07/12/2019
Research Article

Nanotechnology to improve the biofouling and corrosion performance of marine paints: from lab experiments to real tests in sea

George Kordas*

Nanocontainers of the type CuO, ZnO and CeMo were developed in the present work and incorporated into commercial paints. The nanocontainers were filled with bromosphaerol (CuO and ZnO), SeaNineTM 211 (CuO and ZnO), and 8Hydroxyquinoline (CeMo). The new resulting paints were tested in the lab and in the sea via painting a fraction of two ships. The outcome of this work is encouraging demonstrating that the new nanotechnology-based paints yield to superior commercial paints that may present a major milestone in the new generation of marine paints.

07/15/2019
Research Article

Research of possibilities of studying the areas of development of erosion of slope lands in Azerbaijan and fight it

Rans Aliev ZH*

The study proved that in gully systems with the largest catchment area ranging from 5.0 to 28.8 km2, the degree of dismemberment of gully systems is small, varies mainly from 1 to 3 km / km2, less often from 3 to 5 km / km2. As can be seen, the average annual growth of ravines is 0.34 ... 7.48 m in length, 0.20 ... 2.48 m in width, 0.10 ... 1.16 m in depth. The intensity of erosion development (ravine, planar, etc.) is mediated by their catchment area. Moreover, the degree of division of individual gully systems here is not dependent on their catchment area, moreover, the greatest dissection is observed in gully systems that have the smallest catchment area, which is associated with the conditions of their location.

07/27/2019
Case Report

A fatal portal vein thrombosis: A case report

M Kechida*, W Ben Yahia and W Mnari

Background: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired hematologic condition which could be revealed by deep venous thrombosis. It could be fatal unless correctly treated.

Case report: We report here the case of a 28 year-old male with no medical history who was admitted to the emergency room for severe abdominal pain. Computerized Tomography angiography (CT) scan revealed portal vein thrombosis. Laboratory findings showed pancytopenia with severe regenerative normocytic anemia resulting in PNH. Because of the lack of Eculizumab, treatment was first based on curative anticoagulation until bone marrow transplant, with no success.

Conclusion: PNH remains a severe disease with bad prognosis unless treated with Eculizumab.

07/29/2019
Review Article

Fifth “dark” force completely change our understanding of the universe

Robert Skopec*

For something that’s literally as old as the universe, dark matter doesn’t get much attention outside scientific circles. Maybe that’s because, other than a short-lived SyFy series and a late-period Randy Newman album, this nebulous star stuff has had a tough time breaking the pop-culture barrier. But the truth is that today, dark matter has never mattered more. Our own Milky Way is embedded in a massive cloud of it, we’re looking for its interactions deep inside the earth, and there are whole galaxies without it. So what is dark matter, anyway? Why can’t scientists get enough of the stuff, even though they can’t actually find it? What deep, dark secrets does it hold? And could it ultimately shape the future of life as we know it?

07/26/2019
Research Article

The effects of a clinical ladder program on professional development and job satisfaction of acute care nurses

Yolanda A Coleman* and Romy Desai

Nurses play a vital role in acute care hospitals and health care delivery. The purpose of this research study is to identify the nurse’s perception of the Clinical Ladder Program at their hospital and the correlation it has on the nurse’s job satisfaction and their professional development.A quantitative study will be conducted using two convenience samples from Alexian Brothers Hospital and Saint Anthony’s hospital with a total of 52 nurses who are currently participating in the clinical ladder program. The results of this research should be used as opportunities for improvement within the nursing profession at an acute care hospital. This project is beneficial in advancing nursing knowledge and practice because many nurses do not understand why participating in this advancement program can positively impact many aspects of their role at work aside from being a nurse, such as role and identity development at their workplace. Implementing clinical advancement programs in a facility can also increase quality of patient care delivery by retaining excellent nurses. These nurses can demonstrate their It is important in the field of nursing to actively seek improvement and education in practice to keep up with the new evidence-based research practices that are developed daily. The Clinical Ladder Program has become a widespread program in various acute care hospitals for nurses to increase their professional role development.

07/26/2019
Review Article

Subungual exostosis: Pediatric aspects

Mohamed Anouar Dendane, Achraf El Bakkaly*, Zakaria Alami Hassani and Abdelouahed Amrani

Subungual exostosis (SUE) is a benign phalangeal tumor of an osteocartilaginous nature [1]. SUE is most commonly diagnosed in children and young adults; most of these lesions are located in the big toe, although they can occur (albeit infrequently) in other toes. We report five observations of SUE described in young children under 10 years and discuss the particularities of this pathology in the pediatric population.

07/24/2019
Research Article

Epidemiological Prevalence of Tuberculosis in the State of Maranhão between 2014 and 2016

Pedro Agnel Dias Miranda Neto*, Hortência Biatriz de Melo Santana, Vanessa Maria das Neves, Hermerson Sousa Maia, Thayna Milena Nunes Franca and Rosana Karla Costa

Introduction: Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis (Bacillus of Koch), and presents chronic evolution affecting the lungs frequently.

Objectives: Analyse, in the state of Maranhão, the epidemiological prevalence of tuberculosis between 2014 and 2016.

Materials and Methods: Documentary and descriptive study of secondary data collected in the database of the dates, epidemiological information and morbidities, between 2014 and 2016.

Results: 3,897 cases of tuberculosis in the state of Maranhão were recorded. The most affected age range was 15 to 59 years, totaling 3,111 cases, for both gender; of 60 to 79 years, 577 cases were totaled.

Conclusion: Tuberculosis affects more adolescent males from adolescence to old age, and it is necessary to promote knowledge of the disease for the population in order to advance in the control of the same and obtain satisfactory clinical results.

 
Conclusion: Tuberculosis affects more adolescent males from adolescence to old age, and it is necessary to promote knowledge of the disease for the population in order to advance in the control of the same and obtain satisfactory clinical results.

07/24/2019
Research Article

The New (2018) European Hypertension Guidelines an overview and comments

Mohsen Ibrahim M*

The European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) jointly developed a series of hypertension guidelines in the years 2003, 207 and 2013. The most recent guidelines were issued by the two societies in August this year (2018) and were published in the European Heart Journal. The new guidelines are printed in more than 90 pages and cover almost all aspects of hypertension based on extensive review of literature giving highest priority to data from randomized controlled trials and well conducted meta-analysis. In important areas where there is inadequate or no evidence, guidelines authors resort to expert opinion. The text was developed over approximately 24 months and was reviewed by representatives of ESC and ESH national hypertension societies. Although it is less than five years since the last hypertension European guidelines in 2013, the recent 2018 guidelines show important differences in diagnosis and treatment strategies with the addition of new sections and recommendations on management of hypertensive emergencies, hypertension in women and pregnancy, different ethnic groups, chronic obstructive pulmonary disease, cancer therapies, peri-operative management, sexual dysfunction and perioperative management.

In this message, I will give an overview of the main recommendations in the European guidelines under two headings: diagnosis and treatment and I will conclude by comments.

The European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) jointly developed a series of hypertension guidelines in the years 2003, 207 and 2013. The most recent guidelines were issued by the two societies in August this year (2018) and were published in the European Heart Journal. The new guidelines are printed in more than 90 pages and cover almost all aspects of hypertension based on extensive review of literature giving highest priority to data from randomized controlled trials and well conducted meta-analysis. In important areas where there is inadequate or no evidence, guidelines authors resort to expert opinion. The text was developed over approximately 24 months and was reviewed by representatives of ESC and ESH national hypertension societies. Although it is less than five years since the last hypertension European guidelines in 2013, the recent 2018 guidelines show important differences in diagnosis and treatment strategies with the addition of new sections and recommendations on management of hypertensive emergencies, hypertension in women and pregnancy, different ethnic groups, chronic obstructive pulmonary disease, cancer therapies, peri-operative management, sexual dysfunction and perioperative management.
In this message, I will give an overview of the main recommendations in the European guidelines under two headings: diagnosis and treatment and I will conclude by comments.

07/24/2019
Research Article

Rehabilitation of hearing by cochlear implantation

Abdelaziz Raji*, Houda Mounji, Youssef Rochdi, Hassan Nouri and Mehdi Elfakiri

Background: Cochlear implants (CI) are nowadays a widely accepted treatment for sensorineural hearing loss SNHL.

Aim: This study aimed to describe the epidemiological characteristics and the surgical approach and to evaluate the outcomes of our experience in cochlear implantation.

Setting: Department of Otolaryngology-Head and Neck Surgery of University Hospital Mohammed VI Marrakech Morocco.

Methods: A retrospective chart review was conducted on 113 patients with severe to profound hearing loss who underwent a cochlear implantation between 2007-2018.

Results: There were 65 females and 48 males with severe to profound bilateral deafness, of whom 103 had prelingual deafness. The mean age of pediatric cochlear implantation was 5.25 years. Implantation was unilateral in all patients. The procedure was followed by regular adjustments and speech therapy. The evaluation was carried out by the same team each month during the first 6 months, then every 6 months. The average duration of follow-up was 37.54 months. All patients benefited from their implants with inter individual variability.

The good results were correlated with early implantation, significant parental investment and a steady follow-up of speech therapy.

Conclusion: Cochlear implantation has revolutionized the management of severe to profound deafness. It is a safe and effective technique when it is aimed at correctly selected populations.

