Open Access Case Study

Thoracic Aorta Aneurysm-Endovascular Aortic Repair

Prem Krishna Anandan, K. Subramanyam, Shivananda Patil, R. Rangaraj, C. N. Manjunath

Journal of Advances in Medicine and Medical Research, Page 634-638
DOI: 10.9734/BJMMR/2015/17600

Endovascular aortic repair (EVAR) is the treatment of choice for patients with descending thoracic aortic aneurysm who are unfit for open surgery. We report a 50-year-old Asian woman who presented with a saccular symptomatic thoracic aortic aneurysm and underwent EVAR with a covered stent with prompt relief of symptoms and no residual complications at 1 year of follow up.

Open Access Original Research Article

Antibacterial and Physico-chemical Properties of Local Honey in Guyana

Atiya Diane N’djelekulu, Rajini Kurup, Abdullah Adil Ansari

Journal of Advances in Medicine and Medical Research, Page 564-569
DOI: 10.9734/BJMMR/2015/17063

Aim: The present study evaluates the antimicrobial activity of different samples of honey produced in Guyana and a comparison of their effectiveness with conventional antibiotics.
Methods: A disk diffusion method was used to assess the activity of honey against microbial pathogens. The honeys were tested at different concentrations ranging from 100%, 50%, 25% and 1%.
Results: The study showed that honey H2 was most effective on Escherichia coli and Klebsiella pneumoniae, while honey H3 was most effective on Staphylococcus aureus. Effective concentration for H1, H2 and H3 were 1%, 25% and 25% & 50% respectively.
Conclusions: The study showed that honey has antibacterial activity (bacteriostatic and bactericidal effect), similar to antibiotics, against test organisms and provides alternative therapy against certain bacteria.

Open Access Original Research Article

Prescribing Pattern of Drugs in Hypertensive Patients-A Retrospective Study

M. S. K. M. Chaitanya, Mohammad Tausif Khan

Journal of Advances in Medicine and Medical Research, Page 570-575
DOI: 10.9734/BJMMR/2015/16853

Aims: The prescribing pattern of drugs used for treating hypertension changes over time in response to changes in recommended guidelines and innovations in drug formulations, among others. In addition, the classes of antihypertensive drugs used vary among the countries. The objective of this study was to analyze the Prescribing practice of antihypertensive medications in a tertiary care hospital in India.
Study Design: Retrospective analysis of prescription practice for hypertensive outpatients.
Place and Duration of the Study: Tertiary care hospital, Kanchipuram District, Tamil Nadu, India and duration of the study was one year.
Methodology: Prescription practice for 400 hypertensive outpatients were analyzed on basis of age, percentage of male and female patients, anti-hypertensive drug category, most frequently prescribed hypertensive drug and percentage of one/two drug combination.
Results: As monotherapy ACE-Inhibitors 38.25% (153) were the most commonly prescribed antihypertensives followed by calcium channel blockers 19.25% (77), Loop-Diuretics 13.25% (53), Beta-blockers 6.75% (27), Angiotensin-2 antagonists 6.75% (27) and Vasodilator 3.5% (14) ranked last in this study. Combination treatment usually consisted of two antihypertensive drugs as a Co-formulation, the most common combination was a ACE-Inhibitors+CCB 5% (20), followed by Beta-blocker+CCB 3.5% (14), ACE+ Loop-diuretics 2.75% (11) and CCB+CCB 1% (4). Patients gender, age and comorbidities significantly influenced which treatment was prescribed.
Conclusion: In this study it was keenly noted that the ACE-Inhibitors are the most commonly prescribed monotherapy antihypertensive agents 38.25% (153) and their prescribing pattern was in consistent with the guidelines. Thiazides and the combination drugs were underutilized in this study, despite robust evidence to support their use.

Open Access Original Research Article

Human Bone Marrow Subpopulations Sustain Human Islet Function and Viability In vitro

Lu Guang Luo, Fang Xiong, Philippe Ravassard, John ZQ Luo

Journal of Advances in Medicine and Medical Research, Page 576-587
DOI: 10.9734/BJMMR/2015/17536

