Πέμπτη, 8 Δεκεμβρίου 2016

Alpha1-antitrypsin restores colonic epithelial permeability in irritable bowel syndrome with diarrhea

Source: Journal of Molecular Pathophysiology
Julien Boyer, Marie-Hélène Vivinus-Nébot, Valérie Verhasselt, Thierry Piche, Meri K Tulic.


Solving the puzzle: what is behind our forefathers’ anti-inflammatory remedies?

Source: Journal of Intercultural Ethnopharmacology
Javier Rodriguez Villanueva, Jorge Martín Esteban, Laura Rodríguez Villanueva.
Inflammation is a ubiquitous host response in charge of restoring normal tissue structure and function but is a double-edged sword, as the uncontrolled or excessive process can lead to the injury of host cells, chronic inflammation, chronic diseases and also neoplastic transformation. Throughout history, a wide range of species have been claimed to have anti-inflammatory effects worldwide. Among them, Angelica sinensis, Tropaeolum majus, Castilleja tenuiflora, Biophytum umbraculum, to name just a few, have attracted the scientific and general public attention in the last years. Efforts have been made to assess their relevance through a scientific method. However, inflammation is a complex interdependent process, and phytomedicines are complex mixtures of compounds with multiple mechanisms of biological actions, which restricts systematic explanation. For this purpose, the omics techniques could prove extremely useful. They provide tools for interpreting and integrating results from both the classical medical tradition and modern science. As a result, the concept of network pharmacology applied to phytomedicines emerged. All of this is a step toward personalized therapy.


The adjuvant use of calcium fructoborate and borax with etanercept in patients with rheumatoid arthritis: Pilot study

Source: Journal of Intercultural Ethnopharmacology
Saad Abdulrahman Hussain, Sattar Jabir Abood, Faiq Isho Gorial.
Objective: The present study was designed to evaluate the effects calcium fructoborate (CFB) and sodium tetraborate (NTB) as supplements in Iraqi patients with active RA maintained on Etanercept. Materials and Methods: A double blind randomized placebo-controlled clinical trial with 60 days treatment period was carried out at Baghdad Teaching Hospital, Medical City, Baghdad, Iraq. Eighty RA patients were randomized into 3 groups to receive either 220 mg/day calcium fructoborate, 55 mg/day sodium tetraborate in capsule dosage form (equivalent to 6 mg elemental Boron), or placebo formula once daily. Only 72 patients completed the study. All patients were clinically evaluated utilizing DAS28-ESR, SDAI-CRP and CDAI scores at baseline and at the end of the study. Venous blood was obtained at baseline and after 60 days, and utilized for the measurement of erythrocyte sedimentation rate (ESR), hemoglobin (Hb), in addition to evaluation of C-reactive protein (hsCRP), TNF-α, interleukin-1α (IL-1α) and IL-6. Results: After 60 days, both types of boron significantly improve the clinical scores, in association with significant decrease in the serum levels of ESR, hsCRP, IL-1α, IL-6, and TNF-α with remarkable superiority for CFB over NTB, compared to baseline and placebo-treated group. Conclusion: The use of boron, as adjuvant with etanercept, have potentiated therapeutic outcomes in RA patients, and may be a new strategy to improve treatment and avoid the problems associated with biologics utilized in RA treatment.


Primary Adrenal Lymphoma Infiltrating in to Pancreas: A Rare Cause of Adrenomegaly

Source: Journal of Interdisciplinary Histopathology
Lovelesh Kumar Nigam, Kamal V Kanodia, Aruna V Vanikar, Rashmi D Patel, Kamlesh S Suthar, Syed J Rizvi.
Primary adrenal lymphoma is a rare entity and may be suspected in patients having bilateral adrenal masses, with/without lymphadenopathy, and with/without adrenal insufficiency. We report a rare case of a 45-year-old man who presented with pain in the abdomen, with no signs of adrenal insufficiency and bilateral adrenal masses on imaging. Light microscopy findings with immunohistochemistry and flow cytometry confirmed the diagnosis of diffuse large B-cell lymphoma. The patient was offered cyclophosphamide, adriamycin, vincristine, and prednisolone chemotherapy regimen and doing well till the last follow-up.