 

07/23/2019
Research Article

Prevalence and seasonal variations of eggs of gastrointestinal nematode parasites of goats from smallholder farms in Mozambique

Alsacia Atanasio-Nhacumbe* and Carlos Francisco Sitoe

A survey was carried out to determine the prevalence and seasonal variations of eggs of gastrointestinal nematodes in goats in four provinces of Mozambique, from November 2016 to October 2017 in Tete and Cabo Delgado, and from November 2016 to October 2018 in Maputo and Gaza. In each province, flocks were selected from both lowlands, located within the valleys of the rivers, and uplands which are located outside the valleys. Faecal samples were collected at monthly intervals to monitor faecal egg counts fluctuations. The modified McMaster technique was used for quantitative analysis of nematode eggs and for detecting cestode eggs in faecal samples. The sedimentation technique for detecting trematode eggs in faecal samples was used. A total of 2 703 samples were examined for nematode eggs and 2 587 for trematode eggs. Faecal examination indicated that between 18% and 100% of goats sampled were infected with gastro-intestinal nematodes. The prevalence varied according to the season of the year and the ecological conditions. The highest prevalence and worm egg counts were recorded at about the peak of the rainy season. Strongyloides papillosus, Calicophoron spp., Fasciola spp. and Schistosoma mattheei eggs were also found. Moniezia expansa and Moniezia benedeni eggs were found in all the four study areas but its prevalence was low and irregular. Based on the results of this study, which showed a clear seasonal pattern, strategic anthelmintic medications to effectively control helminth infections in goats in the different ecological zones of Mozambique are suggested.

07/24/2019
Case Report

Severe Infantile Transaldolase deficiency: A case report

Khaled Alqoaer*, Ziad Asaad and Maisa Halabi

Transaldolase TALDO deficiency is a rare autosomal recessive disorder of the pentose phosphate pathway. It has variable presentations with poor outcome when present early in life. We present a young Saudi infant with a fatal early presentation of TALD deficiency.

07/31/2019
Research Article

Is there improvement in renal function in patients undergoing bariatric surgery?

Juliana Amaro Borborema Bezerra, Carlos Teixeira Brandt*, Daniel Mozart Bezerra Borborema, Arthur Quirino Ramos, Matheus Rodrigues de Souza and Fernanda Andrea Menezes Florencio Maciel

Introduction: Obesity may cause progressive chronic kidney disease. Weight loss in the postoperative follow-up of bariatric surgery may improve renal function in these patients. Thus, the purpose of this study was to give insight on the subject using a sensible biomarker.

Methods: This cross sectional study was performed in the Obesity Department from Campina Grande – Paraiba, Brazil. It was randomly enrolled 23 postoperative patients (7 bypass and 16 sleeve), with at least two years of follow-up, from the outpatient Department and 29 (18 bypass and 11 sleeve) in the preoperative period for bariatric surgery. They were homogeneously from both genders with ages ranging from 25 to 57 years. Serum levels of creatinine and cystatin C were measured, and the glomerular filtration rate (GFR) was estimated using the CKD Epi (chronic kidney disease epidemiology collaboration) cystatin-creatinine equation. The investigation was approved by the Ethics Committee.

Results: The mean body mass index (BMI) of the preoperative group was significantly greater than the postoperative group (p ≤ 0.0001). The mean serum levels of C cystatin was significantly greater in the postoperative group as compared to preoperative (p= 0.0197). However, there was no mean difference between creatinine serum concentrations comparing the two groups (p = 0.3252). The mean glomerular renal function rates of the groups were similar (p = 0.1240).

Conclusion: There is no definitive evidence for supporting the hypothesis that there is improvement in the kidney renal function after bariatric surgery in obese patients. Prospective cohorts are necessary to enlighten the answer for this important question.

07/31/2019
Research Article

The turing machine theory for some spinal cord and brain condition, A toxicological - antidotic depurative approach

Mauro Luisetto*, Behzad Nili Ahmadabadi, Ahmed Yesvi Rafa, Ram Kumar Sahu, Luca Cabianca, Ghulam Rasool Mashori and Farhan Ahmad Khan

Aim of this work is to produce a general theory related an new depurative strategy to be devalued for reduce or delay some spinal cord and brain degenerative and inflammatory chronic disease or acute traumatic condition. It is used and informatics approach in order to set correct the problem and the process. Scope of this project is to submit to the researcher a new therapeutic strategy (under a depurative- toxicological-pharmacological) in this complex kind of disease. A Turing machine theory say us a method to TRASLATE the need of a strategy in a practical hypotesys of work. A global conceptual map can help in this field.

07/24/2019
Research Article

Comparative study of carboxylate and amide forms of HLDF-6 peptide: Neuroprotective and nootropic effects in animal models of ischemic stroke

Аnna P Bogachuk*, Zinaida I Storozheva, Andrey Т Proshin, Vyacheslav V Sherstnev, Irina V Smirnova, Tatyana M Shuvaeva and Valery M Lipkin

Aim: The work was to perform a comparative study of the neuroprotective and nootropic activities of two pharmaceutical substances, the HLDF-6 peptide and its amide form (HLDF-6-NH2).

Materials and Methods: We used in the study healthy adult male Wistar rats aged 180–200 days weighing 280–300 g. We modelled ischemic stroke in rats by chronical occlusion of carotid arteries. Solutions of the HLDF-6-NH2 and HLDF-6 peptides were administered intranasally. Cognitive functions we assessed with Novel object recognition test and Morris maze.

Results: The amide form of HLDF-6 peptide is more efficient: the neuroprotective activity of HLDF-6-NH2, evaluated by improvement of cognitive functions in animals, surpassed that of the native HLDF-6 peptide. A dose of 250 µg/kg of HLDF-6-NH2 peptide resulted in practically complete restoration of the disturbed functions. In the model of ischemic stroke, the amide form of the peptide significantly excelled the reference substance mexidol both in the effective dose and biological activity.

Conclusion: The results of study of the agent allow hoping for its success in further clinical investigation. In view of high demand for the agent and in case of successful clinical trials, it will surely become widely used in clinical practice in treatment of IS.

07/31/2019
Research Article

P wave dispersion in patients with premenstrual dysphoric disorder

Seyda Yavuzkir, Suna Aydin*, Melike Baspinar, Sevda Korkmaz, Murad Atmaca, Rulin Deniz, Yakup Baykus and Mustafa Yavuzkir

Background: Growing evidence has revealed that fear and anxiety related situations could affect cardiac parameters. P wave dispersion (Pd) is an important index. In the present study, we aimed to evaluate Pd values in patients with premenstrual dysphoric disorder.

Methods: The study was composed of twenty-five female patients with premenstrual dysphoric disorder and same number of healthy controls. Pd, Pmin and Pmax values were determined by electrocardiogram (ECG) in the subjects.

Results: It was found that patients with premenstrual dysphoric disorder had considerably higher Pmax and Pmin values compared to those of healthy subjects. Pd was also significantly higher in patients with premenstrual dysphoric disorders than that of healthy subjects.

Conclusion: Study suggests that patients with premenstrual dysphoric disorder seems to have increased Pd, as can be seen in anxiety and fear related clinical conditions, considering that this group of patients have an increased trend to cardiac abnormalities, particularly cardiac arrythmias. To access strong conclusion, it is required novel studies with larger samples.

07/31/2019
Research Article

Preclinical stiff heart is a marker of cardiovascular morbimortality in apparently healthy population

Charles Fauvel, Michael Bubenheim, Olivier Raitiere, Charlotte Vallet, Nassima Si Belkacem and Fabrice Bauer*

Background: The prognostic signifi cance of impaired left ventricular (LV) relaxation and increased LV stiffness as precursor of heart failure with preserved ejection fraction and death is still largely unknown in apparently healthy subjects.

Methods: We constituted a cohort of 353 patients with normal ejection fraction (>45%) and no significant heart disease, based on a total of 3,575 consecutive left-sided heart catheterizations performed. We measured peak negative first derivative of LV pressure (-dP/dt) and operating chamber stiffness (Κ) using a validated equation. Patients were categorized as having: 1) normal diastolic function, 2) isolated relaxation abnormalities (-dP/dt > 1860mm Hg/sec and K <0.025mm Hg/ml), or 3) predominant stiff heart (K ≥0.025mm Hg/ml).

Results: During a follow-up of at least 5 years, the incidence of the primary composite endpoint (death, major arterial event, heart failure, and arrhythmia) was 23.2% (82 patients). Compared to isolated relaxation abnormalities, predominant stiff heart showed stronger prognostic significance for all events (p=0.002), namely heart failure (HR, 2.9; p=0.0499), cardiac death (HR, 5.8; p=0.03), and heart failure and cardiac death combined (HR, 3.7; p=0.003).

Conclusion: In this apparently healthy population referred to our center for cardiac catheterization, the prevalence of diastolic dysfunction was very high. Moreover, predominant stiff heart was a better predictor of cardiovascular outcomes than isolated relaxation abnormalities.

07/30/2019
Case Report

Severe Infantile Coarctation and Mid Aortic Stenosis in Williams Syndrome

Lousararian Marina, Troglia Ana, Cabrera Maria J and Alday Luis E*

We report a challenging patient with Williams syndrome and severe coarctation of the aorta. As in a few similar cases reported, several surgical and catheter interventions for recoarctation, intrastent intimal proliferation and stenosis of the left sub-clavian artery were required. Aortic patch angioplasty is planned for the future in a grower child.

07/23/2019
Research Article

Longitudinal and transverse dimensions of Hypertrophied Cardiomyocytes in human Left Ventricle (LV) at autopsy; Heart failure might result from changes in chamber geometry without contractile weakening

Richard E Tracy*

The shapes and sizes of human cardiomyocytes are accessible to systematic observation under most circumstances only at autopsy. This constraint has seriously curbed the study of these topics, thereby leaving a crippling gap in our understanding of heart failure. In recent years the only published ongoing findings have come from this laboratory. This article is a condensation of these reports, using those sources to develop fresh analyses designed to construct a set of organizing principles. The data are entirely retrospective thereby forbidding hypothesis testing and permitting only hypothesis formation. The hypotheses generated in this way are novel and surprising. In spite of the severe limitations in this methodology is seems possible that some useful new directions of inquiry might evolve from pursuing these original observations.

