Open Access Original Research Article

Parallel Group Comparison of the Effects on Skin Condition of Two Antimicrobial Hand Wash Products

J. Djokic-Gallagher, P. Rosher, J. Walker, K. Sykes, V. Hart

Journal of Advances in Medicine and Medical Research, Page 1628-1640
DOI: 10.9734/BJMMR/2014/5642

Aims: The aim of this study was to compare the effects on skin condition of a hand cleansing protocol comprising repeated use of alcohol rub supplemented with one of two different antimicrobial hand washes, Dermol Wash (DW) and Hibiscrub (HS) when used for 5 consecutive days.
Methodology: Forty females applied the alcoholic rub 24 times and used their allocated antimicrobial wash product 13 times on test days (Days 1, 3 and 5) and applied the alcoholic rub 12 times and used the antimicrobial wash 7 times on intervening days. On test centre visit days, an investigator made visual assessments of skin condition and performed corneometry and pH measurements. Transepidermal water loss (TEWL) was measured at baseline and day 5. Subjects also assessed how their skin felt compared to baseline.
Results: Investigator visual assessments of skin dryness barely changed for DW but significantly deteriorated by the end of each test day for HS. Subjects' assessments of how their skin felt significantly deteriorated for HS, with five withdrawals. There was one withdrawal in the DW group. Corneometry measurements significantly improved for DW by 19% over the study, compared to a significant deterioration by 18% for HS. Apparent skin surface pH tended to increase for HS only. TEWL increased in both groups.
Conclusion: The use of an appropriate hand wash product, such as DW, even in conjunction with ubiquitous alcohol rubs, can achieve significant benefits- assessed in terms of subjects’ own assessments of how their skin feels, investigator visual assessments of skin dryness and skin hydration measured by corneometry.

Open Access Original Research Article

Severe Cognitive Dysfunction and Occupational Extremely Low Frequency Magnetic Field Exposure among Elderly Mexican Americans

Zoreh Davanipour, Chiu-Chen Tseng, Pey-Jiuan Lee, Kyriakos S. Markides, Eugene Sobel

Journal of Advances in Medicine and Medical Research, Page 1641-1662
DOI: 10.9734/BJMMR/2014/7317

Aims: This report is the first study of the possible relationship between extremely low frequency (50-60 Hz, ELF) magnetic field (MF) exposure and severe cognitive dysfunction. Earlier studies investigated the relationships between MF occupational exposure and Alzheimer’s disease (AD) or dementia. These studies had mixed results, depending upon whether the diagnosis of AD or dementia was performed by experts and upon the methodology used to classify MF exposure.
Study Design: Population-based case-control.
Place and Duration of Study: Neurology and Preventive Medicine, Keck School of Medicine, University of Southern California, 2 years.
Methodology: The study population consisted of 3050 Mexican Americans, aged 65+, enrolled in Phase 1 of the Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE) study. Mini-Mental State Exam (MMSE) results, primary occupational history, and other data were collected. Severe cognitive dysfunction was defined as an MMSE score below 10. The MF exposure methodology developed and used in earlier studies was used.
Results: Univariate odds ratios (OR) were 3.4 (P< .03; 95% CI: 1.3-8.9) for high and 1.7 (P=.27; 95% CI: 0.7-4.1) for medium or high (M/H) MF occupations. In multivariate main effects models, the results were similar. When interaction terms were allowed in the models, the interactions between M/H or high occupational MF exposure and smoking history or age group were statistically significant, depending upon whether two (65-74, 75+) or three (65-74, 75-84, 85+) age groups were considered, respectively. When the analyses were limited to subjects aged 75+, the interactions between M/H or high MF occupations and a positive smoking history were statistically significant.
Conclusion: The results of this study indicate that working in an occupation with high or M/H MF exposure may increase the risk of severe cognitive dysfunction. Smoking and older age may increase the deleterious effect of MF exposure.

