Review Article

Strategic Plans for Diagnosis, Treatment and Control of Hypertension

M Mohsen Ibrahim*

Two major challenges face the practicing physicians and medical community regarding the management of hypertension. First is accurate diagnosis and finding who is the truly hypertensive patient in need of life-long treatment. Second is to improve blood pressure control through addressing hypertension risk factors, adherence to treatment and frequent monitoring.
- Current Challenges in Management

  • Accurate diagnosis of hypertension
  • Improving blood pressure control

- What Do We Need For The Future?

Research Article

“Iliosacral bridging” - A new alternative minimal invasive fixation of unstable pelvic ring fractures

Siekmann H*, Becherer L, Neef R, Kunath T and Florian Radetzki

Introduction: Fractures of both the anterior and posterior pelvic ring are common injuries in polytrauma and the elderly that extend beyond those of simple low-impact trauma. While conventional X-rays predominantly show the ventral aspect of the injury, computed tomography often detect additional fractures of the sacrum. A large number of these fractures are B-injuries by AO, mainly compression fractures at an advanced age. In addition, the prevalence of pelvic insufficiency fractures caused by osteoporosis rather than subsequent to an obvious trauma is increasing, with such an injury often associated with pain that impairs mobilization. The standard sacroiliac screw fixation is often characterized by loosening and thus failure of the osteosynthesis especially in osteoporotic bone of elderly patients.

Method: A new alternative surgical minimal invasive technique, the “iliosacral bridging”, stabilizes the fractures of the sacrum with an internal fixation from S1 pedicle of the uninjured side to the ilium on the affected side. The combination of this internal fixation with the standard single sacroiliac screw on the injured side allows an immediate full weight bearing and pain free mobilization. We present a case series of 8 patients.

Results: The clinical and radiological analysis analogous to the pelvic-outcome-score brought forward that 2 patients showed an excellent and 2 patient a good result. The other 4 patients achieved sufficient results.

Conclusions: The “iliosacral bridging” we have introduced in the present study provides evidence of an expected increased stability of the pelvis after B-injuries.

Research Article

Emergency laparoscopic left sided colonic resection with primary anastomosis: Feasibility and Safety

Mohamed Abdelhamid*, AM Rashad, MA Negida, AZ Garib, SS Soliman and TM EL-Gaabary

Patients undergoing laparoscopic surgery had a lower incidence of major complications, such as anastomotic leak, intra-abdominal bleeding, abscess, and evisceration. Controversies about the operative management of left colonic emergencies are decreasing. Nowadays there is worldwide shifting towards primary resection, on table lavage and primary anastomosis. The aim of this study is to record the safety of laparoscopic primary anastomosis in left-sided colonic emergencies.

Patients: The study was carried out at Beni-Suef University Hospital, in the period between January 2016 and July 2017. Twenty-six patients were included in this study, twelve with left colon cancer, twelve with left colonic complicated diverticulitis and two cases with sigmoid volvulus. Patients presented clinically with either obstruction or perforation. All patients were subjected to laparoscopic resection, on table lavage and primary anastomosis.

Method: Decompression was done prior to starting the intervention, followed by resection and on table lavage then colorectal anastomosis using the circular stapler. The study was approved by the ethical committee in the faculty.

Results: Mean operative time: 185 min (160- 245).

LOS: 12 (10- 18).

Leak: one in obstruction group and two in perforation group.

Redo one in perforation group.

Conclusion: Emergency laparoscopic left-sided colonic resection and primary anastomosis can be performed with low morbidity, however with caution if there was free perforation with peritonitis.

Research Article

Micronutrient deficiency, a novel nutritional risk factor for insulin resistance and Syndrom X

