Τρίτη 25 Οκτωβρίου 2016

A Rare Case of Hamartoma Chest Wall Following Trauma in a 42-year-old Man

2016-10-25T18-45-55Z
Source: Medical Archives
Mojtaba Ahmadinejad, Asghar Alie Pour, Peyman Khadem Hosseini, Amir Masoud Hashemian, Koorosh Ahmadi.
Background: Chest wall mesenchymal hamartoma (CWH) is a distinct and extremely rare tumor-like lesion of the thorax. It usually presents in the neonatal period or in infancy. The common presentation is in the form of a visible chest wall mass with or without respiratory distress. Case presentation: A 42-year-old man with a history of chest wall trauma since 5 years ago was admitted with a swelling of the anterior of the chest wall and during this period has grown slowly. Physical examination showed a left anterior chest wall deformity. Chest radiographs and chest CT showed a left anterolateral chest wall mass involving the fourth and fifth ribs. Thoracotomy was performed. The tumor and involved ribs were resected with a 5cm safe margin. The histopathologic examination showed hamartoma. The patient has been fallowed up since 60 month ago, and has not had any complaints in this time. Result: Despite the rarity of chest wall hematoma, this side effect must always be taken into consideration while studying the chest wall injuries especially in the case of trauma history due to other differential diagnosis and her side effects such as respiratory problems. Conclusion: Although rare, this condition ought to be kept in mind while dealing with hamartoma Chest wall following trauma in order to avoid its complications such as respiratory problems. Surgical excision is usually curative in combination with conservative therapy if possible.


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Colonic Perforation in a Young Tetraplegic Male Caused by Zucchini

2016-10-25T18-45-55Z
Source: Medical Archives
Biserka Pigac, Silvija Masic.
Introduction: Colonic perforation is a clinical condition which occurs due to variety of reasons, such as intrinsic disorders of the intestine, extrinsic causes, but also due to presence of foreign bodies. Foreign objects enter gastrointestinal tract by oral or transanal introduction. Case report: we present an uncommon case of a 26- year-old tetraplegic male, whose death was a consequence of a widespread purulent peritonitis provoked by colonic perforation inflicted by an unusual foreign body, transanally introduced 28 centimeters long zucchini (Cucurbita pepo L.). Conclusions: we share our experience in order to emphasize the importance of consideration and early recognition of foreign body presence in the alimentary tract as possible diagnosis.


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Adenoid Cystic Carcinoma of The breast: a Clinical Case Report

2016-10-25T18-45-55Z
Source: Medical Archives
AAkin Firat Kocaay, Suleyman Utku Celik, Ilkin Hesimov, Tevfik Eker, Sibel Percinel.
Introduction: Adenoid cystic carcinoma (ACC) is an uncommon tumor of the breast, accounting for approximately 0.1% to 1% of all breast cancers. It is characterized by rare lymph node involvement and distant metastasis, and associated with a favorable prognosis with excellent survival, despite its triple-negative status. In the current state of knowledge, results of breast-conserving treatment with postoperative radiotherapy seem to be equivalent to mastectomy alone, with respect to survival for ACC of the breast. Due to its rarity, there is no consensus on optimal treatment for patients with ACC. Otherwise, the role of chemotherapy and hormonal therapy remains controversial. Further clinical studies are required to compare treatment options for ACC. But, a long-term follow-up is very important and mandatory for affected patients, due to the late onset of local relapse and occurrence of distant metastasis. Case report: Here, we report the case of a patient who presented with a palpable breast mass in the left breast that turned out to be an ACC of the breast.


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Accessory Spleen in the Splenic Hilum: a Cadaveric Study with Clinical Significance

2016-10-25T18-45-55Z
Source: Medical Archives
Shabnam Mohammadi, Arya Hedjazi, Maryam Sajjadian, Naser Ghrobi, Maliheh Dadgar Moghadam, Maryam Mohammadi.
Aim: An accessory spleen is an additional tissue of the spleen that may be found near the spleen. It is a congenital anomaly of the spleen that its incidence has been reported 10-30% of the population. Hence, the objective of this study was evaluation the incidence of accessory spleen in Iranian cadavers. Method: Sixty hundred and ninety three spleens (541 males, 152 females) were excised from cadavers in the dissection hall of Mashhad Forensic Medicine Organization cadavers. Inclusion criteria were as follows: Fresh Iranian cadavers with no history of alcohol, poisoning or drug abuse, and no evidence of pathologic abnormality or injury to the spleen. The presence of accessory spleens, its dimension and weight investigated in cadavers. Results: During routine postmortem examination, five cases with an accessory spleen were found in the autopsy laboratory of Mashhad legal Medicine Organization between June 2014 and July 2015. Of the cases, 3 were male and 2 were female. The accessory spleens were observed at the splenic hilum. The length of the accessory spleens ranged from 2-3.5 cm, while the range of width was between 0.5 and 2.5 cm. The accessory spleens were confirmed by histological examination. Conclusion: An accessory spleen has clinical importance in some locations. When an accessory spleen is situated in another site, it may mimic some tumors such as pancreatic tumor and adrenal tumor. In addition, accessory spleen may cause hyperplasia after splenectomy and be responsible for a recurrence of the hematological disorders.