Open Access Original Research Article

Comparative Study of the Efficacy of Brushless Surgical Hand Preparation Techniques Using Antiseptic Soap, Alcohol and Non-medicated Soap

Mohammed Al-Biltagi, Jameel Al-Ata, Asif A. Jiman-Fatani, Abdullah Sindy, Abdullah Alghamdi, Abdulhameed Basabrain, Abdulrahman Alsabban, Ahmad Jefri, Ahmad Alzomity

Journal of Advances in Medicine and Medical Research, Page 1663-1671
DOI: 10.9734/BJMMR/2014/5529

Background & Objectives: Preoperative hand preparation with a brush-less method is almost a common practice. The aim of this study was to compare the efficacy of brush-less preoperative hand preparation using alcohol to antiseptic soap, and non-medicated soap in eliminating germs by standard proper pre-operative hand preparation.
Methods: Twenty volunteers tried three different ways of surgical hand preparation with antiseptic soap, alcohol, and non-medicated soap-based preoperative hand preparation.
Results: There was no positive bacterial growth sample in the alcohol-based scrubbing group while it was 2% with positive bacterial growth in the antimicrobial soap and 55% with positive bacterial growth in the non-medicated soap group.
Conclusion: The alcohol-based pre-operative hand preparation was significantly more efficient than both the antimicrobial soap and the non-medicated soap.

Open Access Original Research Article

Assessment of Antiretroviral Effects of a Synthetic Aluminum-magnesium Silicate

Maduike CO. Ezeibe, Augustine A. Ngene, Idika K. Kalu, Ikenna O. Ezeh, Ijeoma J. Mbuko, Jonathan O. Ekwuruke, Ifeanyi Anene, Bridget Amechi, Peter Olowoniyi, Idika F. Ifekwe

Journal of Advances in Medicine and Medical Research, Page 1672-1679
DOI: 10.9734/BJMMR/2014/7103

Aim: For an affordable therapy for Human immune-deficiency virus (HIV) infections, antiretroviral effects of a synthetic aluminum-magnesium silicate (AMS) were tested.
Materials and Methods: Plasma that tested positive to HIV and the AMS were mixed, on equal volume to weight basis, incubated one hour at room temperature and centrifuged for ten minutes at 3,000 revolutions per minute. These procedures were repeated on each supernatant. HIV titres of the two sets of supernatants and the titres in portions of the plasma, not incubated with the AMS were assessed by direct passive hemagglutination test.
Results: Mean HIV titres of the plasma increased from 4.00±1.60 to 14.00±2.00 when incubated with the AMS. Repeating the incubation, reduced mean HIV titres in plasma from 14.00±2.00 to 6.50±1.50 (P=0.024).
Conclusion: It was concluded that the AMS has antiretroviral effects and could be an inexpensive antiretroviral therapy for regular treatment to reduce high rate of HIV infection among low income groups.

Open Access Original Research Article

The Multifaceted Effects of Vitamin D and Its Potential Contribution to Rheumatoid Arthritis

Kayo Masuko

Journal of Advances in Medicine and Medical Research, Page 1680-1690
DOI: 10.9734/BJMMR/2014/7647

Vitamin D (VD) is known to have pleiotropic effects on various tissues and organs including those of the immune and musculoskeletal systems. VD deficiency has been suggested to trigger the onset of autoimmune diseases including rheumatoid arthritis (RA), although the significance of this finding remains controversial. Conversely, patients with RA often have VD deficiency, and it may modify the pathophysiology of the disorder. This review summarizes recent findings on the multiple roles of VD that may modulate the clinical course of RA. The possibility of administering VD as a therapeutic option for RA is also explored.

