Open Access Short Research Article

Organotherapic Medicine Improves Blood Glucose Levels in AIDS Patients

A. R. T. Pupulin, L. Mortean, M. Spack Jr

Journal of Advances in Medicine and Medical Research, Page 335-341
DOI: 10.9734/BJMMR/2015/14036

Aims: To evaluate the effect of an organotherapic drug, produced from the pancreas of a young pig, on glycemic alterations in AIDS patients.
Methodology: Current study was carried out in a double-blind, placebo controlled and randomized design. AIDS patients who had high fasting glucose (>110 mg/dL) were selected so that the effect of the organotherapic drug could be evaluated. The patients were divided into two groups: Group I comprised patients who received the organotherapic drug diluted in 1x1012 alcohol/ water 8%, once a day, with a sublingual-administered fasting dose of 10 drops, during four months. Group II consisted of patients receiving placebo once a day at the same dosage. Glucose oxidase method and ELISA, following the manufacturer’s instructions, respectively determined levels of glucose and insulin before treatment and monthly until four months after the start of treatment.
Results: Results registered hyperglycemia in 30% of the patients (60/200), higher than in the population at large (7-15%). This fact could be related to the time of infection (10.0±4.78 years) and treatment (9.3±3.76 years) of the patients. On the other hand, patients who underwent treatment with organotherapic medicine showed a significant reduction (p<0,001) in blood glucose levels (from 204.5±86.63 to 86.63±16) and lower insulin levels after four months of treatment (organotherapic group with 8.02±3.598 versus placebo with 23.83±3.670 p<0,001) within normality, regardless of age, time of infection and time of treatment. This fact suggests that the organotherapic drug was effective to stabilize blood glucose levels in patients.
Conclusion: Current study evidences that the organotherapic drug obtained from the pancreas of a young pig, diluted 1x1012 in alcohol/ water 8% improves blood glucose levels in patients with hyperglycemia keeping within the normal range after four months of treatment. Considering the HAART therapy that significantly increases the life expectancy of AIDS patients but with significant metabolic alterations this study shows the possibility of utilization of complementary and alternative therapies. Although results indicate a significant effect of the organotherapic drug, additional studies are needed to evaluate the long-term effects.

Open Access Opinion Article

Can Selenite be an Ultimate Inhibitor of Ebola and Other Viral Infections?

Boguslaw Lipinski

Journal of Advances in Medicine and Medical Research, Page 319-324
DOI: 10.9734/BJMMR/2015/14858

It is known that the virulence of Ebola and other RNA enveloped viruses involves in the first step their attachment to host cell membranes. Following this initial step the virus enters the target cell cytoplasm by forming hydrophobic spikes that make holes in the membrane lipid bilayer. Formation of such spikes is catalyzed by the reduced form of viral protein disulfide isomerase (PDIred) thus initiating chain of disulfide exchange reactions. Consequently, hydrophobic protein epitopes become exposed, which in the absence of proper chaperones form hydrophobic ‘spikes’ capable of penetrating the host cell membranes. In this communication evidence is discussed showing that the chain of disulfide exchange events can be inhibited by a small redox molecule – sodium selenite. It is suggested that this inexpensive and readily available food supplement can be an ultimate inhibitor of Ebola and other enveloped viral infections.

Open Access Minireview Article

The Role of Transglutaminase 2 (TG2) in Definition of Cancer Hallmarks

Odii Benedict Onyekachi, U. Lawani Ebidor, Omabe Maxwell

Journal of Advances in Medicine and Medical Research, Page 297-311
DOI: 10.9734/BJMMR/2015/13919

