08/27/2019
Research Article

The place of health innovation in space to improve the lives of earthlings

Brigitte Godard

For over twenty years, following the creation of space stations, MIR first and then the ISS (International Space Station) men (3 to 6) live and succeed each other continuously about 300 - 400 km of altitude to make scientific experiments. For this reason sending men into space has become an activity “almost banal or regular “but this remains potentially a very dangerous environment for the adapted manon Earth and thus requires medical monitoring to ensure the health of astronauts and the persistence of their ability during their mission. In general, the medical benefits on Earth of space conquest go far beyond envy and the need for man to discover the cosmos but to develop many tools medicines to also offer solutions for all living beings on Earth!

08/27/2019
Research Article

Evaluating cortical bone porosity using Hr-Pqct

Rique AM, Madeira M, Luis L, Fleius MLde F, Paranhos NF and Lima I*

This work aims to evaluate cortical porosity through a high-resolution peripheral quantitative micro-tomography in a group of 47 patients. All patients, in vivo, were subjected to the medical care protocol of the University Hospital Clementino Fraga, 020-213. Patients were women aged from 37 to 82 years old, who did not present fractures in their lower and upper limbs, all of them showing good health. During screening, they were required to have normal BMD (as determined by DXA; T-score ≥ 1.0) and no low-trauma fractures history. The exclusion criteria for all the individuals enrolled in this control study include, for example, alcoholism, chronic drug use, and chronic gastrointestinal disease. Male patients ranging from 42 to 79 years old presented the same health issues as women group. Results showed an increase in the amount of pores on the cortical bone of the evaluated patients over time; however, this increase was also observed in pore diameter, as well as a decrease in the border between the cortical and trabecular bone, indicating a deterioration in cortical bone quality over the years.

08/22/2019
Review Article

Management of Ischemic Stroke during cardiac catheterization: A case report and review of literature

Naoufal Chouaib*, Said Jidane, Mounir Lekhlit, Ahmed Belkouch, Tahir Nebhani, Saad Zidouh and Lahcen Belyamani

Stroke following coronary interventions is a devastating and most dreaded complication with signiβicant morbidity and mortality. Various factors have been ascribed for this complication including the technical errors [1]. A small percentage of strokes are iatrogenic, including those associated with invasive cardiac procedures. According to the literature, it is a rare complication of left heart catheterization [2]. Percutaneous coronary intervention is increasingly used to treat patients with diffuse atherosclerosis, acute coronary syndromes and even high-risk patients such as low ejection fraction [1]. The authors describe a patient who underwent percutaneous coronary intervention in the context of inferior infarction, which was complicated by ischemic stroke during cardic catheterization.

08/21/2019
Research Article

Risk factors of survival in breast cancer

Akram Yazdani*

Background: In this study, we aimed to investigate the role of prognostic factors on breast cancer survival in Iran.

Methods: This study was carried out using data from 500 participants with breast cancer. Data were gathered from medical records of patients referring to four breast cancer research centers in Esfahan, Iran, between 1990 – 2000. Age at diagnosis (year), size of tumor, Involve lymph nodes, tumor grade, and family history and married were the prognosis factors considered in this study. A Cox model was used.

Results: The median follow-up period was 29.71 months with the interquartile range of 19-61 months. During the follow-up period, 57 (10%) patients died from breast. The Cox model showed that number of lymph nodes involved, and the tumor size and grade tumor are the prognostic factors survival in breast cancer.

Conclusion: This study, confirmed the importance of early diagnosis of cancer before the involvement of lymph nodes and timely treatment could lead to longer life and increased quality of life for patients.

08/22/2019
Case Report

Unilateral retinitis pigmentosa: Case report and review of the literature

Denise Goodwin*, Amanda M Olsen and Karl Citek

Significance: Due to the limited number of reported cases little is known about the characteristics of unilateral retinitis pigmentosa. Information from additional case reports can aid in learning more about the condition. We report a case of retinitis pigmentosa that has remained unilateral for 28 years and review the available literature.

Case Report: A 40-year-old Caucasian female presented for an opinion as to the cause of her vision loss. Fundus autofluorescence demonstrated hypoautofluorescence in the midperipheral retina and a hyperautofluorescent ring surrounding the area of preserved photoreceptors in the macula. Optical coherence tomography showed disruption of the ellipsoid zone and the external limiting membrane. Electroretinography (ERG) showed severely reduced rod and cone function monocularly.

Discussion: Retinitis pigmentosa is typically bilateral and symmetric. Unilateral retinitis pigmentosa is a rare condition that manifests with only one eye having changes typical of retinitis pigmentosa. The unaffected eye can have no signs of retinitis pigmentosa and must have a normal ERG after long-term follow up. It is critical to rule out inflammatory, traumatic, toxic, and cancer associated retinopathy that can present with retinal pigmentary changes. Unilateral retinitis pigmentosa generally remains unilateral, but long-term follow up with ERG is important. There is currently no treatment that can stop the process of retinitis pigmentosa, but gene therapy shows promise.

