Open Access Case Study

Treatment of Non-healing, Post-traumatic Wound with High Frequency Ultrasound of 10 MHz: A Case Report

Thomas Gohla, Ekaterina Kruglikova, Ilja L. Kruglikov

Journal of Advances in Medicine and Medical Research, Page 520-526
DOI: 10.9734/BJMMR/2012/1458

We present a case of a non-healing, post-traumatic wound, which as an alternative to reconstructive surgical intervention, was successfully treated with a non-invasive, high-frequency ultrasound of 10 MHz.

Open Access Case Study

Urachal Cancer in a 47-Year-Old Patient: A Case Report and Literature Review

C. Ceylan, O. Baytok, T. T. Keklik, O. G. Doluoglu

Journal of Advances in Medicine and Medical Research, Page 693-700
DOI: 10.9734/BJMMR/2012/1702

Aims: Urachal cancer is an uncommon neoplasm associated with poor prognosis. No concensus has been reached regarding diagnostic criteria so far. The management of urachal carcinoma is controversial, too. In this case presentation, we reported a 47 year old female with urachal cancer and treatment approach discussed with published literature.
Presentation of Case: A 47-year-old female patient was admitted with abdominal pain and hematuria. A soft mass was noticed under her navel. Computerized tomography revealed a tumor which is a cystic lesion arising from the urachus and a solid mass component at the urinary bladder dome. The tumor was removed by partial cycectomy. Histological examination showed urachal adenocarcinoma (colonic type and well differentiated), which had invaded the urinary bladder. The patient has been followed up without a recurrence for the next 6 months.
Discussion: Urachal carcinoma is a rare type of, approximately 0.5 to 2%, bladder neoplasms. The pathogenesis of urachal tumours is not fully understood, so far. Currently, the most effective treatment of localized urachal cancer is cystectomy. It is unclear whether lymphadenectomy or chemotherapy is usefull for the patients with urachal carcinoma.
Conclusion: Regarding the treatment of urachal cancer, surgery remains the mainstay of therapy. Moreover, the achievement of a complete urachectomy, including umbilectomy and negative surgical margins, is critical for low-stage, localized, well-differentiated urachal cancer.

Open Access Original Research Article

Steady-State Levels of Troponin and Brain Natriuretic Peptide for Prediction of Long-Term Outcome after Acute Heart Failure with or without Stage 3 to 4 Chronic Kidney Disease

Yutaka Endo, Shun Kohsaka, Toshiyuki Nagai, Kimi Koide, Masashi Takahashi, Yuji Nagatomo, Kazuki Oshima, Hiroaki Miyata, Keiichi Fukuda, Tsutomu Yoshikawa

Journal of Advances in Medicine and Medical Research, Page 490-500
DOI: 10.9734/BJMMR/2012/1384

Aim: To determine whether assessment of a combination of steady-state discharge levels of biomarkers improves risk stratification after acute decompensate HF.
Study Design: Retrospective cohort study.
Place and Duration of Study: Keio University Hospital, between January 2006 and September 2011.
We analyzed 244 patients with acute HF due to ischemic or dilated cardiomyopathy who were enrolled in a prospective, single institution-based registry between January 2006 and September 2011. Patients were stratified by discharge values of BNP and/or TnT. The primary endpoint was a composite of HF readmission or death during the 2-year period after discharge.
Results: The population was predominantly male (69.3%), and the mean age was 66.6±15.3 years. Patients with higher BNP levels or detectable TnT had a worse prognosis (BNP45.0% vs. 18.8%, p<0.001; TnT 43.8% vs. 25.1%, p=0.002, respectively). The primary event rate was additively worse among patients with both increased BNP levels and detectable TnT compared to those with increased levels of BNP or detectable TnT alone (log-rank p<0.001). A similar trend was observed in the subgroup of patients with CKD stage III–V (n=172).
Conclusion: Assessment of both BNP and TnT values may have a significant predictive value for HF prognosis, even among patients with CKD, a condition affecting biomarker levels.

Open Access Original Research Article

Antibiotic Resistance and Chromosomal Variation in Equine Faecal Salmonella spp.