Over the past three decades, TGM2, a stress-responsive gene encoding transglutaminase 2 (TG2) has been identified as one of the several genes that may be involved in carcinogenesis and cancer physiology. TG2 is a pleiotropic calcium-dependent enzyme belonging to the transglutaminase family of enzymes, which post-translationally modify glutaminyl and lysyl side chains on the surface of both in vivo and in vitro substrate proteins. Unlike other members of the transglutaminase family, TG2 has additional Ca2+-independent enzymatic and non-enzymatic activities, which have been directly or indirectly implicated in diverse cellular physiological events, including cell growth and differentiation, cell adhesion and morphology, extracellular matrix stabilization, wound healing, cellular development, receptor-mediated endocytosis, apoptosis, and disease pathology. TG2 has specialized biochemical, structural and functional elements, wide tissue distribution and sub-cellular localisation, as well as broad substrate specificity. These specialised features of TG2 account for its multiple patho-physiological functionalities. Considering the multiplicity of TG2 functions and its importance in disease pathology, including cancer; we have reviewed herein, the importance of TG2 in the definition of the hallmark capabilities of cancer cells. This was done with the view to deepen our understanding of the role of TG2 in carcinogenesis and recapitulating its potential as a therapeutic target for cancer treatment.

Open Access Original Research Article

Does Methadone Exposure During Avian Development Alter Sex Ratio of Survivors?

Sherry Dingman, Zofia Gagnon, Maria Melilli Otte, Kate Annunziato

Journal of Advances in Medicine and Medical Research, Page 254-264
DOI: 10.9734/BJMMR/2015/13746

Aim: Methadone is commonly used to treat pregnant heroin users and presumed to be safe for developing offspring. An avian model, free of confounding maternal variables, was used to investigate sex differences from methadone exposure during development.
Place and Duration of Study: Studies were conducted at Marist College, Poughkeepsie, NY between June 2012 and May 2013.
Methodology: In the first experiment, methadone in phosphate buffered saline was administered to fertilized eggs at one of two doses (0.458 mg/kg or 1.75 mg/kg) for one of three durations of exposure (Late, Incubation Days 12 to 19; Mid to Late, Days 9 to 19; or Early to Late, Days 5 to 19) with six eggs in each dose x duration condition and six controls (N = 42 eggs). Feathers were taken from eggs with developed embryos from this study for DNA analysis. DNA analysis was not attempted on embryos that had died early in development and decomposed before eggs were opened on Day 20. In a second experiment, methadone (1.00 mg/kg) was administered to eggs from which embryos were sacrificed at four time points during development to investigate growth retardation in methadone exposed embryos as compared with controls. Feathers were taken from randomly selected eggs exposed from Day 8 to Day 19 for sexing (N = 10 exposed and N = 10 controls.
Results: Methadone exposure significantly affected embryo viability. The sex ratio of exposed specimens was 2:1 in favor of females, a departure from the normal 1:1 ratio. The results suggest that most of the embryos that died during incubation were male.
Conclusion: The skewed sex ratio observed in this study suggests a sex difference in mortality from methadone exposure during development.

Open Access Original Research Article

An Analytical Study of Retesting of Retained Sample Results

Shyamali Pal

Journal of Advances in Medicine and Medical Research, Page 265-277
DOI: 10.9734/BJMMR/2015/13629

Aims: The sample retention policy for Clinical Chemistry analytes in accredited medical laboratories as per ISO 15189:2012 is 24 hrs. Serum/ plasma to be separated in aliquot within 20 minutes of collection unless the primary containers are gel vacutainers. Rigorous maintenance of such procedure is difficult and as a result the possibility of deviation from such schedule may not be very uncommon. The 1 year Turn Around Time (TAT) analysis of the laboratory is a good guide to find out time lag from sample collection to sample processing & average time of collecting samples in aliquot for retained sample testing. The laboratory retested 22 common analytes on the basis of such time lag and evaluated the deviation from 1st observation. The accumulated data has helped to evaluate and implement sample retention policy.
Study Design: The average time lag from collection to completion of test performance of a batch is 4hrs± 30 minutes. The analytes were retested in the time lag. After accumulation of sufficient data the time lag increased to 6 hours±30 minutes which is the average lag from sample collection to end of the day duty personnel. In the 3rd phase total retention time ie, 24 hrs has been considered as time interval of retained sample retesting. But the samples remained at room temperature for 6hrs±30minutes before being preserved at 2°C-8°C. Hence time lag was (6hrs±30min) at room temperature and 17hrs ±30min at 2°C-8°C. The samples always retested from primary container.
Place and Duration of Study: The study took place in JMD Diagnostics Private Limited, Kolkata, India. The duration of study is 2 yrs.
Methodology: The analytes were tested in Cobas Integra 400plus system. The tests have been performed as routine tests and considered as 1st observation. 2nd observation values obtained after the specified time lag. The results obtained were compared using statistical software. Comparison of 1st and 2nd results and bias of all analytes were studied. Electrolytes have been eliminated from the study as the electrolytes are preferred to be retested from freshly collected sample. Labile parameters like L-Lactate, ammonia, bicarbonate were also not considered for the same reason.
Conclusion: Only 3 analytes, total protein, total calcium and inorganic phosphorus cannot be preserved in primary containers. The analytes also need not to be separated within 20 minutes of collection. Upto 4hrs±30 minutes all the parameters have shown excellent correlation coefficient. Hence, the laboratory earns a time lag between collection to preservation of samples for these analytes. For other 19 analytes sample may be kept in primary container.

