bluuebunny/crossref_metadata_2025 huggingface dataset:
Skin Stem Cells; Definition, Function, Importance and Methods of Isolation
Authors: Rezaie Fahimeh , Momeni-Moghaddam Madjid
Published: August 2018

Stem cells (SCs) are a population of undifferentiated cells with high self-renewing and differentiation potency. On the basis of origin, SCs are divided into four main groups: embryonic stem cells (ESCs), fetal stem cells (FSCs), induced pluripotent stem cells (iPSCs), and adult stem cells (ASCs). Interestingly, in different literatures, ASCs are considered as unipotent progenitor cells, multipotent stem cells or even pluripotent stem cells with variety of differentiation potential. ASCs reside in many adult tissues such as liver, bone marrow, adipose tissue, neural tissues, skin and etc. Among adult tissues, skin is considered as a fast self-renewing tissue which is capable to reconstruct itself during skin homeostasis and injuries. In fact, skin is mentioned as a pool of different types of SCs including keratinocyte stem cells (KSCs), hair follicle stem cells (HFSCs) and sebaceous gland stem cells (SGSCs). During skin regeneration, cooperation between these stem cells is essential for reconstruction of skin. Among these SCs, KSCs are most common cells in epidermis layer (mostly in basal layer) which are the important population of SCs for regeneration of epidermis. Herein, we reviewed different methods for skin stem cells isolation and characterization, and their potential for clinical application.
Ethanol and Stem Cells
Authors: Farokhi Afsaneh , Koohpeima Fatemeh , Mokhtari Mohammad Javad
Published: August 2018

Many studies have showed disadvantageous effect of ethanol exposure on stem cells. Ethanol exposure during development leads injury to various types of stem cells including neural stem cells (NSCs), dental pulp stem cells, mesenchymal stem cells, embryonic stem cells and etc. Because NSCs play a basic role in the development and maturation of the central nervous system, it is vital to understand the effect of ethanol on NSCs differentiation. Additionally, alcohol misusage appears lead to periodontal disease, tooth decay and mouth wounds that are potentially precancerous. Individuals who abuse alcohol are at high risk of having seriously destroyed teeth, gums and compromised oral health in general. Some of these adverse situations maybe are because of ethanol effects on stem cells. Therefore, here, ethanol effects on the various types of stem cells were reviewed.
Hypoxia-based Stem/Progenitor Cell Therapy: Focus on CXCR4/SDF-1 Axis
Authors: Heirani-Tabasi Asieh , Toosi Shirin Hamedakbari , Mirahmadi Mahdi , Raeesolmohaddeseen Mahmood
Published: August 2018

Cell therapy is becoming a promising approach to treat degenerative diseases. Homing of the transplanted cells is one of the continuous challenges being faced by the stem cell biologists. Chemokine receptors are one of the highly studied factors which are known to be crucial in controlling the cell/stem cell migration and targeted homing to the damaged tissues. The expression of chemokine receptors is dependent on a number of transcription factors and HIF-1α has been considered the crucial molecules controlling cellular migration and homing. Several studies have revealed that hypoxia conditions stabilize the HIF-1α which upregulate the CXCR4/SDF-1 expression and help in the improvement of tissue regeneration. Here, we review pivotal roles of HIF-1α /CXCR4/SDF-1 pathway in homing of progenitor/Stem cell which were affected by physical hypoxia as well as various hypoxia-mimicking agents.
Dental Tissue-Derived Stem Cells as a Candidate for Neural Regeneration
Authors: Malekzadeh Samira , Edalatmanesh Mohammad Amin , Mehrabani Davood , Shariati Mehrdad , Malekzadeh Sima
Published: August 2018

In recent years, stem cell therapy tried to improve the life of patients that suffer from neurodegenerative disease, like Alzheimer's disease. Although teeth are non-essential for life, but the dental tissues are an important source of mesenchymal stem cells that are suitable for neural regeneration. The studies showed that dental stem cells (DSCs) have the potential to differentiate into several cell types that among the most important is neural progenitor. In this review article, discusses the types of dental stem cells and then focused on application of dental stem cells on neural regeneration.
Classification of Wounds: Know before Research and Clinical Practice
Authors: Irfan-maqsood Muhammad
Published: August 2018

Cutaneous wounds are known as the damages and injuries on the skin. Knowing the type of wound is very important before any kind of treatment or therapy being applied. Each type of wound is different from other due to the different structure, biology and pathophysiology, therefore, a kind of treatment for one wound cannot be specified for others. Considering the importance of types of wounds, these wounds are classified into different categories because of their different pathobiology. This manuscript would be a great piece of knowledge for the tissue engineer to develop specific skin substitute for specific wound which might help for the development of appropriate treatment strategies.
CRISPR as a Versatile Technology for Gene Activation and Genome Editing
Authors: Rezanejadbardeji Habib , Behroozi-Asl Bahareh , Amirkhah Raheleh
Published: August 2018