07/30/2019
Research Article

Determination of anthocyanin content in two varieties of Hibiscus Sabdariffa from Selangor, Malaysia using a combination of chromatography and spectroscopy

Yew-Keong Choong*, Nor Syaidatul Akmal Mohd Yousof, Jamia Azdina Jamal and Mohd Isa Wasiman

The calyces of Hibiscus sabdariffa have been used by many communities as herbal tea. Their anthocyanin contents have been reported as the key component in anti-obesity studies. This present work reported results of anthocyanin content of calyces in two varieties of H. sabdariffa collected from Sabak Bernam, Selangor, Malaysia.The samples have been authenticated in the Herbarium, Institute of Bioscience, University Putra Malaysia prior to the study. The samples were processed and the ground dry raw material and its aqueous extract were analyzed using Fourier Transform Infrared (FTIR) and Two-Dimensional Infrared (2DIR). The short hybrid calyces (FT11-15A) raw material spectrum showed more than 80% similarity with long wild variety calyces (FT11-15B) when using “Compare” in analysis. The differences of both samples were obviously shown in their aqueous extract spectra. The peak at 1672 cm-1 and 841 cm-1 showed that tri-substituted double bond in FT11-15B aqueous extract was not present in FT11-15A aqueous extract spectra, whereby a double peak was assigned at 1221 cm-1 referred to anti symmetry stretching of aromatic and vinyl =C-O-C- with other =C-O- and 1192 cm-1 is assigned In-plane δ C-H in FT11-15A aqueous extract. The peak at 1071 cm-1 assigned as bonding C-H in plane bending of phenyl of both samples was the only peak comparable with standard delphinidin and cyanidin which are used for qualification and quantification of sample content. Aqueous extract spectra of both samples showed higher number of peaks detected compared with raw material spectra, which was attributed to the higher solubility of anthocyanins in water. The 2DIR correlation spectroscopy is advantageous in enhancing the qualitative analysis of herbal products. The anthocyanin content in both varieties of H. sabdariffa in descending amount is delphinidin-3-O-sambubioside (DS), cyanidin-3-O-sambubioside (CS), delphenidin-3-O-glucoside (DG) and lastly cyanidin-3-O-glucoside (CG). FT11-15A has more content of DS and DG of raw material and CG of water extract plus TFA than FT11-15B, whereby, FT11-15B has more content of CS, CG of raw material and DS, DG, CS of water extract plus TFA than FT11-15A.

07/23/2019
Research Article

Analysis of the characteristics of chinese traditional sports culture in the new period

SC Wang*

Through cultural consciousness, the characteristics of traditional Chinese sports culture in the new period are analyzed and studied, and the traditional Chinese sports culture in the new period has the following six characteristics: 1. Sports social model of “etiquette” 2. Sports personality model of the gentleman’s way; 3. The sports behavior mode of the golden mean; 4. The social nature of sports of socialism with Chinese characteristics; 5. Sports cultural nature of emotional culture; 6 limited competitive sports competition.

07/23/2019
Short Communication

Triathlon challenge – from craggy to crazzy a different kind of pain management program

Michael G Serpell*

Sea swim (2.4 mile), bike ride (112 mile) and Marathon (26 mile), all in one day!
There are lessons that the 7.8 million UK Chronic Pain patients can learn from the world of endurance sports, and vice versa [1]. The training, psychological tools and strategies used by athletes to complete an endurance event, are equally relevant for those with chronic pain, who wish to regain some form of “normal” life if treatment therapies have failed [2,3].

This is my reflection of how, using some of the techniques involved in Pain Management Programs, I trained for an Ironman Triathlon in just over one year.

07/22/2019
Review Article

Update on Phenobarbital for Alcohol Withdrawal Syndrome in Intensive Care

Rukma Parthvi* and Parker Agne

Alcohol abuse is a global health problem. Alcohol withdrawal syndrome (AWS) ranges from mild to severe symptoms that can lead to fatal delirium tremens requiring ICU admission and incurring high health care cost as high as $20,000 a month. The latest published reports suggest that phenobarbital is a promising therapeutic option for management of AWS as evidenced by less ICU admissions, length of stay in hospital, use of adjunctive agents, health care costs and attention from the nursing staff than that of patients treated with commonly used benzodiazepines such as lorazepam, diazepam, and chlordiazepoxide. Phenobarbital is beneficial for the treatment of AWS, both in the emergency and inpatient settings and both as monotherapy or in conjunction with benzodiazepines. It is safe for patients without severe hepatic impairment, has a better mechanism of action and longer half-life than benzodiazepines, and leads to less delirium and agitation. Powered randomized controlled trials with large populations are required, yet phenobarbital can be used to safely to treat AWS.

07/19/2019
Research Article

Causal agents of Post-harvest Rot of Pumpkin (Cucurbita pepo L.) and their control using Indigenous Practices in Hong, Adamawa State

Kazi N, Chimbekujwo IB and Anjili SM*

Pumpkins (Cucurbita pepo) are grown all around the world for a variety of reasons ranging from agricultural purposes to commercial and ornamental sales. The pathogens causing the rot of pumpkin in the world include fungi, bacteria, and viruses. The study was aim to identify fungal pathogens of pumpkin rot during storage, as well as control measures of the diseases using wood ash, mango leaf and rice chaff.Three hundred and sixty-six (366) fruits of pumpkins were studied in Pela, Gaya and Kulinyi districts of Hong Local Government Area of Adamawa State. The diseased samples (fruits) were randomly purchased. Of all the districts visited, Kulinyi has the highest percentage of disease samples (43.82%) while the least is Gaya district with 21.35%. Potato Dextrose Agar (PDA) was used for the isolation of pathogens and these gave Fusarium solani, Aspergillus niger, Aspergillus flavus, and Phytophthora capsici. All the fungal isolates exhibited different degree of pathogenic effect on the pumpkin fruits. The pathogens are susceptible to treatment both In-vitro and In-vivo control trials with wood ash and mango leaf at p ≤ 0.05. Inhibition improved with increased in concentration of the wood ash and mango leaf. Rice chaff treatment equally proved worthwhile with significant inhibition compared to the control at p ≤ 0.05.

07/15/2019
Research Article

The beneficial effects of varicella zoster virus

Khalid Ahmed Al-Anazi*, Al-Anazi WK and Al-Jasser AM

Varicella zoster virus behaves differently from other herpes viruses as it differs from them in many aspects. Recently, there has been growing evidence on the beneficial effects of the virus in immune compromised hosts and these effects are translated into prolongation of survival. The reported beneficial effects of the virus include: (1) stimulation of bone marrow activity in patients with hematologic malignancies and bone marrow failure syndromes, (2) antitumor effects in various hematologic malignancies and solid tumors, and (3) association with graft versus host disease which has anticancer effects. Additionally, there are several reports on the safety of the live-attenuated even in severely immune suppressed individuals and on the emerging role of the virus in cancer immunotherapy. In this review, the following aspects of the virus will be thoroughly discussed: (1) new data on the genetic background, pathogenesis, vaccination, and new therapeutic modalities; (2) bone marrow microenvironment and hematopoiesis; (3) cells involved in the pathogenesis of the virus such as: mesenchymal stem cells, dendritic cells, natural killer cells, T-cells and mononuclear cells; (4) cellular proteins such as open reading frames, glycoproteins, promyelocytic leukemia protein, chaperons, and SUMOs; (5) extracellular vesicles, exosomes, and micro-RNAs; and (6) signaling pathways, cytokines, and interferons.

07/22/2019
Research Article

ROGAVF STUDY 2019 - Relationship of HbA1C (GLYCEMIC Control) on outcomes of AV FISTULAS: A prospective observational study

Premjeet Singh*, Zainal Ariffin, Hafizan Tajri, Azim Md Idris, Lenny Suryati and Lily Sofida

Objective: The main aim of the study was to compare outcomes based on diabetic control for patients undergoing formation of a new upper limb arteriovenous fistula (AVF). Research design and methods: A prospective cohort study was performed where we obtained baseline HbA1c in 65 patients before undergoing AV fistula formation. Patients were followed up at our clinic 6 weeks after creation to assess fistula maturity.

Results: Multiple logistic regression was used to analyze the association between HbA1c status and maturity of AVF at 6 weeks after controlling for possible confounding factors such as age, sex, presence of hypertension and dyslipidaemia. Those with HbA1c less than 6.5 were 22 times likely to have maturity of AVF at 6 weeks as compared to those with HbA1c 6.5 or more (AOR = 22.65, p < 0.005).

Conclusion: Good diabetes control, reflected by an HbA1c of less than 6.5, is associated with a very high possibility of AVF maturity at 6 weeks post creation.

07/22/2019
Review Article

Idiopathic post-operative biliary duct system dilatation; potential etiology and management

Mohamed M Nasr* and Maged M Nasr

What is called “idiopathic biliary duct system dilatation” or better to name it “un-explained biliary dilatation” is mostly following surgical procedures related to upper gastrointestinal and hepato-bilio-pancreatic systems. Having such situation, adaptive physiology of the biliary duct system has to be considered and rational has to be explained. The vast multimodal progress in techniques of investigations that has been applied on studying the hepato-bilio-pancreatic system has been utilized to clear the clinical ambiguity of biliary duct system dilatation for no logic reason but missing the correlation between both fields; the technical and the clinical ones. This clinical review is trying to fill this gap and introduce a comprehensive discussion of the subject.   Mechanical, biochemical and immune causes constitute a wide diversity of etiology related to biliary system dilatation that in some situations is really difficult to verify clinically. On the least, even we could not verify the etiology we need to identify that reaching a closed road is different than postulating suspicions that never exist. This review is a trial collecting all subject-related data that might be related to etiology mechanisms and utilize to find a correlation rationale. At some point verification of such correlation is really a far target that might be even impossible clinically with availing technical tools and hope in the future could be achieved.

