bluuebunny/crossref_metadata_2025 huggingface dataset:
Prophylactic and Curative Assessment of Essentiale ForteÂ® On Carbon Tetrachloride-Induced Liver Damage in Wistar Rats
Authors: Olukiran Olaoluwa S , Akomolafe Rufus O , Bamitale Kayode O , Ajayi Akande O , Okonji Raphael E , Bejide Ronald A
Published: October 2015

AIM: This study was to assess the prophylactic and curative effects of Essentiale forte (ESF) on carbon tetrachloride (CCl4) induced liver damage in Wistar rats.MATERIALS AND METHODS: Twenty-four adult Wistar rats were randomly divided into four groups of six rats each. Group I (control group) received 0.3 ml/kg/day of propylene glycol for one month; group II (toxic control) was given 0.7 ml/kg/day of CCl4 dissolved in olive oil (1:1,v/v) orally for 7 days; group III (prophylactic group) received 4.3 mg/kg/day of ESF for one month followed by CCl4 for one week; group IV (curative group) was treated with CCl4 for one week and subsequently received ESF (4.3 mg/kg/day) for one month. Half of the rats were sacrificed at active period, the other half after a 2-week recovery period.RESULTS: The activities of serum AST, ALT, ALP, total bilirubin level were significantly higher, total protein and GSH levels were significantly reduced in the toxic control group compared to the control group. Group III had significantly higher AST and ALT activities compared to the control rats at active period, whereas after the recovery period no significant differences were observed in almost all the parameters. Moreover, no significant differences in the parameters mentioned above were observed in group IV compared to the control rats at active and recovery period.CONCLUSION: The results of this study showed that Essential forte was better as a curative agent rather than a prophylactic agent in rats.
Kaempferol Attenuates the Development of Diabetic Neuropathic Pain in Mice: Possible Anti-Inflammatory and Anti-Oxidant Mechanisms
Authors: Abo-Salem Osama M.
Published: October 2015

BACKGROUND: Diabetic neuropathic pain (DNP) is one of the most difficult types of pain to treat.Â  Many studies emphasized on the role of microglial cells, oxidative stress (OS) and inflammatory cytokines (IC) in the development of diabetic neuropathy (DN).AIM: Present study was designed to evaluate the effect of kaempferol in attenuation of DN in mice.Â METHODS: Diabetes was induced in mice by i.p. injection of a single dose of streptozotocin (STZ) (200 mg/kg). Cold allodynia, thermal hyperalgesia and chemical hyperalgesia were assessed, as well as markers of inflammation and OS.RESULTS: Diabetic mice (DM) showed an increased pain sensation, IC and OS accompanied with reduced body weigh gain. Treatment of DM with kaempferol (25, 50 and 100 mg/kg/day/orally) attenuated the development of DN and reduced pain sensation. Moreover, it reduced interleukin-1Î² (IL-1Î²), tumor necrosis factor-Î± (TNF-Î±), lipid peroxidation and nitrite, concomitant with the improvement of antioxidant defense and body weight gain. In contrast, kaempferol (100 mg/kg) had no effects on the behavioral and biochemical parameters. Our results strongly suggest that activated microglia, IC and OS are involved in the development of DN.CONCLUSIONS: Kaempferol attenuates the development of DNP in mice probably by inhibition of neuroimmune activation of microglia and, partly mediated by reducing IC and OS.
Effect of Diabetes Mellitus and Its Control on Myocardial Contractile Function in Rats
Authors: Alsawy Bassem M. , El-Damarawi Magdi A.
Published: October 2015

AIM: This work was done to study the effect of both types of diabetes mellitus (DM) on myocardial contractility in rats. Also, we investigated the role of treatment of DM with insulin and rosiglitazone (used as treatment for type 1 and type 2 DM respectively) in improvement of myocardial dysfunction in diabetic rats.METHODS: The study included 50 male Wistar albino rats, divided into 5 groups: control (group I), streptozotocin induced type 1 DM (group II), fructose induced type 2 DM (group III), insulin treated type 1 diabetic rats (group IV) and rosiglitazone treated type 2 diabetic rats (group V). At the end of the study, retro-orbital blood samples were withdrawn and blood glucose, plasma triglyceride (TG), total cholesterol (TC) and thyroid hormones levels were measured. Rats were then anesthetized and their hearts were excised and connected to Langendorff apparatus to perform mechanical cardiac performance tests including heart rate (HR), left ventricular developed pressure (LVDP) and maximum rate of pressure rise (+dp/dt).RESULTS: Data of the study showed that relative to control group, there was significant increase in blood glucose, plasma TG and TC levels while, thyroid hormones and myocardial performance parameters showed significant decrease in both type 1 and type 2 diabetic rats. Treatment of type 1 diabetic rats with insulin and type 2 with rosiglitazone resulted in significant decrease in blood glucose, plasma TG and TC levels associated with significant improvement in thyroid hormones and myocardial performance parameters. The results also showed that insulin treatment of type 1 was more effective in ameliorating all parameters than treatment of type 2 by rosiglitazone.CONCLUSION: We concluded that the induction of both types of diabetes resulted in decreased myocardial performance parameters. TheÂ  treatment of type 1 and type 2 diabetes by insulin and oral rosiglitazone respectively improved to a great extent the altered metabolism andÂ  mechanical myocardial parameters, with more improving effect ofÂ  insulin in type 1 than rosiglitazone in type 2 DM.
Vascular Endothelial Growth Factor in Colonic Cancer, Ulcerative Colitis and Colonic Adenoma: An Immunohistochemical Study
Authors: Gamal el Din Amina A. , Esmail Reham Sh. E. , Hareedy Amal A.
Published: October 2015