CRISPR/Cas system, a microbial adaptive immune system, has rapidly transformed the ways researchers can interrogate the genome. CRISPR has many advantages over traditional methods such as Transcription activator-like effector nucleases (TALEN) and Zinc-finger nucleases (ZFN). Since CRISPR discovery as an adaptive immune system used by bacterial against viruses, it has been repurposed to help in many different genome-related studies such as gene knocking in and out, gene expression upregulation and downregulation. Also CRISPR holds vast therapeutic potential for the management of genetic disorders by straight modifying disease-causing mutations. Although the Cas9 protein has been revealed to attach and cleave DNA at off-target sites, the ﬁeld of Cas9 speciﬁcity is quickly progressing, with marked modifying in guide RNA choice, protein and guide engineering, innovative enzymes, and off-target recognition methods. In current review we mostly focus on CRISPR unique ability in gene activation/ upregulation, which has wide applications in different aspects such as gene studies, stem cell differentiation, and trans-differentiation. Compared to other gene activation methods such as viral gene overexpression, TALEN and ZFN, CRISPR offers many benefits such as easy designing and high precision.
Overexpression of Chemokine Receptors on Neural Stem Cells Pretreated with Valproic acid: Towards Improved Homing
Authors: Karimi Fahime , Hashemzadeh Mohammad Reza , Edalatmanesh Mohammad Amin , Naderi-Meshkin Hojjat
Published: August 2018

Neural stem cells (NSCs) have considerable capacity for self-renewing and also ability for generating neurons in the mammalian brain. However, one of the big challenges is the migration and targeted homing of transplanted NSCs into the injured site to treat neurodegenerative diseases including Alzheimer´s disease (AD), Parkinson’s disease (PD), multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), brain ischemia (BI) and spinal cord injury (SCI). To improve homing capacity, pretreatment of NSCs with Valproic acid (VPA), which is supposed to cause diverse effects on migration ability of NSCs, is a strategy. More recently, hind brain and olfactory bulbs have been introduced as a good source of NSCs. So, NSCs were isolated from these two sources of postnatal day 1 (PND1) rats. These isolated cells were characterized by expressing neuronal markers such as Nestin and Sox2. The expression of four selected chemokine receptors (CXCR4, CXCR6, CCR1 and CCR7), which are important effectors in homing of stem cells, was investigated. It is concluded that VPA treatment enhances NSCs migration and homing showing its potential to be applied for cell-based therapies.
APX2 induction via herbicide infiltration (DCMU, DBMIB, Methyl Viologen) v1
Authors: R Ganguly Diep , Estavillo Gonzallo
Published: August 2018

Infiltration of leaveswith various herbicides, targetting photosynthetic electron transport, were utilized to mimic changes in redox state (otherwise caused by changes in light irradiance)of photosynthetic electron transport components and study the response of APX2. This was successfully utilized in the following publication: Jung, H., Crisp, P.A., Estavillo, G.M., Cole, B., Hong, F., Mockler, T.C., Pogson, B.J., and Chory, J. (2013). Subset of heat-shock transcription factors required for the early response of Arabidopsis to excess light. Proc. Natl. Acad. Sci. 110: 14474–14479.
Diagnosis and therapy experience of Insulin Autoimmune Syndrome in a single Chinese center v1
Authors: Yuan* Tao , Li* Jiapei , Li Ming , Li Naishi , Duan Lian , Ping Fan , Li Wei , Wang Linjie , Zhao Weigang
Published: August 2018

Insulin autoimmune syndrome(IAS) is a relatively rare cause of hypoglycemia characterized by endogenous hyperinsulinism and autoantibodies against endogenous insulin despite no prior exposure to exogenous insulin. Most studies of IAS were case reports, and the clinical characteristics of IAS were seldom summarized before. Here, we retrospectively reviewed a series of IAS cases, and the clinical characteristics were explored thoroughly.The medical records of inpatients with the final diagnosis of IAS were collected from August,2007 to August,2017 in Peking Union Medical College Hospital. Clinical characteristics and laboratory test results were summarized.Besides, the results of serum glucose, insulin, true insulin and C-peptide during 5-hour oral glucose tolerance tests(OGTTS) were summarized. Circulating immune complexes were assessed qualitatively by precipitation with polyethylene glycol (PEG) in some subjects.
The pregnancy outcomes of patients with a rudimentary uterine horn v1
Authors: Xiaoyan Li , ping Peng , Xinyan Liu , Weilin Chen , Juntao Liu , Jianqiu Yang , Bian Xuming and
Published: August 2018

Objectives: To evaluate the presentation, assessment, treatment, and pregnancy outcomes of 22 women with a rudimentary uterine horn. Methods: We reviewed the data regarding the outcomes of patients with a rudimentary horn pregnancy (RHP) who were managed at Peking Union Medical College Hospital over the last 30 years. Twenty-two pregnant patients with a rudimentary horn have been treated at our institute over the last 30 years. All patients with RHP were divided into two groups: Type A (n=4), a rudimentary horn with a cavity that communicated with the uterus; and Type B (n=7), a rudimentary horn with a cavity that did not communicate with the uterus. We classified all 22 patients into a communicating group or a noncommunicating group according to the anatomical connection of the rudimentary horn to the contralateral hemiuterus. Results: The mean gestational age of Type A patients (23.5 weeks) was significantly higher (P=0.046) than that of Type B patients (10 weeks). The rudimentary uterine horn carried 4 of 5 (80%) pregnancies in the communicating group. Three case of rudimentary horn pregnancies ruptured before a gestational age of 12 weeks, and one abortion occurred after 12 weeks. In the noncommunicating group, 7 of 17 (41.2%) cases were RHPs, and 3 ruptured after a gestational age of 12 weeks. Conclusions: The diagnosis and management of the rudimentary uterine horn continues to be challenging. Medical and radiological personnel must maintain a high degree of alertness to prevent the morbidity associated with this condition. In particular, patients with RHP (Type A), who have a higher chance being misdiagnosed before 12 gestational weeks, have a higher risk of potential complications. If pregnancy in the rudimentary horn is diagnosed, excision of the pregnant horn is recommended, regardless of the type of unicornuate uterus
A Convolutional Neural Network Application for Predicting the Locating of Squamous Cell Carcinoma in the Lung
Authors: NOĞAY H. Selçuk , AKINCI Tahir Cetin
Published: August 2018

