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Advances In Food Technology and Nutritional Sciences – Open Journal (AFTNSOJ)
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Food Security
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Article in press

  • 2015, March

    research

    Microbial Safety of Foods in the SupplyOpen Access

    Mohamed T. Elkhishin, Ravi Gooneratne and Malik A. Hussain
    DOI: http://dx.doi.org/10.17140/AFTNSOJ-3-141
    Provisional PDF980.81 KB 980.81 KB
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  • 2015, December

    case report

    Squamous Metaplasia in Colorectal PolypsOpen Access

    Naziheh Assarzadegan* and Felipe J. Solano
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-101
    Provisional PDF479.00 KB 479.00 KB
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  • 2016, January

    editorial

    Some Problems of Vaccination Campaigns in Developing CountriesOpen Access

    Chengjun Sun*
    DOI: http://dx.doi.org/10.17140/VROJ-1-e001
    Provisional PDF272.33 KB 272.33 KB
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  • 2016, February

    opinion

    Liquid Biopsies: Handle With CareOpen Access

    Deyali Chatterjee*
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-102
    Provisional PDF312.45 KB 312.45 KB
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  • 2016, February

    mini review

    Leading Ebola Vaccine CandidatesOpen Access

    Vincent Pavot*
    DOI: http://dx.doi.org/10.17140/VROJ-1-101
    Provisional PDF364.53 KB 364.53 KB
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  • 2016, February

    mini review

    Mast Cells: The Key Players in Cardiac RemodellingOpen Access

    Amrit Pal Singh*, Harpal S. Buttar
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-103
    Provisional PDF539.78 KB 539.78 KB
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  • 2016, February

    review

    Quality Improvement in Clinical Laboratories: A Six Sigma ConceptOpen Access

    Jawahar (Jay) Kalra* and Ashish Kopargaonkar
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-104
    Provisional PDF496.92 KB 496.92 KB
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  • 2016, March

    editorial

    Cosmetology: Past, Presence and FutureOpen Access

    Varvaresou Athanasia*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-e001
    Provisional PDF256.50 KB 256.50 KB
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  • 2016, March

    systematic review

    Is There Scientific Evidence that Panax Promotes Hair GrowthOpen Access

    Frederico EHFF*, Sá-Caputo DC, Dionello CF, Cardoso ALB, Morel DS, Maiworm A, Guimarães CAS, Santos R, Guedes-de-Aguiar EO, Gonçalves CR, Carvalho-Lima RP, Kutter CR, Machado-Rocha L, Pereira FG, Brandão-Sobrinho-Neto S, Jaña- Rosa A, Neves RF, Moreira-Marconi E, Paineiras-Domingos LL, Costa-Cavalcanti RG, Almeida-Farias C, Souza PL, Paoli S, Presta GA and Bernardo-Filho M
    DOI: http://dx.doi.org/10.17140/TCOJ-1-101
    Provisional PDF651.99 KB 651.99 KB
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  • 2016, March

    editorial

    A Novel Application for a Rheumatologic MedicationOpen Access

    Charles F. Haller, Matthew B. Carroll*, Christopher Smith, Yolanda Moulds-Love, William Pomeroy and Bryan C. Ramsey
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-e001
    Provisional PDF282.11 KB 282.11 KB
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  • 2016, April

    perspective article

    Perspective: Ultrastructural Origins of Bone FragilityOpen Access

    Jitin Samuel, Rohit Khanna and Xiaodu Wang*
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-101
    Provisional PDF642.68 KB 642.68 KB
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  • 2016, April

    short communication

    The Use of Botulinum Toxin-A for Neck PainOpen Access

    Abdulrazzaq Alobaid*
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-102
    Provisional PDF303.82 KB 303.82 KB
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  • 2016, April

    commentary

    C-C Chemokine Receptor Seven (CCR7): Coming of Age In VaccinesOpen Access

    Colin A. Bill, Olga B. Soto and Charlotte M. Vines*
    DOI: http://dx.doi.org/10.17140/VROJ-1-102
    Provisional PDF338.02 KB 338.02 KB
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  • 2016, April

    case report

    Bier Spots on the Face: The First Case ReportOpen Access

    Hamza Yildiz* and Huseyin Saman
    DOI: http://dx.doi.org/10.17140/TCOJ-1-102
    Provisional PDF950.96 KB 950.96 KB
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  • 2016, April

    original research

    Herd Immunity Conferred By Hepatitis B Vaccination Increases the Protection Efficacy against Hepatitis B Virus InfectionOpen Access

    Yuting Wang, Ling-Ling Lu, Dongmei Wang and Chunfeng Qu*
    DOI: http://dx.doi.org/10.17140/VROJ-1-103
    Provisional PDF375.02 KB 375.02 KB
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  • 2016, April

    mini review

    Is Normal Knee Biomechanics Reproduced by Modern Total Knee Arthroplasty Designs? The Role of FluoroscopyOpen Access

    Pier Francesco Indelli*
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-103
    Provisional PDF530.35 KB 530.35 KB
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  • 2016, May

    original research

    Galdieria sulphuraria Relieves Oily and Seborrheic Skin By Inhibiting the 5-α Reductase Expression in Skin Cells and Reducing Sebum Production In VivoOpen Access

    M. Bimonte, A. De Lucia, A. Carola, A. Tito, S. Buono, A. L. Langellotti, V. Fogliano, G. Colucci and Fabio Apone*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-103
    Provisional PDF601.97 KB 601.97 KB
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  • 2016, June

    editorial

    Model Based vs. Rule Based Designs in Phase I Dose Finding Clinical TrialsOpen Access

    Yunfei Wang, DrPH; Jichuan Wang, PhD*
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-e001
    Provisional PDF330.16 KB 330.16 KB
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  • 2016, July

    case report

    Gouty Arthritis of the Axial Skeleton: A Case ReportOpen Access

    Yuko Kobashi*, Yohei Munetomo, Akira Baba, Shinji Yamazoe and Takuji Mogami
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-104
    Provisional PDF1.02 MB 1.02 MB
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  • 2016, July

    editorial

    Current Status of Human Immunodeficiency Virus VaccinesOpen Access

    Daniela Sosa, Rahul Dev Jayant*, Ajeet Kaushik and Madhavan Nair*
    DOI: http://dx.doi.org/10.17140/VROJ-1-e002
    Provisional PDF359.54 KB 359.54 KB
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  • 2016, July

    mini review

    Cultural Adaptation for Common Orthopedic Disorders Pathology and Presentations With Focus on Middle Eastern and Asian PatientsOpen Access