BACKGROUND: Colon cancer is one of the most common malignancies worldwide. Colonic adenoma and ulcerative colitis (UC) are important precancerous lesions. Vascular Endothelial Growth Factor (VEGF) is a well-known pro-angiogenic factor plays important role in physiologic and pathologic conditions and in neovascularization in cancer and hence becomes a potential target for anti-angiogenic cancer therapy.AIM: This study investigated VEGF immunohistochemical expression in colon cancer and its precancerous lesions. MATERIAL AND METHODS:Â  Paraffin blocks from two hospitals were collected in a year: Colon cancer: 20 cases, colonic adenoma: 15 cases, UC: 15 cases and 5 controls from normal mucosa. VEGF was assessed immunohistochemically using a primary anti-VEGF antibody (VG1, Dako, Denemark).RESULTS: Median age was 49 years (range 31-52) in cancer, 40 years (range 31-52) in adenomas and 33 years (range 27-43) in UC. VEGF expression was negative in control, significantly strongly positive in 90% of colonic adenocarcinoma (p= 0.001), significantly positive in adenomas (p= 0.002) - the weak positivity significantly seen in mild dysplasia (p= 0.001) - and significantly positive in 73.3% of UC cases (p=0.022).CONCLUSION: The significant increase in positivity of VEGF in precancerous to cancerous lesions may point to its potential role in the pathogenesis and progression of colonic neoplasia.
Usefulness of Estimation of Glycated Albumin and Glycosylated Haemoglobin in Indian Diabetic Chronic Kidney Disease Patients
Authors: Ramanathan Kumaresan , Padmanabhan Giri
Published: October 2015

BACKGROUND: It is unclear whether the glycated hemoglobin (HbA1c) assay accurately reflects glycemic control in patients withÂ chronic kidney disease (CKD).AIM: To evaluate the usefulness of glycated albumin (GA) in diabetic CKD population with reference to glycemic control in comparison to HbA1c.MATERIALS AND METHODS: Totally 194 Diabetic CKD (Male: 126, Female: 68) patients who attended a private nephrology clinic, were taken for the study. The age ranged between 18 to 87 years. Blood samples were collected in fasting state in all the patients and all biochemical estimations were done using fully automated analyzer.Â RESULTS: The mean estimated GFR levels were 82.47, 44.32, 24.13 and 10 ml/min/1.73 m2 in Group I, II, III & IV respectively. The GA levels were significantly increased when the eGFR levels have been decreased. Also the GA: HbA1c ratio differed significantly when compared between the groups I & II, I & III and group I & IV of CKD patients.CONCLUSION: GA estimation is a useful marker in assessment of short term glycemic control in stage III & IV (< 30 ml/min/1.73m2) diabetic CKD patients. GA: HbA1c ratio if routinely done may also become a useful marker in Diabetic CKD population in future.
Pregnancy in Women with Aortic Stenosis
Authors: Garnizov Teodor , Atanasova Vangeliya , Filtcheva Mariela
Published: October 2015

OBJECTIVE: The aim of this study was to provide data about the course and outcome of pregnancy in the women with aortic stenosis (AS) with special attention to complications in pregnant with severe AS, which was asymptomatic prior to conception.METHODS: Eleven pregnant women with different grades of AS were monitored in ambulatory and clinical conditions during pregnancy, childbirth and the post-partum period. The Apgar scores of the neonates born by mothers with AS were compared to those of neonates born by healthy mothers, using the variation statistical analysis.RESULTS: In the group with severe AS, asymptomatic prior to conception, aggravation of the NYHA functional class (FC) with left ventricular heart failure was observed. Pregnancy, childbirth and post-partum period were normal in the group with moderate aortic stenosis and in those with ventricular defects, corrected prior to conception. The sums of the Apgar scores for the whole group did not differ from those for the neonates, born by healthy mothers.CONCLUSION: The results suggest that there is a need of consensus for the complex of examinations, enabling diagnostic differentiation of pregnant women with severe AS requiring urgent defect correction and, the prognosis of pregnancy in women with asymptomatic severe AS.
Feasibility of Early Physical Therapy Program In-Hospital Patients with Acute Ischemic Stroke
Authors: Grigorova-Petrova Kristin , Lubenova Daniela , Dimitrova Antoaneta , Baldaranov Dimo , Lozeva Julia
Published: October 2015

BACKGROUND AND PURPOSE: Clinical practice guidelines for patients with stroke recommend early stroke rehabilitation at acute stroke unit care. The purpose of the study is to determine the feasibility of the application of feedback breathing device for respiratory training during the acute period in patients with ischemic cerebral stroke and appropriate program of physical therapy.MATERIAL AND METHODS: Seven patients in acute period â€“ not later than 48 hours after the accident with light to moderate stroke severity under the NIHSS scale. The applied study methods are the following: functional respiratory evaluation, inspiratory capacity with incentive spirometer device, assessing diaphragmatic movement by ultrasonography.RESULTS: Better results in Forced Vital Capacity, Peak Expiratory Flow, inspiratory capacity and ultrasonography have been observed.CONCLUSION: An early targeted impact on respiratory disorders in patients with ischemic cerebral stroke is applicable. To determine the clinical significance larger studies are needed.
The Correlation between Ultrasound Testicular Volume and Conventional Semen Parameters in Albanian Subfertile Males
Authors: Kristo Adrian , Dani Evin
Published: October 2015