07/19/2019
Review Article

Lecture:

Shapovalov KA, Shapovalova LA

  1. The concept of wounds.
  2. Classification of wounds.
  3. Signs of wounds.
  4. Factors affecting the course of the wound process.
  5. Phases of the wound process.
  6. Types of wound healing.
  7. Features of wounds in children.
  8. First (first emergency) help.
  9. Complications of wounds.
  10. Specific bite wounds. Notion Treatment. Complications.
  11. Snake bites. First aid.
  12. Arthropod bites. First aid.

Wounds are called traumatic violation of the integrity of the skin or mucous membranes with possible damage to the deeper tissues.

07/17/2019
Case Report

Anasarca in a 35 year old man- A diagnostic dilemma

Okafor UH*, Okorie GO and Ede S

Anasarca is generalized swelling of the body following accumulation of fluid in the extracellular compartments. It may result from multiple aetiology mainly of renal, hepatic or cardiovascular origin. 

The aim of this case report is to highlight the challenges encountered in making diagnosis in a patient with anarsaca.

We report a case of a 34 year old transporter who presented with anasarca. He had clinical features and risk factors suggestive of renal, hepatic and cardiovascular disease. However investigations ruled out renal, hepatic or cardiovascular diseases as the aetiology of the anarsaca. The anarsarca was also noted to be unresponsive to diuretics. The diagnosis of the disease causing the anarsaca was therefore a dilemma.

07/17/2019
Research Article

Cognition and Memory Impairment among Patients of Depression in Pakistan-The Role of Conventional and Newer Anti-Depressants

Madeeha Malik*, Muhammad Usama Khan, Azhar Hussain and Ayisha Hashmi

Background: Antidepressant therapy is the most adopted treatment option for depression. The evaluation of cognitive effects related to antidepressant drug use is important for better selection of antidepressant drugs that leads to improved cognitive performance and patient health related quality of life. Aim: The aim of the present study was to evaluate the effects of antidepressant drugs on cognition and memory among patients of depression in Pakistan. 

Method: A descriptive cross-sectional study design was used. A pre-validated data collection tool Mini Mental State Examination was used. The sample size was calculated to be 382 with 95% confidence interval and 5% level of error. The data was cleaned, coded and analyzed statistically using spss 21. Chi-Square test (p ≥ 0.05) was used to find association among different variables.

Results: The results showed that out of 382 respondents, 7.3% (n=28) were being prescribed amytryptyline and among them 46% (n=13) had questionably significant cognitive impairment and 53% (n=15) had mild cognitive impairment. On the other hand out of 23% (n=89) patients on escitalopram monotherapy, 85% (n=76) had impairment of questionably significant impairment and only 13.4% (n=12) had mild impairment. Area of residence and medication therapy were significant variables (p<0.05) that can affect cognition and memory among patients of depression. 

Conclusion: The results of present study concluded cognitive impairment of questionably significant nature among patients of depression in Pakistan. For the better management of depression, it is recommended that anti-depressant drug therapy should be tailored according to individual patient requirements.

07/16/2019
Research Article

Assessment of lipid and hematological profile among blood donors in European Gaza Hospital, Palestine

Ahmad M Tabash, Wesam M Afana, Abdrabbou M Elregeb, Sameer Abu Eid and Ayman M Abu Mustafa*

Background: There is an important shortage of blood in the greatest blood banks worldwide to meet up with requirements for numerous medical interventions. Limited studies have associated regular blood donation to the lowering of lipid function parameters. Assessing the lipid function is a classical method of evaluating an individual’s risk for coronary heart disease.

Objective: The general goal of the study is to determine lipid and hematological profile among blood donors in European Gaza Hospital, Palestine.

Materials and Methods: This study was a case-control study that involved 120 male, 40 of whom were regular blood donors (study group), 40 first time donors and 40 non- donors (control group) aged between 18-60 years. A volume of 5ml venous blood was drawn from each fasting participant into a dry biochemistry screw-capped tube. This was allowed to clot and the serum was used to determine total cholesterol (TC), triglycerides, High-density lipoprotein cholesterol (HDL-C), Low-density lipoprotein cholesterol (HDL-C), while HDL-C/LDL-C and TC/LDL ratio were calculated by using the following formula. Anthropometric parameters (weight, height) of donors were measured using standard protocol. The height (in meter), weight (in kilogram) were used to calculate the body mass index (BMI) using the following formula. BMI= weight (kg)/ (height in meter)² and blood was collected from each participant in EDTA (for hematocrit, ESR). Three groups were matched for age and BMI. Data were analyzed using SPSS version 23. Chi-square (χ²) was used to compare the relationship between categorical variables, ANOVA was used to measure the difference between means. Data were summarized using tables, pie charts, histograms. A P-value < 0.05 was considered to be statistically significant for all tests conducted.

Results: The mean total cholesterol (169±10.85 mg/dl), triglycerides (116±9.73 mg/dl), HDL (54±2.5 mg/dl ), LDL (92±11.4mg/dl), LDL/HDL ratio (1.73±0.25) and TC/HDL ratio (3.16±0.26) were lower in the regular blood donors than the first time donors(198±10.13, 179±5.82, 42.33±1.6, 120±11.2, 2.85±0.36, 4.7±0.40) and non- donors (202±10.19, 180±12.68, 41.75±1.4, 125±11.7, 2.99±0.33, 4.86±0.32) respectively and statistically significant (P < 0.05).The mean ESR (6.63±0.87mm/hr) was lower statistically significant in the regular blood donors than the first time donors (7.40±1.17) and non- donors (7.60±1.48) respectively (P < 0.05). The mean HCT (42.98±0.86%) was lower statistically significant in the regular blood donors than the first time donors (44.63±0.90) and non- donors (44.75±0.74, P < 0.05).

Conclusion: Regular donors have reduced risk of developing coronary heart disease as reflected by the low total cholesterol, triglycerides, LDL-c, LDL-c/HDL-c ratio, TC/HDL-c ratio and HCT and high HDL. BMI in regular donor was less than the donor for the first time and did not donate, but did not reach the statistical significance. Also in our study regular donors have reduced risk of developing inflammation as reflected by low ESR.

07/16/2019
Case Report

Single Trans apical access for double aortic and mitral valves-in-valves procedures with high risk of thrombus embolism

Julien Adjedj*, Mathias Kirsch, Anna Nowacka and Olivier Muller

Background: Persistent left atrial thrombus remains a contra indication to transeptal valves in valves procedure. We aimed to perform a double valves in valves replacement through transapical access with cerebral angiography control during the procedure just after implantation. Our case shows the feasibility of this strategy and the management of right ventricle laceration successfully treated after extra corporeal membrane oxygenation implantation and local hemostasis. We reported a feasibility case report of successful double valves in valves implantation through transapical access with 6 months of clinical and computed tomography follow up.

07/16/2019
Research Article

The relationship between serum and sputum levels of azithromycin and clinical endpoints in patients with bronchiectasis using azithromycin maintenance treatment

Josje Altenburg*, Erik B Wilms and Wim G Boersma

Background: Azithromycin (AZM) is a macrolide antibiotic with distinct pharmacokinetic properties and is increasingly used as maintenance treatment in patients with bronchiectasis in order to reduce infectious exacerbations and improve pulmonary symptoms. The exact mechanism of action is not known and the relation between azithromycin dose level, local and systemic drug levels and clinical effect however, has not been extensively studied yet.

Objectives: To explore the relation between AZM serum and sputum concentrations, clinical effect parameters and side effects.

Methods: Azithromycin concentrations were measured in serum and sputum samples of bronchiectasis patients receiving one year of AZM treatment (250mg OD) enrolled in the Bronchiectasis and Azithromycin Treatment (BAT) trial, a double blind, randomised placebo-controlled trial. Results were correlated with data on AZM dose level, exacerbation frequency, lung function (forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), quality of life and symptoms collected within the same year.

Results: 83 sputum samples from 31 patients and 151 serum samples from 43 patients were available for analysis. Mean AZM dose-level ranged from 18.8 to 39.8 mg/kg body weight/ week, generating mean AZM concentrations of 7.57 mg/L (SD 9.49) in sputum and 0.11 mg/L (SD 0.085) in serum. No correlation was found between side effects and AZM dose level, sputum- or serum concentrations. Significant correlation was found between AZM sputum concentration and CRP-level (r= -0.6).

Conclusion: High and stable AZM sputum levels were reached during long term treatment, as opposed to low AZM levels in serum. Apart from CRP-levels to AZM sputum concentration, no other outcome parameter showed significant correlation to AZM serum- or sputum levels. AZM dose- or exposure levels were not predictive for the occurrence of side effects.

07/16/2019
Research Article

Cloning and Characterization of a Pseudo-Response Regulator 7 (PRR7) Gene from Medicago Sativa Involved In Regulating the Circadian Clock

Yilin Shen and Weifeng Nian*

The circadian clock is an endogenous molecular oscillator with a period of about 24 hours, which regulates the physiology and developmental processes of almost all higher plants. Pseudo-response regulators (PRRs) are an important part of the central clock oscillator, together with other clock genes, constituting interlinked transcriptional feedback loops, which partly influence plant growth and development.In this study, a circadian clock-related gene MsPRR7 was cloned from Medicago sativa (alfalfa) by homologous cloning. The full length MsPRR7 gene was 2648 bp in length, with an open reading frame of 2385 bp encoding a protein of 795amino acids. Phylogenetic analysis showed that the MsPRR7 was closely related to PRR7 from the PRR family of Arabidopsis thaliana. Subcellular localization analysis found that MsPRR7 was located in the nucleus. Quantitative reverse-transcription polymerase chain reactions (qRT-PCR) demonstrated that expression of MsPRR7 gene transcripts in leaves was affected by circadian rhythms, and that its expression level increased with an extension of illumination time, reaching a peak around 8–10 hours. These results will provide the experimental basis for further study of the regulation of PRR family genes in alfalfa.