    Abdulrazzaq Alobaid*
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-105
    Provisional PDF342.66 KB 342.66 KB
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  • 2016, August

    letter to the editor

    A Simple Method for Breast De-epithelialization: The Monobloc MethodOpen Access

    Musa Kemal KELES, Ugur Horoz* and Hakan Cepni
    DOI: http://dx.doi.org/10.17140/TCOJ-1-104
    Provisional PDF3.82 MB 3.82 MB
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  • 2016, September

    editorial

    Medical Error Disclosure: A Point of ViewOpen Access

    Jawahar (Jay) Kalra*
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-e001
    Provisional PDF347.61 KB 347.61 KB
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  • 2016, September

    hypothesis

    Tumor Necrosis Factor Inhibitors May Improve Glycemic Control in Patients Rheumatoid Arthritis and Concomitant Type 2 Diabetes MellitusOpen Access

    Abhijeet Danve*, Shivtej Sehra, Divya jaykumar and Supriya Kulkarni
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-106
    Provisional PDF319.93 KB 319.93 KB
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  • 2016, September

    case report

    A Rare Cause of Shoulder Pain: Ganglion Cyst of the Acromioclavicular JointOpen Access

    Hakan Sarman*, Metin Celik and Mehmet Murat Bala
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-107
    Provisional PDF1.40 MB 1.40 MB
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  • 2016, September

    review

    Innovations in Microbial Biodiscovery, Targeting Silent Metabolism and New Chemical DiversityOpen Access

    Zeinab G. Khalil* and Robert J. Capon
    DOI: http://dx.doi.org/10.17140/VROJ-1-104
    Provisional PDF1.43 MB 1.43 MB
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  • 2016, September

    original research

    Dendritic Cell Maturation is a Critical Step in Dendritic Cell Vaccine Preparation for Cancer TherapyOpen Access

    Samad Farashi-Bonab and Nemat Khansari*
    DOI: http://dx.doi.org/10.17140/VROJ-1-105
    Provisional PDF961.51 KB 961.51 KB
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  • 2016, November

    original research

    The QuickDASH in the Assessment of Rheumatoid Arthritis Disease ActivityOpen Access

    Matthew B. Carroll*
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-108
    Provisional PDF510.58 KB 510.58 KB
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  • 2016, November

    review

    Overview of Adult Immune ThrombocytopeniaOpen Access

    Leonard I. Boral*, Gregory P. Monohan and Valentina Moirangthem
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-105
    Provisional PDF469.63 KB 469.63 KB
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  • 2016, November

    editorial

    Innovation of Wound and Burn Care Dressings from Traditional to Nonwoven Polymeric ScaffoldsOpen Access

    Sukhwinder K. Bhullar*, Harpal S. Buttar
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-e002
    Provisional PDF510.32 KB 510.32 KB
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  • 2016, December

    case report

    Invasive Moderately-Differentiated Mucinous Adenocarcinoma Incidentally Identified in Perforated Acute Diverticulitis With Abscess FormationOpen Access

    Mahmoud L. Soliman, Sandra R. Cerda and Huihong Xu*
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-106
    Provisional PDF2.31 MB 2.31 MB
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  • 2017, January

    mini review

    Medical Micro-NeedlingOpen Access

    Ebtisam Elghblawi*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-105
    Provisional PDF513.12 KB 513.12 KB
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  • 2017, January

    editorial

    Chemical Peels: A Must Have ArmamentariumOpen Access

    Rahul Pillai*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-e002
    Provisional PDF269.93 KB 269.93 KB
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  • 2017, February

    editorial

    Mesotherapy Cocktails Can be the Secrecy for Youthful KeepingOpen Access

    Ebtisam Elghblawi*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-e003
    Provisional PDF276.52 KB 276.52 KB
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  • 2017, February

    systematic review

    Could Hair Loss be a Relevant Symptom Associated with ChikungunyaOpen Access

    Danúbia Sá-Caputo, Laisa Liane Paineiras Domingos, Eliane O Guedes-Aguiar, Rafaelle P. Carvalho-Lima, Severo de Paoli, Danielle Soares Morel, Igor Bastos, Clailson H. A. Farias, Claudia F. Figueiredo, Glenda Dias, Eric H. F. Frederico and Mario Bernardo-Filho
    DOI: http://dx.doi.org/10.17140/TCOJ-1-106
    Provisional PDF672.49 KB 672.49 KB
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  • 2017, March

    original research

    Distribution and Conduct of Clinical Trials Involving Music Therapy: Registered Clinical Trials in the Lost 15 YearsOpen Access

    Keiko Yukawa, Hitoshi Fuji and Hajime Sato*
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-101
    Provisional PDF491.29 KB 491.29 KB
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    Abstract [+]

    Objective: This study aimed to conduct an evaluation of music therapy clinical trials
    worldwide, to understand what trials have been conducted and to show the chronological
    changes. Additionally, we sought to clarify issues related to providing clinical trial registration
    information.
    Methods: We searched the International Clinical Trials Registry Platform (ICTRP) database for
    “music therapy,” and identified the disease target for each article found.
    Results: A total of 150 clinical trial studies were found in the ICTRP using the term “music
    therapy.” In these trials, music therapy was used for improvement of social functioning in
    schizophrenia and/or serious mental disorders, anxiety and depressive symptoms, and cancer
    symptoms. Twenty-five clinical trials were actively recruiting. Sixteen of the 25 trials were
    registered in the United States at ClinicalTrials.gov, of which 9 trials were conducted in the US.
    Seven trials were conducted in other countries such as Spain, Taiwan, and China.
    Conclusion: A search for music therapy clinical trials retrieved 150 trials from the ICTRP, and
    the number of clinical trial registrations has increased yearly. Music therapy is widely used in
    patients with various diseases, including Alzheimer’s disease, anxiety, and arthritic pain and
    has the potential to improve certain disease outcomes, but there is not enough evidence to
    substantiate its efficacy. It is important to enlighten researchers and pharmaceutical companies
    on the proper management of the quality of such clinical trial information, as this is an important
    issue.