08/26/2019
Case Report

Carotid artery disease: AngioCT features

Joana Ferreira*, Olinda Miranda, Alexandre Lima Carneiro, Sandrina Braga, Joao Correia Simoes, Celso Carrilho, Amílcar Mesquita and Jorge Cotter

The objective of this paper is to emphasis the AngioCT features of carotid dissection/mural hematoma. The image show an internal carotid artery with narrowly eccentric lumen surrounded by a crescent-shaped hypodense mural thickening, with a visibly enhancing vessel wall. The carotid hematoma is a hypodense mural thickening that leads to expansion of the arterial wall, compression of the lumen and release of thrombogenic factors by intimal damage. Hematoma between the intima and media causes vessel expansion diameter and a narrow eccentric lumen. Peripheral hyper density is due to the contrast enhancement of the vasa vasorum in the adventitial layer. The physician should be familiar with the imagiologic features of carotid arterial disease, due to the diferent treatment options.

08/28/2019
Case Report

The Pierre Marie-Sainton syndrome: Report of a family

Salem Y*, Omar Y, Dorsaf S, Sonia M, Samir B and Olfa B

Pierre Maria and Sainton syndrome or cleido-cranial dysplasia (CCD) is a rare syndrome presenting an autosomal pattern of inheritance, characterized by characterized by a triad: clavicular aplasia, delayed ossification of the fontanelles and sutures of the vault of the skull. To these may be added multiple dental inclusions.

08/26/2019
Research Article

Gender and left ventricular structural and functional differences in pulmonary hypertension among end stage renal disease patients on maintenance hemodialysis

Umar Malik, Ihab Ajaaj, Jon P Blaschke, Betty Skipper, Sandra L McClelland, Kathleen Fagan, Antonia M Harford, Philip G Zager and Veena Raizada*

Introduction: Pulmonary hypertension (PH) is prevalent in hemodialysis (HD). In the general population, more women than men have PH due to left ventricular (LV) disease with preserved ejection fraction (EF). Little is known about the gender-specific prevalence of PH and associated LV abnormalities in patients with end stage renal disease (ESRD) on HD. Our aim was to evaluate gender differences and LV structural and functional changes in PH among ESRD patients on HD.

Methods: Ninety-four patients (ages 23-77 years) underwent echocardiography after HD. Patients were divided based on estimated pulmonary artery systolic pressure (PASP) (Group A PASP < 40 mm Hg, Group B PASP ≥ 40 mm Hg). LV measurements included LV mass, LV internal dimensions, and LV ejection fraction (EF). LV diastolic function (LVDF) was assessed from mitral inflow deceleration time (DT) and E/A ratio.

Results: Fifty-five patients (59%) had PH, including 32 of 49 men (65%) and 23 of 45 women (51%). LVEF was lower in Group B (46.4 ± 17.6 vs. 62.4 ± 14.4%, p < 0.001). Men with PH had higher LVIDd, cm (5.52 ± 0.89 vs 4.78 ± 0.75, p < 0.001), LVIDs, cm (3.75 ± 0.94 vs 3.14 ± 0.91, p = 0.03) LV mass, g (236 ± 74vs 189 ± 56, p = 0.02) and lower LVEF (40.0 ± 16.7 vs 52.0 ± 15.6, p = 0.008) than women.

Conclusion: Patients on HD have a high prevalence of PH. PH was not associated with clear LV structural changes. There was a depression in LV systolic function without changes in LVDF. PH patients were more often men with hypertrophied LV with depressed LV systolic function.

08/20/2019
Research Article

Colour keys to emotion in management of children and intellectual distraction using coloured games in dental environment for children

Rajakumar S*, Kavitha Ramar and Revanth MP

Aim and objective: Dentistry for children is not difficult but is different from what is practiced for adults. The children reacts to differently to people and places around them. Anxiety is an emotional state that helps normal individual defend themselves against a variety of threats and
Dental anxiety refers to patients specific response towards dental suitation-associated stress. So the aim is to evaluate the anxiety related management of the children using intellectual mind game of the individual.

Study design: The background of the study is to evaluate and study the effectiveness of anxiety control of children using colour distraction between 5 and 12 yrs of age group as one part and the intellectual distraction of children between the same age group using buchanan facial imaging scale and intellectual coloured game chart

Results and conclusion: lowering of anxiety was noticed in the children obtained the favorite colours in the dental environment and easy distraction can be achieved using intellectual gamings.