Mohamed O. Ahmed, Nicola J. Williams, Peter D. Clegg, Malcolm Bennett

Journal of Advances in Medicine and Medical Research, Page 501-509
DOI: 10.9734/BJMMR/2012/1238

Aims: Equine hospital Salmonella spp. were investigated retrospectively using antibiotic resistance typing and macro-restriction pulsed field gel electrophoresis techniques.
Study Design: Retrospective study.
Place and Duration of Study: Department of Comparative Molecular Medicine and department of Animal and Population Health, School of Veterinary Science, University of Liverpool.
Methodology: Twenty four achieved Salmonella isolates of equine faecal origin, previously collected from a UK equine hospital, were serotyped, phagetyped and tested both for antimicrobial susceptibility, by disc diffusion (BSAC) and for genetic relatedness by XbaI I-PFGE.
Results: Most isolates were Salmonella typhimurium (n=21), including five DT104; two were Salmonella enteritidis, and one was untypeable. Sixteen isolates, including five Salmonella typhimurium DT104 isolates exhibiting the classic penta-resistance phenotype (ACSSuT), were characterized as multidrug resistant (MDR). Fourteen MDR isolates showed additional resistance to florfenicol, although no resistance to ciprofloxacin was detected. MDR isolates showed two dominant resistance phenotypes: ACTSSuFlo (N=8) resistant to ampicillin, chloramphenicol, tetracycline, trimethoprim, streptomycin, sulfamethoxazole and florfenicol and ACTTrSSuFlo (N=6) which is also resistant to trimethoprim. Dendrogram analysis identified eleven distinct genetic groups showing an overall similarity of 84%. The dominant resistance phenotypes were located mainly in two genetic groups: ACTSSuFlo isolates were all collected in the same year and were restricted to one clonal PFGE group showing >99.5% genetic similarity; ACTTrSSuFlo isolates were genetically more diverse with 4/6 clustering in a closely-related group showing 94% similarity.
Conclusion: These findings suggest that although some Salmonella infections were introduced to the hospital from outside, infections spreading within the equine hospital could also be a reservoir of MDR Salmonella zoonotic infections and play a role in the development and dissemination of antibiotic resistance.

Open Access Original Research Article

Metabolic Endotoxemia and Inhibition of Direct Bone Regeneration: A Pilot Study

E. C. Wahl, J. Aronson, L. Liu, R. A. Skinner, M. J. J. Ronis, C. K. Lumpkin Jr.

Journal of Advances in Medicine and Medical Research, Page 510-519
DOI: 10.9734/BJMMR/2012/1547

Aims: Clinical and pre-clinical studies have demonstrated that alcohol abuse, aging, diabetes and rheumatoid arthritis are associated with increased risk of fractures compounded with impaired fracture repair. We note that these and other pathologies are characterized by chronic inflammation (CI) as a risk factor. How these CI pathologies inhibit bone repair is unclear, but one candidate mediator is endotoxin (lipopolysaccharide/LPS). LPS promotes inflammation and is present in increased serum concentrations in some inflammatory conditions. The distraction osteogenesis (DO) model developed in this laboratory provides the opportunity to isolate and study the effects of CI on direct bone formation during bone regeneration. The aim of this study was to determine whether endotoxin at concentrations that mimic levels reported in chronic inflammatory conditions would impair bone formation in a mouse model of DO.
Study Design: Mouse bone repair study.
Place and Duration of Study: Arkansas Children's Hospital Research Institute, Little Rock, Arkansas, April to June 2009.
Methodology: LPS or vehicle (PBS) was chronically administered to 11-week old mice via alzet pump. Mice underwent the DO protocol concurrently with LPS administration. Radiographic and histologic quantitation was performed on the DO gap to determine the amount of new bone formed.
Results: Radiographic (51.9 ± 7% vehicle vs 21.0 ± 7.3% LPS: P < .01) and histologic (68.1 ± 8.5% vehicle vs 33.6 ±10.3% LPS; P < .02) results indicate that bone formation during DO was significantly decreased in LPS treated versus vehicle treated mice.
Conclusion: The magnitude of the osteoinhibitory effects of systemic LPS in this mouse model of CI was equivalent to two months of ethanol treatment, 24 months of aging, or two months of Type 1 diabetes. These results support the hypothesis that LPS exposure could be responsible for the decreased bone formation observed in chronic inflammatory conditions.