Squamous

cell carcinoma, one of the most common types of lung cancer types, usually

occurs in the middle, right or left bronchi. Squamous cell carcinoma can be

easily detected by imaging methods to determine the location within the

lung.  However, rarely the location of

some tumor types cannot be determined. In this case, it may be delayed to obtain the results of

the assay such as biopsy. This possible delay also means delayed diagnosis and

delayed start of treatment. In order to solve this problem, it is possible to

perform applications with machine learning methods. In this study,

convolutional neural networks method was used to determine the location of

cancerous tumor in squamous cell carcinoma of lung. With the designed convolutional neural network model,

squamous cell carcinoma tumor location in lung cancer was estimated with an

accuracy rate close to 100%.
Caracterización de la severidad de la bronquiolitis en menores de dos años en el Hospital Niño Jesús de Barranquilla durante los años 2015 y 2016
Authors: Arredondo Escalante Jan Carlo , Cabezas Canole Herlin
Published: August 2018

Obejetivos: Identificar las características clínicas, tratamiento y complicaciones de la severidad de la bronquiolitis en niños menores de dos años en el Hospital Niño Jesús de Barranquilla durante los años 2015 y 2016. Metodologia:  La muestra estará conformada por pacientes menores o igual a 2 años con diagnóstico de bronquiolitis que consultaron el servicio de Urgencias del Hospital Resultados:  el medicamento más utilizado fue el salbutamol, seguido por salbutamol con adrenalina, la solución salina, las micronebulizaciones con adrenalina, el bromuro de ipratropio + Fenoterol, el berodual entre otros, los pacientes estudiados las complicaciones que se presentaron fueron la co-infección bacteriana y el deterioro del patrón respiratorio con inminencia de falla respiratoria con requerimiento para ingresar a la Unidad de Cuidados intensivo.
Caracterización de los pacientes que ingresan a UCIP por neutropenia febril Clínica Prevenir Barranquilla 2015 –2016
Authors: Medina Caicedo Malvin , Ramos Castro Jose
Published: August 2018

Objetivo: Caracterizar a los pacientes que ingresan a Unidad de Cuidados Intensivos Pediátricos (UCIP) por Neutropenia Febril, en la Clínica Prevenir de la ciudad de Barranquilla Método: Se presenta un estudio descriptivo y retrospectivo, diseñado con el objetivo de caracterizar a los pacientes que ingresan a Unidad de Cuidados Intensivos Pediátricos (UCIP) por Neutropenia Febril, en la Clínica Prevenir de la ciudad de Barranquilla, periodo 2015 – 2016.Resultados: La neutropenia febril (NF) es una entidad común en niños afectados con enfermedades oncohematológicas y que reciben quimioterapia; esta se presenta en promedio de seis episodios durante esquemas de dos años (1). Factores como defectos de la inmunidad humoral y celular que se asocian a la enfermedad primaria y al tratamiento quimioterapeutico o radioterapia, la desnutrición e inclusive el daño de las barreras anatómicas, hacen a esta población susceptible de procesos infecciosos, esto sumado al principal factor como tal que es el bajo conteo de neutrófilos circulantes, lleva a un aumento marcado de la morbimortalidad infecciosa en estos pacientes; así entonces existe un alto riesgo de ingreso a Unidad de Cuidado Intensivo Pediátrico (UCIP) que de acuerdo a lo descrito por Lane y cols (2) se presenta entre el 30 al 42% de todos los pacientes pediátricos con neutropenia febril. Conclusión:Se concluyo que el comportamiento de la población que demanda atención en la UCIP es similar a la descrita en la literatura en términos de sexo, edad, tipo de neoplasia, severidad de neutropenia, niveles de hemoglobina y plaquetas, e identificación de focos infecciosos.
Quality of health care in Nigeria: a myth or a reality
Authors: Ephraim-Emmanuel Benson Chukwunweike , Adigwe Adetutu , Oyeghe Roland , Ogaji Daprim S. T.
Published: August 2018

The delivery of high quality health care is crucial to achieving enhanced health benefits, patient safety and a positive patient experience of health care. This article provides insight on the quality of the health care delivery in Nigeria and aim to uncover if quality health care in Nigeria is a reality or a myth. Relevant information was abstracted from included articles and used to provide both descriptive and analytical discourse on the subject. Discussions and reflections were carried out along an established quality framework of treatment effectiveness, acceptability, efficiency, the appropriateness of the means of delivery as well as equity. The slow pace of development of quality systems in health service delivery in Nigeria is evidenced by the poor quality of health services as well as the poor health status of the population. The pace of developing quality systems in health care delivery in Nigeria is unsatisfactory. There is a need to galvanise the efforts of relevant stakeholders including the patient in charting a new agenda for health care quality improvement in Nigeria.
The assessment of risk factors, lipid profile, uric acid and alanine aminotransferase in Helicobacter pylori-positive subjects
Authors: Ndebi Martin Ernest , Guimtsop Yvette Alvine Tonleu , Tamokou Jean-de-Dieu
Published: August 2018