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Modern Strategy for Identification of Congenital Heart Defects in the Neonatal Period

2016-10-25T18-45-55Z
Source: Medical Archives
Mediha Kardasevic, Ida Jovanovic, Jelica Predojevic Samardzic.
Introduction: Congenital heart defects are the most common congenital anomalies and occur with an incidence from 0.8 to 1% per 1000 live births. In recent years, the pulse oximetry has become a strong candidate for detecting cyanogen congenital heart defects and in combination with routine clinical exam can improve diagnostic of congenital heart diseases. Objective: To apply the modern algorithm for early detection of congenital heart defects in order to improve the diagnosis in the neonatal period. Patients and Methods: This was a prospective study that included children born in Bihac Cantonal Hospital during 2012. The diagnostic algorithm included a clinical examination of the newborn, measuring of transcutaneous oxygen saturation with the pulse oximeter between 24 and 48 hours of life, and, in some cases, additional tests (cardiac ultrasound). Results: A total of 1,865 children were examined. The application of diagnostic protocol identified the existence of congenital heart defects in 29 children. In re-evaluating the auscultator and ultrasound findings, we identified congenital heart defects in 19 children. Conclusion: The application of the modern algorithm for early detection of congenital heart diseases in the neonatal period can significantly improve the making of diagnosis of these anomalies. The concept is simple, inexpensive and applicable in most maternity wards.


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Pressure Ulcers: Developing Clinical Indicators in Evidence-based Practice. A Prospective Study

2016-10-25T18-45-55Z
Source: Medical Archives
Konstantinos Tsaras, Maria Chatzi, Christos F. Kleisiaris, Evangelos C. Fradelos, Lambrini Kourkouta, Ioanna V. Papathanasiou.
Aims and objectives: It is widely recognized that Intensive Care Unit (ICU) patients have a greater likelihood of developing pressure ulcers in comparison to hospital or home care patients. Accordingly, this study aimed to evaluate whether specific clinical characteristics could be used as clinical indicators towards pressure ulcers prevention. Method: We monitored 210 hospitalized ICU patients during a 12-month period. Pressure ulcers were assessed following the current guidelines. Clinical characteristics such as gender, age, hospitalized days, hemodialysis treatment, hematocrit, and serum albumin levels were considered as the most common predictors for pressure ulcers development. The significance of associations was controlled using multiple logistic regression after adjusting for clinical characteristics and was presented as adjusted odds ratio (AOR). Results: The prevalence of pressure ulcers was 24.3%. Logistic regression revealed that patients with increased age AOR=1.04; (CI: 1.01-1.07) and last-long hospitalization AOR=1.17; (CI: 1.11-1.23) were significantly more likely to present pressure ulcers compared to the younger ones and patients with less length of stay, respectively. We also found that patients under hemodialysis treatment were more likely to present pressure ulcers AOR=4.09; (CI: 1.12-14.98) compared to patients that did not underwent hemodialysis and the risk of pressure ulcers development was decreased by 9% for every single unit of hematocrit value increase AOR=0.91; (CI: 0.82-0.99). Conclusion: Our data analysis confirms that the clinical characteristics that were studied are independently associated with pressure ulcers development, and therefore, it is a crucial incentive to consider that these specific clinical characteristics are important indicators in the evidence-based practice.


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Does Remote Ischaemic Preconditioning Protect Kidney and Cardiomyocytes After Coronary Revascularization? A Double Blind Controlled Clinical Trial