08/22/2019
Research Article

Role of novel cardiac biomarkers for the diagnosis, risk stratifi cation, and prognostication among patients with heart failure

Jennifer Miao, Joel Estis, Yan Ru Su, John A Todd and Daniel J Lenihan*

Background: Current guidelines for diagnosis and management of heart failure (HF) rely on clinical findings and natriuretic peptide values, but evidence suggests that recently identified cardiac biomarkers may aid in early detection of HF and improve risk stratification. The aim of this study was to assess the diagnostic and prognostic utility of multiple biomarkers in patients with HF and left ventricular systolic dysfunction (LVSD).

Methods: High-sensitivity cardiac troponin I (cTnI), N-terminal pro b-type natriuretic peptide (NT-proBNP), interleukin-6 (IL-6), endothelin-1 (ET-1), pro-matrix metalloproteinase-9 (pMMP-9), and tumor necrosis factor-alpha (TNF-α) were measured using single-molecule counting technology in 200 patients with varying stages of HF. Plasma detection with cross-sectional associations of biomarkers across all HF stages, and advanced-therapy and transplant-free survival were assessed using multivariate analysis and Cox regression analyses, respectively.

Results: NTproBNP, pMMP-9, IL-6 were elevated in early, asymptomatic stages of HF, and increased with HF severity. Higher circulating levels of combined IL-6, NTproBNP, and cTnI predicted significantly worse survival at 1500-day follow-up. Cox regression analysis adjusted for ACC/AHA HF stages demonstrated that a higher concentration of IL-6 and cTnI conferred greater risks in terms of time to death, implantation of left ventricular assist device (LVAD), or heart transplantation.

Conclusion: Biomarkers of inflammation, LV remodeling, and myocardial injury were elevated in HF and increased with HF severity. Patients had a significantly higher risk of serious cardiac events if multiple biomarkers were elevated. These findings support measuring NTproBNP, cTnI and IL-6 among patients with HF and LVSD for diagnostic and prognostic purposes.

08/19/2019
Case Report

Late discover of a traumatic cardiac injury: Case report

Benlafqih C, Bouhdadi H*, Bakkali A, Rhissassi J, Sayah R and Laaroussi M

Blunt chest trauma leads to a wide range of lesions, relatively minor parietal injuries to potentially fatal cardiac lesions, making diagnosis and management difficult. The diagnosis is currently facilitated by imaging, however, these lesions may go unnoticed and be discovered late through complications.

We report the case of a neglected heart wound revealed by a heart failure. This case is notable due to a favourable outcome despite a delay in diagnosis due to a lack of pericardial effusion and the absence of cardiac symptoms, and a long delay from injury to appropriate treatment in the presence of a penetrating cardiac wound deep enough to cause a muscular ventricular septal defect and lacerate the anterior mitral leaflet.

08/28/2019
Review Article

Biologic therapy in severe asthma: An update

Maha A Al Ammari*

Asthma is a chronic inflammatory disease of the airways characterized by airway inflammation, bronchial hyperresponsiveness, reversible airflow obstruction and recurrent symptoms. Patients often present with coughing, wheezing, dyspnea, and chest tightness, were they usually responds to the mainstay of treatment that relies on inhaled glucocorticoids (ICS), and long acting β2 agonist (LABA), along with leukotriene. In around 20% of the patient’s morbidity, mortality and cost of therapy increased because they fail to benefit from the existing gold standard therapy regimen. Both immunoglobulin-E (IgE), interlukin-5 (IL-5) had proven to play important major role in asthma pathogenesis. Over the past two decades biologic therapy that targeting IgE begins the era in treating severe asthma, and recently anti-IL-5, revealed major role in eosinophils maturation, activation, survival, and recruitment process of severe asthma. The different biologic therapy that is currently available in the market are supported by solid evidence from controlled randomized clinical trials, to guide the clinician on the type of patients that will benefit from the therapy, with an insight on the appropriate monitoring parameters and patient evaluation plans. This review was conducted by searching PubMed, EMBASE, and Google Scholar to identify peer-reviewed clinical trials, guidelines, and review articles published in English in the role of biologic therapy in severe asthma. The main aim from publishing this review is to summarize the current available evidence on the approved biologic therapy in treating patients with severe asthma.

08/16/2019
Letter to the Editor

Serum MicroRNA-155 in Acute Graft-Versus-Host-Disease (aGVHD)

Yvonne A Efebera*, Amy S Ruppert, Apollinaire Ngankeu, Sabrina Garman, Prasanthi Kumchala, Alan Howard, Steven M Devine, Parvathi Ranganathan and Ramiro Garzon

Allogeneic hematopoietic stem cell transplant (alloHSCT) is a curative treatment for many hematologic malignancies. Unfortunately, about  30-50% of all recipients undergoing alloHSCT develop acute graft-versus-host-disease (aGVHD), which is associated with high morbidity and mortality [1,2].Treatment of aGVHD involves the use of immune suppressive drugs such as high dose of steroids that leads to further immunosuppression and risk for opportunistic infections. Often patients are refractory to steroids therapy making the prognosis dismal. Thus, it is critical to identify robust biomarkers to detect aGVHD before onset of clinical symptoms so that therapeutic strategies can be implemented that may result in better treatment responses and less toxicity.