Aims: Allogeneic bone marrow (BM) has been shown to support human islet survival and function in long-term culture by initiating human islet vascularization and β-cell regeneration. Various BM subpopulations may play different roles in human islet functions and survival. In this paper we investigated the effects of BM and its subpopulations, endothelial progenitor cells (E) and mesenchymal (M) cells on human islet’s β-cell function and regeneration.
Study Design: Isolation and identification of subpopulations from human bone marrow and culture with allogeneic human islet to investigate effects of different cell population on human islet function and regeneration.
Place and Duration of Study: Department of Medicine, Center for Stem Cell & Diabetes Research, RWMC, Providence, RI, USA, between 2010 - 2014.
Methodology: Human islets were distributed from Integrated Islet Distribution Program (IIDP) and human bone marrow (BM) was harvested by Bone marrow transplantation center at Roger Williams Hospital. BM subpopulation was identified cell surface markers through Fluorescence-activated cell sorting, applied in flow cytometry (FACS), islet function was evaluated by human ELISA kit and β cell regeneration was evaluated by three methods of Cre-Loxp cell tracing, β cell sorting and RT-PCR for gene expression.
Results: Four different BM and seven different islet donates contributed human tissues. We observed islet β-cell having self regeneration capability in short term culture (3~5 days) using a Cre-Loxp cell tracing. BM and its subtype E, M have similar benefits on β cell function during co-culture with human islet comparison to islet only. However, only whole BM enables to sustain the capability of islet β-cell self regeneration resulting in increasing β cell population while single E and M individual do not significantly affect on that. Mechanism approach to explore β-cell self regeneration by evaluating transcription factor expressions, we found that BM significantly increases the activations of β-cell regeneration relative transcription factors, the LIM homeodomain protein (Isl1), homologue to zebrafish somite MAF1 (MAFa), the NK-homeodomain factor 6.1 (NKX6.1), the paired box family factors 6 (PAX6), insulin promoter factor 1 (IPF1) and kinesin family member 4A (KIF4a).
Conclusion: These results suggest that BM and its derived M and E cells enable to support human islet β-cell function. However, only BM can sustain the capability of β-cell self regeneration through initiating β-cell transcriptional factors but not individual E and M cells suggesting pure E and M cells less supportive for islet long-term survival in vitro.

Open Access Original Research Article

Effect of Isolation Stress on Glucose/Lipid Metabolism in Spontaneously Diabetic Torii (SDT) Fatty Rats

K. Miyajima, Y. Toriniwa, Y. Motohashi, Y. Ishii, M. Shinohara, H. Yamashiro, T. Yamada, T. Ohta

Journal of Advances in Medicine and Medical Research, Page 588-594
DOI: 10.9734/BJMMR/2015/17988

Aim: The Spontaneously Diabetic Torii (SDT) fatty rat is a novel obese type 2 diabetic model, showing hyperphagia, obesity, and diabetes mellitus from a young age. In this study, we investigated the effects of isolation stress on pathophysiology in SDT fatty rats.
Methods: SDT fatty rats (4 weeks old) were housed 3 per cage for 2 weeks and separated as males or females so as each gender will be placed in a separate cage to avoid mating. After acclimatization in 6 weeks of age, the rats were exposed to isolation stress (IS) (one rat per cage, using 5 animals in each sex). In the control group, each sex of experimental rats were housed separately continuously 3 per cage (using 6 animals in each sex). Food intake, body weights, and blood chemical parameters, such as glucose, insulin, triglyceride and total cholesterol levels, of the rats from 6 to 15 weeks of age were measured at every 3 weeks. Satellite groups were prepared for pathological analyses. Necropsy of satellite group was performed at 12 weeks of age, and the pathological analyses, such as adrenal, thymus and spleen, were performed.
Results: The blood glucose level in IS group in female SDT fatty rats was significantly increased at 12 weeks of age as compared with that in control group. Female SDT fatty rats showed accelerated diabetic progression, but the male rats did show the effects of IS on the glucose/lipid metabolism. In male SDT fatty rats, an increase of adrenal weight and a decrease of thymus weight were observed in IS group and the female rats in IS group showed a tendency of an increase of adrenal weight and a decrease of thymus weight. In histopathological analyses, adrenal hypertrophy and thymus atrophy were observed in IS group in both male and female rats.
Conclusion: Isolation stress affected the progression of diabetes in female SDT fatty rats. Housing conditions is a factor to care for in evaluation of pathophysiology in diabetic models.