Open Access Original Research Article

Effectiveness of Triple Therapy Regimens in the Eradication of Helicobacter pylori in Patients with Uninvestigated Dyspepsia in Ekiti State, Nigeria

Olusoji A. Solomon, Akande O. Ajayi, Patrick T. Adegun, Olusegun E. Gabriel, Ohunakin Afolabi, Oluremi O. Solomon

Journal of Advances in Medicine and Medical Research, Page 278-285
DOI: 10.9734/BJMMR/2015/14103

Aim and Objective: The term dyspepsia has been used inconsistently by healthcare professionals to describe different patterns of upper gastrointestinal symptoms. It denotes a symptom and does not itself represent a disease. In this study, we seek to determine the effectiveness of common triple therapy regimens in use in the eradication of H. pylori in this environment and to compare it what is obtained worldwide.
Materials and Methods: One hundred and four Consecutive adult patients, aged 18 to 50 years presenting newly with uninvestigated dyspepsia and without alarm symptoms at General Outpatient Clinics of the Ekiti State University Teaching Hospital, Ado-Ekiti and the Federal Medical Centre, Ido-Ekiti, Nigeria were randomized into five treatment groups in the study. Approval was obtained from Ethical Committees of the two study centres. Treatment outcome was computed using frequency table.
Results: The mean age of the studied population was 37.8±12.98 years. 32.7% were males while 67.3% were females. Most prevalent symptom for uninvestigated dyspepsia was abdominal discomfort 100 (96.2%), this was followed by early satiety, abdominal fullness and vomiting with 32 (30.8%), 26 (25%) and 13 (12.5%) of the participants respectively. 76.0% were positive for H. pylori infection by Urea Breath Test Heliprobe® System with highest prevalence of H. Pylori infection within age group 31-45 years (36.7%).
Rabeprazole-Clarithromycin-Metronidazole group (RCM) had the highest eradication rate per protocol [77.8%], followed in descending order by Rabeprazole-Amoxil- Levofloxacin group (RAL) [53.3%], Omeprazole-Tinidazole-Clarithromycin “ulcer kit” (OTC) [44.4%], Rabeprazole-Amoxil-Metronidazole group (RAM) [44.4%] and Rabeprazole-Amoxil-Clarithromycin (RAC) [30.0%].
Conclusion: This study showed there is difference in eradication rates of popularly known triple therapy regimens. This may be due to geographical differences in antibiotics resistant pattern to H. pylori. Further study is suggested to find out the national sensitivity pattern to the commonly used triple therapy regimens in Nigeria.