Open Access Original Research Article

Refractory Coeliac Disease; Role of Nigella sativa as Immunomodulator

Muhamed T. Osman, Ghada Al-Duboni, Balsam I. Taha, Luay A. Muhamed

Journal of Advances in Medicine and Medical Research, Page 527-535
DOI: 10.9734/BJMMR/2012/1608

Aim: The aim of this study was to assess the immunological and histological profiles of adult coeliac patients after commencing Nigella sativa (NS) oil with gluten free diet (GFD) for a period of 1 year ± 1month to prove its validity in treatment of refractory coeliac disease (CD).
Methodology: Thirty two adult coeliac patients who all accepted to do endoscopy and duodenal biopsy in addition to serological assessment before and after treatment of GFD alone or with NS oil capsules for a period of 1 year ± 1 month. Duodenal biopsies were interpreted histologically according to modified Marsh criteria and the sera were tested for antigliadin antibody (AGA), anti tissue transglutaminase antibody (tTG) and endomysium antibody (EMA).
Results: The response to gluten withdrawal with NS oil for a period of 1 year ± 1 month in CD patients was better than GFD alone with significant response to serological markers.
Conclusion: The administration of NS oil with GFD to CD patients leads to a significant decreases more than GFD alone in the levels of all immunological parameters with histological improvement and stop the disease process (P=0.001). Ultimately, the results emerging from this study may substantially improve the immunotherapeutic application of NS in clinical management of refractory CD cases.

Open Access Original Research Article

Validity of Workers’ Self-Reports. Evaluation of a Question Assessing Lifetime Exposure to Occupational Physical Activity

Anne Møller, Susanne Reventlow, Johan Hviid Andersen, Kirsten Avlund, Ole Steen Mortensen

Journal of Advances in Medicine and Medical Research, Page 536-552
DOI: 10.9734/BJMMR/2012/1607

Aims: In epidemiological studies exposure assessment based on questionnaires is the most cost-effective method. A question about lifetime exposure to occupational physical activity (OPA) was used in a population-based survey (part of the Copenhagen Aging and Midlife Biobank, CAMB). The aim of the study was to validate this question through a three-step process.
Methodology: Firstly, the response process was studied by cognitive interviewing of 7 persons. Secondly, 64 persons participated in semi-structured interviews about their work-life, and expert judgments of exposure to OPA were compared with questionnaire-data. Exposure was 20 years of work in one of four categories of OPA: sedentary, standing and walking, moderate or high OPA. Kappa values were calculated for agreement and interpreted according to Landis and Koch’s criteria. Agreement was visualized in Bland-Altman plots. Thirdly, intra- and inter-rater reliability of expert judgments was tested.
Results: Response process: The question had a complicated instruction, and the respondents found it hard to remember, categorize, and summate exposures. Semi-structured interviews: Kappa value for exposure to sedentary work was ‘substantial’ (0.71) but ‘fair’ for the other categories of OPA (0.27-0.29). Agreement between questionnaire and interview was higher in sedentary jobs and jobs with high OPA. Intra-rater reliability of expert judgments was ‘substantial’ or ‘moderate’ (0.60-0.71). Inter-rater reliability was high in sedentary jobs but lower in the more active jobs.

Conclusion: Self-reports of lifetime exposure to sedentary work are valid in the CAMB cohort, whereas the validity of self-reports of exposure to high levels of occupational physical activity (OPA) are questionable. Thorough pre-testing of questions about lifetime OPA is recommended.

Open Access Original Research Article

Estimation of Sex Using Demarking Points from Diameters of Lumbar Pedicles in Adult Nigerians

Danladi Sambo Amaza, Aminu Ahmed Rufai, Tamunotonye Watson Jacks, Joseph Vandi Zirahei, Ahidjo Ahmed, Luteino Lorna Hamman

Journal of Advances in Medicine and Medical Research, Page 553-567
DOI: 10.9734/BJMMR/2012/1324