Christopher Edet Ekpenyong*

Emerging evidence indicates that micronutrient deficiency could play a significant role in the pathogenesis and progression of many chronic diseases including diabetes mellitus, hypertension, obesity, dyslipidemia, hyperuricemia, kidney disease, cancer, anemia and other cardio-metabolic and neurodegenerative diseases through the induction of Insulin resistance (IR). However, there are still gaps in our scientific knowledge regarding the links between micronutrient deficiencies, IR, and cardio metabolic disorders. This review provides current information on recent advances and a global perspective regarding the relationship between micronutrient deficiency, IR, and cardio metabolic disorders. Empirical evidence indicates that deficiencies in either micronutrients associated with insulin activity (such as Chromium, manganese, magnesium, and iron) or antioxidant enzyme cofactors (such as vitamin A, copper, zinc, and manganese) could impact several physiological processes leading to a cascade of metabolic and biochemical derangements such as B-cell apoptosis, loss of islet cell mass, defective tyrosine kinase activity, oxidative stress, pancreatic β-cell dysfunction, reduction in lean body mass, defective insulin signaling mechanism, elevated protein kinase C activity, and excess intracellular calcium. Collaboratively, these states of metabolic malfunctioning are associated with IR, which triggers the onset of many cardio metabolic diseases. Undoubtedly, the prevention of micronutrient deficiency may indeed ameliorate the incidence of IR and cardio-metabolic disorders in those at risk and in the general population.


Is there an ideal blood pressure during cardiopulmonary bypass to prevent postoperative cerebral injury? – What does the recent evidence say?

Ahmed Zaky*

Post cardiac surgery stroke is a devastating complication with an incidence as high as 50%1. The association between intra-operative mean arterial blood pressure (MAP- better called linear blood pressure) during cardiopulmonary bypass (CPB) and the development of postoperative stroke-as diagnosed by neuroimaging- and of cognitive dysfunction (POCD) is controversial. This is due to differences in the study populations, stroke assessment tools, operation and conduction of MAPs, variations in neurocognitive testing and duration of follow up. As a result there is a gap in the knowledge on an ideal MAP as a preventive measure of post CPB stroke and POCD.

Review Article

Herbal approach for obesity management

Preeti Singh*

Heftiness, a mind boggling interchange among ecological and hereditary factors and is related with critical horribleness and mortality. Utilization of herbs for the administration of heftiness in the ongoing occasions is pulling in consideration.A web and manual based writing overview was led to survey the measure of data accessible on the natural items for weight administration. Customary writing, PubMed, Scopus, Google researcher databases were screened up to February 2012. The pursuit words were “stoutness”, “home grown medication/items/separates”, “restorative plants”, “customary drug”, “Ayurvedic prescription” without narrowing/constraining looking words or components. Distributions just with edited compositions/full articles and books were inspected in the pursuit. In light of the accessible writing, for huge numbers of the natural and weight reduction items, there is minimal distributed data and there have been no clinical preliminaries or the level of proof is restricted. Our writing study additionally demonstrated that these home grown items fall under an adequate level of proof or with no scientific foundation by any stretch of the imagination, or they have a logical discerning however not to an acknowledgment level. Endeavors were made in the audit to characterize the highlights of conceivable natural weight reduction item. A perfect home grown enemy of stoutness item ought to diminish the weight by 10% over fake treatment of treatment by demonstrating a proof of change of bio markers like blood pres-beyond any doubt, lipids and glycemia with no reactions.

Case Report

Cranioplasty with preoperatively customized Polymethyl-methacrylate by using 3-Dimensional Printed Polyethylene Terephthalate Glycol Mold

Mehmet Besir Surme*, Omer Batu Hergunsel, Bekir Akgun and Metin Kaplan

Cranioplasty is a reconstructive procedure for the repair of skull defects or deformities. Polymethylmethacrylate (PMMA) is a commonly used alloplastic material when autologous bone is unavailable.However, manual shaping of bone cement for frontal and orbital bone defects is challenging and may not lead to cosmetically satisfactory results. Advances in computer-aided 3-dimensional (3D) design and printing technology allow the production of patient-customized implants with improved cosmetic and functional results. A 39-year-old female patient presented with right-sided frontal swelling and headache. Computerized tomography (CT) demonstrated a right frontal calvarial mass extending to the orbital wall. The boundaries of the lesion were marked using a 3D design software. A polyethylene terephthalate glycol (PETG) mold was manufactured with help of a 3D printer. Artificial bone flap was formed by pouring PMMA into the mold. After surgical resection of the calvarial mass, customized PMMA implant was applied with titanium mini plate and screws. The defect was closed properly with good aesthetic results. Production of customized PMMA cranioplasty implants with 3D printed molds is a useful technique and can be preferred for calvarial defects due to skull tumors, bone resorption and traumatic bone loss.

