09/28/2018
Research Article

Impact of four obesity interventions on biometric measures of individuals positive and negative for food addiction

Trina Aguirre*, Leeza Struwe, Ann Koehler, Rebecca Kreman, Rebecca Bowman, Erica Schulte, Kayla Pierce, Molly Bloodgood and Jeffrey Holloway

Obesity is a major contributor to ill health and numerous comorbidities globally. Recent studies suggest that addictive-like tendencies toward foods, especially highly processed foods, contribute to this epidemic. Therefore, interventions used to treat substance-use disorders may be effective for treating overweight/obese patients with food addiction (based on the Yale Food Addiction Scale, version 2.0). This pilot study evaluated four interventions, selected because of their effectiveness in the treatment of substance-use disorders [motivational interviewing, pharmacotherapy (naltrexone-bupropion), pharmacotherapy with motivational interviewing, information control (diet and physical activity instruction)], in overweight/obese individuals with and without food addiction. The food addiction construct identified a distinctive subset of overweight/obese individuals. Through one month, response to interventions differed between food addiction phenotypes with those who were positive for food addiction showing similar or less response to the interventions than those who were negative for the trait. This suggests that individuals with addictive-like tendencies toward food may require longer and more intensive intervention to achieve their goals. The greatest changes in biometric measures occurred between baseline and 1 month during which time participants were attending weekly intervention sessions. Across all groups, those who attended more sessions (dose) was correlated with a reduction in body mass index.

09/25/2018
Research Article

The Impact of Adenotonsillectomy on Health-Related Quality of Life in Paediatric Patients

Shuaib Kayode Aremu*

Objective: To determine the impact of Adenotonsillectomy on Health-related quality of life (HRQoL) in children’s before and after surgery.

Study Design: Prospective, Observational, before and after the trial. 142 children who underwent Adenotonsillectomy were included in the study. Parents were made to fill pre and post-operative questionnaires which were customized from Tonsil and Adenoid health status instrument (TAHSI) and HR-QoL (Health-related quality of life) forms, one day prior to the surgery and 6 months after the surgery respectively, and the results were tabulated and analyzed.

Setting: Tertiary pediatric otolaryngology practices.

Result: Out of the 142 children in the study, 80 were male and 62 were female. Male to Female ratio is 1.3:1. Age group 1-4 years had the highest number of patients while the age group 9-12 had the least. Preoperatively the Mean score of the domain for Sleep disturbances, Physical Symptoms, Emotional distress, Daytime functions, and Caregiver concern was 14.1, 15.83, 6.89, 7.54, and 13.78 respectively. After 6 months of the surgery, the score decreased to 4.65, 4.22, 4.32, 3.1 and 4.2 respectively. This shows a significant improvement in the symptom complex and the quality of the life.

Conclusion: Adenotonsillectomy definitely leads to an improvement in the HRQoL in children as the majority of parents were extremely satisfied with the surgical outcome. Almost all of the parents reported a decrease in Sleep disturbances, Physical Symptoms, Emotional distress, Daytime functions, and Caregiver concern.

09/21/2018
Research Article

Effect of spiritual health (Sound Heart) on the other dimensions of health at different levels of prevention

Minoo Asadzandi*

Introduction and goal: From the perspective of Islam, spiritual health means having a Sound Heart (a calm, confident and optimistic soul, with hope for God’s mercy, satisfaction with destiny and vitality). The way to achieve spiritual health is strengthening the faith and taking good deeds based on religious spirituality. This study was conducted with the aim of determining the impact of spiritual health (Sound Heart) on the other aspects of health at different levels of prevention.

Methods: In nine phases of research in 16 years, after designing and validating the “Sound Heart Model”. The spiritual problems of patients and healthy clients were determined. Spiritual care guidelines and the spiritual counseling model in patients and healthy clients were designed. Then “Parent’s Spiritual Empowerment Program”, “inter-professional spiritual health care training program” was extracted. Based on the findings of the previous steps, the effect of spiritual health on other aspects of health at different levels of prevention was extracted.