  • 2017, March

    letter to the editor

    Plaque Psoriasis Formation and Body Hair (Re)Growth: A Common Pathway ActivationOpen Access

    Linda Lazzeri, Antonietta D’Errico and Francesca Prignano*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-107
    Provisional PDF734.19 KB 734.19 KB
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  • 2017, May

    editorial

    Cell Derived Virus-Like Particles (VLP) in Future Vaccine DevelopmentOpen Access

    Pramila Walpita*
    DOI: http://dx.doi.org/10.17140/VROJ-1-e003
    Provisional PDF258.24 KB 258.24 KB
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  • 2017, May

    editorial

    Essential Oils and Cosmetic AromatherapyOpen Access

    Saima Siddique*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-e004
    Provisional PDF320.90 KB 320.90 KB
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  • 2017, May

    editorial

    Nanocosmetics: The Good, the Bad and the BeautifulOpen Access

    Rinti Banerjee*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-e005
    Provisional PDF315.91 KB 315.91 KB
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  • 2017, May

    observational study

    Topical Corticosteroid Misuse Among Females Attending at Dermatology Outpatient Department in EthiopiaOpen Access

    Feleke Tilahun Zewdu*, Awel Abdulkerim, Mahelet Dessie Nigatu, Getasew Mulatu Akenaw and Mastewal Misganaw Alemayehu
    DOI: http://dx.doi.org/10.17140/TCOJ-1-108
    Provisional PDF400.65 KB 400.65 KB
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  • 2017, May

    review

    Ebola Virus: Promising Vaccine CandidatesOpen Access

    Reema Sameem and Sajani Dias*
    DOI: http://dx.doi.org/10.17140/VROJ-1-106
    Provisional PDF385.19 KB 385.19 KB
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  • 2017, June

    editorial

    The Swan Song of a Pathologist: “Why Do I Love Thee, Pathology? Let Me Count the Ways….”Open Access

    Bhagirath Majmudar*
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-e003
    Provisional PDF352.68 KB 352.68 KB
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  • 2017, June

    original research

    Fluorinated Lipids Conjugated to Peptide Antigens do not Induce Immune Responses Against Cervical CancerOpen Access

    Waleed M. Hussein, Saori Mukaida, Tzu-Yu Liu, Istvan Toth and Mariusz Skwarczynski*
    DOI: http://dx.doi.org/10.17140/VROJ-1-107
    Provisional PDF521.95 KB 521.95 KB
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  • 2017, June

    original research

    Aesthetic Crowns for Restoring Anterior Primary IncisorsOpen Access

    Baydaa Ali Othman Al-Rawi*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-109
    Provisional PDF823.32 KB 823.32 KB
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  • 2017, August

    editorial

    Recent Advances in Adenovirus-Vectored Vaccines DevelopmentOpen Access

    Alexander N. Zakhartchouk*
    DOI: http://dx.doi.org/10.17140/VROJ-1-e004
    Provisional PDF310.46 KB 310.46 KB
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  • 2017, October

    editorial

    Hair Loss and Chemotherapy: An Overview about What You Need To KnowOpen Access

    Danúbia Sá-Caputo and Mario Bernardo-Filho*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-e006
    Provisional PDF344.62 KB 344.62 KB
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  • 2017, October

    review

    Clinical Investigations on Medical Devices, after the New European Regulation (2017/745)Open Access

    Salvatore Bianco*, Alfredo Nunziata and Giacomo Pozzoli
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-102
    Provisional PDF387.89 KB 387.89 KB
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  • 2017, October

    mini review

    Cluster Randomized Controlled Trials: A Quick Update on Concepts and TypesOpen Access

    Bolaji Emmanuel Egbewale*
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-103
    Provisional PDF348.57 KB 348.57 KB
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  • 2017, November

    review

    Immunobiology of Anticancer Virotherapy With Newcastle Disease Virus in Cancer PatientsOpen Access

    Samad Farashi-Bonab and Nemat Khansari*
    DOI: http://dx.doi.org/10.17140/VROJ-1-108
    Provisional PDF438.63 KB 438.63 KB
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  • 2018, April

    editorial

    Education and Health System Collaboration are Indispensable in Vaccination CoverageOpen Access

    Chengjun Sun*
    DOI: https://dx.doi.org/10.17140/VROJ-1-e005
    Provisional PDF402.68 KB 402.68 KB
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  • 2018, May

    editorial

    The Case for Flu VaccinationOpen Access

    Olukayode A. Akinlaja*
    DOI: https://dx.doi.org/10.17140/VROJ-1-e006
    Provisional PDF270.56 KB 270.56 KB
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  • 2018, August

    review

    The Concept of Developing a Plasmodium vivax Malarial Vaccine with a Focus on its Pre-erythrocytic StageOpen Access

    Tuan Imaad Aarif, Sajani Dias*
    DOI: https://dx.doi.org/10.17140/VROJ-1-109
    Provisional PDF318.29 KB 318.29 KB
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  • 2018, September

    editorial

    Don’t Shun the Shunt: Surgical Portosystemic Shunts in the Era of TIPS and Liver TransplantationOpen Access

    Her-HsinTsai*
    DOI: http://dx.doi.org/10.17140/LROJ-3-e004
    Provisional PDF260.48 KB 260.48 KB
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  • 2018, October

    systematic review

    Hair as a Specimen to Determine the Concentration of Cortisol Levels in Individuals that have Performed Physical ActivityOpen Access

    Alexandre Gonçalves de Meirelles*, Marcia Cristina Moura-Fernandes, Eloá Moreira-Marconi, Tânia Regina Lemos-Santos, Gefferson da Silva-Costa, Sérgio Oliveira De-Carvalho, Ivana de Cássia Araújo Ventura, Ygor Teixeira-Silva, Laisa Liane Paineiras-Domingos, Danúbia da Cunha de Sá-Caputo and Mario Bernardo-Filho
    DOI: http://dx.doi.org/10.17140/TCOJ-1-110
    Provisional PDF412.83 KB 412.83 KB
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  • 2019, January

    review

    Glucocorticoid Induced Hypothalamic-Pituitary Axis Alterations Associated with Hypogonadotropic HypogonadismOpen Access

    Navid Mahabadi, Ashley Doucet, Andrew Lun Wong, and Vahid Mahabadi*
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-109
    Provisional PDF428.78 KB 428.78 KB
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  • 2019, January

    original research

    Fractional CO2 Laser Treatment for Vaginal Rejuvenation in Post-Menopausal Indian WomenOpen Access

    Rahul Pillai* and Safal Rahim
    DOI: http://dx.doi.org/10.17140/TCOJ-1-111
    Provisional PDF403.86 KB 403.86 KB
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  • 2019, February

    case report

    Actinic Lichen Nitidus with Dermoscopic Features, and Response to HydroxychloroquineOpen Access

    Smriti Shrestha* and Aditi Mishra
    DOI: http://dx.doi.org/10.17140/TCOJ-1-112
    Provisional PDF436.98 KB 436.98 KB
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  • 2019, February

    original research

    The Effectiveness of Transcutaneous Electrical Nerve Stimulation Versus Carbamazepine in Trigeminal Neuralgia: A Randomized Controlled TrialOpen Access

