Open Access Case Study

Periodic Catatonia after Thyroid Cancer

Darinka Aragon, Paris Humphries, Michelle Heare, Robert G. Bota

Journal of Advances in Medicine and Medical Research, Page 1-4
DOI: 10.9734/BJMMR/2016/24784

We are presenting the case of a 52 year old female with three distinct episodes of clinical deterioration over a 20 year period after thyroid cancer treatment. The first decrease in functioning happened after the diagnosis of thyroid cancer, resulting in the patient not achieving her PhD thesis. The second deterioration happened ten years later when she presented with psychotic symptoms and the symptoms of anorexia. The last period of deterioration occurred one year before this hospitalization. During that time the patient worsened to the point where she became bedbound and dependent on a PEG tube for feeding. Once hospitalized, the patient had partial response to lorazepam (27 mg a day) and so dextroamphetamine was added with positive response. The addition of memantine helped with the residual symptoms. The PEG tube was finally able to be removed and the patient was discharged home in stable condition.

Open Access Case Study

Squamous Cell CarcInoma of Gallbladder: A Case Report

Hüseyin Pülat, Huseyin Eken, Oktay Karaköse, İsmail Zihni, Kazım Çağlar Özçelik, Metin Çiriş, Hasan Erol Eroğlu

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/BJMMR/2016/23849

Although gallbladder cancers are rarely seen, the mortality rates are high. Pure squamous cell cancer, which is one of the most rarely seen cancer types in the gallbladder, originates from the squamous metaplasia which forms following chronic irritation in the mucosa. The majority of cases are generally at the inoperable stage when diagnosed as they have been followed up for long-term cholelithiasis.

The case is here presented of a 59-year old female who underwent surgical and medical treatment for a bladder tumour 10 years previously and although gallbladder stones were determined at that time, as she was asymptomatic, surgery was not recommended, then with the progression of time, gallbladder squamous cell carcinoma developed.

Open Access Minireview Article

Psychosomatic Disorders Affecting the Mouth: A Critical Review

Ankit Dhimole, Neha Bhasin, Divya Pandya, Neha Dwivedi, Anil Kumar Nagarajappa

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/24743

Modern medicine has come to the realization that the human body cannot be treated in terms of a mere sum of its different parts, but must rather be dealt with in terms of the psychophysiological aspects of the organisms as a whole. The mouth is a window to body’s health and oral health state can offer lot of clues about the overall health and sometimes the first sign of a disease shows up in mouth. So there is need to learn more about the intimate connection between oral and overall health. A psychosomatic disorder involves both body and mind and these diseases have physical symptoms originating from mental or emotional causes like stress, anxiety and depression. There is a rapid upsurge in prevalence rates of psychosomatic disorders in past few decades globally as a consequence of rapidly changing modern life style of people as well as long standing emotion, social and professional stress. It cannot be argued that there are a significant number of patients reporting to the dental office with complaints primarily of psychological origin that affects oral and paraoral structures having definite psychosomatic cause but unfortunately remained unrecognized because of limited nature of their presenting features. Such patients consistently complain of a symptom that he or she interprets as abnormal but dentist can find no convincing physical explanation for the same. This has emerged as one of the most difficult problems faced in clinical practice these days for the dental professionals. Thus this review highlights the significance of increasing psychological factors in society resulting in altered physiological responses causing orofacial region pathologies, struggles in handling such patients and challenging treatment plans with highly important role played by recognition of such patients with role of counseling and early referral in patients to psychiatrist.

Open Access Original Research Article

Heparin Inhibits Proliferation and Migration of Patient-Derived Vascular Cells Only at Non-physiological Concentrations Due to Antagonistic Pathways

Vegard Skalstad Ellensen, Iren Abrahamsen, James Lorens, Torbjörn Jonung

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/BJMMR/2016/24646

Aims: Experimental animal models have demonstrated inhibition of intimal hyperplasia processes by heparin. These effects have not been observed in clinical trials. Diverging experimental conditions are the most conspicuous reasons. This study was designed to test if heparin inhibits intimal hyperplasia processes on patient-derived vascular cells at clinically relevant concentrations.

Study Design: Comparison of heparin effects on patient-derived vascular cells in culture.

Place and Duration of Study: Department of Biomedicine, University of Bergen, Norway between 2012 and 2014.

Methodology: Vascular cells isolated from patient biopsies were treated with heparin and evaluated for effects on proliferation, migration and cell signaling using image based cell enumeration, real time migration monitoring and flow cytometry.

Results: Reduced proliferation and migration in vascular cell cultures could only be detected after addition of high non-physiological heparin concentrations. In cultures stimulated by human fibroblast growth factor (hFGF), mitogen-activated protein kinase extracellular signal-regulated kinase (MAPK-ERK) phosphorylation was increased at lower heparin concentrations, while it was reduced dose-dependently by heparin in unstimulated cultures.