Review Article

Neuroscience, Rehabilitation and New Technologies: Perspectives and critical points for a synergistic development

Alessandro Giustini*

The growth of Rehabilitation, in all of its field and mainly in neuro-rehabilitation applications and settings, is showing increasingly strong interaction with the growth of technology and its innovative applications.

Nevertheless, is should be stressed that the use of machinery has always been a fundamental mainstay of Rehabilitation practices facing the whole person’s aspects and involving the whole physical world around the disabled people as it is: as it was in the past with physical exercises, physical modalities, and in many other trainings and activities that employed physical and technological means as Aids, Prostheses and Orthotics.

Research Article

Some aspects of quality of ambulance care and completeness of information in the transfer forms of emergency patients who arrived in ambulances at the National Hospital of Sri Lanka

Gangadevi Nandasena and Chrishantha Abeysena*

Objective: To describe some aspects of the quality of ambulance care and completeness of information in the transfer forms of emergency patients who arrived in ambulances to the National Hospital of Sri Lanka (NHSL).

Methods: This was a descriptive study. All ambulances arrived at the NHSL during the study period with an emergency patient were selected (n=409) and from those 250 transfer forms, which could be traced were taken. An interviewer-administered questionnaire was used for ambulance staff. A Checklist, which has been derived from the standard patent chart, was used to determine the availability of information on transfer forms.

Results: Of the 409 ambulances, the patient was accompanied by a doctor in 4% (n=16), a nurse in 4% (n=15) and Emergency Medical Technicians (EMTs) in 1% (n= 4), and there were 675 miner employees and 409 drivers. Twenty six percent (n= 4) of doctors, 12.5% (n= 2) of nurses, 100% (n=4) of EMTs, 56.9% (n=189) of drivers and 24.3% (n=164) of minor employees had received training in emergency medicine/pre-hospital care.

The time interval between receipt of the message and loading the patient to the ambulance was >15 minutes on 19% (n= 75) of the occasions and from the latter time to commencement of the journey was >15 minutes on 7% (n=27) of the occasions.

The call number of sending facility 0.4% (n=1) and sending time 33.2% (n=83) were poorly documented. The past surgical histories 20.8% (n=52), chronic diseases 48% (n=120), psychological problems 13.2% (n=33) and allergies 9.2% (n=23) were poorly documented. Details of physical examination findings except cardio-vascular system were not documented in >50% of transfer forms. Medications had been documented fairly (>60%) in most of the transfer forms and however, the procedures (IV fluids, ECG) were poorly documented (<30%).

Conclusion: The completeness of information in the transfer form was not up to standards. This emphasizes for need of well-structured standard transfer form in the country.

Research Article

Effects of intraoperative epidural anesthesia during hepatectomy on intraoperative and post-operative patient outcomes

Christopher Mallard, Brad Withers, Brooke Bauer, Paul A Sloan, Sean Dineen and Annette Rebel*

Objective: The objective of this study was to evaluate the effects of intraoperative epidural anesthesia combined with balanced general anesthesia on intraoperative hemodynamics and fluid requirement, and on postoperative patient outcome.

Design: The study design was a retrospective data analysis of patients undergoing open hepatectomy at a single tertiary care center from May, 2013 to June, 2016. Patients undergoing hepatectomies were separated into two groups: patients not receiving epidural local anesthetic intraoperatively (either no epidural or epidural catheter not used intraoperatively) were designated the control group and patients receiving epidural local anesthetic intraoperatively (bolus and/or continuously). Patients were excluded if they underwent laparoscopic or non-elective procedures.

Results: 103 patients were included in the data analysis: Control n=14, Epidural = 89 patients. There were no major differences in demographics between groups. Epidural patients did not have higher requirements in intraoperative intravenous fluid administration, blood loss, or vasopressor use compared to control patients. Patients who received epidurals required less intravenous opioids with better post-operative pain scores initially and also on post-operative day 2. There were no differences in length of time to ambulation, or post-operative acute kidney injury amongst groups.

Conclusions: This study shows that patients undergoing hepatectomies using combined epidural and general anesthesia: 1) have no increased requirement for intraoperative crystalloid, colloid, or blood component therapy, 2) require lower total intravenous opioid dose, and 3) subjectively report better pain control. Therefore, intraoperative epidural anesthesia combined with general anesthesia may be advantageous for ERAS protocol based oncological procedures.