07/12/2019
Research Article

Feasibility study on the evaluation of the effect of narrow-band CEChirp ASSR in the hearing fi eld after hearing aid in hearingimpaired children

Wang Yonghua* and Xing Shuoyao

Objective Study: Whether the narrow-band CE-Chirp ASSR test in the sound field is an objective evaluation method for the hearing aid compensation effect, and whether there is a difference in children with different hearing loss levels.

Methods: 39 children (67 ears) wearing full digital hearing aids with good rehabilitation effect and ability to cooperate with behavioral audiometry were selected. The narrow-band CE-Chirp ASSR test group in the sound field was set as the experimental group, and the sound field behavioral audiometry after hearing aid was set as the control group. According to the degree of hearing loss, it was divided into moderate hearing loss group, severe hearing loss group and extremely severe hearing loss group. The difference between test results of experimental group and control group was compared.

Results: There were no significant differences between the experimental group and the control group in the moderate hearing loss group and the extremely severe hearing loss group at 0.5, 1, 2, and 4kHz (P > 0.05). The results of the experimental group and the control group in the severe hearing loss group, There was no significant difference at 0.5, 1, 2kHz (P > 0.05), there was a significant difference at 4kHz (P < 0.05), and the mean difference was - 6.4dB HL. When the degree of hearing loss was not grouped, there was no significant difference between the experimental group and the control group at 0.5, 1, 2kHz (P > 0.05), 4kHz was significantly different (P < 0.05), and the mean difference was -3.2dB HL.

Conclusion: It is clinically feasible to evaluate the hearing aid compensation effect of the narrow-band CE-Chirp ASSR in the hearing-impaired children. The grouping according to the degree of hearing loss can be more accurate in evaluating the hearing aid compensation effect. The narrow-band CE-Chirp in the sound field of children with moderate and very severe hearing loss ASSR results can be directly used to assess the hearing aid compensation effect, while children with severe hearing loss need to apply correction values at 4kHz.

07/12/2019
Case Report

Methotrexate in management of Morbidly Adherent Placenta at Latifa Hospital, DHA, Dubai, UAE.: Case report

Atif BE Fazari*, Maria Eugenia Ramirez Aristondo, Faiqa Azim, Basma Abdo AlMaamari and Rasha Eltayeb

Morbidly adherent placenta (MAP) includes the spectrum of placenta accreta, increta, and percreta. It is a major cause of obstetric hemorrhage. Caesarean section is main risk factor for MAP. Ultrasound scan is highly sensitive method for MAP diagnosis and sometime Magnetic resonance image is of choice. Early diagnosis timed elective planned intervention after preparation under skillful multidisciplinary team improve the outcome and minimize the morbidity. Caesarean hysterectomy, major arteries ligation, arteries embolization and leave the placenta in-situ all are choices of management. Use of Methotrexate for the placenta in-situ in MAP is still debatable. We present a case of MAP in which placenta left in- situ followed by multiple Methotrexate injection during postpartum with good outcome and acceptability.

07/15/2019
Review Article

Predictive vision on governance and total quality in sports

Ibouchoukene Mohamed, Aboura Rabah, Hadiouche Abdelnour, Labane Karim* and Fahssi Mohamed Riadh

The aim of our study is to try to give a predictive vision on governance in the field of sports in Algeria.

This predictive approach looks at the overall quality of governance in order to be at the continental level or even across the Arab world.

To identify this and answer our questions, we conducted a survey of some leaders of the different sports institutions, namely the presidents of clubs (football, handball, athletics and judo), managers also have a sports experience and occupy currently responsible positions as managers of sports facilities.

The results of the survey we reveal significant figures on the component related to sports development prospects.

However, there are other aspects that are ambiguities in the management and organization that have an impact on good governance in sports.

 

 

To identify this and answer our questions, we conducted a survey of some leaders of the different sports institutions, namely the presidents of clubs (football, handball, athletics and judo), managers also have a sports experience and occupy currently responsible positions as managers of sports facilities.

07/11/2019
Opinion

The science of enduring pain. What can athletes and chronic pain patients learn from each other?

Michael G Serpell*

“It isn’t the mountains ahead to climb that wear you out; it’s the pebble in your shoe.” Muhammad Ali

What mind strategies can an endurance athlete use to get their body that bit further or faster, to be a inisher? At "top-level" sport, some say it's all in the mind!! When we push ourselves to the limit, we experience adversity. How and if we overcome that, will deine us, and our achievements.

“Adversity causes some men to break; others to break records.” William A. Ward (Inspirational Writer)

Pain is not only a physical experience, it is an emotional one as well. This is encapsulated in the very definition of pain by the International Association for the Study of Pain [1].

07/12/2019
Research Article

High water intake in preventing the risk of Uric Acid Nephrolithiasis: A systematic review and meta-analysis

Zhijian Lin, John C Lieske*, Yue Li and Muthuvel Jayachandran

Background: Hyperuricosuria, persistently low urinary pH, and low urinary volume are the main risk factors of uric acid nephrolithiasis. Epidemiologic studies suggest that high water intake is protective against the occurrence of symptomatic kidney stone events of all types. The objective of this systematic review and meta-analysis were to evaluate the effectiveness of increased water intake to prevent symptomatic uric acid kidney stone events.

Methods: Seventeen studies were identified for the meta-analysis. Analysis of Q and I2% statistics revealed that a high heterogeneity in 16 studies, thus, random effects model was used. Protective associations were identified for high water intake individuals (SMD=0.52 L; 95% CI: 0.19, 0.84; p=0.002); a significantly decreased relative super saturation of uric acid versus controls (SMD=-1.15; 95% CI: -2.00, -0.30; p=0.008). Risk factors including urinary uric acid excretion and pH were not significantly related to high water intake (SMD=7.32mg/d, 95% CI: -52.27, 66.91; p=0.81), (SMD=0.14; 95% CI: -0.02, 0.31; p=0.09), respectively. Further subgroup analyses revealed that urinary uric acid excretion was significantly decreased in healthy individuals (SMD=-36.23 mg/d, 95% CI: -65.14, -7.31; p=0.001) compared to stone formers (SMD=27.41 mg/d, 95% CI: -33.18, 88.01; p=0.38); urinary uric acid excretion was significantly decreased in routine water intake groups (SMD=-61.49 mg/d, 95% CI: -120.74, 12.24; p=0.04) compared to mineral water intake groups (SMD=44.50 mg/d, 95% CI: -18.30, 107.29; p=0.16); urinary pH was significantly higher in mineral water groups (SMD=0.13, 95% CI: 0.01, 0.46; p=0.04) compared to regular water groups (SMD=-0.00, 95% CI: -0.13, 0.13; p=0.98).

Results: A total of 129 patients had 150 internal jugular catheter insertions. The mean age was 51.4±15.2 years with male to female ratio of 1.5:1. All the patients had chronic kidney disease; about 80% had tunneled IJC and 96.9% of the catheters were inserted in the right internal jugular vein. Immediate complications were recorded in 10% and late complications in 34.9% of the procedures. The immediate complications were kinking of guide wire (2%), arterial puncture (1.3%) and difficulty in locating the internal jugular vein (1.3%) or tunneling (1.3%). The late complications were infection (12.8%), poor blood flow (9.2%), bleeding (5.5%) and spontaneous removal of the catheter (5.5%). There was no statistical significant difference in both immediate and late complication with age and sex.

Conclusion: This meta-analysis identified evidence that urinary uric acid excretion, volume, pH and relative supersaturation of uric acid can be altered with high water intake intervention, reducing the risk of uric acid kidney stones.

07/11/2019
Research Article

Complications of Internal jugular catheters in haemodialysis patients at a kidney care center in Nigeria

Okafor Umezurike Hughes*, Alade Stella and Edeh Samuel

Internal jugular vein catheters (IJC) is recommended as the central venous access of choice in haemodialysis patients. However it is associated with complications of variable severity.

Objectives: To study the complications associated with internal jugular vein catheters in haemodialysis patients in southern part of Nigeria.

Methodology: The clinical details of patients who had IJC insertion at the kidney house, Hilton clinics Port Harcourt from 1st October 2011 to 30th September 2016 were documented. Complications from the IJC developed by the patients during the study period were also documented. The data obtained was analyzed using SPSS version 22. P value less than 0.05 was considered significant.

Results: A total of 129 patients had 150 internal jugular catheter insertions. The mean age was 51.4±15.2 years with male to female ratio of 1.5:1. All the patients had chronic kidney disease; about 80% had tunneled IJC and 96.9% of the catheters were inserted in the right internal jugular vein. Immediate complications were recorded in 10% and late complications in 34.9% of the procedures. The immediate complications were kinking of guide wire (2%), arterial puncture (1.3%) and difficulty in locating the internal jugular vein (1.3%) or tunneling (1.3%). The late complications were infection (12.8%), poor blood flow (9.2%), bleeding (5.5%) and spontaneous removal of the catheter (5.5%). There was no statistical significant difference in both immediate and late complication with age and sex.

The ultrasound examination at discharge had a sensitivity of 31% and specificity of 87% to detect future symptomatic lymphoceles. The positive predictive value was only 10%. The second ultrasound test had the best test variables to detect symptomatic lymphoceles with a sensitivity of 93% and a specificity of 87% and a predictive value of 28%.

Conclusion: Internal jugular catheter is froth with immediate and late complications in haemodialysis patients.

07/11/2019
Opinion

Proposal for the elimination of allergies

James F Walles*

A man I knew had an extreme allergy to poison ivy when he was a child. When he was about four-teen, he was hanging out with a group of his friends who dared him to eat some poison ivy. He did, and never got poison ivy again. Presumably, the ingestion of the allergen led to the development of immunity.