Aim: To estimate sex using demarking points and index of sexual dimorphism of horizontal and vertical diameters of lumbar pedicles in male and female Nigerians.
Study Design: Retrospective study.
Place and Duration of Study: Department of Human Anatomy and Department of Radiology (University of Maiduguri Teaching Hospital), University of Maiduguri, Borno State Nigeria between February 2007 and June 2008.
Methodology: Four hundred (400) radiographs of adult Nigerians (200 males and 200 females) were measured.Age range for the individuals was 18-76 years. Radiographs used for this study were obtained from the collection of record unit of the Radiology Department, University of Maiduguri Teaching Hospital (UMTH) in Borno state, Nigeria.Radiographic viewing box, temporary maker, pencil and a meter rule were used for the measurements.The radiographs for males and females were classified separately into six (6) age groups with ten (10) years interval. Vertical and Horizontal diameters of lumbar pedicle were represented on the radiographs by “h” (taken as the maximum dimension of the pedicle between the upper and lower margins of the pedicles) and by “t” (maximum diameter between the medial and lateral aspect of each pedicle). Distance between upper and lower extremities, as well as that between medial and lateral extremities of each pedicle were marked and measured as vertical and horizontal diameters respectively.
Results: The result of the present study showed that, the vertical and horizontal diameters of the lumbar pedicles in adult Nigerians were all greater in male than in female counterpart. It was also observed that sexual differences in the two parameters were found to be statistically significant (P<0.001) in both sexes. Index of sexual dimorphism (ISD) was also calculated and it was observed that all parameters were found to be greater than 100; this showed that male had higher values over female counterpart. Demarking points were also calculated for each parameter, the result also showed similar pattern of increase in male parameters over female counterpart. The result also showed age-related significant (P<0.001) variations for the lumbar pedicle diameters, from 18-27 through 38-47 years age groups with a decrease in diameters at the 48-57 through 68-77 years age groups in both sexes.
Conclusion: It was observed that the vertical and horizontal diameters were sexually dimorphic; the demarking points of male diameter were all higher than those of the female counterpart. Index of sexual dimorphism also showed that male vertical and horizontal diameters were all greater than female vertical diameter as the index of sexual dimorphism were all greater than 100 from L1 through L5. This study reconfirms the fact that osteometric assessment is highly population- specific. It may be added that more studies are required in the southern part of Nigerian population to give a better picture of the racial variation that exists there and to offer more osteometric standards for assessing sex for the entire country.

Open Access Original Research Article

Trichomonas vaginalis Associated with Adverse Pregnancy Outcomes: Implications for Maternal Health Care Delivery System in South Eastern Nigeria

Okonkwo Eucharia Chinyere, Iroha Ifeanyichukwu Romanus, Onwa Ndubuisi Collins, Nworie Okoro, Oji Egwu Anthonia

Journal of Advances in Medicine and Medical Research, Page 568-574
DOI: 10.9734/BJMMR/2012/1345

Pregnant women infected with Trichomonas vaginalis are often untreated and evidence from the biology and epidemiology of the organism suggests that it may play an important role in causing adverse pregnancy outcomes. Using high vaginal swab from consenting pregnant women, a follow-up hospital based survey of T. vaginalis infection and its effect on pregnancy outcome among pregnant women attending antenatal clinics was conducted. Pregnancy outcome was determined on the basis of delivery before 37 weeks of gestation (according to general standards), low birth weight infants and neonatal conjunctivitis. The presence of T. vaginalis was re-examined at the point of delivery to exclude treated cases of infection during gestation period. Of the 688 pregnant women who gave birth within the study period, 89(12.9%) were positive for T. vaginalis with 31(19.38%) of the positive patients having pre-term delivery. Also, of the total of 89 infants from the infected mothers, 21(24.14%) had low birth weight of below 2.5 Kg, while 31(18.8%) had conjunctivitis. The result shows that the infection of T. vaginalis during pregnancy is significantly associated with adverse pregnancy outcomes. In view of the public health importance of this common sexually transmitted disease (STD), we advocate routine surveillance of trichomoniasis among pregnant women and prompt treatment of infected individuals and their sexual partners.

Open Access Original Research Article

Left Ventricle Twisting in Athletes: A Comparison between Subjects with Bicuspid Aortic Valve and Tricuspid Ones

Laura Stefani, Gianni Pedrizzetti, Alessio De Luca, Loira Toncelli, Maria Concetta Robertina Vono, Roberto Mercuri, Gabriele Innocenti, Stefano Pedri, N. Maffulli, Giorgio Galanti

Journal of Advances in Medicine and Medical Research, Page 575-586
DOI: 10.9734/BJMMR/2012/1286