OBJECTIVE: The study is conducted to evaluate the relationship between testicular volume measured by ultrasound and conventional sperm parameters (volume, concentration, total count, motility and morphology) in Albanian subfertile males and to determine a normal limit value of the testicular volume.MATERIALS AND METHODS: A total of 500 males were observed for this study. The testicular volumes of all subjects were measured by ultrasonography. The semen samples were collected by the process of masturbation after 3-5 days of ejaculatory abstinence and were analyzed according to WHO criteria 2010.RESULTS: Testicular volume has a strong positive correlation with sperm count, total count and motility and a positive correlation with semen volume.CONCLUSION: Testicular volume has a direct correlation with semen parameters and the critical total testicular volume indicating normal testicular function is approximately 26.6 ml (the mean testicular volume 13.3 ml). The measurement of testicular volume can be helpful for assessing fertility at the initial physical examination.
Multiple Erythema Lesions Obscured As Fungal Skin Infection
Authors: KoÃ§inaj Allma , GÃ«rÃ§ari Antigona , Ferizi Mybera , Lashi Edlira , Gjunkshi Lorela , Fida Monika
Published: October 2015

Erythema migrans is a ring like erythema, with a few centimeters in diameter. Usually it occur solitary, days to weeks after an infected tick bite. According to skin changes it can be manifested acutely such as erythema migrans in Lyme Borreliosis, borrelial lymphocytoma (subacute), or as a late Lyme disease with acrodermatitis chronica atrophicans. All stages of this disease can be treatable with antimicrobial agents. As a first case in our department with multiple lesions, we describe a 14-year-old female and review the patientâ€™s clinical and laboratory features, the causes of the disease, diagnosis as well as treatment.
Successful Heart Transplantation Following Decompressive Craniectomy in a Patient with Restrictive Cardiomyopathy and Extensive Stroke in the Region of the Right Middle Cerebral Artery
Authors: Gulsen Salih
Published: October 2015

Restrictive cardiomyopathy (RCM) in children is associated with a greater risk of embolic stroke than are other congenital heart diseases. After diagnosis, 50% of children with RCM die within 2 years without heart transplantation. As such, all RCM patients are placed on the heart transplantation list and must wait for an appropriate heart for transplantation. Every type of embolic stroke can occur while waiting for a donor heart; therefore, the cardiovascular team must initiate antithrombotic therapy at time RCM is diagnosed. Some pediatric RCM patients experience embolic stroke (50% are the cerebral type) despite antithrombotic therapy, including acetylsalicylic acid, warfarin, and heparine. Neurosurgeons working in hospitals that perform organ transplantation expect to see RCM cases with restrictive large cerebral infarct. We think that decompressive craniectomy should be performed as soon as possible after determining the clinical condition of any patient with RCM and a large right middle cerebral artery (MCA) infarct.
Application of the First Expert Arthrodesis Nail to a Patient with Previous Performed Arthrodesis According to Ulrich Holz â€“ Case Report
Authors: Stojmenski Slavcho , Dimitrovski Dejan , Merdzanovski Igor
Published: October 2015

AIM: The aim of this paper was to present application of the first expert arthrodesis nail in our clinic to a patient with previous performed arthrodesis according to Ulrich Holz.CASE REPORT: Patients A.M. on the age of 22 (1992) have a motor vehicle injury, (fall from a motor bike) with diagnosis polytrauma, shock, supra and transcondyar open fracture of the right femur III degree, open fracture of the right tibia and fibula. We perform reposition and fixation of supra and transcondyar femoral fracture with â€œcobraâ€ plate. Also we perform reposition and fixation of right cruris with external fixation. After the operation we found fistula in the place of operation of the right crural regia. During the time the infection goes worse and the patient develop osteomyelittis on the right crural regia. After 5 months with therapy the situation become calm. We remove the external fixation. The patient develops severe â€œpes equinusâ€ on the right leg and he cannot walk. We try to reduce this equines situation with elongation of the Achilles tendonin the first step, and because we didnâ€™t solve the problem we continue with complete section of the Achilles tendon and after that we perform osteotomy of the right talocrural joint simultaneous to tibia plafond and talus and resection of fibula 2sm.above the syndesmosae tibiofibularis and we fixed the talocrural joint with two screws according the technique of Ulrich Holz.CONCLUSION: So we received fixed position on of the food on 110 degrees which was steel unacceptable for normal walking. At last we remove the screws, make once again osteotomy with positioning of the food in maximal dorsiflexion and perform the Experf Hindfood arthrodesis nail so with this method we achieve correction of dorsiflexion on 95 degrees, and the patient become satisfied because he can walk without support.
Management of Persistent Hypotension after Resection of Parasagittal Meningioma
Authors: Gulsen Salih
Published: October 2015

Various complications including air embolism have been discussed in large clinical series regarding the parasagittal meningioma. We presented and discussed the patient suffering from persistent hypotension after excision of parasagittal meningioma. A 47-year-old man was admitted to our hospital with complaints of headache and frontal region swelling. His cranial MRI showed a bilaterally located parasagittal meningioma at the anterior one third of the sagittal sinus. Conspicuously, he had large frontal sinus and its length was about totally 7 cm in sagittal and transverse part.During cranitomy, we had to open frontal sinus because of its large size and open the sagittal sinus while removing of the tumor. So coincidental opening of the superior sagittal sinus and/or emissary veins located within diploe of the cranium and frontal sinus may cause hypotension after extubation due to normal respiration led to air escaping from the frontal sinus to the emissary veins placed next to the frontal sinus. Bilateral application of the tamponade embedded with vaseline inside to the nose prevents air escaping from the frontal sinus to the emissary veins.
A Severe Case of Wheat-Dependent Exercise-Induced Anaphylaxis in Adulthood
Authors: Hoxha Mehmet , Deliu Albana , Nikolla Elida , Loloci Gjustina , Kalo Tritan
Published: October 2015