Findings: Belief in God and divine love creates spiritual health (Sound heart) with wisdom, chastity, courage, justice, dignity, kindness, and sincerity in action. Faith prevents neglecting from the God’s remembrance and its consequences such as: unhealthy lifestyle, risky behaviors, destructive excitements, psychosocial diseases in clients and eliminates the fear, anxiety, sadness and disappointment in patients. Spiritual health causes living in the present time with patience and grace of God, creates hope, optimism for the future, courage to face life crises. By creating mental health, it improves the psycho-neuron-immunologic function and improves physical health.

Conclusion: Considering the great impact of spiritual health on the other aspects of health at all levels of prevention, it is imperative that students and health care staff, by referring to these concepts, carry out spiritual care/counseling.

09/21/2018
Opinion

Medical bioethics vs. Medical ethics*

Jose Ma Barrio Maestre*

The current situation of bioethics illustrates what has become known as “the anthropological halt”, described with great lucidity by C. S. Lewis in his book The Abolition of Man as the neglect of the “Tao”, a not very extensive body of basic axioms which enable the overall integrity of reason, both in theory and practice.

09/20/2018
Research Article

Sounding procedure for characterization of big fusion reactor chambers by means of a compact neutron source with a nanosecond pulse duration

Gribkov VA, Bienkowska B, Jednorog S, Paduch M, Tomaszewski K

In the paper a methodology that is elaborated for characterization of big-sized chambers of modern and future nuclear fusion reactors is described. It gives an opportunity to define distortions introduced by surroundings, systems and elements of the chamber into the neutron field generated during the reactors’ operation. The procedure is based on two types of experimental techniques supported by MCNP numerical modelling. These two classes are: 1) the neutron activation methods for measuring changes in anisotropy of the “absolute” neutron yields, and 2) the time-of-flight process for determination of neutron spectra deformations. MCNP calculations afterwards give an opportunity to fix just those elements of the surroundings that introduce the main impact in the perturbed neutron field characteristics.

09/17/2018
Case Report

Successful management of disseminated Fusarium infection in a patient with acute myeloid leukemia

AlShammasi S, AlNujaidi D, Bakhit K, Algarni A and AlAnazi KA*

Background: Invasive fungal infections cause significant morbidity and mortality in patients with hematologic malignancies and in recipients of hematopoietic stem cell transplantation.

Case: We report a patient with relapsed acute myeloid leukemia who developed disseminated Fusarium infection during the neutropenic period following the salvage cycle of chemotherapy given at King Fahad specialist Hospital in Dammam, Saudi Arabia. The invasive fungal infection was successfully managed with a combination of voriconazole and liposomal amphotericin-B.

Discussion: Fusarium species can cause invasive infections that may become disseminated and life-threatening in patients with acute myeloid leukemia.

Conclusion: Combined antifungal therapy and recovery of neutrophil count are essential to control invasive Fusarium infections

 
Conclusion: Combined antifungal therapy and recovery of neutrophil count are essential to control invasive Fusarium infections
 
Conclusion: Combined antifungal therapy and recovery of neutrophil count are essential to control invasive Fusarium infections

09/13/2018
Review Article

Diagnosis of Asthma in Childhood Age

Ibrahim A Ali*, Elia Adil Nabih and Ahmed MS Eltohami

Background: Asthma is the most common chronic respiratory disorder in childhood. Asthmatic attacks are described and classified according to the type of wheezing to Non –atopic and Atopic asthma (IgE mediated wheezing). The aim of this review is to determine the onset of clinical diagnosis in relation to clinical presentation of asthma in children and obstacles related to delay of Asthma diagnosis.

Methods: This review highlights the results of studies done regarding clinical diagnosis in relation to clinical presentation and of asthma in children. An extensive search has been conducted for researches about asthma in children. This search based on the publications posted on the National Center for Biotechnology Information PubMed or by Google Scholar. Key words used for the research: Asthma, clinical diagnosis, children.

