Research Article

Some Aspects of medicine distribution in Sudan

Abdeen Mustafa Omer*

The strategy of price liberalisation and privatisation had been implemented in Sudan over the last decade, and has had a positive result on government deficit. The investment law approved recently has good statements and rules on the above strategy in particular to pharmacy regulations. Under the pressure of the new privatisation policy, the government introduced radical changes in the pharmacy regulations. To improve the effectiveness of the public pharmacy, resources should be switched towards areas of need, reducing inequalities and promoting better health conditions. Medicines are financed either through cost sharing or full private. The role of the private services is significant. A review of reform of financing medicines in Sudan is given in this study. Also, it highlights the current drug supply system in the public sector, which is currently responsibility of the Central Medical Supplies Public Corporation (CMS). In Sudan, the researchers did not identify any rigorous evaluations or quantitative studies about the impact of drug regulations on the quality of medicines and how to protect public health against counterfeit or low quality medicines, although it is practically possible. However, the regulations must be continually evaluated to ensure the public health is protected against by marketing high quality medicines rather than commercial interests, and the drug companies are held accountable for their conduct.

Case Report

Small cell carcinoma of the ovary with hypercalcemia: Case report and review of the literature

Gerday A*, Marbaix E, Squifflet JL, Mazzeo F and Luyckx M

We describe here the case of a 23-year old woman with small cell carcinoma of the ovary of the hypercalcemic type (SCCOHT) with SMARC-A4 mutation who benefited from surgery in two steps leading to a total hysterectomy with bilateral salpingo-oophorectomy, omentectomy, pelvic and lombo-aortic lymph nodes dissection. She also received 6 courses of poly-chemotherapy after the surgery. A close follow-up was then performed by clinical examination every three months with determination of serum calcium and CA125 level as well as imaging with thoraco-abdominal CT scan. To date, the patient has a disease-free survival of more than 9 years. We also reviewed the literature on this topic and discuted the new diagnostic and prognostic genetic tool SMARC-A4 mutation.

Research Article

Control of phytopathogenic microorganisms of post-harvest in tomato (Lycopersicon esculentum Mill.) with the use of citrus extract

Ruíz-Alvarado Cristina, Juan Jose Reyes-Perez, Hernández-Montiel Luis Guillermo, Murillo Amador Bernardo and Rueda Puente Edgar Omar*

Diseases are a major cause of post-harvest losses depending on season, region and management practices. Chemical control is the most used but with serious consequences for human health and the environment. This forces us to carry out more exhaustive studies on botanical products.The general objective of the present study was to evaluate the effect of citrus extracts for the control of pathogens that cause post-harvest diseases in tomato fruit. The product to be evaluated is of botanical origin from citrus extracts. Doses were evaluated (0, 666, 1000, 2000, 4000, 8000 ppm). The treatments were located at a temperature of 25°C±2 and 45% relative humidity (rH). The design used corresponded to a completely random design. The least significant difference was estimated by Tukey Multiple Range test at P=0.05. The statistical tests were performed through the SAS computer program. The results indicate that the pathogens detected and identified correspond to Alternaria tenuissima; Botrytis cinerea; Cladosporium fulvum; Colletotrichum coccodes; Fusarium oxysporum; Geotrichum candidum; Rhizopus stolonifer and Stemphylium macrosporoideum. Our conclusion is that the efficient doses correspond to 666, 2000 and 8000 ppm. With the application of citrus extracts, the damage percentage of tomato fruit was reduced in relation to the control treatments. Based on the results with the application of citrus extracts, the shelf life of the tomato was lengthened.