The Significance of BerEp4 and Cytokeratin 19 Expressions in Epithelial Tumors of Kidney and Renal Pelvis

Source: Journal of Interdisciplinary Histopathology
Ayhan Ozcan, Ibrahim Yavan, Melih Kilinc, Sami Uguz, Sukru Ozaydin.
Objective: The differential diagnosis in the epithelial tumors of kidney and renal pelvis can be problematic due to their overlapping morphologic features. This is much more complicated in some conditions, such as renal oncocytoma (RO) vs chromophobe renal cell carcinoma (ChRCC) and renal cell carcinoma (RCC) vs urothelial carcinoma of renal pelvis (UC-RP). The purpose of this study was to assess potential contributions of BerEP4 and cytokeratin 19 (CK19) expressions in the differential diagnosis of these challenging cases. Methods: A total 57 cases consisted of 11 chromophobe (ChRCC), 18 clear cell (CCRCC), 12 papillary (PRCC), and 2 unclassified RCCs, 1 multilocular cystic renal cell neoplasm (MCRCN) with low malignant potential, 7 UC-RP, and 6 renal oncocytomas (RO) were stained against BerEp4 and CK19 antibodies using automated immunostainer. Results: All ROs demonstrated membranous BerEP4 expression, but no CK19 expression. Unlike ROs, most ChRCCs exhibited diffuse and strong CK19 expression, but no or focal and weak BerEP4 expression. This distinctive opposite expression pattern was highlighted in hybrid oncocytic chromophobe tumor (HOCT). CCRCCs showed highly variable expression patterns for both markers. PRCC type 1 tumors demonstrated diffuse and strong BerEp4 and CK19 expressions. PRCC type 2 exhibited BerEP4 and CK19 expressions, but their expressions were focal and weaker than for PRCC type 1. MCRCN demonstrated diffuse and strong BerEP4 expression, but no expression for CK19 unlike cystic CCRCC, which is strongly positive for both markers. Epithelioid cells in unclassified RCC showed strong CK19 and weak BerEP4 expression, whereas spindle cells in the tumor did not express CK19 and BerEp4 or exhibited scattered and weak expressions. UC-RP showed diffuse and strong CK19 expression, but no or scattered BerEP4expression was seen in the tumor. We also evaluated CK19 and BerEP4 expression in non-neoplastic adjacent kidney and renal pelvis. Conclusion: This study revealed that 1) BerEP4 and CK19 exhibit variable and distinctive immunoprofiles in epithelial tumors of kidney and renal pelvis, 2) an immunoprofile of BerEP4 (+)/CK19 (-) favors RO in contrast to an opposite profile for ChRCC, 3) The heterogeneous expressions of BerEP4 and CK19 in low grade RCC with eosinophilic cytoplasm favors HOCT, 4) PRCC type 1 strongly express both biomarkers, and 5) although RCC subtypes express CK19 in a variable proportion and intensity, diffuse and strong CK19 expression favors UC-RP.


Consequences of the Fukushima nuclear accident with special reference to the perinatal mortality and abortion rate

Source: Journal of Environmental and Occupational Science
Sergei V. Jargin.