Results and Conclusion: Diagnosing asthma in young children is difficult because children often cough and wheeze with colds and chest infections, but this is not necessarily asthma. Miss diagnosis of asthma in children occurs when physicians diagnose patients with asthma from the clinical diagnosis in the first attack without excluding other asthma mimickers which can be any other respiratory problem. There is over-diagnosis of asthma due to the symptoms which mimic other respiratory infections. First episodes of cough, runny nose and fever that happen in cold/flu season- fall/winter/early spring is likely not asthma. If the child has several more episodes of wheeze and cough, it is likely to be asthma. Since there is no diagnostic test available for children younger than 6 years of age, making a diagnosis in this age group is more difficult than in older children. Over the age of about 6 years it is possible for a child to have a spirometer test.

09/13/2018
Research Article

Comparison of Efficacy and Safety of Hydroxychloroquine and Teneligliptin in Type 2 Diabetes Patients who are Inadequately Controlled with Glimepiride, Metformin and Insulin therapy: A Randomized Controlled Trial with Parallel Group Design

Prakash Ranjan, Sajjad Ahsan*, Rabi Bhushan, Bipin Kumar, Tushar, Anup Kumar Gupta, Anand Kumar Verma and Mukesh Jain

Aim: The aim of the present study is to assess the efficacy and safety of Hydroxychloroquine in comparison with Teneligliptin in type 2 diabetes patients whose blood glucose levels were inadequately controlled with metformin, Glimepiride and insulin therapy.

09/13/2018
Research Article

Adaptive planning and toxicities of uniform scanning proton therapy for lung Cancer patients

Yuanshui Zheng*, Hardev Singh, Suresh Rana, Gary Larson, Prabhu Kiran, Lucius Doh and James Wong

Purpose: Adaptive planning is often needed in lung cancer proton therapy to account for geometrical variations, such as tumor shrinkage and other anatomical changes.The purpose of this study is to present our findings in adaptive radiotherapy for lung cancer using uniform scanning proton beams, including clinical workflow, adaptation strategies and considerations, and toxicities.

Methods: We analyzed 165 lung patients treated using uniform scanning proton beams at our center. Quality assurance (QA) plans were generated after repeated computerized tomography (CT) scan to evaluate anatomic and dosimetric change during the course of treatment. Plan adaptation was determined mutually by physicists and physicians after QA plan evaluation, based on several clinical and practical considerations including potential clinical benefit and associated cost in plan adaption. Detailed analysis was performed for all patients with a plan adaptation, including the type of anatomy change, at which fraction the adaption was made, and the strategy for adaptation. Toxicities were compared between patients with and without plan adaptation.

Conclusion: Adaptive planning is necessary in proton therapy to account for anatomy change and its effect on proton penetration depth during the course of treatment. It is important to take practical considerations into account and fully understand the limitations of plan adaptation process and tools to make wise decision on adaptive planning. USPT is a safe treatment for lung cancer patients with no Grade 4 toxicity.
 

Results: In total, 32 adaptive plans were made for 31 patients out of 165 patients, with one patient undergoing adaptive planning twice. Anatomy changes leading to plan adaptation included tumor shrinkage (17), pleural effusion (3), patient weight loss (2), and tumor growth or other anatomy change (9). The plan adaptation occurred at the 15th fraction on average and ranged from the 1st to 31st fraction. Strategies of plan adaptation included range change only (18), re-planning with new patient-specific hardware (9), and others (5). Most toxicities were Grade 1 or 2, with dermatitis the highest toxicity rate.

Conclusion: Adaptive planning is necessary in proton therapy to account for anatomy change and its effect on proton penetration depth during the course of treatment. It is important to take practical considerations into account and fully understand the limitations of plan adaptation process and tools to make wise decision on adaptive planning. USPT is a safe treatment for lung cancer patients with no Grade 4 toxicity.