Food-dependent exercise-induced anaphylaxis (FDEIA), is a severe form of allergy for which the ingestion of a specific food, usually before physical exercise induces symptoms of anaphylaxis. Patients typically have IgE antibodies to the food that triggers the reactions; however, the symptoms appear only if the co-factors act together. The most common reported cause of these reactions seems to be wheat. In some cases FDEIA is displayed even when the food is eaten immediately after exercise, showing that in FDEIA, not the sequence but rather the coincidence of triggering factors use, is of crucial importance. The risk to develop anaphylaxis in these patients depends on the presence and, in some cases, on the amount of cofactors of anaphylaxis. There are lots of evidences about the role of NSAIDs as cofactors of anaphylaxis.
Health 2020 â€“ Achieving Health and Development in Todayâ€™s Europe
Authors: Jakab Zsuzsanna , Tsouros Agis D.
Published: October 2015

AIM: To present contemporary major public health challenges and comprehensive policy framework and strategic vision of the "Health 2020" for improving population health and well-being in Europe.METHODS: Retrospective study based on the available indicators of the health status of the population in Europe, social determinants of health and health-related behavior, health systems and public health services, and analysis of the WHO policy documents, reports and commitments leading to the new coherent approach and strategic vision "Health 2020".RESULTS: The 21st-century health landscape is shaped by growing global, regional and local interdependence and an increasingly complex array of interlinking factors that influence health and well-being. Most of todayâ€™s major public health challenges, including non communicable diseases, antimicrobial resistance, health inequalities and the health effects of austerity measures in some countries, cannot be addressed effectively without inter sectoral and coordinated action at supranational, national and local levels. The 53 countries of the WHO European Region developed and adopted a European policy framework and strategy for the 21st century (Health 2020) as a common, evidence-informed policy framework to support and encourage coordinated action by policy-makers at all levels and in all sectors to improve population health and well-being.CONCLUSION: This article presents the development process of Health 2020 and its main strategic goals, objectives and content. Further, it describes what is needed to successfully implement Health 2020 in countries and how WHO can provide technical assistance to countries that embark on developing health policy aligned with the Health 2020 policy framework. The development and implementation of Health 2020 is a powerful vehicle for concerted inter-sectoral action across the WHO European Region for improving health and well-being of present and future generations. Successful implementation of Health 2020 needs providing technical assistance by WHO to the countries to embark on developing health policy aligned with the Health 2020 policy framework.
Efficacy and Tolerability of Eight Antimicrobial Regimens in the Outpatient Treatment of Exacerbations of Chronic Obstructive Pulmonary Disease
Authors: Minov Jordan , Karadzinska-Bislimovska Jovanka , Petrova Tatjana , Vasilevska Kristin , Stoleski Sasho , Mijakoski Dragan , Risteska-Kuc Snezhana
Published: October 2015

BACKGROUND: Bacterial infections are considered as the most important cause of exacerbations in patients with chronic obstructive pulmonary disease.AIM: To compare the efficacy and tolerability of eight antibiotics empirically administered for outpatient treatment of exacerbations of COPD.METHODS: We performed an observational study including 343 COPD patients with probable bacterial exacerbation (Group A and Group B COPD patients) managed in an outpatient setting. Eight antibiotic regimens each used 10 days were evaluated: amoxicillin/clavulonic acid, doxycycline, cefuroxime, cefixime, clarithromycin, roxithromycin, ciprofloxacin, and moxifloxacin. All patients were followed up for 30 days, with an intermediate visits at 5, 7 and 10 days at which the duration of symptoms and the side-effects of the drug were evaluated.RESULTS: The clinical success rate varied from 69.8% with doxycycline to 80.9% with moxifloxacin. The mean time to relief of symptoms varied from 5.6 days with moxifloxacin to 6.3 days with amoxicillin/clavulonic acid. Significant increase of the post-treatment FEV1value was registered in all treatment groups. Relapse within the first 20 days was registered in the group receiving doxycycline, clarithromycin, and ciprofloxacin. The prevalence of the adverse events was low varying from 6.7% with cefuroxime to 11.3% with ciprofloxacin.CONCLUSION: Our findings suggest high clinical success rate and high safety of all studied regimens.
Prevalence of Hepatitis C Virus in the Population of Albania for the Period 2007-2010
Authors: Vila Brunilda Hysaj , Lila Shundi , Erjona Abazaj , Silva Bino , Tefta Rexha
Published: October 2015

BACKGROUND: Hepatitis C is a blood-borne, infectious, viral disease that is caused by a hepatotropic virus called Hepatitis C virus (HCV).AIM: The aim of this study is to determine the prevalence of active HCV infection (HCVâ€“RNA) in the cases that were anti-HCV positive.MATERIAL AND METHODS: Plasma of 301 high-risk for HCV infection consecutive from University Hospital Centre â€œMother Theresaâ€ Tirana-Albania, during January 2007 to December 2010 was included in this study. To identify the presence of HCV RNA, the samples were examined by Cobas Amplicor HCV test (qualitative method).RESULTS: From 301 samples analyzed in total, 214 of them resulted positive for the presence of HCV-RNA's, corresponding to a prevalence of 71.1%, with 95% CI interval [65.8 - 75.9] for value of Ï‡2 = 52.7 p value <0.0001. Divide by the sex 56% were males and 44% females, with statistically significant difference between them for value Ï‡2 =4306 p value=0.0380. Among the age groups the highest prevalence was observed in the age groups > 25 years with a significant difference with other age groups for p value <0.001.CONCLUSION: Among tested samples, 71.1 % were confirmed to be positive for HCV â€“RNA infections. The prevalence of male was highest compared to female. For males and females infected the prevalence was highest in the age group of > 25 years.
Self-Assessment of Final Year Medical Studentsâ€™ Proficiency at Basic Procedures
Authors: Olajide Thomas , Seyi-Olajide Justina , Ugburo Andrew , Oridota Ezekiel
Published: October 2015