    Rebecca Millan-Guerrero*, Rebecca Isais-Millan, Gabriel Castillo-Varela, Gabriel Ceja-Espíritu and Martha Alicia Higareda Almaraz
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-104
    Provisional PDF538.47 KB 538.47 KB
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  • 2019, February

    editorial

    Alternative Effective Management of the Musculoskeletal PainOpen Access

    Olena Plotkina* and Andrei Bourdeinyi
    DOI: https://dx.doi.org/10.17140/ORHOJ-1-e002
    Provisional PDF319.79 KB 319.79 KB
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  • 2019, March

    review

    A Review of Vaccine Efficacy MeasuresOpen Access

    Sayan Dasgupta*
    DOI: https://dx.doi.org/10.17140/VROJ-1-110
    Provisional PDF379.93 KB 379.93 KB
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  • 2019, April

    review

    Salmonella-based Anticancer Vaccines and their EfficacyOpen Access

    Samad Farashi-Bonab* and Nemat Khansari
    DOI: https://dx.doi.org/10.17140/VROJ-1-111
    Provisional PDF365.81 KB 365.81 KB
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  • 2019, April

    perspective

    Consensus Meeting on International Standards for Oral Whole Cell Killed Cholera Vaccines, 17-18 May 2018, Seoul, Republic of KoreaOpen Access

    Lina Odevall, Sjoerd Rijpkema, Dean Smith, Tong Wu, Firdausi Qadri, Jan Holmgren, Julia Lynch and Viliam Pavliak*
    DOI: https://dx.doi.org/10.17140/VROJ-1-112
    Provisional PDF474.29 KB 474.29 KB
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  • 2019, May

    original research

    The Prognostic Value of PD-L1 Expression in Triple-Negative Breast Cancer: A Cohort Study and Systematic Literature ReviewOpen Access

    Daniel Schmolze, Carolyn E. Behrendt, Peter P. Lee and Sophia Apple*
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-107
    Provisional PDF499.31 KB 499.31 KB
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  • 2019, July

    mini review

    Latest Results from Immunotherapy Clinical Trials in Triple Negative Breast CancerOpen Access

    Alexios Strimpakos*, Konstantinos Tsigaridas and Maria Avgoustidou
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-105
    Provisional PDF469.61 KB 469.61 KB
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    Abstract [+]

    Cancer immunotherapy has evolved enormously in the recent years with better understanding of immune reactions, immune microenvironment and immunosurveillance. Breast cancer is characterized by large heterogeneity, a fact which rather complicated the development and the approval of novel therapeutic options in comparison to the majority of other solid tumors since each subtype has required a unique scientific approach and different targets and goals. Triple negative breast cancer (TNBC) is considered the most aggressive of the breast cancer subtypes with limited treatment options and worse outcome compared to others. This article summarizes some of the early clinical studies and the recently presented phase III clinical study of immunotherapy checkpoint inhibitors in this difficult setting.

    Keywords: Cancer; Immunotherapy; Triple negative breast cancer (TNBC); Breast cancer.


  • 2019, July

    opinion

    Neoantigen: A New Hope for Effective Cancer ImmunotherapyOpen Access

    Nemat Khansari*
    DOI: https://dx.doi.org/10.17140/VROJ-1-113
    Provisional PDF232.53 KB 232.53 KB
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  • 2019, August

    original research

    Role of Sound Enhancer Device in TeleconsultationOpen Access

    Shijina Koliyath, Ravi Kumar Chittoria*, Vinayak Chavan, Abhinav Aggarwal, Saurabh Gupta, Chirra Likhitha Reddy, Padmalakshmi Bharathi Mohan and Imran Pathan
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-106
    Provisional PDF329.78 KB 329.78 KB
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    Abstract [+]

    Aim

    To study the role of sound enhancer device in teleconsultation.

    Methods

    This study was conducted in the plastic surgery department in a tertiary care centre in the month of May-June 2019. A sound enhancer device was used with mobile phone for videoconferencing as form of teleconsultation by plastic surgery trainees in operation theatre and outpatient department. At the end of the study feedbacks were taken from the trainees.

    Results

    It was found that on using the sound enhancer device, the sound quality improved and it was helpful in the teleconsultation sessions using videoconferencing.

    Conclusion

    The use of sound enhancer is a simple, cost-effective, innovative method of using a simple technology to aid in utilisation of teleconsultation facilities in a very non-sophisticated way.

    Keywords

    Sound enhancer device; Teleconsultation; Telemedicine.


  • 2019, August

    original research

    Self-Adjuvanting Peptide Vaccines Against Cervical CancerOpen Access

    Hannah Hanh-Hong Truong, Waleed M. Hussein*, Tzu-Yu Liu, Zhongfan Jia, James W. Wells, Michael J. Monteiro, Mariusz Skwarczynski and Istvan Toth
    DOI: https://dx.doi.org/10.17140/VROJ-1-114
    Provisional PDF603.54 KB 603.54 KB
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    Abstract [+]

    Background

    Cervical cancer is a common cause of cancer-related deaths in women worldwide, with a fatality rate second only to breast cancer. Human papillomaviruses (HPVs) are the main causative agents of cervical cancer, and are therefore obvious targets for vaccine development. Although two prophylactic HPV vaccines have been commercialized, therapeutic vaccines against HPVs have not been developed yet. Current vaccine technologies emphasize the power of small particles in targeting immune cells, and particles of 20-50 nm have been reported to induce optimal immune responses against a variety of pathogens and cancers.

    Methods

    We synthesized new nanoparticle-based vaccines against cervical cancer by using antigenic 8Qmin peptide epitope derived from HPV-16 E7 protein, a hydrophilic poly-(L-glutamic acid) (PGA) linker, and an 8-arm poly (tert-butyl acrylate) dendrimer-based delivery system (D8).

    Results

    Four different peptides containing 8Qmin and PGA of different lengths were successfully synthesized with high yield and purity. These were then conjugated to alkyne-functionalized D8 by copper-catalyzed alkyne-azide cycloaddition “click” reaction. The conjugates self-assembled into nanoparticles, with decreased particle size corresponding to a greater number of Glu units. The four vaccine candidates were tested in C57 black 6 (C57BL/6) mice bearing well-established (7-day-old) tumors to examine their therapeutic effects.

    Conclusion

    Interestingly, only one conjugate delayed tumor growth, and montanide adjuvanted antigen, used as a positive control, failed to demonstrate any therapeutic effect.

    Keywords

    Peptide-based subunit vaccine; Human papillomavirus; Polyglutamic acid; Therapeutic cancer vaccine; Polymer-peptide conjugate; Self-adjuvanting; Cervical cancer.