09/13/2018
Historical Vignette

Dr. Saul Hertz Discovers the Medical Uses of Radioiodine (RAI)

Barbara Hertz*

Primary sources document Dr. Saul Hertz (1905 - 1950) as conceiving and developing radioiodine (RAI) as a diagnostic tool and as a therapy for thyroid diseases. Dr. Hertz was the first and foremost person to develop the experimental data on RAI and apply it to the clinical setting.

Saul Hertz was born on April 20,1905 to Jewish parents who had immigrated to Cleveland, Ohio. He received his A.B. from the University of Michigan in 1925 with Phi Beta Kappa honors. After graduating from Harvard Medical School in 1929, at a time of quotas for outsiders, he fulfilled his internship and residency at Cleveland’s Mt. Sinai Hospital.

In 1931, he came back to Boston to join the newly formed Thyroid Unit at The Massachusetts General Hospital serving as the Chief from 1931 - 1943.

09/11/2018
Review Article

Anesthetic considerations for endovascular repair of ruptured abdominal aortic aneurysms

KH Kevin Luk* and Koichiro Nandate

Ruptured abdominal aortic aneurysm (rAAA) carries high morbidity and mortality. Advances in endovascular techniques in the last two decades allow for minimally invasive approach for repair of these aneurysms. A succinct but comprehensive pre-operative is essential for delivery of a safe anesthetic for the patient with rAAA. Placement of proximal occlusion balloon in the descending aorta using the rapid control technique can be life-saving. Endovascular aortic repair (EVAR) can be performed under monitored anesthesia care using local anesthetic and IV sedation, and with fewer invasive lines. However, rapid conversion to general endotracheal anesthesia should be expected. Anesthesiologists should be familiar with the hemodynamic management of rAAA and be ready to provide resuscitation to correct for anemia, coagulopathy, and acidemia. In addition, the anesthesiologist should be aware of the common complications related to EVAR, including abdominal compartment syndrome, distal ischemia, and local vessel injury.

09/11/2018
Research Article

Anti-anxiety effects in mice following acute administration of Ficus Thonningii (wild fig)

Aduema W, Akunneh-Wariso C, Ejiofo DC, Amah AK

The effect of acute administration of ethanol extract of F. thoningii on anxiety and fear in Swiss white mice was studied. 30 adult Swiss white mice of both sexes were randomly divided in to three groups of 10 mice each. Group1 served as the control and was administered normal saline only. Group 2 (low dose group) was administered 10mg/kg ethanol extract of the F. thoningii, while group 3 (high dose group) was given 20mg/kg of the same extract. All animals were allowed food and water ad libitum. Neurobehavioral parameter was assessed using the light/dark transition box. The analysis of variance (ANOVA) was used to test for variability within and among groups. Results were expressed as Mean ±SEM (standard error of the mean) and probability level p<0.05 was accepted as significant. The result showed that the frequency of transition in the light/dark transition box was significantly increased in the test groups (p<0.05; p<0.01).Similarly, the Light Box Duration was also significantly increased (p<0.01) in the low and high dose groups respectively. However, the Dark box duration was significantly decreased (p<0.05; p<0.01) in the low and high dose groups compared to control. This index showed a decreased level of anxiety and fear in the test groups. This was followed by a corresponding trend of decreased frequency of stretch attend posture and duration of freezing in the light/dark transition box (p<0.01; p<0.001) compared to the control. Summarily, acute administration of ethanol extract of F. thonningii causes calmness and sedation in moderate and high doses. It is therefore likely that it reduces aggression. If the result from this finding is extrapolated to humans, F. thoningii could be used to reduce anxiety disorders.