Open Access Original Research Article

A Novel Sclerectomy Technique for Glaucoma and Ocular Hypertension Treatment

Ahmed S. Elbably, Ehab Ahmed, Mohamed M. Abo-Zaed, Mohammed S. Elbably, Tag El-Din M. Othman, Ahmed Mousa

Journal of Advances in Medicine and Medical Research, Page 595-600
DOI: 10.9734/BJMMR/2015/17207

Purpose: To introduce and evaluate the efficacy and safety of a new surgical scleral technique for treatment of glaucoma based on the concept of scleral biomechanics.
Methods: Twelve 3-month-old New Zealand white rabbit eyes were operated under general anesthesia. Single large rectangular full thickness sclerectomy (3 mm limbal x 5 mm) exposing the choroid was performed in each eye. The intraocular pressure (IOP) was measured preoperatively, one day, one week and one month postoperatively.
Results: Twelve eyes of 6 New Zealand white rabbits were operated with sector sclerectomy technique. The mean (±SD) intraocular pressure (IOP) was significantly reduced from a preoperative value of 6.0 (±0.0) mmHg to 2.0 (±0.0) mmHg (p = 0.003) in the post-operative assessment. The IOP was quite stable in the following one week and one month follow up assessments at 2.0 (±0.0) mmHg (p = 0.998). Eight out of 12 (66.7%) operated eyes had no postoperative complications. Four (33.3%) eyes faced different complications where: one (8.3%) had corneal perforation by traction suture, 3 (25%) had vitreous loss (one mild and two severe), while one of them (8.3%) had bleeding.
Conclusion: Full thickness sector sclerectomy can change the scleral biomechanical behavior leading to highly significant intraocular pressure reduction.

Open Access Original Research Article

Body Composition Changes and Predictors of Lipodystrophy in a Cohort of Pre-pubertal HIV- infected Children

Cecília Zanin Palchetti, Regina Célia de Menezes Succi, Vera Lúcia Szejnfeld, Patrícia Fonseca Teixeira, Rose Vega Patin, Aída de Fátima Thomé Barbosa, Fernanda Luisa Ceragioli Oliveira

Journal of Advances in Medicine and Medical Research, Page 601-611
DOI: 10.9734/BJMMR/2015/17782

Aim: To evaluate body composition changes in HIV-infected patients and to identify the predictors of lipodystrophy over time.
Methods: A cohort study, evaluated over two and a half years (Time 1: T1; Time 2: T2), including prepubertal HIV-infected children of both genders, between 7-12 years of age. Patient’s data such as transmission, use of prophylaxis for vertical HIV transmission, clinical and immunological classification of disease and current antiretroviral therapy were derived from the medical records. At T1, only subjects with pubertal stage 1 were included. Clinical, anthropometric, body composition and biochemical data were assessed. Patients were divided into two groups: with (LD+) and without lipodystrophy (LD-).
Results: A total of 40 patients were enrolled, and 35 patients completed the study. Mean (SD) age was 9.6 (1.1) and 11.6 (1.2) years at T1 and T2, respectively. At T2, 16 (45.7%) children remained prepubertal. LD+ group (n = 8) showed a higher prevalence of short stature (p = 0.008) in T1; higher insulin (p = 0.010) and HOMA-IR (p = 0.013) and reduction of triceps skinfold thickness (p = 0.026) at T2. In both times, we observed lower concentrations of HDLc (p = 0.027), higher values of trunk to arm ratio (p = 0.002, p = 0.001) and lower values of limb to trunk ratio (p = 0.001) and gynoid fat (p= 0.001) in LD+ group. At T1, predictors of lipodystrophy were short stature (OR = 46.198, p = 0.019) and limb to trunk ratio (OR = 0.00009, p = 0.011); in T2, waist circumference (OR = 1.199, p = 0.025) and HDLc (OR = 0.835, p = 0.015). Presence of lipodystrophy was determinant of high insulin levels at T2.
Conclusion: In a short period, LD+ group had significant changes in body fat distribution and also biochemical alterations associated to lipodystrophy syndrome.

Open Access Original Research Article

Vitamin D Receptor fok I Gene Polymorphism in Angiographically Proven Coronary Artery Disease Subjects: Case - Control Study

B. Sowjanya, Vettri Selvi, B. Suneel, D. Balakrishna, D. R. Nagendra Kumar, B. Phani Krishna, J. N. Naidu

Journal of Advances in Medicine and Medical Research, Page 612-617
DOI: 10.9734/BJMMR/2015/17845

Aims: Coronary artery disease (CAD) is multifactorial disease resulting from modifiable and non modifiable risk factors. Gene polymorphism is one of the non modifiable risk factors, which may contribute to disease susceptibility. Identifying genetic polymorphisms is essential for better understanding of pathophysiology and treatment strategies for a particular disease. The objective of our study was to evaluate the association of vitamin D receptor (VDR) fok I polymorphism with CAD.
Place and Duration of the Study: The study samples were collected at Narayana Medical College Hospital, Nellore and genetic analysis done at Sri Ramachandra University, Chennai, India, from Nov 2013 to June 2014.
Materials and Methodology: The study included 40 angiographically proven CAD subjects as cases and 40 normal healthy controls .VDR fok I polymorphism was analysed by PCR-RFLP method. Chi Square and odds ratio was used to find the association.
Results: F allele frequency is 66.25% in CAD vs 52.5% in controls. There is no significant association of FF (p= 0.099), Ff (p= 0.851), ff (p= 0.138) with CAD.
Conclusion: There is no significant association of VDR fok I polymorphism with CAD in south Indian population. According to our study F allele frequency is more in CAD than in controls.