2016-10-25T18-45-55Z
Source: Medical Archives
Seyed Mahmoud Nouraei, Afshin Gholipour Baradari, Asieh Jazayeri.
Objective: To investigate efficacy of remote ischaemic preconditioning on reducing kidney injury and myocardial damage after coronary artery bypass grafting surgery (CABG). Background: Ischaemic preconditioning of a remote organ reduces ischaemia-reperfusion injury of kidney and myocardium after CABG. Method: To reduce myocardial damage and kidney injury by applying Remote Ischaemic Preconditioning we recruited 100 consecutive patients undergoing elective coronary artery bypass grafting surgery. We applied three cycles of lower limb tourniquet, inflated its cuff for 5 minutes in study group or left un-inflated (sham or control group) before the procedure. The primary outcome was serum creatinine, creatinine clearance and troponin-I Levels at time 0, 6, 12, 24 and 48 h. Secondary outcomes were serum C-reactive protein, inotrope score, ventilation time and ICU stay. Datas were analyzed by MedCalc (MedCalc Software bvba, Acacialaan, Belgium). We compared the two group by student t test, chi-square and Mann-Whitney tests. Results: The two groups were not statistically different in terms of age, gender, smoking habits, drug use, hypertension, hyperlipidemia and diabetes mellitus. This study showed a higher CRP level in study group comparing with control group (P=0.003), creatinine clearance was slightly higher in study group specially 24 h after procedure but was not statistically significant (p=0.11). Troponin-I level was significantly lower in study group (p=0.001). Conclusion: This study showed a lower Troponin-I level in study group which suggest a cardio-myocyte protective function of RIPC. It also showed slightly lower Creatinine clearance in control group, gap between two group increases significantly 24 hours after procedure which may suggest a potential kidney protection by RIPC. Serum CRP level was higher in study group. A multi-center randomized controlled trial with a longer time for creatinine clearance measurement may show the potential effectiveness of this non-invasive inexpensive intervention on reducing kidney injury after CABG.


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Evaluation of Risk Factors of Surgical Wound Dehiscence in Adults After Laparotomy

2016-10-25T18-45-55Z
Source: Medical Archives
Goran Aksamija. Adi Mulabdic, Ismar Rasic, Lejla Aksamija.
Objectives: The percentage of patients with difficult and prolonged healing of the wound is still high, while the immediate complications such as wound dehiscence occurs in up to 3 % of all treated patients in abdominal surgery. The aim of study was to analyze the risk factors and comorbidities in the group patients undergoing laparotomy and associated with early postoperative wound dehiscence. Methods: The retrospective study included all patients treated surgically at Clinic of General and Abdominal surgery, Clinical Center of the University of Sarajevo in the period from January 1, 2013 until January 1, 2016, with clinically verified surgical wound dehiscence. Results: The results showed statistically proportion of male patients (70%) compared to female (30%). The largest number of respondents were in age group 71-80. Surgical wound infection was evident in 61% of patients, malignant staining in 52%, hypoproteinemia was found in 50% of patients, anemia in 43%, peritonitis in 36% and diabetes in 14% of respondents. Of the total respondents with surgical wound dehiscence, 30 (68%) had comorbidities present. By analyzing the prevalence of comorbidity and risk factors recorded in relation to comorbidity, it was noted that hypertension is most often associated with hypoproteinemia (X2=4.399; p=0.036), wound infection (X2=4.112; p=0.043) and malignant diseases (X2=4.016; p=0.045). The frequency of the anemia, peritonitis and diabetes in the sample was not different in relation to the comorbidity conditions (p >0.05). Conclusions: The risk factors occurrence of surgical wound dehiscence in our study were identified as hypoproteinemia, malignant disease, anemia and peritonitis. The highest incidence of dehiscence was in patients operated on in medical emergencies, and in patients with malignant disease.


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Relationship Between Genotype Variants Follicle-stimulating Hormone Receptor Gene Polymorphisms (FSHR) and Morphology of Oocytes Prior to ICSI Procedures

2016-10-25T18-45-55Z
Source: Medical Archives
Zafer Gashi, Shkelzen Elezaj, Afrim Zeqiraj, Driton Grabanica, Isak Shabani, Bujar Gruda, Fitore Gashi.
Introduction: This study investigated association of Asn680Ser FSHR polymorphism with the ovarian response in 104 women of Albanian ethnic population enrolled in ICSI program. The reason of infertility in all cases has been identified as male factor. Methods: Analysis of the Asn680Ser polymorphism was performed using TaqMan® SNP Genotyping Assay. Clinical and endocrinologic parameters were analyzed based on the genotype, age, BMI, oocyte yield, number of transferred embryos and pregnancy rate. Results. The frequencies of the Asn680Ser genotype variants were as follows: Asn/Asn 22.1%, Asn/Ser 47.1%, and Ser/Ser 30.8%, respectively. BMI was significantly higher in the Ser/Ser group as compared to those from the Asn/Ser or the Asn/Asn group (p= 0.0010). The genotype variants Ser/Ser indicates a higher rate of oocyte retrieval (25.9%) in the immature form, metaphase I (MI) as opposed to the other two groups (Asn/Asn 23.7 % vs. Asn/Ser 21.9%), which was statistically significant (p = 0.3020). Conclusions: FSH receptor polymorphism is associated with different ovarian response to controlled ovarian stimulation (COS), but is not an important factor in increasing the degree of pregnancy. Polymorphisms of the FSH receptor is associated with normal morphology and genetic maturation (metaphase II) oocytes in dependence of genotypic variation polymorphisms.