BACKGROUND: Procedural tasks are important in patient management, with varying degrees of proficiency expected at different levels of medical training. Little has been done in this region to assess the medical studentsâ€™ proficiency at performing basic procedures.AIM: The aim of this study is to determine their self-assessed proficiency, degree of participation in performing these procedures and the use of skill-lab training.MATERIALS AND METHODS: The study is questionnaire-based, amongst final year medical students of University of Lagos, Nigeria.RESULTS: One hundred and forty students participated in the study.Â  A significant number (82{58.6%}) self-reported level of proficiency for venepuncture was above average or excellent; for IV line placement it wasÂ  a little less than half (65{46.4%}) and for urethral catheterisation 44 (31.7%); however it was quite low for the other procedures. Many students self-reported high level of participation for venepuncture (83{59.2%}); sixty one (43.6%) for IV line placement and 30 (21.7%) for urethral catheterization. The correlations between self-assessed levels of proficiency and participation were significant for all procedures. There was no exposure to the use of mannequins.CONCLUSION: Self-reported proficiency is lacking for basic procedures in a significant proportion of students with a low level of participation.
Autism and Fragile X: Is There a Neurochemical Link?
Authors: Meguid Nagwa A. , Atta Hazem M. , Rashed Laila A. , Gouda Amr S. , Khalil Rehab O. , Hashish Adel F.
Published: October 2015

BACKGROUND:Autism and Fragile X syndrome are intertwined. This study aimed at assessing Serotonin, Glutamate, and Gama Amino Butyric Acid (GABA) in autism and Fragile X syndrome patients and to detect possible neurochemical similarities between the 2 disorders that can be used as metabolic biomarkers.DESIGN AND METHODS: Eighty subjects divided into four groups, two diseased groups (20 male patients with Autism and 20 males with Fragile X syndrome) and two control groups (20 neurotypical male controls and 20 Down syndrome male patients) were included. Estimation of Serotonin, Glutamate and GABA were done using Enzyme linked Immunosorbent Assay (ELISA), Tandem Mass Spectrometry and high-pressure liquid chromatography (HPLC), respectively.RESULTS: Serotonin was, exclusively, significantly low in autistic children. GABA was significantly high in both autistic and Fragile X children only, but not in Down syndrome children. Glutamate was significantly high in children with autism, Fragile X and Down syndrome Children.CONCLUSIONS: Autism and Fragile X syndrome share some neurochemical similarities with regards of high Glutamate and GABA levels while Serotonin was significantly different in the 2 disorders and may be used a unique biomarker for autism.
25-Hydroxy Vitamin D, Adiponectin Levels and Cardiometabolic Risk Factors in a Sample of Obese Children
Authors: Hassan Nayera E. , El-Masry Sahar A. , El Banna Rokia A. , Abu Shady Mones M. , Al-Tohamy Muhammad , Mouhamed Ali Manal , Abd El-Moniem Mehrevan M. , Anwar Mona
Published: October 2015

BACKGROUND: Association between vitamin D, adiponectin and obesity is a matter of debate, as they play important role in linking obesity with different cardio metabolic risk factors.AIM: Evaluation of association between metabolic risk factors with both adiponectin and 25-Hydroxy vitamin D [25(OH) D] levels and that between adiponectin and [25(OH) D] among obese Egyptian children.SUBJECTS AND METHODS: This case-control cross sectional study consisted of 65 obese and 30 healthy children, aged 8-11 years. 25(OH) D, serum adiponectin, total cholesterol, triglycerides, high-density lipoprotein-cholesterol and low-density lipoprotein-cholesterol were measured.RESULTS: The mean 25(OH)D and adiponectin levels in the obese were lower than that in control group (ð‘ƒ<0.000). 25(OH)D were inversely correlated with body mass index, triglyceride, total cholesterol and LDL-cholesterol. While adiponectin level were inversely correlated with systolic and diastolic blood pressure, and positively correlated with high-density lipoprotein-cholesterol. However, there is no relation between 25(OH) D and adiponectin levels among obese children and total sample.CONCLUSION: Inspite of strong association between vitamin D and adiponectin levels with metabolic risk factors and obesity, there is no relation between 25(OH)D and adiponectin levels. In obese children, There are significant negative correlations between 25(OH)D with lipid profile, and between adiponectin levels with blood pressure.
Physical Growth and Body Composition of Controlled Versus Uncontrolled Type 1 Egyptian Diabetic Children
Authors: Hassan Nayera E. , El-Kahky Ahmed , Hana Mona Atteya , Abu Shady Mones M. , Galal Essam M. , Khalil Aya
Published: October 2015