Open Access Original Research Article

Conventional Ultrasound and the Color Flow-doppler Mapping Function in Evaluation of Libyan Thyroid Tumors

Elfagieh A. Mohamed, Rigig Mossa, Alasifer Husain, Ghellal Ashur, Abdalla B. Fathi

Journal of Advances in Medicine and Medical Research, Page 286-296
DOI: 10.9734/BJMMR/2015/8897

Aims: Conventional Ultrasonography and (CFM) can be expected to improve the distinction between benign and malignant thyroid nodule gland. The aim of this study was to estimate the supporting value of a color flow-Doppler mapping function (CFM) of conventional Ultrasonography of the thyroid nodule, and do so by using different flow patterns and whether ornot, this technique can have a role in the diagnosis of malignant involvement.
Study Design: Prospective [analytic observational] study.
Place and Duration of Study: Department of Surgery and Department of Radiology, Misurata Cancer Center, Libya, between January 2007 and December 2009.
Methodology: This prospective study was based on 54 patients with an available histological diagnosis of the thyroid nodule 41 benign Follicular adenomas (FA) and 13 malignant papillary carcinomas (PC) were examined. Before thyroidectomies, the patients were submitted to US graphic in a two different assessment methods: (i) patients examined with conventional thyroid US and (CFM) method and (ii) then re-examined with CFM method. The CFM produced 3 vascular pattern [A; Peripheral ring of flow with minimal or no internal flow. B; Peripheral ring and small to moderate internal color flow. C; Extensive internal color flow with or without peripheral ring].
Results: The conventional ultrasonographic patterns showed significant differences between benign and malignant cases. The ill-defined and irregular edges of assessment nodules were especially significant. The type A or B blood flow pattern were not significant. However, All samples with type C blood flow pattern were malignant and with sensitivity 61.5%.
Conclusion: The study suggests that the conventional thyroid ultrasound with the color flow-Doppler mapping function can play a useful role in evaluation of the thyroid tumors, and the tumor features that analyzed by ultrasound should be considered at the time of surgical intervention. The method can be used to increase the effectiveness of cytological procedure in doubtful thyroid lesions.

Open Access Original Research Article

Hepatitis D Virus in Chronic Liver Disease Patients with Hepatitis B Surface Antigen in University of Calabar Teaching Hospital, Calabar, Nigeria

D. C. Okpokam, M. Kooffreh-Ada, Z. A. Okhormhe, E. N. Akpabio, J. O. Akpotuzor, V. U. Nna

Journal of Advances in Medicine and Medical Research, Page 312-318
DOI: 10.9734/BJMMR/2015/14543

Aims: It is well known that patients with hepatitis B virus (HBV) could be co-infected with hepatitis D virus (HDV), thus worsening and complicating their condition. The prevalence of HBV and HDV co-infection in University of Calabar Teaching Hospital has not been ascertained. This study was therefore carried out to determine the frequency of hepatitis D virus among chronic liver disease (CLD) patients with hepatitis B surface antigen (HBsAg) in University of Calabar Teaching Hospital, Calabar, Nigeria.
Place and Duration of Study: This study was carried out in University of Calabar Teaching Hospital, Cross River State, Nigeria, from September 2012 to March 2013.
Methodology: A total of 91 subjects were recruited for this study, 76 were CLD patients, while 15 were apparently healthy subjects. Sera samples were subjected to HBsAg using enzyme linked immunosorbent assay (ELISA) technique and finally the HBsAg positive and negative samples were screened using ELISA technique for hepatitis D virus.
Results: Out of the 91 subjects recruited for this study, 76 (83.5%) tested positive for HBsAg, and were CLD patients. Out of the 76 CLD patients who tested positive for HBsAg, 46 (60.5%) had a co-infection with HDV, while 30(39.47%) showed no co-infection. HBV/HDV co-infection was higher in males 27(58.7%) than females 19 (41.3%).
Conclusion: This study shows a high rate of HDV/HBV co-infection which was higher in males than females with chronic liver disease in UCTH, Calabar, Nigeria.