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Musculoskeletal Health of 40-65 Year Old Males and Females in Kosova and the Impact of N05B, A02B (PPI, H2RA), H02AB and Lifestyle Factors on It

2016-10-25T18-45-55Z
Source: Medical Archives
Ermira Krasniqi, Mynyr Koni, Harald Tchan, Blerim Krasniqi, Antigona Kobashi, Arben Boshnjaku.
Background: This observational, cross-sectional study investigates the impact of medication usage, physical activity (PA) and nutritional status on musculoskeletal health (MSH) in males and females aged 40-65 in the population of a post conflict, developing country. Methods: Bone Mineral Density (BMD), T-score and Z-score at distal forearm regions (measured by DEXA scan), together with isometric hand grip strength (dynamometer) were evaluated in a total of 162 subjects (53 Males, average age 55.15±7.12 and 109 Females, 54.27±5.1). Additionally, bio-anthropometric assessments, medication usage, PA level and nutritional status were assessed. Results: Significant differences (p0.05) in BMD, T-score, and hand grip in total population, except for A02B where p


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The Most Common Detected Bacteria in Sputum of Patients with Community Acquired Pneumonia (CAP) Treated In Hospital

2016-10-25T18-45-55Z
Source: Medical Archives
Vesna Cukic, Armin Hadzic.
Introduction: Community acquired pneumonia (CAP) is the most common infective pulmonary disease. Objective: To show the most common detected bacteria in bacterial culture of sputum in patients with CAP hospitalized in Clinic for Pulmonary Diseases and TB Podhrastovi in four-year period: from 2012 to 2015. Material and methods: This is the retrospective analysis. Each patient gave sputum 3 days in a row when admitted to hospital. Sputum has been examined: bacterial culture with antibiotics sensitivity, Gram stain, Mycobacterium tuberculosis; in cases with high temperature blood cultures were done; when we were suspicious about bronchial carcinoma bronchoscopy with BAL (bronchoalveolar lavage) was done. We show analyzed patients according to age, sex, whether they had pneumonia or bronchopneumonia, bacteria isolated in sputum and in BAL. Results: 360 patients with CAP were treated in four-year period (247 males and 113 females). 167 or 43, 39 % had pneumonia (119 males and 48 females). Number of males was significantly bigger (χ2 = 30,186; p


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Behavioral Problems and Emotional Difficulties at Children and Early Adolescents of the Veterans of War with Post-Traumatic Stress Disorder

2016-10-25T18-45-55Z
Source: Medical Archives
Zihnet Selimbasic, Osman Sinanovic, Esmina Avdibegovic, Maja Brkic and Jasmin Hamidovic.
Introduction: Behavioral problems and emotional difficulties at children of the veterans of war with post-traumatic stress disorder (PTSD) have not been researched entirely. In our country, which has a lot of persons suffering from some psychological traumas, this trauma seems to continue. Aim: The aim of this study was to determine the exposure, manifestations of behavioral problems and emotional difficulties at children and early adolescents, whose fathers were the veterans of war demonstrating post-traumatic stress disorder symptoms. Material and methods: The analyzed group comprised 120 school age children (10-15 years of age), whose parents/fathers were the veterans of war. The children were divided into two groups, and each group into the following two age sub-groups: 10-12 (children) and 13-15 (early adolescents) according to PTSD presence at their fathers veterans of war. PTSD symptoms at fathers, veterans of war, were assessed using the Harvard Trauma Questionnaire - Bosnia and Herzegovina version and MKB-10 audit of criteria. To assess the behavioral problems of children, the Child Behavior Checklist for parents was used, and to evaluate the neuroticism at children HanesScale of neuroticism-extraversion was used while the depression level was evaluated using the Depression self-rating scale (DSRS). To analyze the obtained results, SPSS 17 software was used. The value p


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Expression IRF/MUM1>25% Predictor to Three-year Survival of Diffuse Large B Cell Lymphoma in the Immunochemotherapy Era

2016-10-25T18-45-55Z
Source: Medical Archives
Alma Sofo-Hafizovic, Adisa Chikha, Refet Gojak, and Emina Suljovic Hadzimesic.
Introduction: Non Hodgkin lymphoma-Diffuse large B cell lymphoma (DLBC) is composed of more varieties of one disease. Analysis and understanding of a wide range of characteristics of the disease, which include: clinical, immunohistochemical, cytogenetic and molecular characteristics may improve treatment results. Aim: achieving the estimated three-year survival and influence of IRF/MUM1 expression to three-year survival. Material and methods: A study was retrospectiveprospective, patients were followed for seven years a period of dine. The study included 60 patients de novo DLBCL. Age was 18-72 years old, the average age 45 years, male 31 (51,7%) and female 29 (48.3%). Median follow-up was 47 months (3-91 months). To determine differentiation immunophenotype antibodies those were used: anti-CD20, anti-CD10, anti-Bcl-6, IRF-4/MUM1, CD 138. Results: Included the GCB type was 65%. Impact prognostic index IPI>2 GBC vs non GBC p=0,038 X2. Statistically significant difference was confirmed compared to the IPI> 2 to 3 year OS p