Open Access Original Research Article

Porphyria Cutanea Tarda and HFE Gene Mutations in Argentina

Colombo Federico, Martínez Javier, Varela Laura, Gerez Esther, Méndez Manuel, Batlle Alcira, V. Rossetti María, E. Parera Victoria

Journal of Advances in Medicine and Medical Research, Page 1691-1700
DOI: 10.9734/BJMMR/2014/7303

Aims: Porphyria Cutanea Tarda (PCT), the most common of porphyrias is triggered by several factors, including iron overload. Type I Hereditary Hemochromatosis is inherited as an autosomal recessive trait of the mutation p.C282Y or as a compound heterozygous form p.C282Y/p.H63D in HFE gene.
Our aim was to study the frequency of HFE mutations in Argentinean PCT patients and in control subjects.
Place and Duration of Study: CIPYP, CONICET, Hospital de Clínicas José de San Martín: Av. Córdoba 2351, 1º subsuelo, Buenos Aires, Argentina (1120). Between March 2008 and March 2010.
Methodology: We analyzed HFE mutations in 103 PCT patients (67 males, 36 females) and in 93 control subjects (63 males and 30 females). PCT patients were classified as familial, sporadic or Type III PCT measuring URO-D activity in red blood cells. HFE mutations were detected by amplification and automatic sequencing of exons 2 and 4 in the HFE gene. In some cases p.H63D and p.C282Y mutations were also detected by digestion with restriction enzymes (Mbo I for p.H63D and Rsa I for p.C282Y), followed by 3% polyacrilamide gel electrophoresis.
Results: In PCT group, 34.9% carried mutation p.H63D (26.2% heterozygous, 5.8% homozygous and 2.9% as p.C282Y/p.H63D) and 7.8% carried mutation p.C282Y (2.9% in heterozygocity, 1.9% in homozygocity and 2.9% as p.C282Y/p.H63D). In the control group, 30.1% carried p.H63D (28% in heterozygous and 2.1% in homozygous), and 5.4% had p.C282Y in heterozygosity. There were no significant differences between sporadic and familial PCT and neither between PCT and control groups. Our findings are in agreement with the prevalence of the Mediterranean origin of our patients, where p.C282Y mutation is less common than p.H63D mutation.
Conclusion: We conclude that mutations in HFE gene do not play a relevant role in the triggering of PCT in our country.

Open Access Original Research Article

Complicated Fracture and Resorption of an Osteochondroma

Nikolaos K. Sferopoulos

Journal of Advances in Medicine and Medical Research, Page 1719-1728
DOI: 10.9734/BJMMR/2014/7207

Aims: To describe two unusual complications of a typical solitary pedunculated femoral osteochondroma that included a distal fracture of the exostosis and a missed fragment following surgical treatment as well as to evaluate the progress of the untreated free fragment at follow-up.
Case Presentation: A 13-year-old boy consulted for a painful bruising of the medial side of the right knee following injury. Radiological survey indicated a pedunculated osteochondroma of the distal femoral metaphysis but there was no evidence of a fracture line. Surgical removal of the lesion was uncomplicated but the post-operative radiographs indicated an osteocartilaginous portion of the osteochondroma missed in the thigh musculature. No further surgical intervention was undertaken. Radiographic follow-up revealed gradual regression and complete resorption of the free fragment 3 years later. No complications have been recorded at the most recent follow-up, 10 years later.
Discussion: Fracture through the base or stalk of a pedunculated osteochondroma is a rare complication but the diagnosis of a distally fractured exostosis has not been previously reported. Regression or resorption of a solitary pedunculated osteochondroma following a fracture is also very rare. Although recurrence of the lesion in the reported patient would be very likely, complete resorption was evident instead within 3 years.
Conclusion: An obscure distal fracture of a penduculated osteochondroma may be suspected in cases that a clinical diagnosis of a fractured exostosis is not associated with the radiographic detection of a fracture line through its stalk. Radiographic control during surgery is necessary to ensure complete removal in cases with a clinically, or even radiologically, diagnosed fractured exostosis. Surgical excision of a distally fractured osteochondroma may be avoided, since complete resorption of the distal fragment may be evident in a few years.