Conclusion: Heparin inhibits intimal hyperplasia processes in patient-derived VSMC cultures, but only at concentrations exceeding clinical doses. This is due to an increased MAPK-ERK phosphorylation at lower heparin concentrations in the presence of hFGF. MAPK-ERK phosphorylation was influenced by heparin through both inhibitory and stimulatory pathways. These findings can explain the divergence of results between previous in vitro and clinical studies and provide a basis for new therapeutic strategies.

Open Access Original Research Article

Correlation of Serum and Pericardial Fluid Amino Terminal Pro-B-type Natriuretic Peptide

Sofia Amjad, H. R. Ahmad, Shahid Sami

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/BJMMR/2016/24325

Objective: To investigate the correlation of pericardial fluid and serum NT-proBNP levels in patients during coronary artery bypass grafting (CABG).

Study Design: Crossectional study.

Place and Duration of the Study: This study was conducted over a period of one year from March 2010 to March 2011 in Physiology Department Ziauddin University, Clifton Karachi.

Methodology: A crossectional study was done on 50 patients, undergoing CABG. Both the samples of serum and pericardial fluid were collected during CABG and NT-proBNP levels were assessed by an electrochemiluminescence immunoassay. The log transformation of NT-proBNP concentrations was done. We investigated the correlation of the pericardial fluid and serum levels of log NT-proBNP.

Results: Pericardial fluid log NT-proBNP was estimated to be 2.7±0.54 pg/ml in contrast to a serum level of 2.2±0.6 pg/ml in 50 CABG patients. It was found that pericardial fluid NT-proBNP levels were significantly correlated with its serum levels with an r value of 0.85 and a p-value of < 0.0001. The pericardial fluid- serum ratio has been estimated to be 1.25.

Conclusion: Serum NT-proBNP levels have significant correlation with its pericardial fluid levels. It can be used alone in the clinical practice provided kidneys function normally.

Open Access Original Research Article

The Prevalence of JAK2-V617F Mutation in Sudanese Patients with Chronic Myeloproliferative Neoplasms

Hashim M. Abkar, Babiker A. Mohamed, Fathelrahman M. Hassan

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/24741

Myeloproliferative neoplasms (MPNs) are clonal malignant diseases that represent a group of conditions including polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF). The JAK2-V617F mutation has been described as a frequent genetic event in majority of patients with MPNs. The aim of this study was to determine the frequency of JAK2-V617Fmutation in Sudanese patients with myeloproliferative disorders referred to Isotope Center, and to investigate the differences of laboratory parameters between patients with JAK2-V617F positive myeloproliferative neoplasms (MPNs) and JAK2 wild type MPNs. A total of 259 patients with MPNs; 159 with polycythemia vera (PV), 55 with essential thrombocytosis (ET) and 45 with primary myelofibrosis (PMF), and11 healthy adult individuals were enrolled in this study from March 2013 to November 2015. DNA was isolated from peripheral blood leukocytes by innuPREP kit, and JAK2-V617F mutation gene detected by allele specific PCR. The JAK2-V617F mutation was detected in 71% (184/259) patients with MPNs. The prevalence of the mutation was 81.7% in PV, 56.4% inET, and 51.1% in PMF. Mutation was not detected in 11 healthy adult people. The presence of JAK2-V617F was not associated with Hb level, Hct, or the platelet count for PV and ET, whoever the mutation positively correlated with high Hb (P=.039), Hct (P=.04) in PMF patients, and with high erythrocytes count in PV. The JAK2-V617F mutation can be frequently detected in the Sudanese patients with MPNs.

Open Access Original Research Article

Prostate Cancer Incidence in Calabar - Nigeria

G. A. Ebughe, I. A. Ekanem, O. E. Omoronyia, M. A. Nnoli, E. E. Ikpi, T. I. Ugbem

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/23503

Aim: The aim of this study is to determine the incidence of prostate cancer in men living in Calabar- Nigeria, which has not been determined up till now.

Study Design: A trend analysis of prostate cancer cases in Calabar between 1st January 2004 to 31st December 2013.

Place and Duration of Study: Calabar cancer registry, May to June 2015.

Methodology: Record of prostate cancer cases in the Calabar cancer registry between 1st January  2004 and 31st December 2013,was accessed. The patients age, sex, place domiciled in the last one year; whether rural or urban as well as prostate cancer topography and morphology were obtained and analyzed. The population of males domiciled in Calabar was determined using the 2006 national population census data and 3.0% population growth as specified by the national population commission. Excluded are all male genital tract cancers outside prostate cancer .The data was subjected to statistical analysis using SPSS version 21.

Results: Two hundred and seventy nine (279) prostate cancer cases were seen, with mean (SD) age of subjects being 64.2 (9.5) years, with a range 40 to 95 years. About 249 cases (89.3%) occurred in those who are 55 years or older at time of diagnosis, with the commonest age group being 60-64 years. The age specific incidence of prostate cancer is 89 per 100,000, both crude and adjusted incidence rates were highest in 2012 (69.4 and 97.4 per 100,000, respectively). There was significant decrease in incidence rates in the initial five years (2004-2008), and increase in rates in the following five years of study (2009-2013). Within the 5-year period from 2004 to 2008, there was an average annual decrease in incidence rate of 9.63% (95% CI: 6.1%-12.8%). However, within the 5-year period from 2009 to 2013, there was an average annual increase in incidence rate of 11.95% (95%CI: 8.72% to 13.04%).