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Brain Edema After Ischaemic Stroke

2016-10-25T18-45-55Z
Source: Medical Archives
Zikrija Dostovic, Ernestina Dostovic, Dzevdet Smajlovic, Omer C. Ibrahimagic and Leila Avdic.
Objectives: To determine the incidence of brain edema after ischaemic stroke and its impact on the outcome of patients in the acute phase of ischaemic stroke. Patients and Methods: We retrospectively analyzed 114 patients. Ischaemic stroke and brain edema are verified by computed tomography. The severity of stroke was determined by National Institutes of Health Stroke Scale. Laboratory findings were made during the first four days of hospitalization, and complications were verified by clinical examination and additional tests. Results: In 9 (7.9%) patients developed brain edema. Pneumonia was the most common complication (12.3%). Brain edema had a higher incidence in women, patients with hypertension and elevated serum creatinine values​​, and patients who are suffering from diabetes. There was no significant correlation between brain edema and survival in patients after acute ischaemic stroke. Patients with brain edema had a significantly higher degree of neurological deficit as at admission, and at discharge (p = 0.04, p = 0.004). Conclusion: The cerebral edema is common after acute ischaemic stroke and no effect on survival in the acute phase. The existence of brain edema in acute ischaemic stroke significantly influence the degree of neurological deficit.


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The Discrepancy Between Subjective and Objective Findings After Septoplasty

2016-10-25T18-45-55Z
Source: Medical Archives
Sekib Umihanic, Fuad Brkic, Munevera Osmic, Sefika Umihanic, Suad Imamovic, Samir Kamenjakovic and Samir Hodzic.
Introduction: Surgical and medical treatments of nasal obstruction are a common parts of otolaryngologist practice. The definitive treatment of deviated nasal septum is septoplasty. Aim: In this study was to evaluate the values of subjective parameters, and active anterior rhinomanometry parameters prior and three months after the septoplasty. Patients and Methods: We analyzed the subjective parameters (NOSE scale), the active anterior rhinomanometry parameters according to International Committee on Standardization of Rhinomanometry, on 40 patients. Thirty healthy adult volunteers participated belonged to the control group. None of the patients or healthy volunteers had previous history of nasal surgery or active rhinological disease. Results: The post-operative improvement in symptoms of nasal obstruction obtained in 92,5% patients and improvement parameters of the active anterior rhinomanometry in 42,5% patients. Conclusion: The correlation between the findings with rhinomanometry and subjective sensation of nasal patency remains uncertain. There still seems to be only a limited argument for the use of rhinomanometry for quantifying surgical results. Three months postoperative findings are very early results to interpret the permanent effects.


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Plasmapheresis in Pediatric Intensive Care Unit

2016-10-25T18-45-55Z
Source: Medical Archives
Verica Misanovic, Danka Pokrajac, Smail Zubcevic, Admir Hadzimuratovic, Samra Rahmanovic, Selma Dizdar, Asmir Jonuzi and Edin Begic.
Introduction: Plasmapheresis also known as a therapeutic plasma exchange (TPE) is extracorporeal procedure by which individual components of plasma that are harmful or blood cells can be removed from organism by using a blood separation technology. Aim: To present the results of the implementation of plasmapheresis in children in the Department of Pediatric Intensive Care of Pediatric Clinic, Clinical center of Sarajevo University, Bosnia and Herzegovina. Patients and methods: Research (period from December 2011 to June 2016) analyzed 66 plasmapheresis (11 patients6 plasmapheresis per patient). Results: Out of 11 patients, 7 (63.6%) were girls and 4 (36.4%) were boys. The average age of patients was 11.6 ± 3.9 years (the youngest patient had 4 years and 7 months, while the oldest had 16 years and 10 months). Plasmapheresis were significantly more often done in the winter and summer. Underlying disease was in 54.5% of cases of neurological origin. The treatment was in form of receiving IVIG in 7 patients, or the application of mechanical ventilation in 6 patients. The most common complication was hypotension, which occurred in 45.5% of patients, followed by bleeding in 36.3%, hypercoagulability in 27.2% of patients and hematoma in 27.2% of patients. Lethal outcome occurred in 3 (27.2%) patients. Conclusion: Plasmapheresis represents an invasive method due to need for placement of centralized venous catheter that provides adequate blood flow during the procedure. Although complications can be serious, they are rare and are mainly related to the presence of central venous catheter, hemostasis disorders due to use of anticoagulant therapy, and hypotension of the cardiovascular system. It should be noted that for success of plasmapheresis in children multidisciplinary approach is necessary (childrens nephrologist, neuropediatrician, intensive care doctor) as well as well-trained team of doctors and nurses with the acquired knowledge and skills.