Pattern of skin diseases in rural population: a cross sectional study at Medchal mandal, Rangareddy district, Telangana, India

Source: International Journal of Research in Medical Sciences
Janardhan Bommakanti, Pradeep Pendyala.
Background: The skin diseases are affected by various factors. The rural population is more vulnerable because of illiteracy. Therefore an attempt has been made to screen the population of five villages to know pattern of skin diseases. Aims of the study were to assess the prevalence of skin diseases, determine the pattern of skin diseases in the study population in rural community of Medchal mandal and compare previous studies so that inferences can be drawn for the benefit of society. Methods: The study was aimed to include the total population of 5930 consisting of 5 villages. The present study was carried out during a period of one and half year in 5 villages of Medchal mandal. The total population of all the 5 villages comprises of 7726, out of which 5930 persons participated in the present study. In all villages house to house survey was done. A complete dermatological assessment of the study population was done and findings were recorded on the standard study proforma. Results: The total number of 5930 persons was screened during the period of study. Among which 1172 (19.76%) persons were noted to have skin diseases. out of which 533 (45.48%) were males and 639 (54.52%) were females. The majority of population with skin disease was in the age group of 31-40 years with 289 cases (24.65%) and least in 71-80 age groups with 7 cases (0.59%). The prevalence of Non-infectious diseases (705 cases, 60.15%) was more than that of Infectious diseases (467 cases, 39.85%). Among non-infectious conditions Eczema / Allergy was the common disease followed by Pigmentary disorders other conditions like alopecia areata, seborrheic dermatitis and senile xerosis, Papulosquamous disorders, acne and acneiform dermatoses, polymorphous light eruptions and bite and stings, Eczemas followed by lichen simplex chronicus and allergic contact dermatitis. Among infectious conditions, bacterial infections were most common diseases followed by parasitic infestations, fungal infections and viral infections. Among Bacterial infections, secondary Pyodermas followed by folliculitis, impetigo and furunculosis. Based on occupation the majority of population was in the students followed by farmers, labour other than agriculture, housewives and petty business. Based on education, the majority of population was in the primary group (class 1 to 5) followed by secondary (class 6 to 8) and high school and above. Conclusions: Based on the outcome of this study, the common skin problems existing in this area are to be carefully looked for and health education regarding the hygiene, nutrition and healthy life styles is to be stressed for better standard of living by the rural population.


Investigating the defensive medical practices of the physicians working in the city center of Malatya

Source: Medicine Science | International Medical Journal
Burak Mete, Erkay Nacar, Cigdem Tekin, Ertan Unver, Gulsen Gunes.
With this study, we aimed to determine the defensive medical practices of the physicians of different academic title and seniority, who are performing their duty in MalatyaAfter the approval from the ethical committee had been received, our study was conducted by performing surveys and face-to-face interviews with the practitioners, specialists, family practitioners and academicians working in the State and University hospitals as well as Private Hospitals in the city of Malatya. 234 physicians were asked to answer 19 questions regarding the defensive medical practices within the survey. 87% of the research sampling was reached. 176 (75,2%) of these physicians are male, whereas 58 (24,8%) of them are female. The mean age of the women who participated in the research is 38,9. It turned out that the physicians working in the state hospitals as well as private hospitals had referred to defensive medical practices more than those working in the university hospitals (P=0.026), and that the professors and associate professors had avoided the patients with the risk of filing a suit in temrs of medical malpractice less than the specialists and medical practitioners (p=0,003). In conclusion, it was determined that as the degree of professional experience, academic title and seniority in the physicians increased, the rate of defensive medical practices seemed to decrease.


Awareness of dental hygiene amongst the primary school children of low socio-economic strata