Research Article

Is community based case detection of glaucoma relevant? Intraocular Pressure level and vertical Cup Disc ratio of participants at a screening programme in a rural setting in Nigeria

Elizabeth A Awoyesuku* and Ireju O Chukwuka

To determine the proportion of participants with elevated intraocular pressure and abnormal vertical cup disc ratio in a glaucoma screening event in a rural community in Nigeria.

Methods: 242 eyes of 121 participants at a one-day screening programme were examined. Visual acuity was accessed using Snellen literate and illiterate charts, followed by a pen torch examination of the anterior segment. The posterior segment was accessed using a direct ophthalmoscope (Welch Allyn, USA). All participants had intraocular accessed using Keeler non contact tonometer and those with significant media opacity preventing view of the posterior pole had cycloplegic examination after dilatation with 1%Tropicamide drops. Data generated was expressed as percentages and means.

Results: 121 participants (242 eyes) were examined. There were 42 males and 79 females giving a M:F ratio of 1:1.86. Age range of participants was 0-90years with a peak in the 5th decade. Mean age was 32 years. 79.3% of participants had normal visual acuity of 6/4 -6/18, while 9.5% had visual acuity worse than 6/60.

83% of eyes had intraocular pressure within normal level, <21mmHg, 12.4% within 21-30mmHg and 4.6% >30mmHg.

73.1% of eyes had Vertical Cup disc ratio (VCDR) <0.5, 10.7% had 0.5-0.7 and 6.6%>0.7. 9.6% of eyes could not be accessed due to media opacities.

Conclusion: 6.6% of participants had suspicious discs and 4.6% participants had intraocular pressures above 30mmHg. Opportunistic screening for glaucoma remains one of the important modes of case detection for glaucoma in the developing climes and should be encouraged as a way to address the scourge of this blinding disease.

Research Article

Value of ambulatory blood pressure measure in pregnancy hypertension

Ana Correia* and Fatima Leitao

It is still not well known the prognostic cardiovascular value of 24h ambulatory blood pressure monitoring in the pregnant woman with hypertension.

Objectives: Assess to the prognostic value of ABPM parameters in predicting maternofetal event.

Methods: Retrospective and observational study which included 166 pregnant women.

Results: The authors found that the night time DBP was the best predictor of adverse events. Non-dipper profile had worse survival at follow up until delivery compared to those with a dipper profile.

Conclusions: ABPM is a tool for pregnant with HT because this is the unique method available that analyses the night blood pressure.

Research Article

Diagnostic accuracy of Magnetic Resonance Imaging to differentiate benign and Malignant Parotid Gland Tumors

Sadia Ali, Adeena Khan*, Kiran Sarfaraz, Saba Akram, Mariam Javaid and Asma Bano

Objective: To determine the diagnostic accuracy of Magnetic Resonance Imaging (MRI) to differentiate Benign and Malignant Parotid Gland Tumors taking histopathology as gold standard.

Place and duration of study: Department of Diagnostic Radiology, Lahore General Hospital, Lahore from January till July 2014.

Methodology: 200 patients of age between 5 to 80 years of either gender with parotid gland swelling, having radiological evidence and clinical suspicion of parotid tumour like fixation to underlying skin, pain, facial palsy and cervical lymphadenopathy were taken. T1 and T2 plain and contrast enhanced 1.5 Tesla MRI unit using standard imaging coil was then carried out. Imaging was further evaluated for the presence or absence of benign or malignant parotid gland tumours using histopathology as a Gold standard. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of MRI were taken against the gold standard.

Results: There were 170 males and 30 females having mean age of 40.27±15.04 and 40.12±12.15 years respectively. Sensitivity, specificity, positive predictive value and negative predictive value of MRI were 90.4%, 89.33%, 93.39% and 84.41% respectively. The diagnostic accuracy of MRI to differentiate benign and malignant parotid gland tumours was 90%. These results were taken against surgery histopathology as a gold standard.

Conclusion: MRI is highly accurate in differentiating malignant & benign tumours of parotid glands and can be used as an adjunct to histopathology for pre-operative evaluation of the parotid gland tumours.