08/15/2019
Research Article

Discovering the right treatments for diabetes (2), blood’s pressure, and relating diseases

Alaa Hussein Al-Darraji*

For last decades diabetes type 2, blood’s pressure (especially hypertension) and relating diseases are most serious problems for much people over the world. These diseases are not like other different diseases then for studying them very accuracy, this research choose sample from different societies a small city called “Al-Mejar Al-Kabeer” in south of Iraq. People of this city do same activities than other Iraqi cities and during the last twenty years the only change happened in this city is; they changed them drinking water from tap water to commercial water called it R.O. Population of this city is about 70000 persons and about 20000 from them have diabetes that means more than 28% from all people of this city have this disease, this ratio or may be more for hypertension. 

Results of this research show that the main reason for diabetes type 2, blood’s pressure and relating diseases is civilization. It shows according good evidences that the right treatment for diabetes, hypertension and relating diseases is about 5g/day potassium ions (K+) with less amounts from sodium ions such as 2:1. In fact, insulin forming from known amino acids so each body need sufficient amounts from these acids therefore the right treatment for diabetes type 2 is not only potassium it must there sufficient amounts from proteins each day or each three days.

References of this research indicated; Diabetes and hypertension are well understood but this research find that these diseases need a chemist touch to be fully understood.

08/13/2019
Research Article

Validation of the Omron HBP-9031C blood pressure monitor for clinics and hospitals according to the ANSI/AAMI/ISO 81060-2:2013 protocol

Kanako Saito, Yukiko Hishiki and Hakuo Takahashi*

Objective: The present study aimed to evaluate the accuracy of the Omron HBP-9031C automated oscillometric upper-arm blood pressure (BP) measurement device for blood pressure monitoring, according to the ANSI/AAMI/ISO 81060-2:2013 protocol (ANSI/AAMI/ISO).

Participants and Method: The device evaluations were performed in 85 participants, who fulfilled the inclusion criteria of the protocol. The validation procedure and data analysis followed the protocol precisely.

Results: In the ANSI/AAMI/ISO 81060-2-2013 validation procedure (criterion 1), the mean ± SD of the differences between the test device and reference BP was 0.5 ± 7.84/-1.9 ± 6.30 mmHg (systolic/diastolic). The mean differences between the two observers and the Omron HBP-9031C were 0.5 ± 6.69 mmHg (range, −18 to 15 mmHg) for systolic BP and -1.9 ± 5.63 mmHg (range, −17 to 14 mmHg) for diastolic BP, according to criterion 2. The two criteria of the ANSI/AAMI/ISO were fulfilled.

Conclusion: The professional OMRON BP monitor, HBP-9031C fulfilled the requirements of the ANSI/AAMI/ISO validation standard and can be recommended for clinical use.

08/13/2019
Research Article

Assessment of the effect of cigarette smoking on the different denture base material

Ashish Pandey*, Neeraja B, Himanshu Joshi, Deepti Upadhyay and Sonam Pandey

Background: The present study was conducted to assess effect of cigarette smoking on different denture base material.

Materials & Methods: The present study was conducted in the department of Prosthodontics. A total of sixty wax specimens in the shape of circular discs were prepared. These were divided into two groups. Group I (30) specimens were heat‑cured denture base materials and group II (30) specimens were flexible denture base materials. Both specimens were further divided into four subgroups of 15 each. Subgroup I was heat‑cured denture base material specimens (control group), subgroup II was flexible denture base material specimens (control group), subgroup III was heat‑cured denture base material specimens exposed to cigarette smoking (study group) and subgroup IV was flexible denture base material specimens exposed to cigarette smoking (study group). The initial (IRa) and final (FRa) surface roughness was measured before and after smoking test of the specimens.

Results: It was observed that in group I, mean IR (µm) value was 0.182 and FR value was 0.572. In group II, mean IR (µm) value was 0.265 and FR value was 0.831. In group III, mean IR (µm) value was 0.195 and FR value was 1.892. In group IV, mean IR (µm) value was 0.291 and FR value was 1.892. The difference was significant (P< 0.05).

Conclusion: The surface roughness of the specimens fabricated from the flexible denture base material was found to be more compared to heat‑cured denture base specimens after exposure to cigarette smoke. There is need to educate the patients regarding cleanliness of denture to avoid infection in the oral cavity.