Source: International Journal of Contemporary Pediatrics
Ravi Kumar, Deepak Joshi.
Background: Childhood dental caries is a major health concern in children that continues to negatively affect the oral health. The condition if left untreated, can lead to disruption of growth and development of permanent teeth, pain, life threatening infections and expensive treatment. This study was done to assess the prevalence of the dental caries in primary school children and see their current level of awareness about dental hygiene practices. Methods: The present study was questionnaire-based cross sectional study. During the study 1000 school students of age 5-12 years were interviewed personally about the dental hygiene practices. The questionnaires were filled as per the responses given by them and after that basic dental and oral examination was carried out, to look for the condition of teeth, number of carious teeth in the mouth, number of restorations etc. Only one student was interviewed and examined at a time. After that he or she was provided with basic information to maintain good oral and dental hygiene. Results: The prevalence of dental caries is 31.6% and of these 4.43% had carries in more than 3 teeth. 60 children had at least one teeth restored. Only 16.3% children were totally aware of the dental hygiene. About 61.7% of them brush in morning, and only 30.4% for more than 2 minutes. 52.3% had never visited a dentist. Conclusions: Most of the children are not totally aware of the ways to maintain good oral hygiene and those who are aware are not practicing it. The role of parents is also very significant but nearly half of the parents do not guide their children for brushing and maintaining good oral hygiene. Regular dental check-ups by arranging dental camps in schools and educating the children and parents about oral hygiene will improve the situation.


Assessment of nutritional status and its association with feeding practices in children under five years

Source: International Journal of Contemporary Pediatrics
Saba Syed, Biranchi Das.
Background: The level of child and maternal under nutrition remains unacceptable throughout the world. In India 48% of children are stunted, 20 per cent of children under five years of age suffer from wasting due to acute under nutrition. Methods: The present study was a cross-sectional study conducted on 211 children from 6 months - 6 years of age. Data collection included socio-demographic characteristics, anthropometric measurements and assessment of infant and young child feeding practices. Results: A total of 211 (128 females and 83 males) children were included in the study. The prevalence of underweight, stunting and wasting was observed to be 84 (39.81%), 99 (46.92%) and 47 (22.27%) respectively. Proportions of stunting and underweight was significantly more among children whose mothers reported inappropriate feeding practices as compared to their study counterparts. Conclusions: Under nutrition of sizeable magnitude is prevalent in children less than six years; as revealed by results of the present study. Past and current Infant and young child feeding practices were found to be significantly associated with under nutrition.


Prediction of relapses in children with idiopathic steroid sensitive nephrotic syndrome: a retrospective study

Source: International Journal of Contemporary Pediatrics
Prasun B., Payas J., Sujaya M..
Background: Nephrotic syndrome is a chronic recurrent disease commonly affecting children belonging to the age group 1-10 years. The purpose of the study was to identify the factors at the onset of disease responsible for relapses in nephrotic syndrome. Methods: It was a retrospective observational study conducted in a tertiary care hospital in North India consisting of children aged 1-15 years diagnosed as nephrotic syndrome (1st episode) and followed for 12 months. Variables extracted from records (after January 2008) were age of presentation, days to remission, hematuria, and hypertension. Results: Out of 88 cases, 23 were frequent relapsers and 65 were infrequent relapsers. It was observed that cases remitting after 2 weeks have increased chances of frequent relapses. On stratification based on presence or absence of hematuria or hypertension, it was observed that both these variables predispose the patient towards frequent relapses. Conclusions: We concluded that variables like days to remission, haematuria and hypertension can fairly predict future relapses.


A study of assessing knowledge, attitude and practice of pharmacovigilance among medical students of a South Indian teaching hospital

Source: International Journal of Basic & Clinical Pharmacology
Kulkarni Dhananjay, Esanakula Himasri.
Background: Pharmacovigilance is the science relating to detection, assessment, understanding and prevention of adverse drug reaction. The purpose is to improve patient safety in relation to use of medicines. It is estimated that only 6-10% of adverse drug reactions (ADRs) are reported worldwide. The underreporting of ADR is due to lack of adequate knowledge, attitude and practice among healthcare professionals towards ADR reporting. Health care professional like physicians, pharmacist and nurses have immense responsibility in reporting ADR. Therefore, the objective of this study was to evaluate the knowledge, attitude and practices (KAP) of undergraduate medical students towards pharmacovigilance. Methods: A cross-sectional KAP based questionnaires study was carried out in 100 undergraduate students of Konaseema Institute of Medical Sciences, Amalapuram. The response of KAP questionnaires were analyzed in percentage and tabular form. Results: Nearly 87% participants heard about pharmacovigilance, but only 65% know its need or purpose. 88% people feel that ADR reporting may improve patient safety. Less than half of the students know about Institutional ADR centre. 81% students have seen ADR but only 31% knew about ADR reporting form and surprisingly only 20% have reported ADR. More than 80% feels reporting ADR will increase patient safety. Conclusions: Participants have good knowledge about Pharmacovigilance but lacks in attitude and practice towards reporting ADR. Greater awareness of pharmacovigilance and incorporation of it in medical curriculum will further strengthen pharmacovigilance activity.