Open Access Original Research Article

Bacteremia in a Multilevel Geriatric Hospital, Second Look 5 Years Later

Lubart Emily, Kornitsky Ruslan, Dan Michael, Natan R. Kahan, Segal Refael, Leibovitz Arthur

Journal of Advances in Medicine and Medical Research, Page 1729-1738
DOI: 10.9734/BJMMR/2014/6892

Aims: In a previous study (2004) we explored the clinical and microbiological aspects of bloodstream infections (BSI) in a multilevel geriatric hospital, and concluded that follow up and monitoring of these parameters is warranted.
The purpose of this new study is to evaluate the current BSI status and compare these data to those obtained previously.
Study Design and Methodology: We implemented the methodology developed for the initial study. Clinical features, microbiological characteristics and outcome of BSI over the year 2009 were investigated.
Results: The rate of positive blood cultures was similar (10% versus 12%). The rate of BSI was 1.35 per 1000 patients in 2004 and 1.7 per 1000 in 2009. The mortality rate at 2 weeks decreased significantly (from 42% to 22.5%, p=.001). The most common isolate was Escherichia coli in both studies, followed by Proteus mirabilis. Interestingly, antibiotic susceptibility of common pathogens between 2004 and 2009 remained unchanged in 40% while increasing in 32% of cases.
Conclusion: This second look at BSI and revision of BSI parameters provides updated information that may be beneficial for further follow up and antibiotic stewardship program.

Open Access Original Research Article

Nutritional Knowledge, Attitude and Practice of Predominantly Female Preschool Teachers: Effect of Educational Intervention

S. Y. Shaaban, M. F. Nassar, R. H. Shatla, S. M. Deifallah, D. Marzouk, W. I. Abogabal

Journal of Advances in Medicine and Medical Research, Page 1739-1749
DOI: 10.9734/BJMMR/2014/6872

Aims: The study was designed to assess the changes in knowledge, attitude and practice (KAP) of preschool teachers before and after 3 months of attending a nutrition education intervention program.
Study Design: Place and duration of the study: Nine governmental and 13 private schools from 2 urban districts in Cairo, Egypt between September 2011 and March 2012.
Methodology: We included 150 preschool teachers (149 female and 1 male) from 9 governmental and 13 private schools. The teachers filled a questionnaire regarding their KAP towards children nutrition. Re-evaluation was done using the same questionnaire 3 months after attending a nutrition education program.
Results: Initially private school teachers had significantly higher nutrition knowledge and attitude than governmental teachers (P=.012 and <.001 respectively). This difference was eliminated post intervention regarding knowledge (P=.06) but private school teachers still had significantly higher attitude by then (P=.001). Although no significant difference was initially detected in practice (P=.53), that of private school teachers was significantly better post intervention (P=.007). Finally all enrolled teachers showed significant increase in KAP scores after attending the nutrition education sessions (P<.001 for all the KAPs).
Conclusion: Nutrition KAPs are essential for preschool teachers and should thus be assessed and cyclically reinforced by educational programs.

Open Access Original Research Article

Histochemical Investigation of Cyanogenic Toxicity in the Thyroid Epithelial Cells and Follicles of Thyroid Gland in Adult Female Wistar Rats

T. D. Adeniyi, R. A. Bejide, O. M. Ogundele, O. B. Akinola

Journal of Advances in Medicine and Medical Research, Page 1750-1762
DOI: 10.9734/BJMMR/2014/6944