 
 
Results: It was observed that in group I, mean IR (µm) value was 0.182 and FR value was 0.572. In group II, mean IR (µm) value was 0.265 and FR value was 0.831. In group III, mean IR (µm) value was 0.195 and FR value was 1.892. In group IV, mean IR (µm) value was 0.291 and FR value was 1.892. The difference was significant (P< 0.05).
 
Conclusion: The surface roughness of the specimens fabricated from the flexible denture base material was found to be more compared to heat‑cured denture base specimens after exposure to cigarette smoke. There is need to educate the patients regarding cleanliness of denture to avoid infection in the oral cavity.

08/12/2019
Research Article

Wound architectural analysis of 1.8mm microincision cataract surgery using spectral domain OCT

Benedito Antonio de Sousa, Anderson Teixeira*, Camila Salaroli, Nonato Souza and Lucy Gomes

Purpose: Analyze Microincision Cataract surgery wound using Fourier-Domain optical coherence tomography.

Setting: Medical School of Medicine, Catholic University of Brasilia, Brasília, Brazil.

Design: Prospective comparative observational study.

Methods: Forty eyes were included in this prospective study divided in two groups: with contact lens (CL) and without contact lens (WCL). A line scan pattern of the corneal incisions were acquired using a Spectral domain OCT system immediately after the surgery, and at postoperative days 1, 7 and 30. Incisions were analyzed regarding length, location, angle, architecture, and anatomic imperfections.

Results: All incisions were located temporal or nasal superiorly. The average wound length was 1.28 + 0.18mm and the mean incision angle was 49 + 9 degrees. The average wound length of the WCL group mean was 1.24 + 0.17 mm and the mean incision angle was 51 + 8 degrees. Comparing groups for the length and the angle, the incisions measurements were not statistically significant. Anatomic imperfections were observed at the first day postoperative in 12 eyes for CL group and in 13 eyes for the WCL group. No patient presented endophthalmitis during the follow-up.

Conclusion: Epithelial imperfection was observed in two patients in the WCL group with spontaneous resolution. The CL group had the highest length and lowest angle of corneal incision. Using contact lens to prevent wound construction imperfection appears not to be a good option. Further studies using a greater number of patients with an architectural analysis of clear corneal incisions are needed to confirm these preliminary results.

08/09/2019
Review Article

Timing of cardiac surgery and other intervention among children with congenital heart disease: A review article

Chinawa JM*, Adiele KD, Ujunwa FA, Onukwuli VO, Arodiwe I, Chinawa AT, Obidike EO and Chukwu BF

Background: Early diagnosis and improved facilities are necessary for determining the optimal timing of surgery and other interventions in children with congenital heart diseases in Nigeria. This is because late presentation, late diagnosis and delayed surgery can lead to mortality and affect the quality of life among these children.

Objectives: This review article is aimed at enumerating the timing of cardiac surgeries and other interventions and to seek if there is any factor associated with the timing of cardiac surgery.

Methods: A search on PubMed database, World Health Organization libraries, Google scholar, TRIP database, and reference lists of selected articles on timing of cardiac surgery in children was done. The Cochrane Database of Systematic Reviews was also searched. We noted few data from African setting. Key words such as timing of cardiac surgery; children, congenital heart defect were used.

Conclusion: Appropriate timing for cardiac surgery in children with congenital heart disease is very important as late surgical intervention could result in several morbidities and mortality.

08/16/2019
Research Article

Comparison of selected lower limb biomechanical variables between university of ibadan sportsmen with and without patellofemoral pain syndrome

Ayodeji Ayodele Fabunmi* and Samson Oluwaseyi Oladipupo

Patellofemoral pain syndrome is common among athletes who participate in jumping, running and pivoting sports. The aim of this study was to compare selected lower limb biomechanical variables between University of Ibadan students (athletes) with and without patellofemoral pain syndrome.

The research design for this study was a case control survey and a purposive sampling technique was used to recruit participants. Two hundred and twenty two (191(85.8%) males and 31 (14.2%) females) sportsmen participated in this study. The participants’ age was between 20-29 years. Fourty sportsmen tested positive to Clarke’s test while 27 sportsmen tested positive to Eccentric step test. Measurements of static quadriceps angle, hamstring tightness and navicular height were taken for all participants.

Data were analyzed using descriptive statistics of mean, standard deviation, percentages and inferential statistics of Independent ‘t’ test.

The mean lower limb biomechanical variables of participants with patellofemoral pain syndrome were 13.18 ± 2.37°, 106.46 ± 16.11° and 1.21 ± 0.61 cm while those without were 13.65 ± 2.46°, 128.95 ± 25.36° and 1.03 ± 0.58 cm for static quadriceps angle, hamstring tightness and navicular height respectively. There was no significant difference (p > 0.05) in selected lower limb biomechanical variables between participants with and without patellofemoral pain syndrome.