Aim: In athletes with Bicuspid Aortic Valve (BAV) a slight but progressive left ventricle (LV) enlargement with a reduction of longitudinal strain values at basal segments of the same chamber, have been previously demonstrated. The aim of the study is to verify by deformation parameters any possible asymptomatic myocardial dysfunction in BAV athletes.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Sports Medicine (Emergency Unit) between June 2009 and July 2010.
Methodology: The study protocol included all athletes investigated for a prime evaluation to enter the criteria for this particular study. 30 BAV athletes (aged 25± 3) and 30 Tricuspid Aortic Valve (TAV) athletes, regularly trained were submitted to an echocardiographic exam. From the short axis LV view images, the circumferential strain, rotation, twist, distinguished in the endocardial and epicardial component at the basal and apical level, were calculated by the speckle tracking (ST) multi-layer approach. This is a special assisted mode (AHSTM, Aided Heart Segmentation) to track the LV Endo/Epi myocardial points.
Results: In BAV only the epicardial (5.74±1.4) and endocardial (8.64±4.0) apical rotation are significantly higher than in TAV (p<0.01) while the LV basal segments are at the lower limits. The endo/epi twist exams carried out in both BAV & TAV result normal.
Conclusion: ST multi-layer approach improves the assessment of LV myocardial function in asymptomatic trained BAV athletes, where the major apical LV rotation values found seem to compensate for basal dysfunction in them. This confirms the persistence of a normal heart performance despite the mild LV chamber enlargement.

Open Access Original Research Article

Transformation Behaviour, Bending Properties and Surface Quality of 22 Commercial Nickel-Titanium Wires: A Batch-to-Batch Evaluation

Veronique Brosens, Ines Ghijselings, Martine Voet, Pieter Leemans, Jan Van Humbeeck, Guy Willems

Journal of Advances in Medicine and Medical Research, Page 597-620
DOI: 10.9734/BJMMR/2012/1597

Aims: The aims of this study were to investigate batch-to-batch differences in mechanical and thermal properties of 22 commercial nickel-titanium wires and evaluate the surface quality. Secondly the percentages of superelasticity at mouth temperature were measured.
Study Design: In vitro laboratory study.
Place and Duration of Study: Sample: Department of Oral Health Sciences – Orthodontics and Metallurgy and Materials Engineering KU Leuven, between January 2010 and May 2011.
Methodology: The sample comprised 22 NiTi wires of the upper jaw from 7 different manufacturers. For each brand two different batches were investigated (LOT A, LOT B). Three different investigations were carried out. First transformation behaviour and transition temperatures were determined by differential scanning calorimetry, second a three point bending test was done to evaluate the mechanical properties and third scanning electron microscopy was performed on all samples to evaluate surface quality.
Results: Absolute batch-to-batch differences in the investigated properties were all deviating from zero, although most differences were clinically acceptable. Significant interbatch differences in thermal properties were found in 4 wires. Mechanical interbatch differences were found remarkable for 5 wires. Percentage of elasticity showed a non-superelastic curve below a deflection of 1500 µm, which represents clinical small deflections. Surface topography showed also interbatch differences for 4 wires.
Conclusion: This study shows that batch-to-batch differences are obvious in each sample. One has to be careful in the selection of archwires. Therefore more standardized consument information should be provided.

Open Access Original Research Article

Effect of Raphia hookeri Seed Extract on Blood Glucose, Glycosylated Haemoglobin and Lipid Profile of Alloxan Induced Diabetic Rats

G. O. Mbaka, S. O. Ogbonnia, K. J. Oyeniran, P. I. Awopetu

Journal of Advances in Medicine and Medical Research, Page 621-635
DOI: 10.9734/BJMMR/2012/1468