Research Article

Pharmacological effects of Nephrolepis exaltata L. (fern) aqueous extract on an insect-based model (Nauphoeta cinerea)

Danrley Mariel Egidio Sanchez, Jocimar de Souza, Yoko Oshima-Franco and Sandro Rostelato-Ferreira*

In this work we used semi-isolated heart of the cockroach Nauphoeta cinerea for the investigation of the pharmacological effects of extracts (aqueous, 1:1, 1:2, 1:4 and 1:8) from Nephrolepis exaltata L. leaves, a popular ornamental fern considered to be safe.The use of insects in experimental studies has grown due to the easy handling, proliferation/growing assuring its rapid obtention, and absence of ethical issues. An aqueous extract 0.2 % was obtained after maceration of 1 g N. exaltata leaves powder with 20 mL of distilled water (1:20). Diluted extracts in water were obtained to have the following proportion 1:1, 1:2, 1:4 and 1:8. Experiments (n=4) consisted of 200 µL addition onto semi-isolated heart preparation of N. cinerea with concomitant heart beating counting. Aqueous, 1:1 and 1:2 extracts paralyzed completely the heart beatings of cockroachs (p<0.05 compared to saline control), but not 1:4 or 1:8, which showed only a slight decline (p>0.05 compared to saline control). A preliminary thin layer chromatography showed the presence of unidentified terpenoid in aqueous extract of N. exaltata. These pharmacological findings of N. exaltata can be exploited for future use as insecticide or as dose-dependently cholinergic agent.

Review Article

Is It Possible to End Female Circumcision in Africa?

Fiona Dunn*

Female genital mutilation / cutting remains a widespread practice throughout Africa. There has been a worldwide effort to do away with FMG/C, but tensions exist between those who aim to abolish FGM/C and those who desire to perpetuate the tradition. While many Western and African experts and organizations agree on the health risks and human rights concerns with FGM/C, others fear that Westerners are imposing their ideas and lack of cultural understanding, trying to eliminate a practice central to the identity of many Africans. The issue must be approached respectfully and collaboratively, with great effort on the part of Westerners to understand the cultural context and rationale of this tradition. Ultimately, if FGM/C is to be eradicated in the foreseeable future, whole African communities and international support agencies must be engaged and empowered to collectively evaluate the implications of the practice and accelerate its demise.

Review Article

Role of HECT ubiquitin protein ligases in Arabidopsis thaliana

Wei Lan#, Weibo Ma# and Ying Miao*

Ubiquitination is a kind of posttranslational modification of proteins in eukaryotes, and it plays an important role in the growth and development of organisms. The ubiquitination of proteins is a cascade enzymatic reaction involving three enzymes. The homologous to E6-AP carboxy terminus ubiquitin-protein ligases (HECT E3s) family is an important ubiquitin-protein ligases family. The family all have a HECT domain of approximately 350 amino acids in the C-terminus. However, studies on plant HECT E3s, such as structural features, prediction of HECT domain function, and their regulatory mechanisms, are very limited. In this paper, Arabidopsis thaliana HECT family genes were analyzed, including gene structure and functional domains and its limited known functions in protein degradation, gene transcription regulation, epigenetically regulation or other functions, finally speculate their roles in plant morphologies, aging or responsive to environmental stress.

Review Article

Treatment of Retinal Pigment Epithelial Detachment

Ayse Gul Kocak Altintas* and Cagri Ilhan

Anatomical separation of the retinal pigment epithelium from the Bruch membrane is defined as retinal pigment epithelial detachment (PED) andit is classified as drusenoid, serous, and vascularized. Vascularized PED is mostly associated with choroidal neovascularmembrane due to age-related macular degeneration and the risk of vision loss is high in this situation. Studies show that all of baseline values including BCVA, PED height, subretinal fluid, central macular thickness, PED volume, vertical dimension, presence of coincident macular pathology, reflectivity and morphology on optical coherence tomography have prognostic importance. Current treatment protocols mainly based on intravitreal injection of anti-vascular endothelial growth factor (VEGF).Even the bevacizumab was the first anti-VEGF that was used for treatment in PED, there are several reports show the insufficiency of bevacizumab. In treatment-naïve eyes, both of ranibizumab and aflibercepthave similar effect in vascularized PED. In treatment-resistant eyes, high dose bevacizumab or switching therapy of anti-VEGF procedures can be effective when considering of all cases, aflibercept seems more effective than other options.We aimed in this manuscript, to give a general information about different characteristics of PEDs and to investigate the treatment strategies in the light of current literature.

