Open Access Original Research Article

Digoxin Inhibits Retinoblastoma through Suppressing a Non-canonical TGFβ Signaling Pathway

Maryam Sheikhzade, Abolfazl Akbari, Reza Karkhaneh, Fariba Ghassemi, Abdolrahim Sadeghi, Mahshid Shahrzad Kavakani, Gholam Reza Mobini, Masoumeh Mohebbi, Mansour Heidari

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/25709

Aims: Retinoblastoma is a childhood ocular tumor rapidly developing from the immature cells of the retina due to loss of functional retinoblastoma protein. Digoxin, a cardiac glycoside, has been reported to be effective in inducing apoptosis, cell cycle arrest, and cytotoxic effects on human cancers. In this regard, the present study aims to investigate whether digoxin could suppress retinoblastoma cancer through the regulation of transforming growth factor-β (TGF-β) signaling pathway.

Methodology: The effects of digoxin on Y-79 cells, retinoblastoma cancer cell line, were investigated using MTT (3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazoli-umbromide) and BrdU (bromodeoxyuridine) assays to measure cellular cytotoxicity effects and cell apoptosis, respectively. Also, a qPCR assay was employed to analyze the mRNA expression levels of TGFβ signaling pathway including C-MYC, P21, P15, TGFβRI, TGFβRII, and SMAD2, 3, and 4 genes.

Results: The results of the cell function assays revealed that digoxin inhibited the cell viability and proliferation of Y-79 cells. In addition, it was found that digoxin significantly suppressed C-MYC expression and enhanced the expression of P21, P15, SMAD2 and SMAD4 genes in a dose-and time-dependent manner. However, the obtained results could not detect any significant effect of digoxin on TGFβRI, TGFβRII and SMAD3 genes.

Conclusion: Taken together, the findings of the present study suggest that digoxin could be a potential therapeutic agent in the treatment of retinoblastoma by regulating the cell cycle genes via a non-canonical TGF-β signaling pathway.

Open Access Original Research Article

Birth Preparedness and Complication Readiness: Attitude and Level of Preparedness among Pregnant Women in Benin City, Edo State, Nigeria

Obi Andrew Ifeanyichukwu, Okojie Hilda Obehi, Keshi Richard

Journal of Advances in Medicine and Medical Research, Page 1-14
DOI: 10.9734/BJMMR/2016/25127

Lack of advance planning for use of skilled attendants at birth contributes significantly to delays in receiving obstetric care. This study assessed attitude and level of birth preparedness and complication readiness (BPACR) plan among pregnant women in Benin City, with a view to improving utilization of skilled attendants at birth and health facility deliveries.

Materials and Methods: A community based analytical cross sectional study was conducted, involving interviewer administration of pretested structured questionnaires to 252 consenting pregnant women in Benin City, Edo State.

Results: The mean age of pregnant women studied was 28.9±4.9 years. Two hundred and thirty eight (94.4%) respondents had positive attitude towards BPACR. Furthermore, 197 (78.2%) and 218(94.4%) of respondents were well prepared with regard to intended and actual birth plans respectively. Awareness of BPACR (OR=0.337; 95%CI=0.128-0.891; p=0.028) and Antenatal Care (ANC) registration (OR=0.016; 95%CI=0.002-0.127; p˂0.001) were significant predictors identified that influenced BPACR plans.

Conclusion: Majority of pregnant women studied had positive attitude towards BPACR and were well prepared with regards to intended and actual birth plans respectively. There is need to strengthen Antenatal Care (ANC) registration practices to sustain the improved utilization of skilled attendants at birth and health facility deliveries identified among pregnant women in Benin City, Edo State.

Open Access Original Research Article

Web Based Screening for Depression in the Workplace

Hiromi Isoda, Kenichi Asano, Kumiko Muramatsu, Eiji Shimizu

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/25311

Aims: The aim of this study was to examine an effective screening method of depressive disorders in the workplace.

Methodology: Employees with a managerial career track of a large size company completed a web-based psychological assessment using the Patient Health Questionnaire depression scale (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7) at the first screening. After three months, employees who had a PHQ-9 score of 10 or greater were further re-assessed using the PHQ-9 and GAD-7 at the second screening. They were then interviewed using the Mini International Neuropsychiatric Interview (MINI) to determine a clinical diagnosis of depressive disorders. Moreover, analysis of the validity of the PHQ-9 categorical algorithm and the cut-off score of PHQ-9 ≥ 10 were conducted.

Results: Of the 402 participants, 350 employees completed the depression and anxiety scales. Though 20 subjects had a score of10 points or more on the PHQ-9 score at the first screening, and nine of them maintained a score of 10 points or more at the second screening. While nine subjects were diagnosed with a major depressive syndrome by the PHQ-9 categorical algorithm at the first screening, only three of them remained with a major depressive syndrome at the second screening.

Conclusion: Considering the spontaneous remission rate of depression, it seems reasonable to conduct double web-based screening for major depressive disorders in the workplace.