  • 2019, September

    opinion

    Clinical Research: The Future of Medicine Stuck in the Digital PastOpen Access

    Elizabeth Del Mastro Benincasa*
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-107
    Provisional PDF250.67 KB 250.67 KB
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  • 2019, October

    case report

    Role of Bactiguard Infection Technology in Preventing Catheter-Associated Urinary Tract InfectionsOpen Access

    Shijina Koliyath, Ravi Kumar Chittoria*, Abhinav Aggarwal, Saurabh Gupta, Chirra Likhitha Reddy, Padmalakshmi Bharathi Mohan and Imran Pathan
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-108
    Provisional PDF351.27 KB 351.27 KB
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    Abstract [+]

    To study the role of bactiguard infection technology (BIP) in preventing Catheter-associated urinary tract infections. This study was conducted in a tertiary care centre in the Department of Plastic Surgery, JIPMER, Pondicherry, India in the month of August 2019. The study subject was a 55-year-old gentleman with Fournier’s gangrene and type 2 diabetes mellitus (DM). The Foley’s catheter with BIP technology was used and its role in preventing urinary tract infections (UTI) was studied over a period of 10-days. During the period of the catheter use in our subject, patient did not develop features of urinary tract infections. BIP technology is claimed to be effective in preventing Catheter-associated urinary tract infections but further studies in more individuals is required to validate the same.

    Keywords

    Bactiguard infection technology (BIP); Catheter associated urinary tract infection (CAUTI); Biofilm.


  • 2019, October

    opposite to the editorial

    Diagnosis and Cure: Intellectual Honesty is the Basis of All ScienceOpen Access

    Alfred Miller*
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-110
    Provisional PDF271.12 KB 271.12 KB
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  • 2019, October

    commentary

    Remote Consent Clinical ResearchOpen Access

    Preethi Sriram*
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-109
    Provisional PDF281.37 KB 281.37 KB
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    Abstract [+]

    Recruitment in clinical research trials can be challenging in trials that are time-sensitive and/or are rare disease and critical care trials. One of the hurdles for recruitment in these types of clinical trials is due to the consent process, and the need to have consent of the patient within a certain timeframe, or the patient unable to consent for themselves. This paper will discuss the usage of the utilization of remote consent options for these trials.

    Keywords

    Recruitment; e-consent; Remote consent; Clinical trials; Rare disease; Time-sensitive.


  • 2019, November

    review

    Circulating Tumor Cells: Beyond Isolation and DetectionOpen Access

    Michelle J. McNamara*
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-108
    Provisional PDF466.90 KB 466.90 KB
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    Abstract [+]

    Circulating tumor cells (CTCs) are the precursors to metastases and increased numbers of CTCs in the peripheral circulation have been shown to correlate with decreased progression-free and overall survival. Although the current clinical utility has been focused on the prognostic significance, other clinical applications are being explored, such as determining if a patient is a candidate for treatment, determining the efficacy of treatment, evaluation for resistance to therapy, prediction of metastatic site, or as an early predictor of metastases. Current methodologies are based on quantifying CTCs and include technologies based on physical, immunological, and molecular techniques. However, these have limitations, of which most of them do not have the ability to perform morphological evaluation. Using morphological evaluation, CTCs in body fluids could be used for primary diagnosis in the setting of cancer of unknown primary (CUP) or in initial or early diagnostic scenarios. Additionally, cytological specimens have been shown to be useful for ancillary testing in patients when surgical resection specimens or biopsies are not available. Evaluation of CTCs should incorporate histological, immunehistochemical, and molecular characterization to enable clinicians to obtain the comprehensive diagnostic, prognostic and therapeutic information necessary to provide appropriate personalized care to cancer patients.

    Keywords

    Circulating tumor cell (CTC); Circulating; Tumor cell; Cancer; Isolation; Detection; Metastasis; Prognosis.

    Abbreviations

    CTC: Circulating tumor cell; RT-PCR: Reverse transcriptase-polymerase chain reaction; EMT: Epithelial-mesenchymal transition; MET: Mesenchymal-epithelial transition; TRAIL: Tumor necrosis factor-related apoptosis-inducing ligand; CEA: Carcinoembryonic antigen; CUP: Cancer of unknown primary; CAP: College of American Pathologists; AMP: Association for Molecular Pathology; ASCO: American Society of Clinical Oncology.


  • 2019, December

    case report

    Spontaneous Resolution of Pituitary Cystic LesionOpen Access

    Alice Willison, Avinash K. Kanodia*, Kirit Singh, Graham Leese, Douglas Allan, and Kismet Hossain-Ibrahim
    DOI: https://dx.doi.org/10.17140/NOJ-7-133
    Provisional PDF413.59 KB 413.59 KB
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    Abstract [+]

    Differentiating between cystic lesions of pituitary gland may be challenging. Usual differentials are cystic pituitary adenoma (cPA) and Rathke’s cleft cyst (RCC). Diagnostic certainty of magnetic resonance imaging (MRI) is limited in the absence of usual suggestive features. Furthermore, RCC can co-exist with approximately 2% of pituitary adenomas. Over time, these cystic lesions may remain static, resolve spontaneously, or result in symptomatology relating to mass effect and/or hormonal disruption. In cases of an asymptomatic lesion being found incidentally, little is known about how it may progress, raising question whether to proceed with surgical management or follow-up. We a present case of a spontaneously resolving pituitary cystic lesion with imaging features more suggestive of cPA than RCC, for which watchful waiting proved a successful treatment strategy. The current case serves as a reminder that small cystic lesions can be followed-up with spontaneous resolution and should be offered active treatment only when clinically required.

    Keywords

    Pituitary gland; Pituitary cystic lesion; Cystic pituitary adenoma (cPA); Magnetic resonance imaging (MRI).


  • 2019, December

    observational study

    Single-Blind Comparative Study of the Aesthetic Outcome of Armouring Procedures with PLLA/PCL- and HA-Enriched Absorbable ThreadsOpen Access

    Poleva Irina* and Kajaia Albina
    DOI: http://dx.doi.org/10.17140/TCOJ-1-113
    Provisional PDF644.25 KB 644.25 KB
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    Abstract [+]

    Background

    Absorbable threads represent one of the most exciting breakthroughs in aesthetic medicine. The innovative composition of absorbable poly-L-lactic acid (PLLA)/caprolactone (PCL) threads enriched with hyaluronic acid (HA) has triggered the interest of aesthetic practitioners.

    Objective

    To compare the aesthetic outcomes of armouring procedures with absorbable PLLA/PCL threads versus the same procedure performed with PLLA/PCL/HA threads (APTOS, Tbilisi, Georgia threads).