In conclusion there was no significant difference in static quadriceps angle, hamstring tightness and ankle pronation between participants with and without patellofemoral pain syndrome. It was recommended that PFPS development is probably multifactorial with other functional disorders of the lower extremity apart from the selected variables.

 

 

08/09/2019
Research Article

Assessment of shoulder pain and somatic dysfunction in young competitive swimmers: Preventive Osteopathic Manipulative Treatment

Fanny Granger, Marion Etevenard, Jean-Pascal Kily and Martin Garet*

Context: Shoulder pain is one of the most frequent reported complaints in intensive competitive swimming. The so-called ‘swimmers’ shoulder’ has been widely explored and has been reported sometimes without specific reference to contributing mechanisms or structures. Somatic dysfunction is defined as an impaired or altered function of related components of the somatic system and may appear in the early stage of pain feeling.

Aim: To evaluate somatic dysfunctions in a group of young competitive swimmers with and without shoulder pain and its relationship with the shoulder’s mobility along with the efficacy of an osteopathic manipulative treatment (OMT) on shoulder’s mobility, pain, and comfort of swimming.

Material and method: 20 competitive swimmers (14.6±1.3 ys; 11.6±2.4 hs.wk-1) were divided into two groups, with and without shoulder pain (SPG / CG). Before and after light touch/OMT, and 1 week later, somatic dysfunctions, shoulder’s range of mobility, pain, and swimming comfort were assessed by 2 independent osteopaths.

Results: Somatic dysfunctions were observed in both groups without significant differences in the number or localization and were independent of severity of pain. In the SPG, pain decreased significantly after OMT (6.1±1.9 vs. 3.9± 1.8; P=0.001) and remained stable 1-week later (P=NS). Shoulder’s mobility was lower on the aching shoulder in the “shoulder pain” group when compared to the control group on flexion and abduction tests but not on extension or adduction tests. Following OMT, only abduction improved when compared to light touch. Comfort in swimming was reported as “better” in both OMT/light touch groups.

Conclusion: There is no difference between light touch and OMT as both decreased pain and increased comfort in swimming but abduction range of motion only improved in the OMT group.

 
 

08/08/2019
Research Article

Relation of Arachnophobia with ABO blood group system

Muhammad Imran Qadir and Sani E Zahra*

In 1901, ABO system of blood groups was determined by Karl Landsteiner. It is present in different organisms like rodents, primates that includes chimpanzees, bonobos etc. The blood groups type in this system depends on some genes that are specific ABO gene. Arachnophobia is the dread of creepy crawlies and different creature like spiders. Individuals suffering from arachnophobia generally feels uneasy in any place where they accept that they could harbour arachnids or their existence for example, webs. 100 samples of blood from volunteers were used for Blood group test. The Blood groups were tested and results were recorded after the test all the used kits were discarded. The results shows that there is no clear cut difference between the arachnophobic males and non-arachnophobic male’s percentages, so no relation found in males. Similarly, in females both phobic and non-phobic ladies have no differences in their result values so, no relation was found. Whereas, in case of arachnophobic males and females comparison no relation was found. So, there is no relationship between ABO blood group system and arachnophobia and there may be a relation between non-phobia and AB+, B+ blood group in males whereas, in females only B+ blood group have relation with non-phobia.

08/07/2019
Case Report

Daub, Discolouration, Pigmentation-Solar Lentigo

Anubha Bajaj

Solar lentigo is defined as an alteration in cutaneous pigment deposition on account of exposure to ultraviolet radiation. Solar lentigo is a benign, pigmented lesion with a characteristic increment in the quantification of pigmented keratinocytes. It can manifest as a dark brown spot on the skin.

08/08/2019
Research Article

Prevalence of ESBL urinary tract infection in children

Galia ZA Awean, Khalil Salameh*, Hala Elmohamed, Hoor Alshmayt and Mohamed Riad Bur Omer

Urinary tract infection (UTI) is one of the extremely popular causes of febrile illness in children, demanding antimicrobial therapy [1]. Overall, 8% of females and 2% of males, experience at least one incident of UTI by seven years of age, and recurrence takes place in up to 30% during a year [2].

Escherichia Coli has been known as the commonest causative organism of the majority of urinary tract infections in children with prevalence ranging from 80-90% [3]. Extended-spectrum beta-lactamases (ESBL) are enzymes produced by Gram-Negative Bacilli (GNB), accountable for fighting against penicillin, cephalosporin and aztreonam [4].

08/08/2019
Review Article

A Belgian program to fight child maltreatment: The “SOS children” teams

Emmanuel de Becker and Sophie Dechene*

Child abuse remains a complex issue affecting individuals, families, groups and society, and one which WHO prevalence figures show as a significant ongoing problem. The nature of the abuse, be it physical, sexual, psychological, or neglect, places the child at high risk of experiencing the multiple sequelae of the trauma. Depending on the child’s country, the disclosure of abuse by the child or a third party will either be moved into criminal justice system or directed to the medico-psycho-social sector.