Background: Helicobacter pylori infection is associated with gastro duodenal ulcer, chronic gastric, MALT lymphoma and gastric cancer but also to coronary heart diseases, ischemic diseases and metabolic diseases like diabetes. The colonization of the stomach by H. pylori causes persistent inflammation of the stomach wall which can influence some biochemical parameters in the patient. The aim of this study was to investigate risk factors, uric acid and alanine aminotransferase along with lipid parameters in H. pylori-positive and -negative patients at Dschang District Hospital in Cameroon.Methods: A cross-sectional study was carried out on 160 consenting patients of average age 53.91±13.36 years attending the hospital for medical check-up or admitted in the hospital. The determination of anti-H. pylori IgG by the indirect enzyme-linked immunosorbent assay (ELISA) technique, enabled us to distinguish two groups of patients. A questionnaire survey was administered to study participants and potential risk factors for H. pylori exposure sought. Measurements of total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, uric acid and activity of alanine aminotransferase were carried out in serum by methods resulting from commercial kits.Results: The habits of not washing hands after the toilets (OR = 3.33; p = 0.036) and giving of chewed food by the parents to children (OR = 2.26; p = 0.029) were independent risk factors of H. pylori infection. H. pylori infected patients had increased levels of uric acid (p = 0.017), total cholesterol (p = 0.001), LDL-cholesterol (p = 0.021) and total cholesterol/HDL-cholesterol ratio (p = 0.046) compared to the uninfected group.Conclusions: Our study therefore suggests that H. pylori infection can cause modifications of lipid parameters and uremia that are considered as risk factors for cardiovascular diseases and gout.
Insulin resistance and arterial stiffness: impact of gestational diabetes on pulse wave velocity
Authors: Seck Aissatou , Agne Fatou Diallo , Fall Abibatou Sall , Sar Fatou Binetou , Ouedraogo Valentin , Mbengue Arame , Hallab Magid , Ba Abdoulaye , Samb Abdoulaye
Published: August 2018

Background: Gestational diabetes is an intolerance of glucose with the first appearance during the pregnancy. This hyperglycaemia status, because of the pre-existing insulin-resistance, constitute a favourable land of arterial stiffness. The aim of this study is to determine the impact of non obese gestational diabetes on arterial stiffness by measuring the pulse wave velocity (PWV).Methods: We recruited 60 pregnant women aged from 20 to 35 years old. They were between twentieth four and thirtieth five weeks of gestational age. Subjects were divided into two groups: the first group (G1), considered as control group, included 25 normoglycemic pregnant subjects without any history of illness or risk factors of gestational diabetes; the second group (G2) included 35 women with Gestational Diabetes Mellitus (GDM). All pregnant women had not history of smoking, were not taking decoction or medicine, which could disturb pregnancy evolution. Anthropo-physiological and biochemical parameters studied, were: age, body mass index (BMI), blood pressure (BP), triglyceride, cholesterol and HOMA-IR index. The PWV between finger and toe (PWVft) was measured by pOpmètre®.Results: The two groups are matched by age (G1:28±4ans; G2:29±3ans) and BMI (G1:25.6±1.27; G2:26.9±1.3). Blood pressure (BP) values are in normal interval (systolic BP: [110-132mmHg]; diastolic BP: [63-87mmHg]; mean BP: [79-103mmHg]). Total cholesterol (G1:0.95±0.08;G2:2.4±0.7; p˂0.0001), HDL cholesterol (G1:0.44±0.02; G2:0.76±0.2; p˂0.0001, LDL cholesterol (G1:0.40±0.05; G2:1.3±0.5; p˂0.0001), triglyceride (G1:0.57±0.45; G2:1.6±0.4;p˂0.0001), HOMA.IR (G1:1.31±1.05; G2:7.4±1.07; p˂0.01), PWVft (G1:5.99±1.23; G2:10.3±1.9; p˂0.0001) are significantly higher in diabetic group. PWVft is positively correlate to HOMA-IR index, total cholesterol, LDL cholesterol and triglycerides (r=0.3348, p=0.032; r=0.5275, p˂0.0001; r=0.4855,p˂0.0001; r=0.5581, p˂0.0001respectively).Conclusions: Gestational diabetes might induce an increase of pulse wave velocity expressing increment of arterial stiffness. This last constitute an early underlying cardiovascular risk.
Prevalence of hypertension and its risk factors among school teachers in Dhaka, Bangladesh
Authors: Barua Ripon , Alam Monzurul , Parvin Nadira , Chowdhury Rajib
Published: August 2018

Background: School teachers in urban area are experiencing sedentary life style behaviors. This study was aimed to determine the prevalence and risk factors of hypertension (HTN) among school teachers in Dhaka city.Methods: This cross-sectional study was carried out from May to October of 2017. Total 323 school teachers in Dhaka city aged between 25-59 years were enrolled using cluster random sampling technique. Data on socio-demographic profile, different risk factors, co-morbidities, family history and blood pressure (BP) were recorded. HTN was recorded according to pre-defined criteria. Factors associated with HTN analyzed by Chi-square test (χ2).Results: The prevalence of HTN among school teachers was 52%. The mean ± SD age was 46.5±7.8 years. Majority teachers (52%) were earning between 20,000 and 50,000 Bangladeshi Taka per month and about 61.6% had service duration >15 years. Development of HTN was significantly associated with age, monthly family income and service duration (p=0.001). Majority participants were female (65.6%) and female to male ratio was 1.9:1. Female teachers were more hypertensive compared to male (68% vs 32%). Taking extra salt (OR 1.977, 95% CI 1.269-3.079), low intake of fresh vegetables (OR 2.048, 95% CI 1.228-3.416), higher waist circumference (OR 1.990, 95% CI 1.006-3.933) and mental distress (OR 1.724, 95% CI 1.045-2.844) were found to be significantly associated with HTN.Conclusions:The prevalence of HTN was higher among the study participants. Building awareness by promoting healthy life style and behaviors for prevention and control of HTN should be given importance among teachers.
Investigation on the relationship between personal characteristics with lip, jaw and philtrum dimensions
Authors: Kosif Rengin , Diramali Murat , Yilmaz Selin
Published: August 2018