Open Access Original Research Article

Effect of Lateral Osteotomy in Subperiostal Plan in Reducing Severity of Periorbital Edema and Ecchymosis after Rhinoplasty

Atighechi Saeid, Meybodian Mojtaba, Vaziribozorg Sedighe, Behniafard Nasim, Mandegari Mohammad

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/BJMMR/2016/24530

Introduction: Osteotomy is the main reason of periorbital edema and ecchymosis after rhinoplasty due to damage of angular vessels and fracture of the nasal bones and frontal process of maxilla. Several methods are suggested for reducing periorbital edema and ecchymosis.  The main purpose of this study was to determine the effect of internal lateral osteotomy in subperiosteal plan in reducing periorbital edema and ecchymosis after rhinoplasty.

Methods: This double-blinded clinical trial was conducted on 30 patients. Internal lateral osteotomy was performed in one side in subperiosteal plan and opposite side used as a control without elevation of periostium from the bone. The degree of edema/ecchymosis on both sides was compared on the 1st and 7th day postoperatively.

Results: The severity of periorbital edema was more significant in one side with periosteal elevation 24 hours after operation (P. value=0.006). However, no significant difference was found in periorbital edema between both sides 7 days after the surgery (P. value=0.098). The severity of periorbital ecchymosis was also more significant in the side with periosteal elevation 24 hours (P. value= 0.023) and seven days after operation (P. value=0.004).

Conclusion: Since lateral osteotomy in subperiosteal plan increased periorbital edema and ecchymosis after rhinoplasty, performing lateral osteotomies without subperiosteal tunneling during rhinoplasty operation is suggested.

Open Access Original Research Article

Corneal Endothelial Cell Density and Morphology in Nigerians

Efeoghene U. Ani, Sebastain N. N. Nwosu, Chinyere N. Pedro-Egbe, Sotonibi A. H. Cookey, Elizabeth A. Awoyesuku

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/25239

AIM: To determine the mean density and describe the morphology of corneal endothelial cells in adult Nigerians in Port Harcourt.

Study Design: A population-based cross-sectional study.

Place and Duration: A study conducted among adult Nigerians aged ≥ 18 years in Port Harcourt city Local Government Area, Rivers State, Nigeria between January and April 2014.

Methodology: Participants were selected using multi-stage cluster random sampling technique. An interviewer-based semi-structured questionnaire was administered to obtain demographic data. All participants had ocular examinations done including visual acuity measurement, anterior segment examination, fundoscopy, and non-contact specular microscopy.

Results: Four hundred and eighty (n=480) subjects were studied. There were 212 males (44.2%) and 268 females (55.8%) with a mean age of 43.0±14.2 years and range 18-91 years. The mean Endothelial Cell Density (ECD) was 2791±221 cells/mm2. Males had a tendency to have a higher ECD (2882±220 cells/mm2) than females (2784±215 cells/mm2, p=0.490) in ages less than 40 years.

Conclusions: The mean ECD obtained in adult Nigerians was 2791±221 cells/mm2. No statistically significant difference was found in ECD between males and females. The degree of polymegathism of corneal endothelial cells increased with age in the study population but this was also not statistically significant (p=0.141).

Open Access Original Research Article

Simulation Analysis for Non-invasive Measurement for Hemodynamics in Cerebral Arteriovenous Malformation Types

Y. Kiran Kumar, Shashi Bhushan Mehta, Manjunath Ramachandra

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/25436

The Cerebral Arteriovenous Malformation (CAVM) is a complex neurovascular malformation. It contains different types of complex nidus structures combinations. Each CAVM classification is of different clinical procedure and management of disease. The clinical procedure to measure hemodynamics for each CAVM classification is risky, due to complex vessel geometry may get ruptured. In this paper, we address this problem for different AVM classification and nidus complex structures combinations, by measuring hemodynamics non-invasively. The simulation of model is extended for organs other than Cerebral AVM, such as spine and lungs. The modeling results are validated with mechanical measurements. 15 CAVM patients and 20 simulated scenarios of different AVM types are studied to measure hemodynamic indices non-invasively.

Open Access Original Research Article

Impact of Gas Flaring on Cardiopulmonary Parameters of Residents in Gas Flaring Communities in Niger Delta Nigeria