Research Article

Influence of Histidine on the contractility and adrenaline inotropic effect in the experiments with myocardium of right ventricular of Non pregnant and Pregnant Rats

Victor Tsirkin*, Alexander Nozdrachev, Julia Korotaeva and Grigorij Khodyrev

It was investigated contractility and adrenoreactivity of intact myocardium strips of right ventricular in experiment with 60 rats. They were assessed by the force of induce contraction and its changes under the influence of adrenaline (10-9 or 10-5 g / ml). Found that these indicators do not depend on the phases of the estrous cycle and the presence of pregnancy. Histidine (10-10-10-4 g / ml) did not increase the response to adrenalin (10-9 g / ml), but increased the force of the contractions in rats in progesterone dominance (trend) and pregnancy (statistically significant). Against the background of propranolol (10-8 g / mL) or atenolol (10-8, 10-6 g / mL), adrenaline (10-5 g / mL) instead of increasing the force of contraction reduced it (probably due to activation of beta3-, alpha1 - and alpha1 a2- adrenergic receptors), and histidine (10-4 g / mL) prevented this reduction, but does not restore full ability of adrenaline to exert a positive inotropic effect. On the background of nicergoline (10-8 g / mL or nicergoline and propranolol (10-8 g / mL), adrenaline (10-5 g / mL) did not alter the force of contraction, and histidine (10-4 g/mL) restore ability of adrenaline to exert a positive inotropic effect but only in the experiments with nicergoline. Concluded that histidine increases the efficiency of the activation of all three (beta1-, beta2- and beta3-) populations of myocardial beta-adrenoceptoprs, including at lower by adrenergic blockers. Therefore, histidine proposed as an antagonist of beta-adrenergic blockers and as resensitizator of these receptors. 

Core Tip: In the experiments with strips of the right ventricle of 40 nonpregnant and 20 pregnant rats histidine (10-10-10-4 g /mL) did not increase the response to adrenaline (10-9 g / ml), but increased the force of contractions in pregnant rats. On the background of propranolol (10-8 g / mL) or atenolol (10-8, 10-6 g / mL), adrenaline (10-5g/mL) showed a negative inotropic effect, and histidine (10-4 g / mL) prevented it, but does not restore the ability of adrenaline to show positive inotropic effect,. i.e histidine exhibits the properties of the antagonist of beta-blockers and of resensitizator of beta-adrenoceptors.

Case Report

Hyperkalemia: An archenemy in emergency medicine. Description of two case reports

C Naclerio*, A Del Gatto and A Cavallera

Potassium is an important ion capable to maintain intra-extracellular electric gradient. Variations in the intra-extracellular ionic flow may alter cells functions, skeletal and smooth muscle contractility and electric activity of myocardial cells.

In this study we demonstrated that high level of serum potassium may be associated with cardiac and neurological life-threatening diseases.

We describe two case reports in which one patient, chronic hemodialysed, presented with cardiogenic shock in setting of hyperkalemia; the other, with end-stage kidney disease, showed a flaccid paralysis associated to high level of serum potassium during potassium sparing diuretic therapy.
Emergency haemodialysis was performed with a complete remission of the clinical manifestations.
Indeed, the use of simply diagnostic instruments such as serum electrolyte assay and electrocardiographic study (ECG) are helpful in clinical practice solving in timely serious complications due to hyperkalemia.

We describe two case reports in which one patient, chronic hemodialysed, presented with cardiogenic shock in setting of hyperkalemia; the other, with end-stage kidney disease, showed a flaccid paralysis associated to high level of serum potassium during potassium sparing diuretic therapy.

Emergency haemodialysis was performed with a complete remission of the clinical manifestations.

Indeed, the use of simply diagnostic instruments such as serum electrolyte assay and electrocardiographic study (ECG) are helpful in clinical practice solving in timely serious complications due to hyperkalemia.