Background: The relationship between the sizes of the structures that form our face, such as lips, philtrum, and the jaw, and our personality characteristics are unknown. In this study, it was scientifically researched whether lip, jaw and philtrum anatomy can give us clues on personality characteristics or not.Methods: The photographs of the university students were taken using digital camera in two positions. The students who were photographed were asked to simultaneously complete personality test. The photographs were transferred to the computer and, using photoshop program installed on the computer, measurements were made. The mouth widths, upper and lower lip thicknesses, the distance between lip spots, philtrum length and width, lateral mouth width, jaw heights were recorded, and lip type and philtrum depth were identified. The results were compared to the personality characteristics of the students.Results: Lip thicknesses were found to be correlated positively only with the ‘openness to experience’ trait from among personality characteristics. A positive correlation between lip type and ‘conscientiousness’ was also found. There was a negative correlation between philtrum length and ‘negative valence’.Conclusions: This study shows that lip thickness and philtrum length can give us an idea regarding personality characteristics.
Subjective and objective interpretation of tear film interferometry images
Authors: Sharma Nikhil , Oliver Katherine
Published: August 2018

Background: Assessment of the tear film is necessary in routine clinical practice because an unstable tear film can hamper the quality of life by causing vision-related problems and compromising the ocular surface. One of the major concerns related to an unstable tear film is dry eye. Many of dry eye patients suffer from a lack of meibum which forms the lipid layer of the tear film. The lipid layer can be graded and interpreted by using interferometry. However, interpretation and grading of this dynamic layer may be inconsistent in terms of inter- and intra- observations. This study investigated the difficulty of consistent, subjective grading of clinical findings, in general.Methods: The interferometry images of 30 subjects captured from different equipment were analyzed subjectively. The agreement between intra-observer repeatability was also measured.Results: A positive Spearman’s correlation of 0.81 was found among different grading patterns observed using the Tearsope to compare right and left eyes. Similarly, a positive Spearman’s correlation of 0.63 was found among different grading patterns observed under interferometer in right and left eye. Correlations were statistically significant, p<0.001. The agreement between intra-observer repeatability calculated using Cohen’s kappa values were also statistically significant, p<0.001.Conclusions: A correlation between the findings of different equipment could not be made due to the differences in wavelengths of incident light and the image details. However, a new grading pattern has been proposed to describe the thickness of various lipid layer patterns observed under Doane’s interferometer.
Patients’ over-visit phobia versus physician’s over-prescription phobia
Authors: Shanmugam Ramalingam
Published: August 2018

Background: Hospital administrators conduct survey of patients to solicit their satisfactions and/or concerns for accreditation or renewal of license. For the first time in the literature, this article defines and illustrates the existence of patient’s over-visit phobia and the physician’s over-prescription phobia. These phobias pave way to formulate policy to increase hospital’s efficiency.Methods: The number, of times a patient visits the physician (with a visitation rate) and the number, of prescriptions written by a physician (with a prescription rate) are assumed to follow Poisson type probability patterns. This article, in a novel manner, untangles intricacies and inter-relations of these two phobias.Results: An analysis of the Australian Health Survey data, using our model and methodology, estimates visit and prescription rate to be and respectively. The chance for patient’s visit phobia and physician’s prescription phobia is respectively 0.33 (with a reluctance level 2.16 to make additional visits) and 0.46 (with an avoidance level 3.17 to prescribe more medicines).Conclusions: A few comments and suggestions are stated to save service time/cost for the sake of more hospital’s efficiency. With a methodology in this article, level of over-visits by the patients and the level of over-prescriptions by the physicians are estimable to reduce the waste of hospital’s resources.
Diagnostic efficacy of bronchoalveolar lavage (BAL) in lung malignancies
Authors: Tayal Shubhra , Bhale Chandrashekhar P.
Published: August 2018

Background: Lung malignancies are the leading cause of cancer related deaths in men and in women it has surpassed even breast cancer. With the development of flexible fiber-optic bronchoscope, respiratory cytology has newer approach as samples like bronchial washings, bronchial brushings, bronchoalveolar lavage and trans-bronchial needle aspirations could be collected from the respiratory tract, yielding significant amount of cytological material.Methods: A prospective study conducted in department of pathology in MGM Medical College and Hospital, Aurangabad during a period from November 2015 to October 2017. 48samples of bronchoalveolar lavage received and patient data collected.Results: About 48 cases included in the study comprised of 23 (47.92%) malignancies, 16 (33.34%) DLDs and 9 (18%) cases of tuberculosis. In our study, 23 cases of malignancy included 15 male and 8 female patients (male:female ratio= 1.87). Mean age for malignancy was 57.57 years with median age of 60 years. Among 23 cases of malignancies 11 were given as positive/suspicious/atypical cells on BAL, whereas 10 out of 11 bronchial brushing were given as positive/suspicious or suggestive of malignancy.Conclusions: Bronchoalveolar lavage is useful procedure. Efficacy of BAL is increased when used in combination with bronchial brushing.
Study of dengue outbreak in north west zone of Rajasthan, India
Authors: Kumar Surendra , Bhandiwad Chandrashekhar , Lakhiwal Rajkumar , Singh Chandreshwar Pratap , Sharma Nitin , Chhimpa Atmaram , Gupta Akhil , Singhal Vipin
Published: August 2018