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The Relationship Between Hemodialysis and the Echocardiographic Findings in Patients with Chronic Kidney Disease

2016-10-25T18-45-55Z
Source: Medical Archives
Hamidreza Omrani, Sanam Golshani, Vahid Sharifi, Afshin Almasi and Masoud Sadeghi.
Background: The incidence of cardiac morbidity and mortality is high in patients treated with hemodialysis (HD). The aim of this study was to evaluate the relationship between HD and the echocardiographic findings in patients with chronic kidney disease (CKD). Methods: Between 2012 and 2014, 150 patients with CKD. The echocardiographic data were done based on American Society of Cardiology (ASE). Measurement method for Ejection Fraction was E balling and for Diastolic Function was Tissue Doppler. Anemia, thyroid conditions and dialysis through an arteriovenous fistula or permanent catheter of dialysis for the patients are not considered. Results: The mean age at diagnosis for the patients was 57.8 years, 52.7% were males. Out of 150 patients, 112 patients (74.7%) had diabetes and 117 patients (78%) had a history of hypertension. The prevalence of all echocardiographic findings was more after the first dialysis compared with before the first dialysis in diabetic patients (P0.05). Conclusions: According to the findings of this study, seems that more accurate selection of patients for dialysis, paying special attention to hemodynamic change during dialysis, patient education about diet and better control of uremia and diabetes is essential.


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Ancient Indian Medicines

2016-10-25T17-58-36Z
Source: Annals of Ayurvedic Medicine
Vaishali Bhargava.
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AAPI Membership Form

2016-10-25T17-58-36Z
Source: Annals of Ayurvedic Medicine
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How to Subscribe the Journal

2016-10-25T17-58-36Z
Source: Annals of Ayurvedic Medicine
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Prof Ram Harsh Singh Conferred with' Padma Shree'

2016-10-25T17-58-36Z
Source: Annals of Ayurvedic Medicine
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Dosha phenotype specific Ayurveda intervention ameliorates asthma symptoms through cytokine modulations: Results of whole system clinical trial

2016-10-25T17-58-36Z
Source: Annals of Ayurvedic Medicine
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Regulation of Ayurvedic Education and Practice: Unresolved Issues

2016-10-25T17-58-36Z
Source: Annals of Ayurvedic Medicine
Prof Ram Harsh Singh.
Ayurveda is the oldest system of life science and health care in the world, its antiquity going back to the ancient Vedas. Originating from India Ayurveda seems to have reached its zenith in the period of its classics. Ayurveda is claimed to be the world view of its time in the field of life science and health care. With the fast emergence of new European medicine patronized by the British about two centuries ago Ayurveda stopped growing losing its ground and shrank to Indian subcontinent but survived in India and remained in unbroken clinical practice since antiquity till date but suffered great suppression. However, Ayurveda was preserved and practiced by popular Vaidyas largely unofficially without any state support. Thus Ayurvedic education and practice remained alive without any provision of state regulation.


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Burrowing Onto a New World: Entering 5th Consecutive Year of Publishing Annals of Ayurvedic Medicine

2016-10-25T17-58-36Z
Source: Annals of Ayurvedic Medicine
Sanjeev Rastogi.
When started in year 2012, Annals of Ayurvedic Medicine was more like a noble thought emerged as a compelling emotional reflection of ensuing responsibilities which someone sensible from Ayurveda fraternity may owe upon himself towards Ayurveda.


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Immunohistochemical Expression of Leptin (Ob-protein) in Experimentally Hypertensive Rat Kidney Tissues

2016-10-25T16-48-08Z
Source: Journal of Contemporary Medicine
Fikret Gevrek, Meral Öncü, Kanat Gülle, Dilek Bayram, Erdal Karaöz.
Objective: Leptin is an ob gene protein which has a 16 kDa weight. The aim of this study is to determine immunohistochemically the correlation between immunohistochemical expression of Leptin and hypertension in rat kidney tissues. Material and Methods: Wistar albino adult rats were divided into control and experiment groups, with six rats in each. L-NAME was given to the experiment group. The kidneys of all rats were excised surgically. After these kidneys were subjected to routine histologic and immunohistochemical processes, microscopic analyses were performed. Results: The blood pressure levels of the experimental group were higher than in the control, and their renal tissues had some distinctive histopathological changes. Additionally, Leptin immunostaining scores increased in the excretory tubule cells of hypertensive rats. Conclusion: Upregulation of Leptin expression may indicate that Leptin molecules have an important physiological role such as regulation of some kidney functions to adapt high blood pressure; or, contrary to this, they may be a pathophysiological sign. Further research is necessary to determine whether this situation is physiological or pathophysiological process.