BACKGROUND: Type 1 Diabetes Mellitus (T1DM) is one of the most common chronic endocrine disorders of childhood. Data on growth parameters of diabetic children is scarce.AIM: To assess growth and body composition in a group of diabetic children.SUBJECTS AND METHODS: 427 T1DM children (age 2-10 years) were recruited from Diabetic Paediatric Unit, outpatients' clinic of Abou El-Rish Hospital. Anthropometric and body composition parameters were taken and HbA1c was measured for all subjects.RESULTS:Â  Highly significant difference was detected between controlled and uncontrolled groups as regard to weight/age z-score, height/age z-score, BMI z-score, triceps skin fold thickness, subscapular skin fold thickness, midupper arm circumference, fat mass, fat %, lean mass, and body water (p < 0.001). All values are higher in the controlled group than in the uncontrolled group. Uncontrolled subjects were significantly more at risk of being underweight and short, with odds ratio of 15.131 and 16.877 and 95% confidence interval 1.972-116.130 and 3.973-71.694 respectively. However, controlled subjects were significantly more at risk of being obese than the uncontrolled with an odds ratio 0.116 and 95% confidence interval 0.045-0.302.CONCLUSION: Growth was compromised in uncontrolled T1DM children. This is of utmost importance since most of the clinical features are reversible with better glycemic control and appropriate insulin management.
The Relation between Visceral and Subcutaneous Fat to Bone Mass among Egyptian Children and Adolescents
Authors: El-Masry Sahar A. , Hassan Nayera E. , El-Banna Rokia A. , El Hussieny Mohamed S.
Published: October 2015

BACKGROUND: The relation between fat distribution and bone mass is still being debated in children and adolescents.AIM: To verify the influence of both visceral and subcutaneous fat on bone mass among Egyptian children and adolescents.SUBJECTS AND METHODS: The study involved 78 (38 boys and 40 girls) individuals from children (42) and adolescents (36), aged 8-17 years. They were divided into 2 age groups: children group (20 boys and 22 girls) aged 8-12 years and adolescent group (18 boys and 18 girls) aged 13-17 years. Anthropometric measurements, visceral and subcutaneous fat (measured by ultrasound), body composition, BMD and BMC (Measured by DXA), were attempted.RESULTS: Among children, significant positive correlations between visceral fat; in males; and subcutaneous fat; in females; with total BMC, BMD and its Z-score were revealed. After exclusion of age effect, the association between visceral fat in females with total BMD and its Z-score and lumbar BMD-Z-score became significant.Â  For adolescents, no correlation was observed between either visceral or subcutaneous fat with any parameter of bone mass.CONCLUSIONS: Visceral and subcutaneous fat had significant positive association with bone mass in children; males and females respectively. On the contrary such association disappeared during adolescence.
Preoperative Evaluation of Thyroid Epithelial Lesions by DNA Ploidy and Galectin-3 Expression in FNAC
Authors: Elsharkawy Sonia L. , AbdEl-Aal Wafaa E. , Esmal Reham S.E. , Ali Hanan H.M. , Mahfouz Soheir M. , El-Habashi Ahmed
Published: October 2015

AIM: This study aimed to investigate the value of DNA ploidy and galectins-3 immunostain in the preoperative evaluation of thyroid epithelial lesions.MATERIAL AND METHODS: Sixty patients presenting with thyroid enlargement were included in this study and referred by clinicians for FNA. Routine cytological evaluation was done on PAPÂ Â  stained slides according to the WHO criteria and at least three slides were prepared for routine cytological examinations. The nuclear DNA analysis was performed at the Pathology Department, National Research Center using the Leica Qwin 500 Image Analyzer (LEICA Imaging Systems Ltd, Cambridge, England). Galectin-3 expression was investigated in all tissues using streptavidin-biotin technique.RESULTS: Conventional Fine needle aspiration cytology (FNAC) of 60 cases could diagnose malignancy with a sensitivity of 60%, negative predictive value (NPV) 71.4%, and overall diagnostic accuracy of 80%. The aneuploidy was significantly associated with malignancy, with sensitivity 90.9%, specificity 83.3% and accuracy 88.3%. On using galectin-3 immunocytochemichal stain on cell blocks prepared from FNA the values were improved, sensitivity 93.3% specificity 86.7% and overall accuracy 90% and it was noticed that galectin-3 over expression was significantly associated with malignancy.CONCLUSIONS: From the results of this study we can consider that DNA ploidy and Galectin-3 could refine the FNA results andÂ  increase its sensitivity as a screening test from sensitivity(60%) to reach sensitivity (93.3%), thus decreasing the false negative cases. From this study, it is concluded that the application of ancillary techniques as galectin-3 immunocytochemical markers may become a reliable indicator for surgical intervention, DNA ploidy measurements on the other hand may be of value in galectin-3 negative cases to determine the behavior of the lesion in such cases & refine the preoperative assessment by out ruling false negative cases.
Hyperleptinemia May Protect From Cardio-Vascular Complications: A Small Georgian Study
Authors: Zerekidze Tamar , Janjgava Shota , Asatiani Ketevan , Giorgadze Elene
Published: October 2015

BACKGROUND AND AIM: Leptin was assessed to play a coordinating role in obesity and its cardio-vascular complications, however the findings are conflicting and further clinical investigation is required. The aim of the present study was to evaluate the association of serum leptin with cardio-vascular risk factors in different body mass index and age groups.MATERIALS AND METHODS:Â  One hundred and forty nine female patients were enrolled in the study and divided into groups according to body mass index (BMI) and age. Following measurements were carried out: height, weight, BMI, waist circumference, blood pressure. Venous blood sample was obtained for plasma leptin, insulin, glucose and lipid profile analysis. Insulin resistance index was calculated for each patient. Body fat distribution was measured using Dual energy X-ray Absorbtiometry.RESULTS: The lowest leptin concentration was observed in overweight patients, the highest concentration was seen in obese patients. The difference between leptin levels were not observed in age groups. Leptin positively correlated with high density lipoprotein cholesterol levels in obese and elder patients.CONCLUSION: Leptin might act as a preventive measure for cardiovascular complications only in the presence of sufficient amount of fat mass. Further studies are warranted in order to support these results.
Cortisol and Insulin Levels during Major Gynaecological Operations: The influence of Two Anaesthetic Techniques
Authors: Adekola Oyebola O. , Desalu Ibironke , Olatosi John O. , Kushimo Olushola T. , Ajayi Godwin O.
Published: October 2015