Open Access Original Research Article

Sexual Behaviours of Secondary School Students in Port Harcourt

Balafama A. Alex-Hart, Joyce Okagua, Peace I. Opara

Journal of Advances in Medicine and Medical Research, Page 325-334
DOI: 10.9734/BJMMR/2015/14539

Background: Sexual behaviours of adolescents are currently receiving global attention because a high proportion of new HIV and other sexually transmitted infections’ diagnosis are among young people. This study aimed to assess the sexual behaviours of secondary school students in Port Harcourt.
Methods: This is a school-based cross sectional descriptive study, carried out in six public secondary schools in Port Harcourt Metropolis in Rivers State, Nigeria in February 2014. A structured pre-tested, self-administered questionnaire was distributed to 1047 senior secondary 1 to 3 students selected through multistage sampling technique. Information sought included socio-demographics, if they have had sexual intercourse, age at first sex, involvement in sexual intercourse in the last 3 months before the survey, condom use and number of sex partners. Statistical analysis was performed using SPSS version 20.0 statistical software. Univariate and multiple logistic regression analysis were done to describe socio-demographics and sexual behaviours of study participants and to identify independently associated factors.
Results: One thousand and forty seven students participated in the study; mean age 16.19±1.64 SD. Five hundred and thirty seven (51.3%) females and 510 (48.7%) males, male: female ratio was 0.9: 1. Four hundred and forty nine (42.9%) students reported having had sex at least once in their life time. Mean age at first sexual intercourse was 13.37±3.66SD. More females reported having sex compared to the males (χ2=7.357, P=.007). The commonest reason for having sex was because their friends had also had sex. Two hundred and seventy eight (61.9%) students reportedly had sex in the past 3 months before the survey, out of which 14.0% had sex with 4 or more sexual partners and 18% had sex more than once a week. Nineteen point eight percent of the currently sexually active students used condom during their last sexual intercourse. One hundred and forty six (27.2%) females had been pregnant at least once, out of which 75.3% had induced abortion. Students who watched pornographic movies (OR=2.189, CI=1.624-2.951) and those who dated the opposite sex (OR=2.839, CI=2.092-3.851) were 2 times more likely to have engaged in sexual intercourse than those who didn’t. Students who were sexually harassed were 5 times more likely to be sexually experienced than those who were not sexually harassed (OR=5.927, CI=4.408-7.971).
Conclusion: There was a high rate of risky sexual behaviours amongst the secondary school students in Port Harcourt. Intervention program aimed at sexuality education and behavioural change should be inculcated into secondary school education curriculum in Port Harcourt.

Open Access Original Research Article

Use of Cranial Computed Tomography (CT) in Elderly Patients Presenting After a Fall: Can We Predict Those Having Abnormal Head CT Scans

Jennifer M. Bennett, Nathan R. Nehus, Matthew R. Astin, Charles K. Brown, Reuben Johnson, Kori L. Brewer

Journal of Advances in Medicine and Medical Research, Page 342-350
DOI: 10.9734/BJMMR/2015/10435

Aims: Identify factors predictive of increased risk of intracranial injury and assess the ability of the non-age related components of the New Orleans head CT criteria (NOC) to guide decision-making.
Study Design: Retrospective electronic medical record review and application of decision rule.
Place and Duration of Study: Emergency Department (ED) of Vidant Medical Center, Department of Emergency Medicine, Brody School of Medicine at East Carolina University; Greenville North Carolina, USA; January 2008 through December 2008
Methodology: Electronic Medical Records (EMR) of patients > 65 years of age coming to our Emergency Department during 2008 with a diagnosis of fall or traumatic injury were reviewed. Demographics, fall/injury details, risk factors, CT performance, and CT findings were recorded. Revisit within 30 days was reviewed. Non-age related NOC were applied to the population. Transfers, known intracranial injury, and multisystem trauma were excluded. Independent predictors of positive findings were sought using logistic regression.
Results: We identified 783 patients with fall and traumatic injury. Ninety-six met exclusion criteria, leaving 687 for analysis. Three hundred twenty one patients received head CT; 296 met the non-age NOC for head CT. Twelve (3.1%) abnormal head CTs were identified; nine showed an acute finding. Acute findings were not predicted by any independent variable. All 12 of the abnormal head CTs (nine acute, three chronic) were identified by the non-age NOC. Forty five patients presented again within 30 days with no injuries noted.
Conclusion: Age over 65 did not increase the risk for acutely abnormal head CT in the patient presenting to the ED after a fall. No single factor was predictive of acutely abnormal head CT. The use of the non-age related NOC predicted those patients having an abnormal head CT with 100% accuracy. Age may not independently necessitate head CT after a fall.