09/11/2018
Research Article

Evaluation of unexplained clinical features of hepatic diseases through biopsies among hospitalized children: A cross-sectional study in Lahore, Pakistan

Ibtasam Ahmad, Muhammad Haris, Amnah Javed and Muhammad Azhar*

Objectives: There are variations in therapeutic regimens of different liver diseases. The accurate diagnosis ensures prompt recovery from these diseases. The present study aimed to evaluate the underlying causes of unexplained signs and symptoms associated with liver diseases through biopsies.

Methods: A retrospective study was conducted in a public child care specialty of Lahore, Pakistan. The data was collected from medical records of the patients who were index hospitalized with unexplained clinical presentation of liver disease between 1st July, 2017 and 31st December, 2017. Data were analyzed by using Statistical Packages for Social Sciences (IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.), and Microsoft Excel (MS Office 2010).

Results: Overall, the records of 53 patients were selected for the study. Most of them were 11 to 15 years of age. The patients were presented with unexplained hepatomegaly (60.4%) and jaundice (40.7%) during index hospitalization which made them eligible for liver biopsy (LB). The findings of LB revealed that the underlying causes of liver diseases in most of the cases were metabolic (33.9%) and inflammatory disorders (22.6%). Majority of the patients were ≤4 years of age, however cryptogenic cirrhosis (39.1%) was commonly found in >10 years of age. Although most of the patients were suffering from metabolic disorders (p-value=0.07) and liver cirrhosis (p-value=0.08) but these were not statistically significant.

Conclusions: LB was beneficial in evaluating the etiologies of unexplained signs and symptoms of liver diseases. It was found that glycogen storage diseases and liver cirrhosis were the most common etiologies of liver diseases among pediatric patients. But etiologies like metabolic and inflammatory diseases were insignificantly associated with gender.

09/03/2018
Research Article

The failure to provide an effective veterinary service to sheep in Australia

Maxwell JAL

Sheep are not native to Australia and were originally imported; 44 sheep were among the animals transported from Great Britain to the penal colony established on the east coast of Terra Australis in January 1788 http://firstfleetfelowshp.org.au.

The Australian Merino…comprised one of the greatest creative expressions of domestic animal species by and for mankind…one of the greatest contributions to the world economy [1].

These original sheep were for human provisions and consisted of fat-tailed native sheep from the Cape of Good Hope, but the primary source of sheep for the first three or four decades of Australia’s history were from Bengal, the closest British colony to Australia.

 
 
 
The following brief account of the history of wool in Australia is taken from “The Australian Merino” which began;

09/04/2018
Review Article

Women’s Mental Health and Mental retardation

Sharadha Ramesh*

Mental illness is associated with a significant burden of morbidity and disability. Lifetime prevalence rates for any kind of psychological disorder are higher than previously thought, are increasing in recent cohorts and affect nearly half of the population.

09/04/2018
Research Article

Chromium Isotopes Detection in their Ores with Minimal Errors

Loai Aljerf* and Nuha AlMasri

The industrial production and use of chromium have grown considerably during the past five decades. Abundances of the chromium isotopes in terrestrial samples are identical to 0.01%. Among the dominant species of chromium, the trivalent form widely occurs in nature in chromite ores which is extremely immobilized especially in water bodies. Samples were mixtures of separated chromium isotopes and the calibration was made with the same species as those used in the measurements. The method had simplified the conversion of the ores to chromyl fluoride since the element could be readily separated as lead chromate from the leaching of chromite-sodium peroxide fusions. Isotope assay of chromyl fluoride under certain conditions was measured and the measurements of chromium isotopic anomalies ratios and isotope abundance of the chromite ores have been assessed. These provided sufficient quantitative mass spectrometric data, which were analyzed to calculate the abundance and the mean atomic mass of the questioned isotopes. Based on the high mass spectroscopy stability and the correction factors, the results were of good precision (incl. negligible systematic errors normally associated to inter-laboratory discrepancies) and the Cr isotopes availability (52Cr > 53Cr > 50Cr > 54Cr) was in conjunction with other classical tools such as oxygen isotopes. This paper is important for paleoecological, environmental, archeological, forensic, and nuclear researchers.