Effect of vitamin A supplementation in category-I Pulmonary Tuberculosis patients in a Medical College in India: a rapid assessment analysis

Source: International Journal of Basic & Clinical Pharmacology
G. Sujatha, M. Dhanasekaran, Syed Shuja Qadri, S. Jeevithan.
Background: Tuberculosis is one of the major health problems affecting the global population causing immense morbidity and mortality. Studies have shown that a good antioxidant status of the body has immune protective role against tuberculosis and may be associated with a decreased risk of the disease and slower rate of progression. Objective of the study was planned to evaluate the beneficial effects of Vitamin A as add on therapy to the standard drug therapy in patients with sputum positive pulmonary tuberculosis. Methods: The study was done in a Tuberculosis clinic, Department of Internal Medicine, Stanley Medical College for duration of 6 months. All the newly diagnosed sputum positive pulmonary tuberculosis patients (18-55 years) attending the outpatient were taken for the study purpose. A Phase III, prospective, open, two arm parallel group, outpatient, randomized, active controlled study was done. Results: After two weeks of therapy, the number of patients with negative sputum smear was higher in the study group than the control group. Vitamin A supplementation resulted in an earlier elimination of tubercle bacilli from the sputum. Conclusions: This study shows that vitamin A as add on therapy to the existing standard therapy improves the clinical response and decreases the disease activity to a greater extent than with routine standard therapy alone.


A comparative study of mebeverine and synbiotic combination in patients with diarrhoea predominant Irritable Bowel Syndrome in a Medical College in South India

Source: International Journal of Basic & Clinical Pharmacology
G. Sujatha, M. Dhanasekaran, Syed Shuja Qadri, S. Jeevithan.
Background: Irritable bowel syndrome (IBS) is a chronic, episodic functional gastrointestinal disorder characterized by abdominal pain / discomfort and altered bowel habits. Though it is considered as a functional disorder, the burden of the disease to the patients is very high and the quality of life becomes miserable. Currently available IBS therapies are mainly symptom oriented and have limited efficacy. Various studies had done so far which provide a clear rationale for the use of Synbiotic in this disorder. The objective of the study includes, this study was planned to compare the efficacy of Mebeverine + Synbiotic combination with Mebeverine and Synbiotic monotherapy in patients with diarrhoea predominant irritable bowel syndrome. Methods: The study was done in Department of Medical Gastroenterology, Rajiv Gandhi Government Hospital, Chennai for duration of one year. Patients with Irritable Bowel Syndrome (diarrhea predominant type), diagnosed within 1 year and attending outpatient department were taken. A randomized, Phase III, prospective, interventional, open label, , outpatient, comparative study design was done. A total of 60 patients divided into 3 groups were finally selected for the study purpose. Results: Twelve weeks after completion of active drug therapy, the Mebeverine + Synbiotic combination improved all the symptoms of IBS except abdominal pain. Further it was evident that combination therapy had significant remission in stool frequency and consistency when compared with other groups. Conclusions: Combination of Mebeverine + Synbiotic is more effective in improving most of the troublesome symptoms in patients with diarrhea predominant irritable bowel syndrome than other therapies and also in maintaining remission, in terms of frequency and consistency of stools.


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