Case Report

Equine Anti-Thymocyte Globulin (ATGAM) administration in patient with previous rabbit Anti-Thymocyte Globulin (Thymoglobulin) induced serum sickness: A case report

Joseph B Pryor*, Ali J Olyaei, Joseph B Lockridge and Douglas J Norman

Thymoglobulin is a rabbit-derived anti-thymocyte antibody directed at T-cells and commonly used for induction immunosuppression therapy in solid organ transplantation, especially in immunologically high risk kidney transplant recipients. Despite its frequent use and efficacy, the heterologous makeup of thymoglobulin can induce the immune system resulting in serum sickness which typically presents with rash, fever, fatigue, and poly-arthralgia in the weeks following drug exposure. ATGAM is another anti-thymocyte antibody, targeting the same epitopes, but differs from thymoglobulin by the animal in which the preparations are generated (equine vs. rabbit). Herein, we present a case of a patient with a known history of thymoglobulin-induced serum sickness, who presented with evidence of acute cellular and vascular rejection at their 12-month post-operative visit. Given their immunologically high risk status, they were successfully treated with ATGAM with improvement in their rejection and kidney function. To the author’s knowledge, this is the first case report of successful administration of ATGAM in a patient with a documented history of thymoglobulin induced serum sickness, demonstrating a possible treatment option for acute rejection in patients with reactions to thymoglobulin.

Research Article

Active gaming and self-paced exercise: A self-determination perspective

Danielle D Wadsworth*, Colleen M Daly and Shelby J Foote

Purpose: This study aimed to identify physical activity, enjoyment, and factors for future activity between an active video game (AVG) condition and self-paced exercise (SPE) among college-aged students.

Methods: Thirty college-aged volunteers (age=22±1.68 years) completed 4-45 minute physical activity sessions (2 AVG; 2 self-paced). A survey and a brief structured interview followed.

Results: Overall, participants expended more calories, accumulated more steps, and more physical activity during SPE; however, participants in the AVG condition met daily exercise recommendations. The majority of participants (81%) enjoyed playing the AVG. Autonomy and competence were found as common themes among those who preferred the SPE condition; whereas, lack of knowledge and exercise variety were emergent themes among those who preferred AVG.

Conclusions: This study provides evidence that college students could meet daily exercise recommendations by participating in AVG interventions; although AVGs that provided autonomy and allowed users to demonstrate competence would be preferable.

Research Article

The body composition analysis: Differences between students and the trend of their change

Ratko Pavlovic*, Zoran Radic, Irina Juhas and Mensur Vrcic

Anthropometric characteristics, represent one of the most important subsystems within the “system” of man, and which can be in affected by physical exercises in the direction of the desired transformation.Very often the anthropometric parameters (height and weight) are used in the assessment of the morphological status of an individual, and on the basis of the results of Body Mass Index (BMI) bring certain estimates and conclusions. BMI as a statistical measures, is used in many public health campaigns as an approximate measure of the ideal body mass and the degree of nutrition of a population. The main goal of the research was to determine and analyze differences in BMI parameters between male and female students, aged 18±0.5 years, and determine the trend of changes. Using the T-test module, the obtained results confirmed that there are statistically significant differences in body height (t=8,17; p<0.001) and body weight (t=5,29; p<0.001), while in BMI values there are not statistically significant differences (t=-0.68, p>0.001). Based on BMI values, a positive trend of somatic changes of both poles is evident.

Review Article

TMD and pregnancy?