07/02/2019
Research Article

Gestational hypercholesterolemia helps detect familial hypercholesterolemia and prevent late pregnancy complications

Josef Hyanek* František Pehal, Kseniya Dryahina, Ladislava Dubska, Blanka Míkova, Lada Gombíkova, Miroslav Prucha, Stanislav Kubu, Petra Halackova and Jaroslav Feyreisl

Introduction: In this retrospective study, we comment on the cause and diagnostic potential of the elevated serum total cholesterol and some non-cholesterol sterols in a population of healthy pregnant women from Prague, Czech Republic. 

Methods: Based on a total of 21,000 clinical biochemistry tests of healthy pregnant women with hypercholesterolemia observed during pregnancy, a testing group of 84 women with a total cholesterol (TC) above 7.0 mmol/l was established to analyze their non-cholesterol sterols (NCS) by Gas Chromatography–Mass Spectrometry. Lathosterol (Lat) and desmosterol (Des) were evaluated as markers of endogenous cholesterol synthesis, whereas campesterol (Cam) and sitosterol (Sit) were analysed as markers of intestinal absorption.

Results: In the basic population, the frequency of gestational hypercholesterolemia with the serum TC levels > 7.0mmol/l was 1 to 136.The mean values were: TC 6.8 mmol/l, LDL-C 4.6 mmol/l, and HDL-C 2.2 mmol/l. In the selected testing group of 84, the mean values were: Lat 7.8+/-1.7 μmol/l, Des 4.7+/-0.9 μmol/l, Cam 9.8+/-2.6 μmol/l, and Sit 9.6+/-3.8 μmol/l. Lat correlated with TC (r = 0.53), LDL-C (r = 0.36), and non-HDL-C (r = 0.35). No such correlations were observed for Cam or Sit.

Conclusion: Our findings prove that gestational hypercholesterolemia is caused by increased endogenous cholesterol synthesis via lathosterol. Subsequently, we demonstrate how a single cholesterol test taken in the fifth to sixth month gestation can efficiently help detect familial hypercholesterolemia, and prevent related late pregnancy circulatory complications.

07/05/2019
Research Article

Knowledge, perception and practices of Suez Canal University students regarding Hepatitis C Virus infection risk and means of prevention

Hesham El-Sayed, Sohair Mehanna, Adel Hassan, Mahmoud Sheded, Maha Abdel-Fattah, Samar Elfiky, Nermine Elmaraghy*, Nehal Lotfy and Zeinab Khadr

Background: Egypt has the highest prevalence of HCV in the world as more than 10% of population suffers from HCV infection. High prevalence of HCV in Egypt represents a great risk to the whole population that requires aggressive mass awareness regarding routes of infection and means of prevention. 

Aim: To determine the knowledge and practices of university students in 5 different faculties in Suez Canal University regarding HCV infection and means of prevention.

Materials and method: A cross sectional study was conducted in five university faculties in Suez Canal University.

Results: The study included 698 students from the faculties of Medicine, Pharmacy, Dentistry, Nursing and Education in Suez Canal University in Ismailia city in Egypt. There was a statistically significant difference regarding the knowledge about the diagnosis, complications and routes of transmission total knowledge score for HCV among the different faculties.

Conclusion and Recommendations: Knowledge and practices of university students in Suez Canal University is partial to weak especially in students of non-biological sciences who have less close contact with patients.

07/05/2019
Research Article

Virulence Genes in Pseudomonas Aeruginosa Strains Isolated at Suez Canal University Hospitals with Respect to the Site of Infection and Antimicrobial Resistance

Nermine Elmaraghy*, Said Abbadi, Gehan Elhadidi, Asmaa Hashem and Asmaa Yousef

Background: Pseudomonas aeruginosa is one of the top five pathogens causing healthcare-associated infections. Biofilm formation is nowadays a major problem. Aim: The aim of this study was to examine the prevalence of virulence genes in clinical isolates of Pseudomonas aeruginosa at Suez Canal University Hospitals with respect to the site of infection and microbial resistance of the strains.

Materials and methods: A cross-sectional descriptive study was carried out on 47 Pseudomonas aeruginosa strains collected from hospitalized patients from December 2015 to August 2017. To detect biofilm formation, we used Tissue Culture Plate Method. The virulence genes (toxA, algD, nan1, pslA and pelA) were amplified using PCR technique.

Results: The highest sensitivity was to Imipenem and Ciprofloxacin (85.1% and 68.1% respectively).With respect to the virulence genes, toxA gene was detected in 45 isolates (95.7%), algD gene in 42 isolates (89.4%), pslA in 42 isolates (89.4%) %), pelA cted in 41 isolates (87.2%) and nan1gene was detected in 19 isolates (40.45%).

Conclusions and Recommendations: We conclude that there is relationship between virulence genes and biofilm formation in Pseudomonas aeruginosa. We recommend the expansion of work on a larger sample size in a longer period of time.

07/08/2019
Research Article

Endoscopic treatment of pancreatic diseases via Duodenal Minor Papilla: 135 cases treated by Sphincterotomy, Endoscopic Pancreatic Duct Balloon Dilation (EPDBD), and Pancreatic Stenting (EPS)

Tadao Tsuji*, G Sun, A Sugiyama, Y Amano, S Mano, T Shinobi, H Tanaka, M Kubochi, K Ohishi, Y Moriya, M Ono, T Masuda, H Shinozaki, H Kaneda, H Katsura, T Mizutani, K Miura, M Katoh, K Yamafuji, K Takeshima, N Okamoto, Y Hoshino, N Tsurumi, S Hisada, J Won, T Kogiso, K Yatsuji, M Iimura, T Kakimoto and S Nyuhzuki

Treatments via the minor papilla is effective where the deep cannulation via the major papilla is impossible in such cases as [1] the Wirsung’s duct is inflammatory narrowed, bent or obstructed by impacted stones [2] pancreatic duct divisum (complete or incomplete) [3], maljunction of pancreatico-biliary union with stones [4], pancreatic stones in the Santorini’s duct. In [1,2] cases, the pancreatic juice flow via the major papilla decreases, while that of the minor papilla increases. Then the size of minor papilla and its orifice shows corresponding enlargement. This substitutional mechanism is an advantage when undertaking our new method. Since the pancreatic juice flow is maintained via the minor papilla in these cases, accurate and careful endoscopic skills are necessary to prevent pancreatitis due to the occlusion of the Santorini’s duct after this procedure. We have experienced 135 cases treated via minor papilla in these 27 years, so we would like to report about its safety and efficacy.

07/09/2019
Research Article

Blockade of the distal sciatic nerve with the patient in the supine position using a newly developed position aid with integrated ultrasound probe holder

Jens Magunia, Hans-Bernd Hopf and Michael Schutz*

Background: We have developed a femoral supporting pad with an integrated ultrasound probe holder and examined its practical usability on patients with lower limb surgery.

Objectives: To evaluate the function of this novel femoral supporting pad with respect to its practicability during the performance of a distal sciatic nerve blockade, the time needed to perform this blockade including the catheter insertion and the quality of postoperative analgesia within the first 24 hours.

Methods: 50 patients which had been scheduled for elective lower leg, ankle or foot surgery had received a continuous blockade of the distal sciatic nerve. Sciatic nerve blockade was performed sonographically controlled with the patients in supine position by using our novel femoral supporting pad with an integrated ultrasound probe holder.

Primary endpoint: duration of the intervention. Secondary endpoints: pain intensity (visual analogue scale VAS 0-10) at the first postoperative day; cumulative opioid (piritramide) requirement during their stay on the post Anaesthesia care unit (PACU) with vs. without distal sciatic nerve blockade.

Results: 49/50 patients received a distal sciatic catheter, which had been sonographically placed within a mean time (mean ± sd) of 11:30 ± 3:13 minutes. VAS at the first postoperative day was (mean ± sd) 1 ± 2 at rest and 2 ± 2 as maximum. The piritramide requirement during PACU stay (mean ± sd) was 11 ± 8 mg without vs. 3 ± 6 mg with distal sciatic nerve blockade (p< 0.05).

Conclusion: Continuous distal sciatic nerve blockade using a novel femoral supporting pad with an integrated ultrasound probe holder was feasible in 49 of 50 patients within 11 minutes and 30 seconds.

07/09/2019
Research Article

The value of routine ultrasound at discharge to identify patients at risk of developing symptomatic lymphoceles after kidney transplantation: A case-cohort study

Maja Joosten, Paul P Poyck, Frank C d’Ancona and Wilbert A van der Meijden*

Introduction: Ultrasound examination is frequently used to evaluate the graft after renal transplantation and to detect possible lymphoceles. The first ultrasound scan in our hospital is normally performed on the day of discharge. We questioned whether perirenal fluid collections detected by ultrasound examination at discharge are predictive for future symptomatic lymphoceles.

Methods: All ultrasound reports of all renal transplant recipients treated in our hospital between January 2010 and December 2017 were collected and screened for abnormalities such as fluid collections. Patients that developed a symptomatic lymphocele were compared with a control group from the same cohort. Sensitivity and specificity of ultrasound examination to detect symptomatic lymphoceles were calculated for the primary and consecutive ultrasounds tests.

Results: There were no significant differences at baseline characteristics between the Symptomatic lymphocele group and control group, with the exception of mean age at kidney transplantation (47 ± 17 years in the control group vs. 56 ± 13 years in the symptomatic lymphocele group, p=0.02).

The ultrasound examination at discharge had a sensitivity of 31% and specificity of 87% to detect future symptomatic lymphoceles. The positive predictive value was only 10%. The second ultrasound test had the best test variables to detect symptomatic lymphoceles with a sensitivity of 93% and a specificity of 87% and a predictive value of 28%.

Conclusion: Routinely use of ultrasound testing on the day of discharge does detect perirenal fluid collections, but is not predictive for development of symptomatic lymphoceles in the future.