Aim: To examine the effect of Raphia hookeri (RH) seed extract on blood glucose, glycosylated haemoglobin and lipid profile of alloxan induced diabetic rats.
Materials and Methods: In the oral glucose tolerance test (OGTT), the animals received the extract (1 g/kg) or glibenclamide (0.01 mg/kg) or vehicle and 30 min later they received oral glucose load (1 g/kg). Glucose was estimated at 30min, 1, 2, 3 and 4 h. In hypoglycaemic study, the extract was administered at doses of 100, 250 and 500 mg/kg body weight (bwt) doses. In fasting blood glucose study (FBG), diabetic Wister rats, 5 per group, received graded doses (50, 100 and 200 mg/kg) of the extract or glibenclamide (10 mg/kg) or vehicle for 15 days. Blood was collected on days 0, 3, 5, 7, 9, 11, 13, 15 for glucose estimation. Lipid profile was analyzed using modified enzymatic procedure. Insulin assay was done by Diagnostic Automation Kit and HbA1C by standard protocol. The studies lasted for three weeks.
Results: The diabetic animals treated with the extract showed appreciable weight gain. In oral glucose tolerance test (OGTT), RH seed extract and glibenclamide treated rats blood glucose significantly (P<0.05) decreased in the peak values and the area under curve after 4 h of oral load with decreased values of 48.3±1.0 mg/dL (63.3%) and 62.0±0.8 mg/dL (51.6%) respectively. The hypoglycaemic activity at 250 and 500 mg/kg body weight (bwt) doses showed lowest plasma glycaemic decrease of 50.1% and 54.4% respectively after 8 h of oral administration. In FBG study, after 15 days of extract/glibenclamide treatment, the animals’ blood glucose exacerbated by alloxan challenge returned to normal glycaemia with glycaemic decrease of 87.2±2.3 (79.3%); 57.0±1.7 (86.3%) and 55.0±0.3 mg/dL (87.1%) respectively while glibenclamide showed a maximum glycaemic decrease of 167.4±1.1 mg/dL (60.1%). The tissue morphology of the extract treated showed significant beta cells survivor. The extract ameliorated dislipidaemia and exerted significant (p<0.05) decrease in plasma HbA1C while marked increase in plasma insulin level occurred.
Conclusion: The extract effectively attenuated hyperglycaemia, caused marked decrease in HbAIC concentration and ameliorated dislipidaemia.

Open Access Original Research Article

Costs of Additional Treatment Success (COATS) Based on Numbers Needed to Treat (NNT) is a Simplified Calculation Method to Facilitate Physicians Medical Decisions with Regards to Monetary Costs

Manfred Weiss, Frank Grom, Franz Porzsolt

Journal of Advances in Medicine and Medical Research, Page 636-646
DOI: 10.9734/BJMMR/2012/1379

Aims: Due to limited resources, to provide a simple and transparent tool for physicians to facilitate budget-related, medical decisions in any patient.
Study Design: Comparative study.
Methodology: Several articles with topics referring to the 2008 ”Surviving Sepsis Campaign” guidelines in critically ill patients with varying effects on defined clinical endpoints were analyzed regarding the costs of additional treatment success (COATS). A simplified ICER = incremental cost-effectiveness ratio to assess COATS was expressed as the product of the number of patients needed to treat (NNT) and the difference in treatment costs per patient.
Results: In publications with significant treatment effects enabling calculation of NNTs, calculating “COATS = NNT x delta costs per patient", mean costs to avoid one additional death or morbidity could be defined. Considering the 95% confidence interval, estimated costs at minimum and maximum to reach distinct clinical endpoints could be expressed. In studies with no significant results, NNTs and COATS were tending to infinity.
Conclusion: COATS based on NNT as a simplified ICER is an easy way for the physician at the bedside caring for individual patients to explicitly describe the amount of money which has to be spent to reach definable aims in the clinical setting in one additional patient, such as reduction of mortality or morbidity, or to reassess therapies without significant results. In contrast to COATS, ICER based on quality-adjusted life years may be necessary to perform calculation of the short-term and long-term costs for the community and the adequate allocation of health care resources.

Open Access Original Research Article

Where and When Human Viral Epidemics First Emerged

Sergey N. Rumyantsev

Journal of Advances in Medicine and Medical Research, Page 647-661
DOI: 10.9734/BJMMR/2012/1692

Aims: This article attempts to date the conditions, terms and places of the first emergence of the main human viral epidemics (HIV, influenza, measles, smallpox).
Place and Duration of Study: Department of Evolutionary Immunology Andent, Inc., between May 2002 and July 2012.
Methodology: The investigation was based on the integration and consequent sensing of relevant recent achievements of evolutionary branches of immunology, epidemiology and anthropology. The main focus was on the integration of up-to-date achievements of both evolutionary and historic anthropology with the data regarding inter-ethnic differences in hereditary immunity to relevant infections and the traces of the aforementioned epidemics.
Results: In contrast to rabies infection the considered epidemics emerged non-simultaneously between 14,000 and 10,000 years ago on the Eurasian territories. They were introduced into America and Australia as well as Sub-Saharan Africa during the Great Geographical Discoveries and consequent Colonization.
Conclusion: After their origin, both the epidemics and the traits of hereditary immunity against them continued to exist among humankind to the present, supported by genetically mitigated heterozygous forms of infections.