BACKGROUND: Metabolic and hormonal changes are noticed within the first few hours after surgical injury. These changes are influenced by the intensity, duration, type of injury, and the anaesthetic techniques.AIM: To investigate the effects of anaesthesia on cortisol, insulin and glucose concentrations during major gynaecological surgeries.METHODS: Forty patients were randomly allotted to receive either balanced general anaesthesia (n=20) or combined spinal epidural anaesthesia extending from T5 to S5 (n=20). Blood samples were collected for cortisol and glucose at preinduction, 1, 3 and 4 hours, and for insulin at preinduction and 24 hours after incision.RESULTS: The mean cortisol concentration was significantly lower 4 hours after incision with combined spinal epidural anaesthesia (19.96 Â± 11.32) Î¼g/dl than with balanced general anaesthesia (38.94 Â± 10.6) Î¼g/dl, p = 0.018. The mean insulin concentration, 24 hours after incision decreased with combined spinal epidural anaesthesia, but increased with balanced general anaesthesia p = 0.403. The mean glucose concentrations were significantly lower with combined spinal epidural anaesthesia than with balanced general anaesthesia during the 4 hour study period p â‰¤ 0.05.CONCLUSION: combined spinal epidural anaesthesia extending from T5 to S5 resulted in lower cortisol, insulin and glucose concentrations during major gynaecological surgeries. This may be of benefit in patients scheduled for surgical operations below the umbilicus.
Rendu-Osler-Weber Syndrome: A Case Report
Authors: VukomanoviÄ‡ Vladimir , MatoviÄ‡ Milovan , IgnjatoviÄ‡ Vesna , BeliÄ‡ Branislav
Published: October 2015

Hereditary hemorrhagic telangectasia (HHT) or Rendu-Osler-Weber syndrome, is a rare genetic disorder with autosomal dominance and variable penetrance. The typical findings of the disease are telangiectasias in skin and mucous membranes, and arteriovenous malformations presenting in the organs like lung, intestine, brain and liver. It is characterized by the classic triad of recurrent epistaxis, mucocutaneous telangiectasias and visceral hemorrhages, with familial occurrence. This article describes a case of HHT of an adult patient, associated with multiple angiodysplasic injuries in the nasal mucosa, upper gastrointestinal tract, lungs and who presents continuous blood loss, resulting iron deficiency anemia. Based on clinical and diagnostic findings, we diagnosed this case as HHT, which has rarely been reported in our literature.
Axillary Arterial Thrombosis Secondary to Re-Fracture of the Humerus
Authors: Fatic Nikola , Radojevic Nemanja , Obadovic Jelena , Juskovic Aleksandar
Published: October 2015

In the presented case report, we evaluated mechanism of axillary artery thrombosis in cases of repeated fracture of the shoulder. A 73-year-old female fell down on an outstretched hand. Radiographs demonstrated a Neerâ€™s 2-part displaced fracture of the proximal humerus and open fracture of the acromion. Forty years ago, in a car accident, fractures of the same proximal humerus and clavicle occurred and were surgically treated. Two hours after fixation with Kirschner wires, thrombosis of the axillary artery was quickly diagnosed and rapid treatment allowed revascularisation of the arm without any consequences.
Leptomeningeal Metastases in Solid Tumors
Authors: Karakolevska-Ilova Marija , Simeonovska Joveva Elena , Dimitrovska Ivanova Marija
Published: October 2015

BACKGROUND: Leptomeningeal metastases are diagnosed in 1% to 8% of patients with cancer. The most common histology is leukaemia, lymphoma, breast carcinoma, lung carcinoma and melanoma. The aim of this study is to show the appearance of leptomeningeal metastases in lung and breast cancer with specific biological features.AIM: The study is a review of two cases - breast and lung carcinoma with specific biological features who eventually have developed leptomeningeal metastases.CASE PRESENTATION: Although CNS metastasis most commonly occurs in those with known systemic metastases, our patient had biological indolent disease (nor hormone negative or HER 2 positive and no metastatic disease) and still LM did occur. LM remains a devastating complication of cancer with classic presentation with multifocal neurologic signs and symptoms (like the case with lung cancer), but many patients also have evidence of impaired CSF flow, and hydrocephalus may be the only presenting manifestation of LM.CONCLUSION: The prognostic factors associated with survival in patients with LM metastasis are not certain as well as right treatment for these patients which is still a big challenge. Due to the lack of randomized studies and especially of studies referring to one specific primary tumor, there is currently no generally accepted standard of care in the treatment of LM metastases.
Gait and Computerized Dynamic Posturography (CDP) Aspects in Early Progressive Supranuclear Palsy (PSP) - A Case Report
Authors: Mosalem Douaa M. , El Shabrawy Abeer M. , Alfeeli Aziz , Baqer Ayyoub B. , Ahmed Mohieldin M.
Published: October 2015