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Relationship Between Hearing Losses with Tympanic Membran Perforations and Bony Chain Pathhologies in Chronic Otitis Media

2016-10-25T16-48-08Z
Source: Journal of Contemporary Medicine
Zeki SEZGİN, Mehmet KÜLEKÇİ.
Chronic otitis media ,which is identifed by tympanic membran perforation,suppurative ear discharge from the external ear canal,usually conductive type hearing loss,for more than three months ve resistant to medical treatment is an otitis media type.İn this study we investigated relationship between middle ear pathologies and hearing loss in 112 patients operated due to chronic otitis media between 1999 january and 1999 december in our clinic.Our patients were classified in two different groups as cholesteatomatous and non-cholesteatomatous chronic otitis media.Tympanic membran pathologies are classified as central,attic,total perforations,retraction and intact tympanic membran.Ossicles are classified as functional,destructed,no hearing bony structures and ossicular movement limited or fixed.Audiological tests were performed.Pure tone hearing treshould were determined.Effects about the hearing function of tympanic membran and ossiculer chaine pathologies are investigated.


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Short stature, insufficient annual height growth and back bone age: Nutritional growth retardation or growth hormone deficiency?

2016-10-25T16-48-08Z
Source: Journal of Contemporary Medicine
Oya Balcı Sezer, Derya Buluş.
Objective: Serum insulin-like growth factor 1 (IGF-1) concentrations are affected both by nutritional status and serum growth hormone levels, therefore IGF-1 is useful as an indicator of growth and nutritional status. The aim of this study is to determine the cut-off level of IGF-1 to differentiate nutritional growth retardation (NGR) from growth hormone deficiency (GHD) in children with insufficient annual height growth and back bone age. Design: The study group included 57 children who had been diagnosed with NGR due to malnutrition and 36 children with similar age and sex, who had been diagnosed with short stature due to GHD. Serum free IGF-1 concentrations were determined by chemiluminescent immunometric assay in all children. Results: There was no significant difference in serum IGF-1 levels between NGR and GHD groups (p> 0.05). We could not find a statistically significant cut-off level for IGF-1 to differentiate children with NGR from children with GHD. Conclusions: We suggest that examination of IGF-1 levels in children with NGR to exclude GHD is not useful.


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Cardioprotective function of progesterone: A new perspective

2016-10-25T07-06-56Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Asha Anand Dharwadkar, Raghuram Ramkumar Chitterusu, Anand Rajendra Dharwadkar, Bindu Balakrishnan Chenmarathy, Kavitarati Anand Dharwadkar.
Cardioprotective mechanism in females during reproductive phase is unclear. New perspective explains cardioprotective function of progesterone. Progesterone, the intermediary metabolic product in synthesis of steroid hormones, with t/2 of 30 min, stimulates respiratory center inducing respiratory alkalosis in turn lowers plasma ionic calcium. This results in decreased blood coagulability and cardiac contractility along with smooth muscle relaxation. Vascular smooth muscle relaxation, leading to generalized vasodilatation causes better tissue perfusion resulting in diminished erythropoietin, and erythrocyte count. This reduces blood viscosity and afterload on the heart. Cardiac contractility remains balanced due to opposing influences of decreased plasma ionic calcium and raised basal body temperature. On sudden withdrawal of progesterone, as during premenstrual, postpartum and postmenopausal periods, cardioprotective changes are reversed. The awareness helps to build better body buffer system, aiming to correct acid-base imbalance, during expected fluctuations of progesterone.


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Familial Idiopathic infantile arterial calcification presenting as a refractory hypertension and hypercalcemia in neonatal period.

2016-10-25T06-38-57Z
Source: The Southeast Asian Journal of Case Report and Review
Kanchan Subhash Channawar, VSV Prasad, Manoj Malviya.
Idiopathic infantilearterial calcification (IIAC) is a rare disease characterized by extensive arterial wall calcification. A total of 200 cases have been reported to dateand from India only 5 cases, with most cases diagnosed postnatally and less than 13 cases having been suspected antenatally.Case characteristics: Our case report is first from pediatric department. Message: It is important for clinician to suspect this condition prenatally and so that early diagnosis is associated with improvement in survival rates.


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Carcinoma ovary with carcinoma cervix - A rare case of synchronous malignancy

2016-10-25T06-38-57Z
Source: The Southeast Asian Journal of Case Report and Review
Ashwini Arvind Natekar, Gautam Kr Mandal, Subhasis Basu.
Synchronous malignancies of genital tract are rare. Case report We report a case of carcinoma ovary with incidentally diagnosed carcinoma cervix. The patient had undergone total abdominal hysterectomy with bilateral salpingo-opherectomy with omentectomy and pelvic lymph node dissection for a right ovarian tumor which was reported as borderline malignancy on frozen section. On histological examination the ovarian malignancy was diagnosed as borderline papillary serous carcinoma. The cervix section showed in situ squamous cell carcinoma. Pelvic lymph nodes and omentum were free of tumor. The postoperative period was uneventful and the patient has no signs of malignancy on follow up till date. Conclusion Synchronous malignancies are associated with better prognosis with surgical resection being the treatment of choice. Since synchronous malignancies are rare it has to be reported.