    Materials and Methods

    Eight patients underwent thread insertion in the face (PLLA/PCL threads on one side and PLLA/PCL/HA threads on the other). Aesthetic outcome was determined subjectively by the patient after 7 days using a 5-point rating questionnaire. Wrinkles were evaluated objectively using 3D photosystem software after 7, 30, and 90 days.

    Results

    Seven days after treatment there was significantly less pain, less swelling, less burning and a faster reduction of skin irregularities on the side treated with HA-enriched threads (all p<0.05). The side of the face treated with HA-enriched threads also demonstrated faster and more obvious improvement of wrinkles.

    Conclusion

    Absorbable PLLA/PCL threads have a reliable reputation for oval correction of the face and long-lasting biostimulation. The new HA-enriched threads shorten the post-procedure downtime, accelerate rejuvenation and provide more significant patient satisfaction.

    Keywords

    Absorbable thread; Thread lifting; HA-enriched threads; Aesthetics.


  • 2019, December

    original research

    Analysis of Antibiotic Resistance of the Probiotic Bacteria Found in Commercial Food ProductsOpen Access

    R. M. Asela Priyadarshana* and Clarencia R. Daniel
    DOI: https://dx.doi.org/10.17140/VROJ-1-115
    Provisional PDF644.82 KB 644.82 KB
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    Abstract [+]

    Aim

    The Lactobacillus is an industrially-important group of probiotic organisms that plays an important role in human health by inhibiting harmful and pathogenic bacterial growth, boosting immune function, and increasing resistance to infection. The aim of this study was to identify the probiotic bacteria Lactobacillus based on their phenotypic features and genotypic features. This study also shows the importance of probiotic bacterium, and the effects of their antibiotic resistance to human.

    Method

    Six different brands were cultured on man, rogosa and sharpe (MRS) agar. The identity of the culture was based on the characteristics of the strains of Lactobacillus spp. which was characterized using their phenotypic features (cell morphology, Gram’s staining tests which are specific for Lactobacillus genus). The bacterial deoxyribonucleic acid (DNA) was extracted by two different methods, boiled cell method and cetyl trimethylammonium bromide (CTAB) method. Furthermore, the extracted DNA yields were compared to determine which gives the best yield. The bacterial genus was detected with using genus specific primers, specific to the Lactobacillus. All the isolates were further subjected to antibiotic resistance test using disc diffusion method against a total of 4 antibiotics (Erythromycin, Tetracycline, Vancomycin and Ampicillin) and the antibiotic resistant genes of tet(M) & erm(B), were analyzed by polymerase chain reaction (PCR).

    Results

    Five isolates out of six samples (A to E) were found to exhibit multiple resistance against some of the most commonly used antibiotics. The isolates showed resistance toward tetracycline, erythromycin & vancomycin. Besides that, the isolates displayed a low-level of resistance toward ampicillin.

    Conclusion

    This study proves that antibiotic resistance is present in different species of probiotic strains, which may pose a food safety concern.

    Keywords

    Lactobacillus; Probiotics; Antibiotics; Tetracycline; Vancomycin; Erythromycin; Ampicillin; Antibiotic resistance.


  • 2020, January

    review

    Principles and Applications of Deoxyribonucleic Acid Microarray: A ReviewOpen Access

    Haben Fesseha* and Hiwot Tilahun
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-109
    Provisional PDF482.51 KB 482.51 KB
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    Abstract [+]

    Deoxyribonucleic acid (DNA) microarrays are collections of DNA probes arranged on a base pair and the latest commercialized molecular diagnostic technologies that offer high throughput results, more sensitive and require less time. It is the most reliable and widely accepted tool facilitating the simultaneous identification of thousands of genetic elements even a single gene. Microarrays are powerful new tools for the investigation of global changes in gene expression profiles in cells and tissues. The different types of DNA microarray or DNA chip devices and systems are described along with their methods of fabrication and their use. The DNA microarrays assembly process is automatized and further miniaturized. DNA microarrays are used in the search of various specific genes or in gene polymorphism and expression analysis. They will be widely used to investigate the expression of various genes connected with various diseases in order to find the causes of these diseases and to enable their accurate treatment. Generally, microarray analysis is not only applied for gene expression studies, but also used in immunology, genotyping, diagnostics and sequence analysis. Additionally, microarray technology being developed and applied to new areas of proteomics, cancer research, and cellular analysis.

    Keywords

    Application, DNA, Microarray, Principle.


  • 2020, January

    original research

    Nutrient-Dense, Functional Foods Enhance Hair, Skin, and Nail AppearanceOpen Access

    Kate Bauer, William Clearfield, Rochelle Ramacher, Pei-Ra Ling, Charles Marsland and Stacey J. Bell*
    DOI: http://dx.doi.org/10.17140/TCOJ-2-114
    Provisional PDF332.62 KB 332.62 KB
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    Abstract [+]

    Objective

    The American diet is nutrient-poor and rich in unhealthy compounds like sodium, sugar, and saturated fats. Whether food has an effect on appearance has not been fully elucidated. The purpose of this prospective, single-armed study was to evaluate the impact of consuming two nutrient-dense functional foods, which are low in salt, sugar, and saturated fats, on hair, skin, and fingernail health.

    Methods

    Both subjective (self-reported questionnaires and photographs) and objective (i.e., salivary pH and skin hydration) tests were used to evaluate appearance. Weekly compliance with nutrient-dense foods, body weight, and quality of life assessment were also recorded.

    Results

    Participants(n=28) consumed most of the nutrient-dense foods and remained weight stable, which was the goal of the study to exclude the effect of changes in body weight on appearance. Neither objective measurement of appearance showed significant improvements. Subjective measurements using questionnaires specific to hair, skin, and fingernails improved significantly over the 8-week study. Rating of photographs that the participants took of themselves improved significantly over the 8-weeks. These included reduced redness, decreased pore size, and better skin color. Using an acne-rating scale, a significant improvement was observed at week 8 compared to baseline. The quality of life parameters improved significantly including feeling of well-being, feeling full, having more energy, sleeping better, having less stress, and being more focused.

    Conclusion

    Inclusion of two nutrient-rich, functional foods in the diet improved the appearance of hair, skin, and fingernails. These foods were well-received and easy-to-prepare, leading to excellent compliance with the dietary protocol.

    Keywords

    Appearance; Diet; Functional foods; Nutrient-dense foods; Hair; Skin; Nails.