Functional Electrical Stimulation (FES): Clinical successes and failures to date

Gad Alon

Non-invasive electrical stimulation in the form of neuromuscular electrical stimulation (NMES) and functional electrical stimulation (FES) has been documented as an optional assessment and treatment technology for decades.In contrast, translation of the robust clinical evidence supporting the effectiveness of FES’ enhancement of muscle force generation and adding to the recovery of motor control following damage to the brain appears limited. Furthermore, enabling many patients to regain locomotion ability though utilization of FES as a standard care option in rehabilitation medicine remains unmet. This perspective evolved over years of collaborative experience in clinical research, teaching, and patient care having a common goal of advancing patients’ rehabilitation outcomes. The clinical successes are supported by repeated evidence of FES utilization across the life span, from toddlers to elders, from hospitals’ critical care units to the home environment. The utilization include managing multiple deficits associated with the musculo-skeletal, neurological, cardio-pulmonary, or peripheral vascular systems. These successes were achieved in no small part because of the technological advancement leading to today’s wearable wireless FES systems that are being used throughout the continuum of rehabilitation care. However, failures to benefit from FES utilization are likewise numerous, collectively depriving most patients from using the technology to maximize their rehabilitation gains. The most critical failures are both clinical and technological. Whereas numerous barriers to NMES and FES utilization have been published, the focus of this perspective is on barriers not considered to date.


Edible vaccines to combat Infectious Bursal Disease of poultry

Muhammad Sarwar Khan*

Poultry industry is a domineering section of agriculture sector in the world as it provides meat, income and employment. Of the poultry industry, broiler chicken is dominating, as US export was more than 41 billion pounds of chicken (about 16.5 percent of production) in 2017 [1]. In Pakistan, the poultry industry contributes around 1.4 percent to the GDP and 31 percent to total meat production [2]. The global demand for this meat is rising in developing world including Pakistan. To meet the needs, rearing of poultry at both domestic and commercial levels is imperative [3]. However, the industry faces a lot of constraints, preventing it from reaching its maximal potential. Poor welfare, insufficient quality nutrition and devastating diseases are some of these problems. Amongst the myriad of diseases, Infectious Bursal Disease (also known as Gumboro disease, infectious avian nephrosis and infectious bursitis) is an acute, contagious viral disease of chicken [4-6]. It not only affects domesticated but also wild poultry throughout the world by targeting the immune system. [7-9].

Gumboro disease is caused by Infectious Bursal Disease Virus (IBDV), which is a member of genus Avibirnavirus of the Birnaviridae family. IBDV is a non-enveloped virus having a capsid that contains a double stranded RNA genome, split into two segments A and B [10]. Segment A of the genome encodes four proteins (VP2, VP3, VP4 and VP5) while segment B encodes VP1. Based on Pathogenicity the IBDV strains can be grouped into three pathotypes; classical virulent, antigenic variant and very virulent [11]. Though the first outbreak of very virulent IBD virus was reported in Europe in early 1990s [12], recent pandemics across Asia, Africa and South America [13] have heavily damaged commercial and wild poultry. Contamination of a rearing site with the IBDV leads to a horizontal transmission of disease across the flocks through contaminated feed and water. However, vertical transmission is not reported yet [14]. Classical virulent strains flaunt a mortality rate as high as 20-30%, mostly due to the widespread bursal damage in infected poultry [15]. Classical virulent strains are the source of commercially available vaccines against IBD viral infections. In early 1980s, new antigenic variants emerged, causing more than 50 percent mortality in birds by rapid bursal damage [16]. Current vaccines prepared from classical strains have failed to control the disease caused by these antigenically variant strains. In the late 1980s, very virulent IBD virus strains were reported that induced IBD with a more pronounced bursal lesion and higher mortality (up to 90 percent) when compared to other IBDV strains [17]. In addition, vaccination against the very virulent strains encounters many challenges as very virulent IBD virus can breakthrough protective antibodies, and therefore requires more efficient vaccination approaches.

Review Article

Review of Stereotactic and Neuronavigation Brain Biopsy Methods in the Dog

Felipe AS Abreu* and Samuel T Zymberg

Objective: To perform a review of brain biopsies in the canine species and determine if it is possible to compare the stereotactic and neuronavigation results.

Method: A search was performed in NCBI’s PubMed database for stereotactic or neuronavigational canine brain biopsy publications and articles which met at least one of the inclusion criteria and not any of the exclusion criteria were selected. The inclusion criteria were: 1) assessment of the specificity of the biopsy, 2) assessment of system accuracy, 3) assessment of the biopsy results, and 4) duration of the procedure.