Background: Dengue is one of the most important mosquito-borne viral disease globally. The virus is the member of flavivirus group which typically is a single stranded RNA virus. It is 2nd most common arthropod borne disease in India. Due to its atypical presentation often, dengue missed out as a differential diagnosis. High clinical suspicion and proper investigation help in early diagnosis of dengue and its complications.Methods: A total of 200 patients were selected to be a part of study after applying inclusion and exclusion criteria. Only those patients were included in the study who had classical features of dengue- fever with chills, body ache, headache and thrombocytopenia and had a positive serology against dengue virus. Patients who had malaria, enteric fever, and negative serology were excluded from the study. Other causes of pancreatitis, pneumonitis, ascitis, cholangitis, pleural effusion and thrombocytopenia are rolled out. All patients were subjected to a detailed history and a thorough clinical examination. A complete blood count, liver function tests, renal function tests, chest X-ray and USG abdomen were also done.Results: Among 200 patients diagnosed as dengue fever,106 were male and 94 female. 78% patient were from urban and majority were from 20-30 years age group. Average duration of stay in hospital is 3.5 days. Along with fever and malaise, pain abdomen, bleeding diathesis, itching, cough were the major complaints in decreasing order. Different findings in the investigations are: Mean WBC counts - 4251, mean platelet counts - 41831, mean hematocret - 41.8, mean MPV- 8.55, number of patients with deranged ALT/AST- 88(44%). In USG ascitis and edematous gall bladder were the major findings followed by hepatomegaly, splenomegaly and pleural effusion. Number of patients required platelet transfusion were 60. Among these 60 patients average number of RDP transfused is 2 units.Conclusions: Present study concludes that clinical vigilance about various type of presentations is important as timely recognition can influence outcome and may prevent compilations.
Clinico-physiological profile of patients of pulmonary impairment after tuberculosis at a tertiary care centre
Authors: Singh Gajendra V. , Srivastava Antriksh , Chandra Vinisha , Kumar Santosh , Goel Rishabh
Published: August 2018

Background: Pulmonary tuberculosis (TB) is a unique infectious disease that more often results in permanent structural changes in the lung parenchyma. It is by virtue of these changes that the patients even after bacteriological cure continue to suffer the after effects of the disease. Objective of study was to assess the clinico-physiological profile of patients of pulmonary impairment after tuberculosis (PIAT) attending S. N. Medical College, Agra, Uttar Pradesh, India.Methods: Over the time period of 2 years, 350 patients of healed pulmonary tuberculosis were identified and studied about their clinico-physiological profile. This profile included age, sex, category of treatment, pulmonary function test pattern, exercising capacity, exercise tolerance and quality of life.Results: It was found that majority of the patients were males, >60 years of age and had taken Category-II treatment. Most of the patients were having an obstructive pattern on PFT, poor exercise tolerance and exercise capacity and a poor quality of life.Conclusions: Patients of healed pulmonary TB continue to experience respiratory symptoms owing to the permanent anatomical changes in the lung conferred by the disease.
An observational study of cytopathological analysis of ascitic fluid or peritoneal washings cytology in ovarian neoplasms: correlation with histopathological parameters
Authors: Jaswani Priya , Gupta Sonal
Published: August 2018

Background: Analysis of ascitic fluid and peritoneal washing cytology serves as a useful predictor of ovarian surface involvement and peritoneal metastasis even in the absence of clinical omental spread. The aim of the current study is to correlate peritoneal cytology with various histologic features of ovarian cancers.Methods: It is a retrospective study.  A total of 30 cases of ovarian neoplasms were included in the study. Results of peritoneal cytology were correlated with various histologic features of ovarian tumors including histologic type, grade, tumor size, capsular invasion, and omental metastasis, using chi-square test. A p value of <0.05 was considered as statistically significant.Results: Out of the 30 cases of ovarian tumors involved in the study, twenty-five cases were surface epithelial tumors, two sex-cord stromal tumors, one germ cell tumor, one primary ovarian lymphoma and one metastatic carcinoma. Capsular invasion was seen in 56.3 % of the cases, and omental metastasis in 46.6 % of the cases. A significant positive correlation was seen between positive peritoneal cytology and capsular invasion and omental metastasis with a p value of <0.001.Conclusions: Peritoneal fluid cytology is an indicator of peritoneal metastasis. Positive cytology also correlates with capsular invasion and histologic type in ovarian tumors. Therefore, it should always be used as an adjunctive tool in the surgical management of ovarian tumors.
A study of thyroid function in premenopausal and postmenopausal women of Dibrugarh town, Assam, India
Authors: Bordoloi Gitartha , Jahan Wasima
Published: August 2018