Conclusion: This epidemiologic study demonstrate the incidence of prostate cancer in Calabar, Nigeria, with a predominance of patients in the 60- 64 years age group. West African states have to scale up population screening and study of this neoplasm.

Open Access Original Research Article

Comparison of Cardiac Function Evaluation by 128-Slice Single Source Retrospectively Gated Cardiac CT and 2D/M- mode Echocardiography

Pankaj Goyal, Mansi Jain, Rohit Khisti, Kapisoor Singh

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/24227

Aims: To study the correlation of Cardiac function/ejection fraction derived from 128 slice MDCT (multi detector computed tomography) results with those of functional data from 2D/M-mode echocardiography.

Study Design: Retrospective, comparative study with empirical data.

Place and Duration of Study: Department of Radiology at K. Govindaswamy Naidu Medical Trust hospital, Coimbatore, between May 2013 and October 2013.

Methodology: For this study, 44 patients (M: F = 35: 9; mean age = 49 years) were randomly chosen who had come between May 2013 and October 2013. All the patients were referred to our department from cardiology as well as non-cardiology OPD’s for coronary CT angiography. Ejection fraction data was obtained using two methods; M-mode echocardiography and 128-slice MDCT using retrospective ECG gated coronary angiographic study.

Results: The mean of LVEF (left ventricle ejection fraction) by echo is 64.73 with standard deviation of +/- 5.48 and the mean of LVEF by cardiac CT is 65.18 with standard deviation of +/- 8.70 with P- value of 0.770 (P value ranges from 0-1) which shows good correlation. The evaluation of LVEF by linear regression analysis show good correlation between LVEF by echo and MDCT. (r= 0.486). [r value ranges between -1 and +1].

Conclusion: This study shows the cardiac function evaluation using 128 slice MDCT is as good as the 2D- echocardiography thus the results are interchangeable between the modalities.

Open Access Original Research Article

Changes in Serum Electrolyte Levels in Typhoid Fever Patients Attending Minna General Hospital, Nigeria

A. Y. Kabiru, I. Tahir, M. H. Garba, F. A. Kuta, A. Jibril, M. A. Shuaib

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/23335

Objective: This study was designed to evaluate the effect of Typhoid fever on the serum levels of electrolytes in patients attending Minna General Hospital, Nigeria.

Materials and Methods: Blood samples were obtained from sixty patients with established typhoid fever attending General Hospital Minna, Nigeria. Serum sodium, potassium, chloride, and bicarbonate levels were determined in the samples using Spectrophotometric method. The case studies included 15 adult males and 15 adult females; 15 male and 15 female children of junior secondary school age (9 – 14 years). Widal test was carried out to ascertain the presence of Salmonella enterica serotype Typhi.

Results: The mean ± standard deviations of serum Na+, K+, Cl-, and HCO3- in the sixty patients were 116.11±20.65 mmol/L; 3.40±0.90 mmol/L; 87.13±16.34 mmol/L; and 24.10±5.54 mmol/L respectively. When compared with the controls and the laboratory reported normal values, 50% of the patients were found to be hyponatraemic, 51% were hypochloraemic, 36% were hypokalaemic, while 11% had metabolic acidosis. Results based on sex showed insignificant differences between males and females for all electrolytes determined (p< 0.05). Insignificant differences were also observed between children and adult patients for all parameters determined (p< 0.05). In addition, weak positive correlations were observed between cations and anions determined in this study.

Conclusion: The results obtained in this study showed that electrolytes’ abnormalities exist in patients with established typhoid fever attending General Hospital Minna, Niger state, Nigeria.

Open Access Review Article

Profound Study for Functions of Antimicrobial Peptides in Prevention of Oral Disease

Mohamad Sadek Alalwani, Mohamed Yasser Kharma, Ghassan Aws

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/24528

Antimicrobial peptides (AMPs) have a widespread distribution in human body and have antimicrobial activity against microorganisms with wide-range class of host-defense molecules.  These are small cationic peptides that play an important role in the development of innate immunity with activity against gram-positive and negative bacteria, parasites, fungi and some viruses.

In the oral cavity, the AMPs are produced by the salivary glands and the oral epithelium and serve as defensive purposes. At least forty-five identifiable antimicrobial gene products found in saliva are secreted from oral epithelial cells, salivary glands and neutrophils. AMPs also serve as effective biological molecules in immune response activation, inflammation and wound healing

The aim of this review was to discuss the types and functions of oral AMPs and their role in combating microorganisms and infections in the oral cavity.

AMPs have a promising potential to be used against oral microbes in order to control their growth and biofilm formation. There are many challenges that need to be overcome in order to design and synthesize AMPs that have the ability to with stand the unique and harsh oral environment. AMPs are expected in the future to be used as models for developing effective oral microbial antibiotics.