Results: Only one article met all the inclusion criteria. Eleven articles that partially met the criteria were used for comparison. Authors used different stereotaxic methods and two used neuronavigation equipment. The authors of the stereotactic studies either adapted devices from human medicine or developed their own devices; the level of accuracy was variable (errors of 0.0 mm to 5.1 mm), and the two articles that used animals with spontaneous lesions had a diagnostic specificity rate higher than 90 percent. The accuracy of the neuronavigation studies was approximately 3.3 mm; however, no live animals were used.

Conclusions: It was not possible to properly compare stereotactic and neuronavigation techniques. To do so, the methodologies and the assessed parameters need to be standardized.

Research Article

Primer Pairs for Rice (Oryza sativa L.) Bisulfite Sequencing Studies

Mehmet Karaca* and Ayse Gul Ince

Many agriculturally important properties such as heterosis, inbreeding depression, phenotypic plasticity, and resistance for biotic and abiotic stresses are thought to be affected with epigenetic components.New discoveries related with epigenetics are likely to have a major impact on strategies for crop improvement in rice breeding. However, assessing the contribution of epigenetics to heritable variation in plant species still poses major challenges. Methylation of cytosine in DNA is one of the most important epigenetic mechanisms in plants. DNA methylation not only plays significant roles in the regulation of gene activity, but also it is related with genomic integrity. Although most of next generation sequencing (NGS) technologies do not require the use of target specific primer pairs to identify and study DNA cytosine methylation, validation studies of NGS uses selective primer pairs. Bisulfite sequencing technique is a gold method for DNA cytosine methylation studies. However, bisulfite sequencing requires the development of bisulfite primer pairs to selectively study DNA sequences of interest. In this study 9 bisulfite specific primer pairs were identified and validated. These primer pairs successfully amplified bisulfite converted and unconverted genomic DNA extracted from radicle and plumule of rice (Oryza sativa L.) seedlings. Results of the present study clearly revealed the occurrence of CG, CHG and CHH (H stands for C. T or A nucleotides) contents in studied DNA sequence targets were different indicating potential role of DNA cytosine methylation in these genes. Primer pairs reported in this study could be used to detect DNA methylation which is one of the most important epigenetic mechanisms affecting the development, differentiation or the response to biotic and abiotic stress in rice (Oryza sativa L.).

Case Report

Brooke-Spiegler Syndrome: A rare cause of skin appendageal tumor

Suganthan N, Pirasath S, Dikowita DD.

A 51-year-old women presented with asymptomatic multiple polypoidal nodules over scalp with simultaneous papularnodular skin eruptions involving nose, nasolabial folds and forehead for 40 years duration. Her daughter also noted to be having multiple papularnodular skin eruptions involving nose, nasolabial folds and forehead which raised curiosity of possible familial condition. The punch biopsy of polypoidal nodule indicating histological evidence of spiradenoma was favour in diagnosis of Brook Spienger Syndrome. We report this case as this is a rare clinical entity.

Research Article

Use of essential oils as new food preservatives (Case: Eucalyptus grandis and Eucalyptus crebra)

Sendanyoye Marcel*

This study purposed to study the Preservative agents that are required to ensure that manufactured foods remain safe and unspoiled; work was conducted to evaluate the efficacy of essential oils from two eucalyptus species, Eucalyptus grandis and Eucalyptus crebra in food preservatives; to run this experiment flesh eucalyptus leaves collected from Ruhande Arboretum forest were submitted to hydrodistillation and yields(amount) of 0.38 and 0.34 % for Eucalyptus grandis and Eucalyptus crebra were obtained, respectively. Phaseolus vulgaris, Sorghum condatum, cooked Ipomoea batatas (sweet potatoes) and bread were the sample foods used to assess their preservative efficacy. Acanthoscelides obtectus and Stophilus oryzae were used as pests for Phaseolus vulgaris and Sorghum condatum respectively. For bread and cooked Ipomoea batatas, Rhizopus nigricans are used to assess the efficacy of these two essential oils to inhibit their growth; the obtained results revealed that those essential oils could act as insecticide in the storage of Phaseolus vulgaris and Sorghum condatum. Essential oil from Eucalyptus grandis protected these two foods against pests in the periods of 4 and 9 days, respectively while essential oil from Eucalyptus crebra protected them for the periods of 6 and 11days, respectively.