09/03/2018
Review Article

A Gateway to Metal Resistance: Bacterial Response to Heavy Metal Toxicity in the Biological Environment

Loai Aljerf* and Nuha AlMasri

Heavy metals and metalloids are dangerous because they have the tendency to bioaccumulate in biological organisms over a period of time. However, it is conceived that a number of phytochemical agents as well microorganism can act as heavy metal removing agent both from human beings and the environment surrounding. For instance, microbes are used for the removal of heavy metals from the water bodies including bacteria, fungi, algae and yeast. This review shows that bacteria can play an important role in understanding the uptake and potential removal behaviour of heavy metal ions. The bacteria are chosen based on their resistance to heavy metals (incl. their toxicities) and capacity of adsorbing them. Due to specific resistance transfer factors, cell impermeability is drastically inhibited by several ion (i.e. mercury, cadmium, cobalt, copper, arsenic) forms. Between these elements, free-ion cadmium and copper concentrations in the biological medium provide more accurate determination of metal concentrations that affect the bacteria, than with most of the other existing media. Metal toxicity is usually assessed by using appropriate metal ion chelators and adjusting pH factor. Bacteria and metals in the ecosystem can form synergistic or antagonistic relationships, supplying each other with nutrients or energy sources, or producing toxins to reduce growth and competition for limiting nutritional elements. Thus, this relation may present a more sustainable approach for the restoration of contaminated sources.

09/12/2018
Case Report

A case report of Hypocomplementemic urticarial vasculitic syndrome presenting with Renal failure

Amy M Hopkins, Angela M Gibbs, Ryan S Griffiths, Rupali S Avasare and Firas G Khoury*

We present a case of hypocomplementemic urticarial vasculitic syndrome (HUVS) who developed severe renal failure requiring ICU-level care. Our patient is a 66-year-old man who presented with abdominal pain, rash, confusion, oliguria, and shortness of breath. He was found to be in acute renal failure with leukocytosis and elevated lactate. Work-up for infectious, autoimmune, and hematologic malignant diseases was negative. The presence of chronic urticaria, abdominal pain, hypocomplementemia, and leukocytoclastic vasculitis on skin biopsy confirmed the diagnosis of HUVS. He required hemodialysis for renal failure as well as gastrostomy tube placement for nutritional support secondary to the development of mucosal ulcers, a rare finding in HUVS. He recovered with several months of high-dose steroids and hemodialysis. This case highlights the effectiveness of steroids for initial treatment of HUVS, and the relapsing and remitting nature of the disease. Providers should also be aware of the broad range of presenting symptoms such as mucosal lesions that may require nutritional support. Interestingly, unlike many previously reported cases of HUVS, our patient had not yet developed signs and symptoms of systemic lupus erythematosus, which often overlaps with HUVS.

09/11/2018
Research Article

Effects of KCl (rpm/Heat) on Bacterial Protease Production in E. coli, P. aeruginosa and E. faecalis

Canan Cennet Karaderi and Huseyin Kahraman*

Background: Proteases are a group of enzymes that catalyze the cleavage of peptide bonds in proteins found in nature. Microbial protease constitutes one of the most important for industrial aplications. Proteases play a crucial role in numerous pathologic processes as well. KCl is an unnatural salt. The purpose of this study was to examine the effect of this salt on protease production under different agitation and heat conditions.

Methods: The effects of KCl (rpm/heat) on the production of a protease, of E. coli, P. aeruginosa and E. faecalis strain, were investigated. The decrease in protease production at 37 °C was also observed in this work that proved that heat plays a major role in enzyme production.

Results: The presence of KCl also caused a decrease in protease production in three bacterial species. The use of KCl appears to be a viable alternative when it is necessary to reduce protease activity outside of industrial applications (such as health care). This unique property makes it attractive and useful to be used in health industries. In the future we think that it will contribute to clarification of the matter in this way.