Background: Ageing process can cause some changes in body system controlling mechanism. Consequently thyroid hormone levels may show variations reflected by TSH level in elderly people, more so in females.Methods: Serum TSH level were measured in 304 apparently healthy females of Dibrugarh town, Assam. Unbound T3 and T4 were measured if TSH level was abnormal. TSH levels were compared among different age groups.Results: The prevalence of hypothyroidism was found to be 8.2% in premenopausal and 12.7% in postmenopausal women. There were more cases of subclinical hypothyroidism than clinical hypothyroidism. Difference of Mean± SEM of TSH level in these two groups was significant though there was no correlation between age and TSH level.Conclusions: The study reveals decreasing thyroid function in postmenopausal female population of Dibrugarh town.
A study of knowledge, attitude and practice in diabetic retinopathy among patients attending a primary health care centre
Authors: Geethadevi Malavika , Thampi Bindu , Antony Joosadima , Raghavan Remya , Sasidharan Rekha R. , Mohan Ajith
Published: August 2018

Background: Diabetic retinopathy is a major cause of preventable blindness. Sufficient knowledge about the disease can prevent sight threatening complications. Aim of this study is to evaluate the knowledge and its influence on attitude and practice in diabetic retinopathy among patients attending a primary health centre.Methods: A knowledge attitude practice questionnaire was prepared and pretested in a sample group of representative population. The response was analyzed as to whether the questions were understood or not. Social workers were trained in administering questionnaire. Diabetic patients were given questionnaires at primary health centre and filled in the presence of social workers.Results: Out of 324 patients 60.8% had no knowledge of diabetic retinopathy compared to 39.19% who had knowledge (p <0.001). Knowledge was more in age <40 years (82.60%) and least in 51-60 years (29.34%) (p<0.001) and more among females (38.59%) than males (61.4%). Knowledge was significantly higher among upper socioeconomic group (77.8%). About 83.46% in knowledge group had right attitude which was significantly higher than non knowledge group (32.48%) (p<0.001).  42.51% in knowledge group had practice of visiting ophthalmologist for eye check-up which was significantly higher than non knowledge group (13.19%) (p<0.001).Conclusions: The attitude and practice of diabetic retinopathy was statistically significant in knowledge group compared to those who had no knowledge of diabetic retinopathy. Improving knowledge about diabetic retinopathy through awareness campaigns can increase attitude and practice. Early detection can help in preventing sight threatening complications of diabetic retinopathy.
Evaluation of visual evoked potentials in type II diabetes mellitus subjects attending a tertiary care hospital
Authors: V. Gowri
Published: August 2018

Background: DM is the most common metabolic disorder in the world. The complications of DM take millions of lives every year. There is definite expectation to reason out both vasculopathy and neuropathy associated with DM leads to dysfunction along the visual pathway. The Visual Evoked Potentials (VEPs) as an electrophysiological method to assess conduction in type II DM subjects which is simple. This study attempted to detect earlier visual involvement before the clinical symptoms.Methods: VEP was recorded in 100 subjects (Diabetic 50 and Controls 50) P100 latency was compared between the diabetic and age, gender matched controls.Results: The study evidenced that the mean P 100 latency in DM subjects was found to be significantly prolonged when compared the that of controls.Conclusions: The study will help in supervising the earlier progress of neuropathy and earlier detection of nervous system involvement to reduce the morbidity of the diabetic subject and a special care to improve their quality of life.
Comparison of intramuscular diclofenac sodium, diclofenac sodium suppository and intravenous tramadol for postoperative analgesia in gynaecological surgeries done under spinal anaesthesia
Authors: Khobragade Sonali Mahendra
Published: August 2018

Background: Postoperative pain management is a vital factor contributing towards speedy recovery of the patient in the perioperative period without significant morbidity. The purpose of this study was to compare the analgesic efficacy and safety of three most frequently used analgesic drugs-intramuscular diclofenac sodium, diclofenac suppository and intravenous tramadol hydrochloride in patients undergoing gynaecological surgeries.Methods: A hospital based, prospective, randomized, comparative study was undertaken in tertiary care hospital for a period of two years. The study included 90 adult patients undergoing gynaecological surgeries in spinal anaesthesia. Postoperative pain intensity was assessed by visual analogue scale. Level of sedation was assessed by four point scale along with haemodynamics.Results: There were no significant changes in the pulse rate, systolic blood pressure and diastolic blood pressure after giving I.M. diclofenac, diclofenac suppository and I.V. tramadol. The mean VAS scores were comparable in all three groups (p>0.05). The level of sedation was more in tramadol group than in diclofenac intramuscular and rectal group which was statistically significant (p=0.001).Conclusions: Diclofenac suppository provides effective postoperative analgesia when compared with Inj. Diclofenac I.M. and Inj. tramadol I.V. in patients undergoing infraumbilical gynaecological surgeries with stable vitals and no side effects.
The study of prevalence of metabolic syndrome in the first degree relatives of type 2 diabetes mellitus patients
Authors: Mittal Mahim , Gupta Himanshu , . Deepshikha
Published: August 2018