Open Access Original Research Article

Morphological and Structural Characterization of Two Types of As-Received and In vivo Orthodontic Stainless Steel Brackets

Sofie Hoste, Jean-Pierre Celis, Guy Willems

Journal of Advances in Medicine and Medical Research, Page 662-675
DOI: 10.9734/BJMMR/2012/1874

Aims: To perform a) a topographical analysis of the bracket slot of 12 as-received stainless steel brackets and of in vivo used stainless steel brackets from 7 patients and b) a compositional characterization of the constituting materials of two types of brackets.
Study Design: In vitro laboratory study.
Methodology: 12 as-received brackets and in vivo used brackets of seven patients were analysed. Two commercially available brackets were used for this study. A SEM analysis evaluated the topographic features of each bracket slot while an EDAX analysis was performed to analyse the constituting parts of each bracket.
Results: As-received ORMCO brackets show more traces of plastic deformation than GAC brackets. On the contrary, pits, crevices and grain boundaries were observed on all as-received brackets. An increased plastic deformation and amount of scratches was noticed on ORMCO and GAC brackets after orthodontic treatment. Elemental analysis revealed that base and wing materials were not identical in GAC nor in Ormco brackets. In addition, both ORMCO and GAC brackets consist each of two parts assembled using a different brazing material.
Conclusion: Both as-received brackets show different damage patterns on their slot surface. Increase of damage patterns was visualized after intra-oral use. As a consequence of the use of different constituting materials for the manufacturing of the two types of brackets investigated, galvanic corrosion is likely to occur.

Open Access Original Research Article

The Beneficial Role of Vitamin D in Interstitial Cystitis

Khanh Vinh Quốc Lương, Lan Thi Hoàng Nguyễn

Journal of Advances in Medicine and Medical Research, Page 676-692
DOI: 10.9734/BJMMR/2012/1878

Interstitial cystitis (IC) is a poorly understood chronic bladder disorder that is generally characterized by bladder discomfort and increased urination urgency and frequency. Vitamin D levels are associated with bladder pathology, and both rat and human bladders express receptors for vitamin D3. Vitamin D significantly reduced edema and bladder wall leukocyte infiltration in a IC animal model. Genetic studies have provided the opportunity to determine which proteins link vitamin D to IC pathology (i.e., the major histocompatibility complex (MHC) class II molecules, the transcription factor nuclear factor kappa B (NF-κB), RANTES (regulated on activation, normal T cell expressed and secreted), epidermal growth factor (EGF), transforming growth factor beta (TGF-β) family, and vascular endothelial growth factor (VEGF)). Vitamin D also exerts its effect on IC through non-genomic factors, i.e., Bacillus Calmette-Guérin (BCG) vaccination, mast cells and histamine, prostaglandins (PGs), reactive oxygen species (ROS), and inducible nitric oxide synthase (iNOS).
Conclusion: Vitamin D may have a beneficial role in IC. Calcitriol is best used for IC because it is the active form of the vitamin D3 metabolite, and it modulates inflammatory cytokine expression. Further investigation with calcitriol in IC patients is needed.

Open Access Original Research Article

Maternal - Fetal Interaction: An Insight through the Stable Isotope Fractionation Prism

Yuri K. Doronin, Daria Yu. Bednik, Andrei A. Ivanov, Polina D. Golichenkova, Elene N. Kalistratova

Journal of Advances in Medicine and Medical Research, Page 701-714
DOI: 10.9734/BJMMR/2012/1592

Aims: To compare carbon and nitrogen isotopic composition of maternal and fetal organs.
Study Design: Cross-sectional study.
Place and Duration of Study: Biology Department of Lomonosov Moscow State University; Institute of Geochemistry and Analytical Chemistry, Russian Academy of Sciences; 2008 – 2011.
Methodology: Mass spectrometric measurements of carbon and nitrogen isotopic ratios of corresponding maternal and fetal organs of gravid mice fed a monotonous diet.
Results: Both the maternal and fetal organs (kidney, muscles, liver, myocardium, brain) of mice at the last term of gestation are enriched in 13C and 15N relative to food consumed. Isotopic composition of organs strongly depends on the number of bearing fetuses. The increase of fetuses’ number results in coordinated 13C depletion and 15N enrichment in both the maternal and fetal organs.
Conclusion: The alteration of the δ13C and δ15N values reflects solely the metabolic restructuring during a pregnancy, since mice were fed the monotonous diet prior to conception and during gestation. Isotopic alterations develop as a reaction to the nutritional stress of the maternal organism under the trophic demands of fetuses. The protein replenishment is the most probable cause of isotope ratio changes. Under the controlled experimental condition the stable Isotope composition of biogenic elements can be used as integral indicators of metabolic efforts of the particular organismic structures. The predictive role of such integral indicators consists at least in limitation of possible biochemical conversions underlying the metabolism change.