Aim: This study was aimed at understanding the earlier findings involving chronic, low-level cyanide exposure resulting from eating poorly processed cassava products associated with the development of goitre as seen in cassava endemic regions of Nigeria.
Study Design: 30F1 female adult Wistar rats were divided into five (5) groups of 6 animals each. Groups 1 to 4 represented the treatment groups while group 5 was the control of the experiment. The cyanide treatment dose were; group1: 20mg/KgBW, group 2: 12mg/KgBW, group 3: 6mg/KgBW and group 4: 2mg/KgBW while the control group received 0.25M Sucrose.
Place and Duration of Study: The animal facility of College of Health Sciences, Osun State University, Osogbo, Osun State, Nigeria. The treatment duration was 30days.
Methodology: Animals were sacrificed by cervical dislocation. The blood samples were collected to determine Serum FT3, FT4 and TSH concentration. The thyroid gland was excised and processed for light microscopic examination; while the activities of G6PDH, LDH, ALP, MDA and SOD were assayed from the thyroid tissue homogenates.
Results: Histological observation of thyroid gland of rats from the experimental treated groups revealed markedly distended follicles and diffusely hyperplastic thyroid follicles lined with tall columnar epithelial cells. These thyroid epithelial cells are crowded and enlarged projecting into the lumens of their respective follicles. Their interstitial tissue all had dilated blood vessels. Application of one-way ANOVA statistical analytical method showed that there were highly significant differences PË‚0.05 in the activities of G6PDH, LDH, ALP, MDA, SOD, FT3, FT4 and TSH when compared with those of the control group.
Conclusion: The results obtained from this study showed hyperthyroidism was effectively induced by cyanide.

Open Access Original Research Article

Association of Angiotensin-I-Converting Enzyme (ACE) Insertion/Deletion Gene Polymorphism with End Stage Renal Disease in Egyptian Patients

A. F. AbdeL-Aziz, Afaf EL-Saeed, Khaled EL-Dahshan, Basma AL-Sayed Ebead

Journal of Advances in Medicine and Medical Research, Page 1763-1771
DOI: 10.9734/BJMMR/2014/4463

Angiotensin-I-converting enzyme (ACE) insertion/deletion (I/D) polymorphism has been associated with the genetic susceptibility to end stage renal disease (ESRD) in different populations. ACE DD genotype and D allele are associated with ESRD as risk factors in several studies. In this study, we investigated the association between ACE I/D gene polymorphism and ESRD in the Egyptian patients. Frequencies of D allele and DD genotype were significantly increased, while frequencies of I allele and ID genotype were significantly decreased in the ESRD patients when compared with the control subjects (P = .012, OR = 1.82, 95% CI = 1.139-2.915 for DD) and (P = .018, OR = 1.6, 95% CI = 1.082-2.33 for D). In conclusion, ACE DD genotype and D allele are associated with ESRD as risk factors for ESRD in the Egyptian population.

Open Access Original Research Article

Periodontal Treatment Needs and Oral Ulceration in Children and Adolescents with Celiac Disease

Reem H. Dababneh, Ruwaida Hijazeen

Journal of Advances in Medicine and Medical Research, Page 1772-1782
DOI: 10.9734/BJMMR/2014/7580

Aim: To determine periodontal treatment needs and the incidence of oral ulceration among children and adolescents with celiac disease and to compare their findings with a healthy age and gender-matched control group.
Methods: A prospective study was conducted at King Hussein Medical Center on a total of 86 patients: 43 patients with celiac disease as the study group (comma removed) and 43 healthy age and gender-matched participants as the control group. Both groups were questioned for a history of recurrent mouth ulcers (comma removed) and the frequency of tooth brushing. The dental examination for each patient in both groups included the following: plaque index, gingival index (comma removed) and Community Periodontal Index of Treatment Needs (CPITN). The oral mucosa was examined clinically for any lesion consistent with aphthous ulceration.
Results: There were 26 females and 17 males in each group, with a mean age of 13.2 and 13.3 years respectively. Plaque scores were significantly higher among the study group (p<0.05) while the difference in the gingival scores was not statistically significant (p>0.05). Recurrent aphthous ulceration (RAS) was positive among 13 (30.23%) celiac patients compared to 9 (20.9%) among the control group. However, the result was not statistically significant (p>0.05). CPITN revealed no significant difference between the two groups although the mean index was higher among the celiac group. No one in either group scored 0, while the highest percentage in both groups scored 2. Shallow and deep pockets (scores of 3 and 4) were greater in celiac patients. Overall, the variation between the two groups was not statistically significant.
Conclusion: Oral hygiene status seems worse in celiac patients, which indicates that oral health education programs may be beneficial for these children. Although the need for periodontal treatment and the frequency of RAS are higher in celiac patients, the statistical difference was not significant (p NS).