BACKGROUND: Posture and gait instability may cause of morbidity in individuals with progressive supranuclear palsy (PSP). OBJECTIVE: To quantitatively measure balance control by using computerized dynamic posturography (CDP) and to assess gait analysis in early PSP.CASE REPORT: She was evaluated for Berge balance scale, Functional Independence Measure (FIM) and postural stability using CDP device in early PSP with still able to walk or stand unassisted. Also, Gait analysis was conducted using an 8 M-camera Vicon 612 data capturing system set. Berge balance scale improved from 41/56 to 48/56. The score of FIM improved from 71/126 points to 95/126 points in early PSP. In CDP analysis, there was a decrease of composite equilibrium score (38 %). There was an increase of composite equilibrium score (59%) after three months of treatment. In gait analysis, there was no difference of gait parameters after three months of treatment in early PSP.CONCLUSIONS: Both CDP and gait analysis are important quantitative tools in the assessment of posture and gait instability as well as allow for early disclosure of the failure of the postural control system in early PSP.
Acute Iliac and Femoral Arterial Thrombosis Secondary to Total Hip Arthroplasty
Authors: Fatic Nikola , Zornic Nenad , Radojevic Nemanja , Bulatovic Nikola
Published: October 2015

In the presented case report, we evaluated the mechanism of the external iliac, the common femoral and the superficial femoral arterial thrombosis secondary to total hip arthroplasty. A 75-year-old female sufferd from 5.5 cm shorter left lower limb and same sade coxarthritis. Next day after arthroplasty and eqalisation of the lower limbs, an acute ishemia of the treated leg was presented. Multyscan CT angiography revealed the presence of the external iliac, the common femoral and the superficial femoral arterial thrombosis. From the best of our knowledge, it seems to be the only case of this arterial segment thrombosis after total hip arthroplasty and equalistaion of the lower limbs reported.
The Knowledge and Attitudes towards Breastfeeding of Iranian Mothers during the First Year after Delivery in 2013
Authors: Maryam Zakerihamidi , Moniralsadat Hosseini Tabaghdehi , Zohreh Khakbazan , Banafsheh Mohammadi Zeidi , Amir Salehpour
Published: October 2015

OBJECTIVE: Globally less than 40% of infants less than six months of age are exclusively breastfed. Adequate breastfeeding support for mothers and families could save many young lives. This study aimed to determine knowledge and attitudes of mothers toward breastfeeding in Tonekabon, Iran.METHODS: This study was a descriptive-analytical cross sectional study with convenience sampling. The sample consisted of 200 nursing mothers who have including criteria of the study. Data was collected by a questionnaire including demographic data and questions about knowledge and attitude toward breastfeeding. Data analysis performed by using of SPSS (11.5) and appropriate statistical tests.RESULTS: Most of them (73.5%) were 21-30 age group. 50.5% of them had a diploma education. 46% of them reported the essential information about breastfeeding obtained from medical- health centers. 5% of them had poor and 42% had a medium knowledge about breastfeeding while 53% of them had good knowledge about it. Most of the mothers (79.5%) had positive attitude regarding breast feeding.CONCLUSION: According to most of the mothers had good knowledge and positive attitude about breastfeeding, with proper planning to increase awareness and promote a positive attitude towards breastfeeding can be tried for child survival.
Respiratory Symptoms and Ventilatory Function in Never-Smoking Males Working in Dusty Occupations
Authors: Danilova Marina , Stoleski Saso , Mijakoski Dragan
Published: October 2015

AIM: To assess the effect of occupational exposure on respiratory symptoms and ventilatory capacity in never-smoking male workers exposed to mineral or organic dusts.MATERIAL AND METHODS: We performed a cross-sectional study including 138 never-smoking male workers exposed to mineral or organic dust (34 construction workers, 32 furniture manufacturers, 37 agricultural workers, and 35 bakers) and 35 unexposed controls (office workers). Evaluation of all study subjects included completion of a questionnaire and spirometric measurements.RESULTS: The prevalence of the overall respiratory symptoms in the last 12 months was higher in dusty occupation workers than its prevalence in office workers. Statistically significant difference was found between the prevalence of cough in construction workers, agricultural workers and bakers, as well as between the prevalence of phlegm in construction workers, furniture manufacturers and agricultural workers as compared to its prevalence in office workers. The mean values of spirometric parameters were lower in all groups of exposed workers as compared to their mean values in office workers with statistical significance for all measured parameters in construction workers and furniture manufacturers, as well as for small airways indices in agricultural workers and bakers.CONCLUSION: Our findings indicate significant effect of occupational exposure on respiratory symptoms and ventilatory capacity impairment in workers exposed to mineral or organic dusts.
Patient Attitudes and Patterns of Self-Medication with Antibiotics â€“ A Cross-Sectional Study in Bulgaria
Authors: Dimova Rositsa , Dimitrova Donka , Semerdjieva Maria , Doikov Ilian
Published: October 2015

BACKGROUND: Self-medication with antibiotics is a major concern worldwide because of the high risks of antimicrobial resistance which may result in complicated courses of treatment, increased risk of death and excess costs to the healthcare systems.AIM: The aim was to study the attitudes and self-medication patterns as related to the use of antibiotics among the general Bulgarian population and their determinants.MATERIALS AND METHODS: A questionnaire-based survey was performed among the patients in two randomly selected municipalities. The questionnaire was mailed to 50 randomly selected adult patients by each of the 33 responding GPs thus addressing a total of 1650 participants.RESULTS: A total of 1050 patients completed and returned the questionnaire. The observed self-medication rate was 43%. The women and the younger employees and students tended to have a higher self-medication rate. Fever (22%), sore throat and cough (12.7%) and discomfort when urinating (8.2%) were the most frequent patterns related to the practice of self-medication.CONCLUSION: This analysis reported an extensive use of self-medication with antibiotics in the study population before the changes in the Bulgarian legislation. Younger age and social status (students, employed) were the most important socio-demographic patterns that had probably led towards self-medication with antibiotics.