (p=0.024), (31.0%) of morbid obese were ≥35 years group compared to (13.5%) of morbid obese amongst the younger group. The higher intakes of legumes (OR: 2.134, P=0.003), nuts (OR: 3.917, P=0.019), eggs (OR: 6.840, P=0.009), fast foods (OR: 4.461, P=0.005), and soda drinks (OR: 2.230, P=0.004) were the risk factors linked to the increased risk of morbid obesity. Moreover, the higher intakes of legumes (OR: 8.439, P=0.011), eggs (OR: 6.900, P=0.041), chips (OR: 5.049, P=0.012), sugar (OR: 2.068, P=0.011), and fast foods (OR: 3.029, P=0.025) are risk factors of chronic diseases.

Conclusion: The study identified several lifestyle factors and improper dietary habits associated with obesity among women in Gaza city. There is a great need to change these habits to avoid the increased risk of obesity. Gene-environment interaction can explain the high incidence of obesity. A national plan of action to overcome obesity is urgently needed to reduce its economic and health burden


Research Article

Evaluation of Clupeids and Danish fish meal based diets on the growth of African catfish, Clarias gariepinus fingerlings

Lenient MO Ibiyo*, Rowland MO Kayode, A Oresegun, Oluwaseyi Mogaji and Felicia O Joshua

Two experimental feeding trials were conducted concurrently to study the growth response of African catfish Clarias gariepinus fingerlings to graded levels (0, 5, 10, 15 or 20%) of clupeids in Danish fish meal (DFM) based diets. Chemical analysis of the DFM and clupeids fish meal (CFM) was carried out. Completely randomized design with triplicated groups of fingerlings were used for both trials in an indoor and out-door concrete tanks for six and twelve weeks respectively. The study aimed at achieving a cost effective fish meal from local aquatic resources (clupeids fish) highly prolific and abundant in Nigeria water bodies to replace foreign fish meal in West Africa Region. A project supported by West African Agricultural Productivity Project (WAAPP) in NIFFR, Nigeria.

The results of proximate, amino acid profile, mineral and fatty acid composition analysis of CFM indicated values which are very close to those of the DFM. The proximate analysis revealed CFM to contain 70.6% crude protein while DFM contains 72%. There were no significant difference between the treatments with respect to final weight, feed consumed, feed conversion ratio, digestibility and survival (P>0.05) although there was significant difference in specific growth rate (P<0.05) with the highest value obtained in the diets with both fish meal at ratio 1:1. There were no significant difference in haematological parameters (P>0.05). However the lymphocytes were high in all the groups which might not be particularly due to the treatments. The high proliferation of the body defence cells by the fish could be a mechanism of survival in the aqua-medium which is likely to be high in microbial load due to waste materials. Feed Cost/Kg for DFM was N260.16 while for CFM was N227.16. The results of chemical analysis and feeding trials indicated positive replacement of the DFM with CFM in fish feeds without negative effect on growth performance.

Case Report

Linear IgA bullous dermatosis in a child successfully responding to oral antibiotics

Senhaji G, Bay HB, Dassouli R, Jouari OE, Lamouaffaq A, Z Douhi, S Elloudi and FZ Mernissi

Linear IgA bullous dermatosis (LABD) is a rare, chronic, autoimmune bullous dermatosis affecting young children and adults. The exact pathogenesis of this disease is still unknown, although both humoral and cellular immune response are involved. Clinically, it may show heterogeneous skin manifestations. However, it is characterized histologically by linear immunoglobulin A (IgA) deposits over the basal membrane, causing subepidermal blisters. Studies on LABD are relatively sparse and most of the publications are small series or single case reports. Several treatments are reported in literature, however, they should be used with care due to the risk of side effects. We report a case of linear IgA dermatosis with generalized lesions in a 7 year old child, with good outcome under dermocorticoids and antibiotics.

Research Article

Contractions of athlete’s foot and its muscle oxygenation

A Paiziev* and F Kerimov

Sustained isometric contractions of skeletal muscles produce intramuscular pressures that leads to blood flow restriction. In result an active muscle feels defi cit of oxygen what bring to muscle fatigue.In another side during exercise we have physiological contradiction between raising of oxygen demand by working muscle and restriction of blood flow due to vessel pressing. To clarify this issue many research has been performed based mainly on measurement of blood flow in muscle tissue. The purpose of this study was to assess real-time changes in muscle oxygenation during a sustained isometric contractions of dorsiflexor muscle of low (30%), moderate (60%) and submaximal (90%) intensity. Experiments were conducted using the subject’s dominant (right) leg. Volunteers was recruited from eight male students of USIPC (age: 19±2 years, weight: 75±6 kg). Tissue oxygenation index (StO2) were recorded from the tibialis anterior using NIRS device (NONIN). Saturation was higher at 30% compared with both 60% and 90% MVC at all time points after start exercise and higher at 60% than 90%. Oxygen consumption (VO2) permanently increased from slow (30%) to moderate (60%) and submaximal contractions. After cessation of the each contraction there was a large and immediate hyperemic response. Rate of StO2 increasing after effort cessation what reflects the resaturation of hemoglobin which depend on integrity and functionality of vascular system and reflects blood vessel vasodilation. StO2 restoration rate permanently increased from slow (30%) to moderate (60%) and submaximal contractions too. At last on final stage of experiment arterial occlusion test has been performed to determine the minimal oxygen saturation value in the dorsiflexors. Oxygen saturation reached a 24±1.77% what is significantly higher than StO2 after 60 and 90%MVC.

So, we can conclude that oxygen saturation at 60% and 90% MVC are similar and sharply decreased after start of exercise. It means that after 60% MVC take place occlusion of blood vessels due to intramuscular pressure. Oxygen consumption of active muscle increased depend on intensity of exertion according to increasing of oxygen demand. StO2 resaturation rate (Re) permanently increased from slow (30%) to moderate (60%) and to submaximal contractions. Re increasing after effort cessation reflects the resaturation of hemoglobin which depend on integrity and functionality of vascular system and reflects blood vessel vasodilation.