Open Access Review Article

Wolf-parkinson-white Syndrome-current Concepts in Anesthetic Practice

Vijay Mathur, Sameer Kapoor, Birbal Baj

Journal of Advances in Medicine and Medical Research, Page 1604-1611
DOI: 10.9734/BJMMR/2014/6541

Wolf-Parkinson-White (WPW) syndrome is a disorder of conduction system of heart caused by presence of an abnormal accessory conduction pathway between the atria and ventricles. It is associated with tachyarrhythmias diagnosed by electrocardiography (ECG). The anesthetic management of these patients is challenging as they are known to develop life threatening arrhythmias. Magnesium sulfate (MgSO4) is a good agent for control of peri-operative dysrhythmias.

Open Access Review Article

Static Magnetic Field Effect on Cardiovascular Regulation: A Review

Juraj Gmitrov

Journal of Advances in Medicine and Medical Research, Page 1612-1627
DOI: 10.9734/BJMMR/2014/7227

Mounting evidence suggests that environmental and occupational magnetic fields affect cardiovascular system. In this review, supported by original hemodynamic recordings - direct experimental evidence of the effect - static magnetic field (SMF) effects on arterial baroreflex cardiovascular control mechanism have been summarized. Local exposure of 120 - 350 mT SMF to sinocarotid baroreceptors in rabbits and healthy volunteers exerted a stimulatory effect on arterial baroreflex - normalized arterial blood pressure in hypertensive and hypotensive conditions, significantly increased microcirculation, heart rate variability, arterial baroreflex sensitivity and sodium nitroprusside (spontaneous nitric oxide donor) microcirculatory vasodilatory effect. The improvement of the vasodilator responsiveness to nitric oxide by baroreceptor stimulation suggested to be a new mechanism in baroreflex physiology with potential implementation in a spectrum of cardiovascular diseases where endothelial dysfunction and sympathovagal imbalance that results from a loss of baroreflex control over autonomic activity increases the risk of morbidity and mortality substantially. The modulation of the baroreflex-mediated autonomic cardiovascular control is a new concept for understanding environmental magnetic fields effect on cardiovascular system and an effective strategy to prevent their potential public health hazards.

Open Access Review Article

Biomarkers in Medicine: An Overview

Ezzatollah Fathi, Seyed Alireza Mesbah-Namin, Raheleh Farahzadi

Journal of Advances in Medicine and Medical Research, Page 1701-1718
DOI: 10.9734/BJMMR/2014/6917

Recently, biomarkers in medicine have gained comprehensive scientific and clinical interest. Biomarker or biological marker defined as alteration in the constituents of tissues or body fluids provide a powerful approach to understanding the spectrum of chronic diseases with application in at least 5 areas like screening, diagnosis, prognostication, prediction of disease recurrence and therapeutic monitoring. Therefore, biomarkers are biological indicators of diseases that can be measured either in vivo by biomedical imaging or in vitro by laboratory methods. Many kinds of biomarkers are available in the field of medical science with lots of positive as well as negative effect. These markers can also reflect the entire spectrum of disease from the earliest manifestations to the terminal stages and will become one of the major driving forces of pharmaceutical research and drug development in the coming years. Generally, a biomarker is potentially useful along the whole spectrum of the disease process- before diagnosis; for screening and risk assessment, during diagnosis; for staging, grading and selecting the initial therapy and during treatment for monitoring therapy, selecting additional therapy or monitoring recurrent diseases. This brief review describes the types and major uses of biomarkers in clinical investigation.