07/09/2019
Research Article

Effectiveness of dexamethasone and hyaluronidase + valerate of bethasone associated with prepucial massage in the treatment of child phimosis

Anna Karoline da Rocha and Karine Furtado Meyer*

Introduction: The phimosis condition is characterized by the inability to retract the foreskin on the glans, making it impossible to expose them. Surgical treatment, although effective, has been questioned by the risk to which the patient is exposed. Therefore, we have opted for the use of topical corticosteroids to resolve this pathology.

Goals: To compare the effectiveness of Dexamethasone and Hyaluronidase + Betamethasone Valerate associated with preputial massage in the treatment of infantile phimosis, the degree of regression of phimosis, the time needed to achieve complete efficacy, possible adverse reactions, long-term outcome and parental adherence to treatment in children attending a specialized service in Blumenau, Santa Catarina.

Materials and methods: Controlled clinical trial, quantitative, non-blind, prospective and randomized sample analysis through the analysis of 523 patients.

Results: After 1 month of treatment, 435 patients presented some degree of regression and 63 children were referred to surgery. The success rate in this period was 45.8% in boys who were taking Hyaluronidase + Betamethasone Valerate and 49.8% in those who used Dexamethasone. In the late evaluation, 398 children reached grade 0, and 213 used Hyaluronidase + Betamethasone Valerate and 185, Dexamethasone; 39 patients were referred to the postectomy. Adherence to treatment was similar in both groups. The average time for degree 0 to be reached similar in both.

Conclusion: Both topical corticosteroids were effective in the resolution of phimosis. However, in the evaluation after the first month and in the regression, Dexamethasone proved to be more effective. The time to resolution of the condition was similar for both. The surgical procedure was taken when there was no clinical improvement. No adverse effects were reported in both groups.

07/09/2019
Case Report

Mimicking multiple sclerosis - Ghost tumor that comes and goes in different parts of the brain without any treatment

Long Ching*, Ming Him Yuen, Tak Lap Poon, Fung Ching Cheung, Shun Hin Ting and Wing Chi Fong

Lesions that spontaneously come and go in central nervous system without any treatment at different time points and at different locations (CNS) usually lead ones to think of the possibilities of multiple sclerosis. However, sometimes there are exceptions. Surgical biopsy remains an important tool for defi nitive diagnosis in difficult cases. We report a case of intracranial diffuse large B cell lymphoma that spontaneously disappeared without any treatment and then reappeared at different time points and different locations.

07/09/2019
Research Article

Diseases of the mental sphere revealed by the psychiatrist at contingent of patients of the consultative outpatient admission

Shapovalova LA, Shapovalov КA

Introduction: The problem of protecting and strengthening the mental health of the population is the most important task of ensuring the socio-economic well-being of the Komi Republic (RK) as an integral part of the Russian Federation (RF), since it is a key resource for the development of a subarctic region.

The aim of the work: was to characterize diseases of the mental sphere revealed by the psychiatrist at contingent of patients of the consultative outpatient admission at the 1State Autonomous Health Agency of the Republic of Komi “Consultative and Diagnostic Center of the Republic of Komi” (SAHA RK “CDC”) of the subarctic territory.

Materials and methods: The analysis of a continuous sample of 6255 patients of the psychiatrist of the consultative department in 2015-2017 was carried out. on the basis of medical records. Analysis methods included: analytical and statistical. The control group consisted of a continuous sample of 5,356 psychiatric patients in 2010–2012. The depth of the study was 8 years.

Discussion: Trends in changes in demographic indicators, including gender and age, in the structure of patients of a psychiatrist in an outpatient consultative procedure are considered. Indicators of the identified pathology of the mental sphere, including the first identified and pathology in patients suffering from epilepsy in comparison with the control group are given. Attention is paid to the organizational and methodological work of an outpatient counseling psychiatrist on the targeted identification by internists of signs of mental pathology in patients referred to a diagnostic center with somatic diseases. Priorities for the improvement of specialized advisory (including psychiatric) assistance to the population of the RK and ensuring its quality were identified.

Conclusions:

1. The psychiatrist of the advisory department in 2015-2017. 6255 people were accepted (889 more than in the control group of 2010-2012). The increase was 16.78%. Primary patients account for 64.38% of the total number of people who applied to a psychiatrist (4027 people)

2. In the structure of the psychiatric pathology of the outpatient psychiatric appointment, the proportion of organic, including symptomatic, mental disorders (F00-F09) is 47.9±0.6%; neurotic, stress-related and somatoform disorders (F40-F49) - 39.6±0.6%; mental and behavioral disorders associated with the use of psychoactive substances (F10-F19) - 3.5±0.2%; mood disorders (affective disorders) (F30-F39) - 2.8±0.2%.

3. The most frequently detected pathologies in patients with epilepsy are: 1) Mild cognitive impairment; 2) Personality disorders; 3) Organic emotionally labile (asthenic) disorders. Their share annually accounts for 71.5%-75.8% of all types of nosological forms. The fourth and fifth ranking places are taken by: 4) Organic anxiety disorders; 5) Non-psychotic depressive disorders. Rarely diagnoses are established: “Organic Amnesia Syndrome” and “Dementia”.

4. Organic, including symptomatic, mental disorders prevail in the structure of newly discovered mental disorders; neurotic, stress-related and somatoform disorders (up to 87.7%). Mental and behavioral disorders associated with the use of psychoactive substances and mood disorders (affective disorders) do not exceed 8.4%.

Conclusions:
 
1. The psychiatrist of the advisory department in 2015-2017. 6255 people were accepted (889 more than in the control group of 2010-2012). The increase was 16.78%. Primary patients account for 64.38% of the total number of people who applied to a psychiatrist (4027 people).
 
2. In the structure of the psychiatric pathology of the outpatient psychiatric appointment, the proportion of organic, including symptomatic, mental disorders (F00-F09) is 47.9±0.6%; neurotic, stress-related and somatoform disorders (F40-F49) - 39.6±0.6%; mental and behavioral disorders associated with the use of psychoactive substances (F10-F19) - 3.5±0.2%; mood disorders (affective disorders) (F30-F39) - 2.8±0.2%.

07/09/2019
Research Article

Micropollutants in wastewater irrigation systems: Impacts and perspectives

Jimena Lazaro Gil*

Climate change and the increasing global population pose a severe threat to the availability of freshwater in the world. Over consumption of water and deteriorating water quality are problems that should be addressed in order to ensure water availability for the coming decades. In this context, the increasing presence of micropollutants in water has shown to cause detrimental impact on water quality, given the negative disturbances that they can cause on human health and on the environment. Thus, it is important to study and quantify the presence of micropollutants in water bodies and also in regenerated wastewater based irrigation systems.

07/04/2019
Case Report

Benzine as fire source in operation room

Domingos Dias Cicarelli*, Fernando Chuluck Silva, Carolina Martins Ricardo, Ana Carolina Makinoo Antunes, Murilo Alexandre Carmona and Maria Jose Carvalho Carmona

Provide a safety anesthesia to patient is only possible with the knowledge of material surrounding the operation room. Benzine is highly flammable substance and can produce several injures without the necessary care. This case describes a small fire caused by the presence of benzine in the surgical field concomitant with the use of electrocautery, which caused slight burns to the patient, but which could have been catastrophic, and proposes the use of protocols to prevent such accidents.

07/04/2019
Review Article

Let us start an epidemic by giving away kindness

Yvonne Russer and Kuruvilla George*

‘Patients were left in soiled sheets or sitting on commodes for hours. Some patients needing pain relief got it late or not at all.’ These were a sample of the findings in the Francis Report which revealed severe failings in patient care in the Mid Staffordshire NHS Foundation Trust in the UK. Recommendations in the Francis Report included the need to recruit compassionate staff and having compassion training for clinicians [1].Whether telling a young man that he has cancer or comforting an elderly woman who is feeling anxious, the health professional needs to be skilled in understanding what the other person is going through and respond appropriately.. The crisis of compassion in medicine is multifaceted in origin and some factors identified in the Francis Report were compassion fatigue, overwork, excess demand, lack of continuity and the failure to see the patient as a fellow human being [1]. Unfortunately modern medical practice prioritises technical progress, evidence-based medicine, meeting targets set by bureaucrats and efficiency at the expense of the ‘soul of medicine and medical practice’. Meeting key performance indicators (KPIs) has become the priority rather than the patient. Couple of other factors include increasing commercialisation of healthcare and the overemphasis of the biomedical model in medicine.

07/05/2019
Editorial

Varicella zoster virus: The potentially useful virus

Al-Anazi KA* and Al-Jasser AM

Varicella zoster virus (VZV), a double-stranded DNA virus, is a highly contagious human neurotropic virus that belongs to the alpha group of herpes viruses [1-4]. Primary VZV infection (chickenpox) occurs in childhood then the virus becomes latent in the nerve ganglia [1,5-7]. Reactivation of the virus may occur decades later and cause herpes zoster (HZ) which is manifested by a typical painful skin eruption that has characteristic dermatomal distribution [1,5]. Reactivation of VZV is usually predisposed to: old age; comorbid medical conditions such as diabetes mellitus, chronic obstructive airway disease, and end-stage renal disease; and immunosuppression due to malignancy, autoimmune disorders, immunosuppressive therapies, trauma, cytotoxic chemotherapy, hematopoietic stem cell transplantation (HSCT), and solid organ transplantation (SOT) [1,5-7].