In 1985, in Belgium, specialist teams were established to evaluate and support situations involving child abuse. More than thirty years later, we considered it opportune to update the parameters that our team has developed based on four reflexive themes. The first discusses the transformation of our society, families and individuals, exploring how each influences the others. The second theme describes the diagnostic process, holding in mind the complexity of any situation. The third theme describes the reasoning behind these teams, considering this as a de-judicialisation of such situations. Finally, we describe the different treatments available. This paper describes the evolution of clinical practice including developments in several aspects that have arisen through handling situations of abuse.

08/06/2019
Research Article

Effectiveness of ethinyl oestradiol /cyproterone acetate and ethinyl oestradiol/ desogestrel with or without low-dose metformin on perceived health-related quality of life in hirsute women with polycystic ovary disease: A randomised, double-blind, placebo-controlled study

Sanjeewani Fonseka*, B Subhani, V Alahakoon, CN Wijeyaratne, IB Gawarammana, NS Kalupahana, N Ratnatunga, S Rosairo and PVR Kumarasiri

Background: Polycystic ovary disease (PCOD) is an endocrine disorder. It leads to menstrual disturbances, infertility, obesity and dermatological manifestations such as hirsutism and acne which leads to impaired health-related quality of life (QOL).

Aims: To evaluate the perceived health related QOL in patients with PCOD treated with ethinyl oestradiol (35µg)/cyproterone acetate (2 mg) (EE/CPA) and ethinyl oestradiol (20 µg)/ desogestrel (0.15mg) (EE/DES) alone and in combination with low-dose metformin.

Methods: A total of 117 patients with PCOD diagnosed according to Rotterdam Consensus Criteria 2003 with a hirsutism score of 8 or more according to modified Ferriman-Gallway Score (mFGS) were randomised to receive one of four drug combinations (arm A – EE/CPA, arm B- EE/DES, arm C- EE/CPA plus metformin, arm D- EE/DES plus metformin). The outcomes assessed were body mass index (BMI), hirsutism (using mFGS) and health-related QOL (Polycystic Ovary Syndrome Health- Related quality of life Questionnaire (PCOSQ) and a Visual Analog Scale (VAS) score) at baseline and 12 months after treatment.

Results: PCOSQ score in relation to the hirsutism, emotions, menstruation, obesity, infertility and VAS score in relation to hirsutism and obesity had improved at the end of 12 months (p< 0.001) in all treatment arms. There was no difference between treatment arms in all measured outcomes at baseline and at the end of 12 months.

Conclusion: Treatment with EE/CPA and EE/DES is associated with an improvement in perceived QOL in patients with PCOD. The addition of low-dose metformin did not have a significant benefit.

08/05/2019
Case Report

Clinical, histopathological and surgical evaluations of persistent oropharyngeal membrane case in a calf

Vehbi Gunes*, Gultekin Atalan, Latife Cakir Bayram, Kemal Varol, Hanifi Erol, Ihsan Keles and Ali C Onmaz

A male, 4 days old and 20 kg Simmental calf was evaluated for regurgitation and hyper salivation since birth. The mother became pregnant by artificial insemination and the pregnancy was the second of the mother. A membrane closed the pharynx and a diverticulum on dorsal of this membrane was seen during oropharyngeal examination through inspection. Membrane was also viewed by endoscopy under general anaesthesia. Larynx and oesophagus were imaged by bronchoscopy through the back side of the membrane. After these applications, it was decided that soft palate adhered firmly to the root of tongue causing congenital atresia. Surgical treatment of oropharyngeal membrane was carried out under general anaesthesia. Firstly, tracheotomy was performed for to ease breathing and membrane removed by electrocautery application. Intensive fluid accumulation and oedema formation at the incision area were detected by endoscopic examination following operation and the calf had severe dyspnoea two days after operation and died due to respiratory insufficiency. At necropsy, severe inflammatory reaction, laryngeal oedema and intensive salivation at the surgical side was determined. Direct imaging techniques should be used to determine in the closed oropharyngeal lumen. Moreover, nasopharyngoscopy should be considered to image larynx and oesophageal way. Present case is the first report with concern to pharyngeal membrane formation together with direct imaging and surgical procedures. Therefore, it was considered that this case report could be useful for colleagues and literatures.

08/02/2019
Case Report

Type II myocardial infarction and latent LVOT obstruction due to Systolic Anterior Motion of mitral valve

Makrides Constantinos*

Left ventricular outflow tract obstruction is a well-recognized feature in hypertrophic cardiomyopathy but can occur in other clinical scenarios when anatomically susceptible heart is subjected to permissive physiological conditions that provoke systolic anterior motion of the mitral valve (SAM): ie, reduced preload, increased inotropic state, and decreased afterload.