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Clinical profile and prognosis of patients with posterior circulation stroke

2016-10-25T04-38-40Z
Source: International Journal of Research in Medical Sciences
Kavita J. Rawat, Bhaskar S. Korde, Kavita S. Joshi.
Background: Posterior circulation stroke is less common than stroke involving the anterior circulation. An understanding of the Posterior circulation stroke phenomenology and mechanisms requires knowledge of neurovascular anatomy and of the structure-function relationships of this region of the brain. Identifying mechanisms of stroke is essential so that appropriate preventive therapies may be instituted. Methods: A prospective study was conducted over a period of 1 year after obtaining permission from institutional ethics committee. Recently diagnosed cases of posterior circulation stroke from medicine and neurology wards were enrolled, who fulfilled inclusion criteria. Results: Most common age for posterior circulation stroke in this study was 41-70 years of age with median age of 56.5 years. It is more common in males (55%) than females (45%). Ischemic posterior circulation stroke is more common (63.15%) than haemorrhagic posterior circulation stroke (36.85%). Most common presenting feature of posterior circulation was ataxia (77.3%). Most common risk factor for posterior circulation stroke was hypertension (60.5%) followed by dyslipidemia (55.26%). Most common site of involvement in ischemic posterior circulation stroke was cerebellum (37.5%) followed by occipital lobe (24%). Commonest site of bleed found was cerebellum (64.4%) followed by pons (35.6%). Mortality in posterior circulation stroke in present study was 15.78%. Conclusions: Posterior circulation stroke present with a wide variety of symptoms. Episodes are often staggering and more protracted than those of anterior circulation stroke. Further studies are needed to determine the safest and most effective treatment modalities for the various types of posterior circulation stroke.


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A clinical study of deviated nasal septum with special reference to conventional and endoscopic septoplasty

2016-10-25T04-38-40Z
Source: International Journal of Research in Medical Sciences
Mohammad Nizamuddin Khan, Kripamoy Nath, Shams Uddin.
Background: Deviated nasal septum is a very common condition. It causes nasal obstruction, epistaxis, sinusitis, headache and obstructive sleep apnea. Septoplasty is one of the most common procedures performed for correction of deviated nasal septum. The aim of our study was to determine the incidence of DNS with respect to age, sex, type of septal deviation and presenting complaints and compare if endoscopic septoplasty is better than conventional septoplasty. Methods: The present study was conducted among 115 cases of DNS for a period of one year. While detailed clinical study was done in 115 cases, surgery was performed in 60 cases. They were divided into group A and group B with 30 cases in each group. Conventional septoplasty was performed in group A while endoscopic septoplasty in group B. Results: The male to female ratio was found to be 2.19:1. Majority (37.18%) patients were of age group 11-20 years with deviation to the left (54.78%). Nasal obstruction (58.26%) was the commonest presenting complaint. Postoperatively, a significant relief of symptoms were observed in endoscopic septoplasty in terms of nasal obstruction (93.33%) and hyposmia (87.5%). Post-operative complications were higher in conventional septoplasty with significant rate of residual deviation. Conclusions: Our study showed that functional outcome was better and post-operative complications were less in endoscopic septoplasty. Endoscopic septoplasty provides better illumination which helps to identify septal deviation accurately while reducing the postoperative complications due to limited dissection and lesser trauma to septal cartilage.


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Single umbilical artery with antenatally diagnosed umbilical artery aneurysm in a newborn: a rare case report

2016-10-25T04-20-12Z
Source: International Journal of Contemporary Pediatrics
Ankur Gupta, Dhrithiman Shetty, Prijo Philip.
Single umbilical artery (SUA) is a situation when the umbilical cord contains only one umbilical artery rather than normally occurring two umbilical arteries. Presence of a SUA is associated with an increased risk of perinatal morbidity and mortality. This article reports a case of SUA with antenatally diagnosed umbilical artery aneurysm and its significance in a newborn. Histopathology report from site of insertion of umbilical cord to placenta had shown single umbilical artery aneurysm and persistent vitilo intestinal duct, dilated umbilical artery at insertion of the cord at placenta. ECHO report suggested 7 mm ostium secondum atrial septal defect, 3-4 mm patent ductus arteriosus, dilated right atria and ventricle, severe tricuspid regurgitation, severe pulmonary artery hypertension. Karyotyping was reported to be normal. Child had received treatment for congestive cardiac failure and intravenous antibiotics for Klebsiella sepsis. SUA with antenatally diagnosed umbilical artery aneurysm is a rare entity and has to be thoroughly investigated and treated.


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