Open Access Original Research Article

Study of Morphometric Collo-Diaphyseal Angle of Femur in Homozygous Sickle Cell Nigerian Children

Emue Ewonu Bari Bernard, Tamunotonye Watson Jacks, Danladi Sambo Amaza, Ahmed Ahidjo

Journal of Advances in Medicine and Medical Research, Page 715-726
DOI: 10.9734/BJMMR/2012/1323

Aims: The aim is to investigate the neck-shaft angle or Collo-Diaphyseal Angle (CDA) of femur and the effect of homozygous sickle cell (HbSS) on the angle.
Study Design: A retrospective study.
Place and Duration of Study: Radiology Departments of two Hospitals in Maiduguri, namely Umaru Shehu Modern Hospital and University of Maiduguri Teaching Hospital (UMTH), between January, 2009 - December, 2010.
Methodology: Using plain radiographs of the femur, a total of 194 HbSS and 40 control (non-HbSS) children below 17 years of age were selected. The study samples whose clinical data had been excluded from any diseases that could modify the femur were studied. The Technical Error of Measurement (TEM) was performed by the evaluator. Ethical clearance for the study was obtained from the relevant body of these government hospitals.
Results: The TEM values obtained were less than 1 and were considered as a good measurement method for the evaluator performance. The CDA (mean ± standard deviations) were higher in males than females. The CDA in the left femur was greater than the right both for males and females, respectively. Furthermore, the study documents, probably for the first time that in few cases there was a reduction in the CDA of HbSS when compared with the control groups. The study revealed that there was sexually significant variation (p<0.05). The demarking points and index of sexual dimorphism of CDA show sex differences and can be used for sex determination.
Conclusion: The results from this study reveal that the mean CDA of femur of HbSS children of the study population were sexually dimorphic. The information from this study may aid forensic pathologists, orthopaedic surgeons and future research in evaluation of the femur.

Open Access Review Article

Breast Developmental Anomalies: A Review of the Problem

Pius Agbenorku

Journal of Advances in Medicine and Medical Research, Page 587-596
DOI: 10.9734/BJMMR/2012/1630

The breast is a sign of female sexual identity. However, there are some anomalies that affect normal breast development. These abnormalities could have physiological, psychological and psychosocial effects on an individual and could result in the person developing a negative self image. Not much study on these anomalies has been carried out even though most people are likely to suffer from any one of these breast developmental abnormalities (BDA) than breast cancer. Awareness on these abnormalities is very low unlike breast cancer. Due to low awareness, people with this form of condition are not aware of measures available. Incidence of these anomalies could be high hence the need to educate people on these abnormalities. This review seeks to create the awareness on BDAs and the necessary interventions available.

Open Access Review Article

MicroRNAs and Their Role in Bone Remodeling and Pathogenesis

Ajai Singh, Sabir Ali, Abbas Ali Mahdi, Rajeshwar Nath Srivastava

Journal of Advances in Medicine and Medical Research, Page 727-749
DOI: 10.9734/BJMMR/2012/1543

MicroRNAs, a class of post-transcriptional gene expression regulators that bind to complementary sequences in the 3’ UTR or 5’ UTR of mRNAs have recently been detected in human body fluids including peripheral blood plasma as extracellular nuclease resistant entities. It is now clear that the biogenesis and functions of microRNAs are related to the molecular mechanisms of various clinical diseases and they can potentially regulate every aspect of cellular activity. This review will highlight our current understanding of microRNA biogenesis and their mechanisms of action. It will also summarize recent works on the role of microRNAs in bone remodeling including angiogenesis, osteoblast and osteoclast differentiation and in various bone related pathologies. An in-depth understanding of the roles of these regulatory mRNAs in the skeleton will be critical for the development of new therapeutics aimed on bone remodeling including fracture repair and bone-related diseases.