Ovuakporaye Simon Irikefe, Igweh C. John, Aloamaka Chukwma Peter

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/BJMMR/2016/25326

The purpose of this study was to evaluate the impact of gas flare on cardiopulmonary parameters in some states of the Niger Delta. The study aimed to determine the impact of gas flare on blood pressure, pulse rate, respiratory rate, peak expiratory flow rate and associated changes of these parameters with duration of exposure to gas flare. Two communities (a test and a control) were studied in five states in the Niger Delta - Edo, Rivers, Akwa Ibom, Bayelsa, and Delta. The study adopted the direct administration of questionnaire, observation, recording and free medical checkup methods. The stratified random sampling method was used. The sample size was 1008 participants (504 in gas flaring communities and 504 in non-gas flaring communities). The electronic blood pressure kit was used to measure blood pressure and pulse rate of participants. Respiratory rate of participants was manually recorded while the peak flow meter was used to measure the peak expiratory flow rate of participants. The questionnaire was directly administered to obtain vital information from participants. Data generated were expressed as mean ± SD. A significant difference between the means was determined by student t-test and one-way analysis of variance (ANOVA). A level of p≤0.05 was accepted as significant. Findings showed that gas flare increases mean blood pressure (GFC-184.96±24.07, NGFC- 123.00±2.96), pulse rate (GFC-100.37±3.79, NGFC-78.09±4.68) and respiratory rate (GFC-33.63±0.80, NGFC-23.83±0.82) of residents in gas flaring communities. There was a decrease in mean peak expiratory flow rate (GFC-272.78±16.79, NGFC-460.83±6.53) of residents in gas flaring communities. Findings also showed that these cardiopulmonary parameters increases with longer duration of exposure (blood pressure >10 years -125.10±7.47, 1-5 years -117.25±3.81, pulse rate >10years-91.84±1.77, 1-5 years- 85.16±5.14 and respiratory rate-26.64±2.08, 1-5 years 24.00±1.51), except peak expiratory flow rate that decreases with duration of exposure (>10 years 301±88, 1-5 years 313.87±35.64).

Open Access Original Research Article

Radiographic Prevalence and Clinical Significance/ Etiology of Elongated Styloid Process in Females

Raood T. Al-Kaki, Sara M. El-Khateeb, Eman A. Arnout

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/26152

Aims: The aim of the present study was to investigate the radiographic prevalence of elongation and calcification in styloid complex and its clinical significance and etiology in female patients attending Taibah University Dental Clinics (TUDC) in Al-Madinah, KSA.

Study Design:  Retrospective observational study.

Place and Duration of Study: Oral Radiology Unit, Taibah University Dental clinics, Faculty of Dentistry, Al Madinah Al Monwarah, Saudi Arabia, between February 2015 and February 2016.

Methodology: A total of 2114 archived digital panoramic radiographs of female patients attending TUDC with a mean age of 33.3 that ranges from (18-80 years) were examined for the presence of elongated styloid process or calcification of stylohyoid ligament. We excluded cropped or blurred panoramic radiograph.

Results: The most frequent age for elongation was between 20-40 years.  An overall prevalence of calcification and elongation in the styloid complex was 189 patients (11%) out of 1714. About 176 (10.3%) of them had elongated styloid process with complete calcification while 13 (0.7%) had fragmented calcification. Head or neck injury was the prevalent suspecting etiology in 31.3%, and pain with swallow was a clinical finding of participated patients in the questionnaire.

Conclusion: It is critical that the dentist should be attentive to normal variation in the styloid complex to be able to detect any elongation or calcification which could be discovered incidentally in radiographic examination particularly panoramic radiograph. Panorama is an economical, easily accessible and useful diagnostic screening tool for an early detection of elongated styloid process with or without symptoms.

Open Access Review Article

Adult Intussusception: A Disease Often Uncovered in the Operating Room

Vasa Jevremovic, Martin Benjamin

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/26246

Intussusception is the prolapsing of one bowel segment into another. It is a common entity in the pediatric population, but is rare in adults representing only 5% of cases. A variety of causes are attributable to this disease process, with benign lesions predominating in small bowel cases and malignancy being largely responsible for intussusception of the colon in adults. It is often difficult to diagnose due to the variable onset, presentation of symptoms and possibly intermittent nature, and thus is often revealed at emergency laparotomy. Most surgeons agree that the optimal approach to management is surgical resection with oncological principles due to the high incidence of malignancy-associated intussusception in adults.

Open Access Review Article

Role of Hypoxia Inducible Factors in Obesity Pathogenesis

Hande O. Altunkaynak, Nuray Yazihan

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/25427

The prevalence of obesity, metabolic syndrome and diabetes has been increasing rapidly worldwide. These are a group of metabolic disorders characterized by a chronic hyperglycaemic condition resulting from defects in insulin secretion, insulin action or both. The control of body weight and blood glucose concentrations depends on the exquisite coordination of the function of several cells, organs and tissues. Underlying mechanisms of obesity and insulin resistance remain uncertain. Adipose tissue is composed of heterogeneous cell types. Immune cells within adipose tissue also likely contribute to systemic metabolic processes. Increased production of local and systemic adipokines and cytokines, polarization of macrophages, T helper subtype changes could contribute to pathologies linking obesity to diabetes, both by decreasing insulin sensitivity, by compromising β-cell function and disturbing adipose tissue metabolism and distribution. Tissue oxygen (O2) levels, hypoxia inducible factor (s) (HIFs) secretion differences regulate the plasticity of macrophages and the polarization of macrophages controls functionally divergent processes in cells. A hypoxic and inflammatory phenotype has been reported in adipose tissue during obesity. Therefore, the present review focuses HIFs-mediated effects of hypoxia in adipocyte inflammation and macrophage polarization associated with obesity pathogenesis.