This report describes a case of hemodynamically significant latent LVOTO that was associated with hypotension, syncope, acute myocardial ischemic ECG changes, and an increase in cardiac enzymes. (Type II myocardial infarction) in a non HCM patient with excessive anterior mitral valve tissue.

08/02/2019
Research Article

Effect of Khaya Senegalensis Bark and Oil on Post-Harvest Fungal Agents of Groundnut Seeds Rot in Adamawa State, Nigeria

Channya FK*, Asama P and Anjili SM

Standardized method of seed treatment is of prime importance in the production of groundnut. The study was to carry out control trial using bark extract (aqueous and ethanol) and oil (seed) of mahogany (Khaya senegalensis) on seven (7) isolated fungi from two groundnut varieties (peruvian and valencia).The result shows that both mahogany bark and seed extracts are capable of inhibiting mycelial growth of all the isolates. There was no significant variation between the aqueous and ethanol bark extracts in-vitro, however the in-vivo test shows a significant difference between the aqueous and the ethanol bark extract in which the ethanol extract reduced growth of the pathogens more than the aqueous. For all the pathogens except Rhizopus stolonifer there was no growth between 50% to 100% concentration of the Khaya senegalensis oil in-vitro, however in-vivo control at 50% produced scanty to moderate growth for all the pathogens except Rhizopus stolonifer on peruvian, while there was full coverage on the seeds of valencia variety with Aspergillus niger and Rhizopus stolonifer having total coverage though Pseudaiiescheria boydii and Cylindrocarpon lichenicola were effectively inhibited and showed no growth at the 50% and 100%. Further research to focus on the quantifying the chemical constituents and formulation are suggested.

08/07/2019
Research Article

Prognostic implications of vitamin D deficiency in chronic kidney disease

D Martinez-Lopez, D Jover-Rios, P Esteve-Atienzar, J Mendez-Mora, A Mendez-Jover, F Caparros-Hernandez, V Jorda-Climent, C Segui-Perez, M Segui-Perez, C García-Cervera, JM Nunez-Cruz, J Guzman-Martinez, I Hernandez-Isasi, D Bonet-Tur, S Banon-Escandell, J Peris-García, P Roig-Rico, A Perez-Fullana and JM Seguí-Ripoll*

Chronic kidney disease (CKD) is a highly prevalent disease, imposing high mortality rates worldwide, and it is closely related to cardiovascular events. Vitamin D deficiency is very prevalent in patients with CKD from the earliest stages of the disease, and it has been associated with higher mortality. In order to assess the prognostic implications of vitamin D deficiency in CKD, we undertook a literature review, searching different databases in October 2018 for publications related to vitamin D in patients with CKD and hypovitaminosis D, and not on dialysis. The main cause of death in these patients is cardiovascular disease. Vitamin D is one of the first parameters that CKD changes and has an important prognostic role in this entity. Deficient levels in blood are associated with increased cardiovascular risk and survival impacts, independently of cardiovascular disease. Treatment with paricalcitol appears to reduce this risk. However, the evidence analyzed is insufficient to establish an association between vitamin D levels and the progression of kidney disease.

08/01/2019
Research Article

Carbonic Anhydrase I modifies SOD1-induced motor neuron toxicity in Drosophila via ER stress pathway

Deyi Lu, Xiao Peng, Xuejiao Jia, Guiyi Li, Na Tan, Zhen Wei, Xinzhu Fei, Xiaochen Liu, Tatsuhiko Kadowaki and Jian Liu*

Background: Drosophila models of amyotrophic lateral sclerosis (ALS) have been widely used in understanding molecular mechanisms of ALS pathogenesis as well as discovering potential targets for therapeutic drugs. Mutations in the copper/zinc superoxide dismutase (SOD1) cause ALS by gain of toxic functions and induce toxicity in fly motor neurons.

Results: In this study, we have determined that human carbonic anhydrase I (CA1) can alleviate mutant SOD1-induced motor neuron toxicity in the transgenic fly model of ALS. Interestingly, we found that motor neuron expression of CA1 could independently induce locomotion defect as well as decreasing the survival rate. In addition, CA1-induced toxicity in motor neurons is anhydrase activity-dependent. Mechanistically, we identified that both SOD1- and CA1-induced toxicity involve the activation of eIF2α in the ER stress response pathway. Downstream activation of the JNK pathway has also been implicated in the induced toxicity.

Conclusion: Our results have confirmed that SOD1-induced toxicity in fly motor neuron also involves endoplasmic reticulum (ER) stress pathway. More importantly, we have discovered a new cellular role that CA1 plays by antagonizing mutant SOD1-induced toxicity in motor neurons involving the ER stress pathway. Such information can be potentially useful for further understanding disease mechanisms and developing therapeutic targets for ALS.