  • 2020, February

    review

    Better Together: Evolving Social Process between Bystanders and First Responders is a Force Multiplier for Effective Emergency ResponseOpen Access

    Carmit Rapaport* and Isaac Ashkenazi
    DOI: https://dx.doi.org/10.17140/EPOJ-5-117
    Provisional PDF433.98 KB 433.98 KB
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    Abstract [+]

    Bystanders are an integral part of an emergency scene. Their presence on site makes them the immediate potential responders, who can provide life-saving assistance as well as various rescue actions. Research has shown that bystanders are willing to and are capable of helping, especially (but not limited to) when a leader emerges, as the help is rooted in a collective action. In this article, we suggest a new framework for understanding the effectiveness of bystanders help, based on the evolving social process between bystanders and first responders. As we show, the transition from no help, at the very first moment right after the emergency has occurred, to an effective coordinated response where first responders and bystanders act together, goes through engagement of bystanders. Further, first responders should acknowledge the social organization of bystanders, utilize and leverage it in order to optimize their efforts. This framework has important insights for policy makers when managing emergency and disaster situations with limited resources.

    Keywords

    Bystanders; First responders; Mass casualty incident; Help; Emergency; Cardio-pulmonary resuscitation (CPR).


  • 2020, February

    case study

    Non-Invasive Treatment for Adhesive Capsulitis Not Helped by Physical Therapy: A Case Study in Manipulative MedicineOpen Access

    Jason Strandberg*
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-111
    Provisional PDF287.82 KB 287.82 KB
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    Abstract [+]

    This case documents the treatment of a middle-aged woman with chronic, unresponsive adhesive capsulitis (frozen shoulder) using manipulation, active release therapy, and electronic acupuncture. She had not responded to typical physical therapy but did respond to active release therapy along with adjunctive manipulation and acupuncture. In our course of treatment we wanted to see if we could significantly improve pain-free range of motion and normal; function without using invasive treatments like surgery and manipulation under anesthesia. Over a course of five weeks, using a soft tissue manipulation technique known as active release technique along with electrified acupuncture and home exercises, we were able to increase her range of motion to near normal and her function to normal. She was not forced to miss any work because of the treatment and can now do all the things she needs to do for work.

    Keywords

    Frozen shoulder; Adhesive capsulitis; Manipulation; Active release therapy; Non-invasive treatment.


  • 2020, February

    Case Illustration

    Dynamic Shape Change of an Aortic Valve Cusp Perforation on 3D Transesophageal EchocardiogramOpen Access

    Maedeh Ganji, Jose Ruiz, Robert Percy, Emil Missov and Srinivasan Sattiraju
    DOI: https://dx.doi.org/10.17140/HROJ-7-152
    Provisional PDF301.72 KB 301.72 KB
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  • 2020, February

    editorial

    Outstanding Outcome of Pancreatic Cancer: What Lessons Do We LearnOpen Access

    Muhammad W. Saif*
    DOI: http://dx.doi.org/10.17140/POJ-4-e012
    Provisional PDF294.54 KB 294.54 KB
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  • 2020, February

    original research

    Recombinant Protein D from Haemophilus influenzae Induces Mouse Bactericidal Antibodies Against Typeable and Non-Typeable Haemophilus influenzae, which Partially Protect Infant Rats Against Serotype b BacteraemiaOpen Access

    Nathan Palmer*, Yajun Tan, Manolya Saydam, Arif Felek, Huajie Zhang, Shumin Zhang, Min Fang, Jun X. Wheeler, Qiming Hou, Xiao Ma, Junzhi Wang and Fatme Mawas
    DOI: https://dx.doi.org/10.17140/VROJ-2-116
    Provisional PDF745.98 KB 745.98 KB
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    Abstract [+]

    Aim

    To evaluate the immunogenicity of a recombinant protein D from Haemophilus Influenzae (Hi) and the functional activities of the induced protein D antibodies in a mouse model.

    Methods

    Female Balb/c mice were immunised subcutaneously with recombinant protein D in the presence or absence of adjuvants and the serum immunoglobulin G (IgG) response to protein D was assessed by ELISA. The functional activity of the immune sera was evaluated in vitro using bactericidal assay against typeable Hi serotype b (Hib) and non-typeable Hi (NTHi) clinical isolates and in vivo using an infant rat bacteraemia model and a Hib clinical isolate.

    Results

    A dose-dependent IgG response was induced in mice immunised with the recombinant protein D and this response was further increased by the adjuvants used [CPG, AlPO4 and Al(OH)3], with the latter showing the greatest effect on the antibody response. Immune sera were very effective in bactericidal assay against several Hib and NTHi clinical isolates, with a higher serum bactericidal titre against the NTHi than against the Hib isolates. This is possibly due to the lower expression of protein D on the Hib isolates used in our study, compared to the NTHi isolates. In addition, anti-protein D antibodies were partially protective in vivo infant rat bacteraemia model against a challenge with Hib Eagan strain.

    Conclusion

    Our results suggest that recombinant protein D is a good vaccine candidate against Hi and should be given in combination with other vaccine candidates to ensure complete protection against Hib and NTHi.

    Keywords

    Haemophilus influenzae (Hi); Haemophilus influenzae serotype b bacteraemia; Rats.


  • 2020, February

    case report

    Superior Mesenteric Artery and Nutcracker Syndromes in a Healthy 14-Year-Old Girl Requiring Surgical Intervention after Failed Conservative ManagementOpen Access

    David Wood, Andrew Fagbemi, Loveday Jago, Dalia Belsha, Nick Lansdale and Ahmed Kadir
    DOI: http://dx.doi.org/10.17140/GOJ-5-132
    Provisional PDF360.10 KB 360.10 KB
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    Abstract [+]

    This case report presents the diagnosis of superior mesenteric artery and nutcracker syndromes in a previously fit and well 14-year-old girl. Although these two entities usually occur in isolation, despite their related aetiology, our patient was a rare example of their occurrence together. In this case the duodenal compression of superior mesenteric artery syndrome caused intractable vomiting leading to weight loss, and her nutcracker syndrome caused severe left-sided abdominal pain and microscopic haematuria without renal compromise. Management of the superior mesenteric artery syndrome can be conservative by increasing the weight of the child which leads to improvement of retroperitoneal fat and hence the angle of the artery. The weight can be improved either by enteral feeds or parenteral nutrition. This conservative management initially helped but not in the long-term as the child started losing weight again. The next step in management is surgery (duodenojejunostomy – if the conservative management fails), which the child went through, remarkably improving their symptoms.