Background: Metabolic syndrome (MetS) is associated with higher incidence of new onset DM. First degree relatives (FDR) of T2DM patients also have an increased risk of new onset DM due to common genetic factors that can lead to obesity and dyslipidemia. Objectives of research work was to study the prevalence of MetS in FDR of T2DM patients.Methods: Cross-sectional study of FDR of T2DM patients. MetS defined by both IDF and NCEP-ATPIII criteria. All subjects underwent necessary biochemical tests, a detailed history in a pre defined proforma was taken and clinical examination was done as per protocol.Results: Mean age was 43.61±11.7 years. Prevalence of MetS was 35% by IDF and 25% by NCEP-ATPIII. According to IDF criteria, the most prevalent risk factors among FDR were central obesity and hypertension. Prevalence of MetS was higher in urban, sedentary and obese population.Conclusions: Prevalence of MetS is more in FDR of T2DM than that reported in the general population. Central obesity is the most prevalent risk factor. Targeted lifestyle intervention in this population may help prevent the development of MetS and T2DM.
Safety and efficacy of dialyzer reuse by manual reprocessing: an observational study
Authors: Mittal Mahim , Singh Anoop K. , Yadav Sudheer , U. V. Shilpa
Published: August 2018

Background: Haemodialysis is the main form of RRT in the patients of CKD. Haemodialysis is a costly procedure and is not afforded by many. Reuse of components of Haemodialysis circuit helps in reducing cost but may be associated with decreased efficacy and side effects.Methods: Prospective observational study. Manual reprocessing of dialyzer was done with either formaldehyde or peracetic acid. Single brand (Fresenius) dialyzer were used across all patients. Dialysis efficacy was calculated by URR and side effect and toxicity monitored in a predefined proforma.Results: A total 50 patients were studied (39 male and 11 female) with age ranging from 31-60 years. The mean urea reduction ratio after four dialysis session with the same dialyzer was 62.93% which is below KDOQI recommendation. The findings in our study suggest that URR was adequate upto three session of haemodialysis by reprocessed dialyzer but not beyond that. The choice of chemical for reprocessing did not affect the efficacy. As compared to F6 dialyze F8 dialyzer had better initial URR and this was maintained upto fourth reuse. Serum albumin levels correlated with the fall in efficacy of dialyzers. There were no significant complications of reuse of dialyzers across both methods of reprocessing and there was no dialyzer first use syndrome.Conclusions: ESRD affects a younger age group in our country. Use of large membrane area results in better efficacy. Dialyzer reuse with manual reprocessing is safe and also effective upto third and fourth use. Dialyzer reuse is associated with economic benefits.
Utility of serum lactate dehydrogenase in the diagnosis of megaloblastic anemia
Authors: Gaikwad Amrapali L. , Jadhav D. S.
Published: August 2018

Background: Megaloblastc anemia corresponds to severe macrocytic anemia with hypersegmented neutrophils and very high serum Lactate Dehydrogenase (LDH). The present study was undertaken to evaluate the utility of serum LDH and chloroform inhibited serum LDH in the diagnosis of megaloblastic anemia and to observe if this can be used to differentiate megaloblastic anemia from iron deficiency anemia and hemolytic anemia.Methods: The present study was carried out on 75 patients of anemia categorised on bone marrow examination (into megaloblastic and non-megaloblastic anaemia) to evaluate the efficacy of total serum LDH levels and LDH isoenzyme pattern in the diagnosis of megaloblastic anemia. About 25 healthy adults were taken as controls.Results: In megaloblastic anemia, total serum LDH level was found to be increased to about nineteen folds and in hemolytic anemia it was found to increased four folds as compared to normal. On statistical analysis this increased total serum LDH level in megaloblastic anemia and hemolytic anemia as compared to control group was found to be significant.In the present study serum LDH level above 3000IU/L was associated with megaloblastic anemia and serum LDH level below 900IU/L was suggestive of iron deficiency anemia. The chloroform inhibition test was less than 25% in megaloblastic anemia and more than 25% in hemolytic anemia and these differences were found to be statistically significant (t=9.62, df=49, p<0.001).Conclusions: Total serum LDH levels more than 3000IU/L are diagnostic of megaloblastic anemia. Reversed LDH isoenzyme pattern (LDH1>LDH2) by chloroform inhibition test is an adjuvant in the diagnosis where total serum LDH levels are between 451-3000IU/L and can also differentiate megaloblastic anemia from hemolytic anemia.
USG guided femoral nerve block vs fascia iliaca compartment block as post-operative analgesia in hip fracture patients
Authors: Shukla Usha , Jahan Mizma , Naaz Shagufta , Srivastava Swati
Published: August 2018

Background: Adequate postoperative analgesia facilitates early mobilization which is important to reduce postoperative morbidity. Here, we intended to compare the efficacy of two different nerve blocks for postoperative pain relief in fractured neck of femur patients.Methods: One hundred and five patients posted either for dynamic hip screw or proximal femoral nail implantation under spinal anaesthesia were randomly allocated to three groups. At the end of surgery, group 1 received femoral nerve block (FNB) and group 2 received fascia iliaca compartment block (FICB) for postoperative pain relief. These blocks were ultrasound guided. Group 3 received no block and acted as control. Patients’ pain was evaluated by Visual Analogue Scale (VAS) both at rest and at passive elevation of leg. Rescue analgesia was given when VAS score exceeded 3. Heart rate, mean arterial blood pressure, respiratory rate and total analgesic consumption in first 24 hours were also recorded.Results: Groups 1 and 2 had similar duration of analgesia of around 8 hours (P value = 0.727). Analgesic consumption in both these groups were similar (P value = 0.648). These groups had less pain, less analgesic requirement and more stable haemodynamics as compared to group 3. No adverse effect was seen due to application of block.Conclusions: FICB can be an effective alternative to femoral nerve block, because of its relative simplicity in technique and less invasiveness. Hence FICB holds considerable promise as an effective postoperative analgesia.