VZV infections can cause not only transient pancytopenia but also aplastic anemia that may require allogeneic HSCT [8-12]. Additionally, VZV infections have been reported to be associated with increased risk of developing lymphoid malignancies and solid tumors [13-17]. On the contrary, there is growing evidence showing certain beneficial effects of the virus in immunocompromised individuals and these effects may be translated into prolongation of overall survival (OS) [18,19]. In a single center, case-controlled, retrospective study that included 16 episodes of VZV infections occurring in 14 patients with various types of hematologic malignancies (HMs) and bone marrow (BM) failure syndromes, Al-Anazi KA et al., reported an increase in white blood cell count, hemoglobin (Hb) level, and platelet count starting approximately 6 weeks following VZV infections and this stimulation of the 3 hematopoietic cell lines in the BM that followed VZV infections was maintained for periods longer than 3 years following the infection [18]. In another single center retrospective study that included a large number of patients with multiple myeloma subjected to high-dose melphalan followed by autologous HSCT after control of their primary disease, Kamber C et al., reported that approximately one third of these patients developed VZV infections either before or after HSCT [19]. Despite encountering VZV infections in patients with worse expected prognosis, the OS in patients who developed VZV infection was superior to that in patients who never developed the infection [19]. Recently, Al-Anazi KA et al., reported BM biopsy-proven reversal of pure red cell aplasia manifested by a gradual increase in Hb level starting 6 weeks following a localized HZ infection till the Hb level plateaued above 14g/dL fourteen months following the viral infection [4]. Additionally, several studies have demonstrated that VZV infection may trigger chronic graft versus host disease (GVHD) following allogeneic HSCT [20-22]. GVHD is associated with graft versus cancer effects and, provided GVHD is of low-grade, it can be associated with improvement in OS in patients with acute leukemia or lymphoma [23-25].

07/02/2019
Research Article

Maternal mortality and factors affecting it, among pregnant women in Abeokuta South, Nigeria

Tumilara Busayo Amoo* and Oyinkansola Sarah Ajayi

This observational study assessed the knowledge of pregnant women attending antenatal clinics at two selected hospitals in Abeokuta South, Nigeria on the causes and risk factors of maternal mortality, identified barriers to knowledge acquisition, and examined the influence of parity of respondents on their knowledge of factors causing maternal mortality. Maternal mortality is extremely high in Nigeria, it is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. Descriptive research design was used in this study and qualitative data from 136 respondents selected randomly, were obtained through a self-designed questionnaire that comprised three sections. Data were analyzed and indicated that parity of the pregnant women do not have an influence on their knowledge of factors responsible for maternal mortality. Findings revealed that majority (67.6%) of the respondents had high knowledge on the causes of maternal mortality – haemorrhage, sepsis, prolonged/obstructed labour, anaemia, unsafe abortion, infection, hypertensive disorders, care rendered by unskilled medical practitioners and its risk factors - parity, poverty, place of last delivery and low attendance at antenatal clinic. Educational background, marital status, irregular antenatal visits, socio-cultural practices and occupational status were identified as barriers to knowledge acquisition. This paper concluded that pregnant women may have a high knowledge about the factors responsible for maternal mortality. This is probably due to the fact that all respondents had formal education and because they were interviewed on antenatal clinic days, which suggests that they might have heard about the causes and risk factors for maternal mortality during their visits. Authors recommended that government should employ qualified health professionals and provide medical subsidy, it is hoped that this will ensure that pregnant women get quality care throughout the period of pregnancy and delivery.

07/02/2019
Case Report

Mesenteric cysts: A rare case

Maryam Asgharnia*, Tayebeh Rahbar and Seyedeh Fatemeh Dalil Heirati

Mesenteric cysts are rare benign intra-abdominal tumors with an incidence of 1 case per 250,000 hospital admission. This lesion occurs most frequently in women in the reproductive period.The etiology of such cysts remains unknown but several theories regarding their development exist. Most of these lesions present with vague abdominal pain and nausea. Less commonly they will present with bowel obstruction due to external compression. The diagnosis of these tumors is by abdominal ultrasound or computed tomography. We report a case of Mesenteric cyst in 51-year-old female patient.

07/02/2019
Research Article

Focused Antenatal Care in urban Ghana: A qualitative study into physical accessibility of maternal health services in Kwabre East Municipality

Akowuah Jones Asafo* and Kwarteng Bernard Owusu

Background: Accessibility to healthcare is a major component of primary health care campaign for maintaining population health. Owing to this, the government of Ghana has instituted the free maternal care and focused antenatal care policies into the maternal health care policies to woefully control maternal mortality, morbidity and to ensure improved access, quality and continuous ANC use among pregnant women. Despite these interventions, pregnant women in the Kwabre East Municipality do not fully use ANC services as recommended by the World Health Organization.

Methods: Using an in-depth interview and two focus groups conducted with women of reproductive age (15-49) in the Kwabre East Municipality. The study investigated women’s opinions, perceptions and experiences on their ANC visits.

Results: The study revealed that physical accessibility and the social context of pregnant women continue to influence their ANC use even after the introduction of the free maternal care and focused antenatal care policies.

Conclusion: The study suggests that in order to fully utilize ANC visits as recommended by the WHO in the Kwabre East Municipality, the Municipal Health Directorate should liaise with collaborating stakeholders if not eliminating to limit the influence of restrictive factors to women’s quest of using ANC. It is further recommended that management do away with hindrances that delay women who seek for ANC services in health facilities and adopt strategies and procedures that aim at increasing ANC uptake.

07/02/2019
Research Article

Determinants of women’s perceived satisfaction on Antenatal care in urban Ghana: A cross-sectional study

Akowuah Jones Asafo* and Danquah Benedicta Adoma

Despite evidence on major interventions on the uptake and scale up of interventions meant to promote maternal health care services, little is known about adequate use of such program in urban Ghana among reproductive aged women. This study examined the determinants of women’s Satisfaction on antenatal care use in selected health facilities in the Kwabre East Municipality of Ghana. Using facility-based cross-sectional survey design, a three-stage sampling technique was conducted to sample 220 women attending postnatal care at selected public health facilities. Open-ended questionnaires were used to obtain data from respondents. Descriptive statistics and inferential statistics including binary logit regression model were used to analyze the data with the help of SPSS and STATA software. Logit analytical framework was computed to determine equations of variance. The association between antenatal care use and women’s satisfaction was determined and assessed using Pearson’s χ2 (2) test indicating 1% was run. Most women (92.7%) had at least four ANC visits during their entire pregnancy. The results indicate standard deviation of 7 with 81% regular ANC visits and 19% irregular. Most women (55%) received care by one caregiver, followed by women (35%) who received care by two caregivers and women (10%) who were cared for by three caregivers. The regression results showed varying utilization levels of 10%, 5% & 1% ANC satisfaction. System induced factors aimed at promoting maternal care use satisfaction are suggested. 

07/04/2019
Research Article

Non-chemical control of Armillaria mellea infection of Prunus persica

Jim Downer* and Ben Faber

Peaches, Prunus persica were planted as grafted saplings in an avocado orchard previously infested with Armillaria mellea (Vahl) P.Kumm. Trees were planted in large or small holes with or without fresh yardwaste chips added as an amendment and with or without a Trichoderma biocontrol product sprayed into the hole. Trees were monitored for six years -- growth and mortality was tabulated.Six years later 40% of the trees had died from the disease. Trees planted in a large hole were more likely to survive than in a smaller hole (P=0.07) and trees in large holes with fresh organic matter added were the most likely to survive (P=0.04). Trichoderma sprays in the planting hole did not increase survival rates. While growth was initially retarded by adding fresh yardwaste to the hole, in later years none of the treatments affected growth rates.

07/21/2019
Case Report

Glomus Tumor of the Scrotum: A Case Report

Stephen Legg*

Glomus tumors are rare, usually benign, lesions that arise most often in the
extremities. They are derived from the glomus body and have a propensity to be found in the fingers and toes, and often in the subungual area [1]. They typically demonstrate pinprick sensitivity, cold hypersensitivity and paroxysmal pain [2]. Only two glomus tumors of the scrotum have been reported and we report a third case of this rare tumor.

07/02/2019
Research Article

Insilico investigation of TNFSF10 signaling cascade in ovarian serous cystadenocarcinoma

Asima Tayyeb* and Zafar Abbas Shah

The ovarian serous Cystadenocarcinoma shared large number of deaths in gynecologic carcinoma. It has various numbers of molecular events from initiation to progression and at advance stage, surgery is the end product of such molecular signaling. We assess in this study the whole mechanistic view of TNFSF10 network which has the ideal apoptotic causing identity. We used fresh insilico strategy to uncover the secrets and inter-links from its protein-protein interaction complex. We retrieved the TNFSF10 signaling network from STRING database (www.string-db.org). The network contains 25 nodes and 152 edges with clustering presentation. After retrieval, we performed gene enrichment and characterization analysis of network from WebGestalt toolkit (www.webgestalt.com). Finally, we examined the participation of whole network in ovarian cancer progression from cBioPortal, a cancer genomic data portal (www.cbioportal.org). Our results showed that majority of cases have loss of function of death receptors (DR4 and DR5) that are the main unit of initiation of apoptotic signaling. Most of downstream signaling members showed amplification that regulates cell proliferative pathways including NFkB pathway. TNFSF10 cluster has loss of function and in future it gain attention for further research studies to discover its interactome level view for valuable therapy. FAS cluster has large number of members and majority showed amplification rendering them as co-targets for combinational drug designing.

07/01/2019
Review Article

Cardiomyopathies - The special entity of myocarditis and infl ammatory cardiomyopathy

Felicitas Escher*, Uwe Kuhl, Dirk Lassner and Heinz-Peter Schultheiss

Cardiomyopathy is a heart muscle disease with structural and functional myocardial abnormalities in the absence of coronary artery disease, hypertension, valvular disease, and congenital heart disease. However, it has become clear that diverse etiologies and clinical manifestations (e.g. arrhythmogenic right-ventricular cardiomyopathy/dysplasia (ARVC/D), ARVD/C, left-ventricular non-compaction cardiomyopathy (LVNC)) are responsible for the clinical picture of dilated cardiomyopathy (DCM).