Open Access Original Research Article

Local Corticosteroid and Anesthetic Injection in Trigger Finger Deformity

Volkan Kilincoglu, Afsar T. Ozkut, Erkan Servet, Bulent Guneri

Journal of Advances in Medicine and Medical Research, Page 618-622
DOI: 10.9734/BJMMR/2015/17666

Objective: Efficacy of local corticosteroid and anesthetic injection was investigated in adult trigger finger deformity.
Materials and Methods: Sixty four fingers of 56 patients (40 females mean age: 44(33-58), 16 males mean age: 45(37-62) who did not benefit from 4 weeks of NSAID treatment and rest were referred to orthopaedics or physical therapy departments of our hospital for trigger finger deformity. One cc. depomedrol (methylprednisolone acetate) and 2 cc. citanest (prilocain hydrochloride) mixture was injected at the level of A1 pulley. The follow up period was 3 months.
Results: In forty of 56 patients (32 female, 8 male) triggering and pain completely disappeared. Triggering disappeared but pain was persistant in 8 patients and both triggering and pain were persistant in 8 patients.
Conclusion: Injection of local corticosteroid and anesthetic drug mixture in treatment of trigger finger deformity is an easy, cheap and effective method. We conclude that it is useful to apply this treatment for once before decision to surgery.

Open Access Original Research Article

Comparison of the Partec CyScope® Rapid Diagnostic Test with Light Microscopy for Malaria Diagnosis in Rural Tole, Southwest Cameroon

Judith Lum Ndamukong-Nyanga, Helen Kuokuo Kimbi, Irene Ule Ngole Sumbele, Sunjo Cyrilla Bertek, Kangam Lafortune, Kouodjip Nono Larissa, Mbiakop Kemajou Gaelle, Ngapmen Yamadji Arlette Linda, Nyabeyeu Nyabeyeu Hervé, Assomo Ndemba Peguy Brice, Mbang Sophie Marlyse, Calvin Tonga, Kenneth J. N. Ndamukong, Leopold Gustave Lehman

Journal of Advances in Medicine and Medical Research, Page 623-633
DOI: 10.9734/BJMMR/2015/17927

Introduction/Aim: Malaria is a major public health problem and can lead to fatal consequences within few days if not diagnosed and promptly treated. The aim of this study was to determine the malaria parasite prevalence and assess the performance characteristics of the Partec CyScope® rapid diagnostic test (RDT) in Tole.
Experimental Design, Place and Duration of Study: The study was a cross-sectional survey, carried out in Tole, Southwest Cameroon in July 2014.
Methodology: A total of 231 children were studied. Information on demographic data, temperature and malaria risk factors was recorded. Capillary blood was collected by finger pricking. Thick and thin blood films were prepared for malaria parasite detection and speciation. Ten µL of blood was added unto the DAPI coated slides and read under the Partec CyScope®. Haemoglobin values were determined.
Results and Conclusion: The overall prevalences of malaria parasites, fever and anaemia were 66.2%, 35.9% and 86.6% respectively. Although not statistically significant, malaria parasite prevalence was highest in children aged 1 – 5 years, higher in females, those that had stagnant water and bushes around their homes as well as those who did not use insecticide-treated bed nets and insecticide residual spraying when compared with their respective counterparts. Overall geometric mean parasite density (GMPD) was 3691 (range = 100 - 48000) parasites/µL of blood). GMPD was significantly higher (P = 0.03) in febrile than afebrile children. Prevalence of anaemia was significantly higher (P = 0.01) in malaria positive (68.5%) than negative (45.2%) children. More cases of infections were detected by light microscopy than by Partec CyScope®. The sensitivities and specificities of Partec CyScope® were 87.6% (CI = 81.4-91.1%) and 94.9% (CI = 87.5-98.0%) respectively while the positive and negative predictive values were 97.1% and 79.6% respectively. Partec CyScope® can therefore be used for mass malaria surveillance.