Afa Bayramova*

Pregnancy is a happy stage in life of every woman, but at the same time it is a rather difficult period, since pregnancy represents a serious strain on the body. In the body of a woman during this period there are significant physiological changes that ensure the correct development of the fetus, prepare the body for the upcoming delivery. In this difficult period, the burden on all organs and systems of the woman’s body is significantly increased. Especially often suffer joints; there is a risk of permanent pain, the development of diseases or exacerbation of existing diseases. One of the most common problems is Temporomandibular Dysfunction or Disorder (TMD) which many women face, but still hasn’t been explained.

Research Article

Vestibular-limbic relationships Brain mapping

Paolo Gamba*

Vestibular disorders and anxiety are closely related, probably because they share some neuronal pathways. Ageing and patient comorbidities are important facilitating factors, and multiple vascular risk factors could contribute to the onset of a vestibular syndrome called vascular vertigo. White matter lesions (WML) are often seen on magnetic resonance imaging (MRI) scans of elderly people and are related to various geriatric disorders, including dizziness. The cause of this correlation could be the disruption of neuronal networks that mediate higher vestibular cortical function. Numerous neuronal pathways link the vestibular network with limbic structures and the prefrontal cortex modulates anxiety through its connections to amygdala. The aim of the present work was to investigate the correlation between WML, amygdala and cognitive functions.

Letter to the Editor

Dependence of the results of treatment of acute pneumonia on the doctrine of the disease

Igor Klepikov*

Treatment of various inflammatory processes, including acute pneumonia(АP), over the past decades is identical and does not reflect the specifics of a particular disease. The basis of such treatment is «antibiotics alone». The need for additional therapeutic efforts is realized by the use of General therapeutic techniques, regardless of the diagnosis. This does not take into account the important fact that the localization of inflammation not only determines its clinical picture,but,above all,the mechanisms of influence on other organs and systems of the body.

Attempts to cure fundamentally different diseases with the help of one aid package cannot give the expected result even theoretically. The futility of this approach is illustrated by the current dynamics of the results.Reducing the effectiveness of antibiotics and the emergence of new resistant strains of microorganisms forces the constant development of new antimicrobials. However, the success of pharmacists can not stop the continued increase in the number of purulent complications of АP even in developed countries with maximum capacity to provide patients. There is a solution to the existing problem and it lies in another plane.

Review Article

What is new in Hypertension of Mexico 2018? -Impact of the new classifi cation of high blood pressure in adults from American College of Cardiology/American Heart Association (ACC/AHA)

Martin Rosas-Peralta, Gabriela Borrayo-Sanchez*, Janal Santiago-Lopez, Erick Ramirez Arias, Rosalba Garcia Mendez, Victor Hugo Borja-Aburto, Ana Carolina Sepulveda-Vildosola and Jose de Jesus Arriaga-Davila

The new report of American College of Cardiology/American Heart Association task force on Clinical Practice Guidelines for High Blood Pressure in Adults was published online ahead of print November 13, 2017. The new American recommendation was focused on the criteria to define Hypertension. 130/80 mmHg or more is now considered as the new cut off point to define Hypertension. It is not new if we consider cumulative evidence in the las two decades has been broken the idea to consider 140/90 mmHg as the point to start medical actions. Thus, in México with current ACC/AHA definition it is estimated today around 48 million of adult hypertensive population. In the Mexican Institute of Social Security (IMSS) several strategies has been developed to improve prevention as the key action to confront non communicable chronic disease including hypertension. This updated guideline from ACC/AHA is an extraordinary opportunity to reinforce our preventive programs to high blood pressure control. In this brief report we analyze the epidemiological situation in Mexico and its possible consequences of the new criteria for hypertension diagnosis. The main current strategies that are applied into the IMSS to confront cardiovascular risk factors are directed to prevention. The IMSS is prepared to attend situations as the change of criteria diagnoses in Hypertension and new preventive models are in progression.

Review Article

New pharmacological strategies in some metabolic endocrine disorder under a toxicological approach

Luisetto M*, Ghulam Rasool Mashori and Cabianca luca

In this review After Observing biomedical literature (starting from some heart disease) results that some pathological phenomena are deeply involved in some metabolic endocrine condition: Kinetics and gradients in metabolism, catabolism, time related, toxic like effect, electrical cell membrane status, smooth vascular muscle cell hyper-reactivity, platelet iperactivations, central autonomic control after acute stroke, great electrolytes unbalances et other factors as pro-hypertrophic signaling and oxidative stress. Observing actual current therapy in some metabolic endocrine therapy often is used association of drugs (in example in type II diabetes). In Many other pathologies efficacy drug therapy exist, and often only 1 pharmacological molecule resolve the pathological condition. But in many disease even associating 2-3-4 drugs the % of cure not increase (efficacy, effectiveness). It mean that this drugs strategies are not the really best? Or it mean a low active level? Why for this pathological condition this association drugs in currently use not do the right works as really needed? There is the need for new really efficacy drugs strategy that show a profile of efficacy as requested in order to resolve the pathological condition? Or to be added to the actual therapy? The actual pharmacological strategies in some metabolic endocrine disorder is really the best? Or other strategies can be introduced?

Case Report

Complete recovery of chronic Osmotic Demyelination Syndrome with plasma exchange

Sumbal Nasir Mahmood*, Kunwer Naveed Mukhtar, Osama Kunwer Naveed and Ahmed Kunwer Naveed

A 50-years old female presented with dysarthria, inability to swallow and quadriparesis for three weeks. She had rapid correction of her serum sodium (Na) from 99meq/l to 138meq/l within 24 hours 1 week prior to development of these symptoms. She was diagnosed as a case of Osmotic demyelination syndrome (ODS) formerly known as central pontine myelinolysis (CPM) which was confirmed by MRI. She underwent Plasma Exchange (PE) on the 20th day since her symptoms started and underwent 7 cycles of PE with complete neurological recovery. Pt was discharged with ability to ambulate independently and complete recovery of speech and swallowing. Hence, we report that PE is beneficial in chronic ODS.

Research Article

Nutritional and structural evaluation of selected Black gram varieties for preparation of Fermented Thick Pancake (Dosa)

Kavitha B*, Sugasini D*, Poorna CR Yalagala, Hemalatha C, Kanchana S, Meenakshi V and Umamaheswari R

The quality characteristics of selected black gram varieties viz., VBN 5, VBN 7, ADT 3, T9 and CO 6 and were evaluated for their suitability for the preparation of thick pancake. The foaming stability and foaming capacity were found to be maximum in VBN 5, CO 6 and T9. Maximum rise in volume was recorded in CO 6 (149 ml) followed by VBN 5 (148 ml) and T9 (147 ml) which is an indication good quality of thick pancake. Thick pancake prepared using 5 black gram varieties were analyzed for the physicochemical and microbial load. The texture profile viz., springiness, cohesiveness, chewiness and gumminess was evaluated for VBN 5, CO 6, T9 and VBN 7 respectively. The protein content was higher in thick pancake prepared from VBN 5 (25.47/100 g) compared to CO 6 (24.66 g/100g). Among the selected varieties, CO 6, T9 and VBN 5 had good batter content, texture, and microstructure and were found to be most suitable for thick pancake preparation.


Interplay between asthma and gastroesophageal reflux disease: A controversial issue

Yiannakopoulou Eugenia*

Gastroesophageal reflux disease (GERD) is a quite common disease caused by the reflux of gastric contents into the esophagus and manifested by heartburn and acid regurgitation. Apart from the esophageal manifestations.


Prediction of protein Post-Translational Modifi cation sites: An overview

Md. Mehedi Hasan* and Mst. Shamima Khatun

Post-translational modification (PTM) refers to the covalent and enzymatic modification of proteins during or after protein biosynthesis. In the protein biosynthesis process, the ribosomal mRNA is translated into polypeptide chains, which may further undergo PTM to form the product of mature protein [1].