  • 2020, March

    editorial

    Pathology Hiding in Plain Sight: The NF1 Plasma MembraneOpen Access

    Vincent M. Riccardi*
    DOI: http://dx.doi.org/10.17140/CSMMOJ-6-e008
    Provisional PDF287.00 KB 287.00 KB
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  • 2020, March

    mini review

    Beyond Placebo: Alternative Options to the Randomized Control Trial Design in Rare Disease StudiesOpen Access

    Preethi Sriram*
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-110
    Provisional PDF289.55 KB 289.55 KB
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    Abstract [+]

    Unique difficulties and challenges can arise for rare diseases and orphan disease indications within a clinical trial. Some of the challenges encountered by trials that are working on rare diseases can include recruitment and enrollment. One of the explanations for the challenges that are encountered in rare disease trials is because of the trial design of study, where the investigational product is being compared to the placebo. This review paper discusses the usage of placebo and when other options could be taken into consideration while creating the protocol, specifically with consideration to rare disease studies. It is essential for the investigators and those designing the protocol to consider alternative options from the standard randomized controlled trial. The aim of this paper is to review alternative trial design options. The trial designs discussed in this review paper include crossover trials, single arm studies and historical data, and n-of-1 trials.

    Keywords

    Recruitment; Enrollment; Placebo controlled; Clinical trials; Rare disease; Crossover trials; Single arm study;
    Historical data; n-of-1 trials.


  • 2020, March

    case report

    A Rare Cutaneous Manifestation of the Systemic Erythematosus Lupus: The Chilblain Lupus – A Clinical CaseOpen Access

    David Castro-Corredor*, Prado Sánchez-Caminero, Isabel M. de Lara-Simón and Fiorella L. Piaggio-Muente
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-112
    Provisional PDF408.66 KB 408.66 KB
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    Abstract [+]

    Perniosis or chilblain pernio is an inflammatory skin disease, typically located on acral skin surfaces secondary to prolonged exposure to cold temperatures and damp conditions. This disorder can appear as an idiopathic dermatosis, usually in young women, but occasionally it is associated with diseases such as anorexia, intestinal lymphoma, chronic myelomonocytic leukemia, monoclonal gammopathies, cryoproteinaemia, viral infections, as well as connective tissue diseases, especially lupus, picture that is known as chilblain lupus. We present a case of perniosis associated with Systemic Lupus Erythematosus and review the literature.

    Keywords

    Chilblain lupus; Perniosis; Chilblain pernio; Rare cutaneous; Myelomonocytic leukemia; Systemic Lupus Erythematosus.


  • 2020, March

    case report

    Advanced Heart Failure Exacerbated by Discreet Left Ventricular Lead Non-CaptureOpen Access

    Jon Krathen*, John Costello, Mark Moshiyakhov, Raphael Corbisiero and Kulpreet Barn
    DOI: https://dx.doi.org/10.17140/HROJ-7-153
    Provisional PDF698.54 KB 698.54 KB
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    Abstract [+]

    This case report illustrates a challenging case of worsening heart failure in a previously well-compensated patient with unclear etiology. Further workup revealed the patient’s cardiac resynchronization therapy-defibrillator (CRT-D) left ventricle (LV) lead was losing capture during positional changes. This case demonstrates the importance of device optimization, as well as electrocardiogram (ECG) monitoring to elucidate possible causes of acute systolic heart failure.

    Keywords

    Cardiac resynchronization; cardiac resynchronization therapy (CRT); Systolic heart failure; Lead positioning;
    Advanced heart failure.


  • 2020, March

    brief research report

    Awareness of Ototoxicity among Medical Doctors in AssamOpen Access

    Writisha Bora, Himanshu K. Sanju*, Vijay Kumar, Prasanta Borah and Tushar Jain
    DOI: https://dx.doi.org/10.17140/OTLOJ-6-159
    Provisional PDF444.04 KB 444.04 KB
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    Abstract [+]

    Introduction
    Previous literature has reported ill-effect of ototoxic drug on hearing and balance. Present study investigated awareness among medical doctors for the same.
    Method
    A total of 55-medical doctors of multiple specialties from Assam, India participated in the present study. A total of 14 questions with Likert Scale based scoring pattern were framed and validated for the present study.
    Results
    Outcome of the present study showed high awareness percentage about side effect ototoxic drugs was obtained, which was a satisfying outcome.
    Conclusion
    While low audiological referral and consultation awareness was identified as an area of concern.

    Keywords
    Ototoxicity; Doctors; Assam; Awareness.


  • 2020, March

    mini review

    Rechargeable Battery Solutions for Digital Hearing Aids: A Mini ReviewOpen Access

    Neha Taneja*
    DOI: http://dx.doi.org/10.17140/OTLOJ-SE-5-104
    Provisional PDF331.53 KB 331.53 KB
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    Abstract [+]

    Everyday all of us use rechargeable solutions either its smartphones, televisions, or any other electronic devices. Faster streaming of these electronic devices to other external devices may be facilitated through wireless connectivity. Wireless streaming demands much more battery backup. With advancement of hearing aid technology many features exists in hearing aids which may facilitate better spectral information, improved speech understanding in presence of background noise and thus improving communication and quality of life of the users. The use of these advanced features often requires continuous uninterrupted power supply. Traditional disposable hearing aid batteries cannot be assured of their performance due to their inopportune time discharge. Recently rechargeable solutions in hearing aids have been discovered that can support long-lasting wireless streaming. Modern day rechargeable batteries are expected to be easy to charge which can last for longer duration with more reliability and durability. Rechargeable as a feature is added on over and boon. Rechargeable battery solutions based on its various benefits may support as boon for environment, hearing aid users and professionals (better counseling and more satisfied users). The aim of this article is to highlight the awareness of these different rechargeable solutions for the users and professionals. In addition mentioning in brief the superiority of Lithium ion battery which is widely accepted in rechargeable hearing aids.

    Keywords
    Rechargeable hearing aids; Wireless streaming; Batteries for hearing aids; Li-ion batteries.


  • 2020, April

    review

    Bone Grafting, Its Principle and Application: A ReviewOpen Access

    Haben Fesseha* and Yohannes Fesseha
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-113
    Provisional PDF413.45 KB 413.45 KB
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    Abstract [+]

    Bone grafting is a surgical procedure that replaces missing bone through transferring bone cells from a donor to the recipient site and the graft could be from a patient’s own body, an artificial, synthetic, or natural substitute. Bone grafts and bone graft substitutes are indicated for a variety of orthopedic abnormalities such as comminuted fractures (due to car accidents, falling from a height or gunshot injury), delayed unions, non-unions, arthrodesis, osteomyelitis and congenital diseases (rickets, abnormal bone development) and are used to provide structural support and enhance bone healing. Autogenous, allogeneic, and artificial bone grafts are common types and sources of grafts and the advancement of allografts, synthetic bone grafts, and new operative techniques may have influenced the use of bone grafts in recent years. Osteogenesis, osteoinduction, osteoconduction, mechanical supports are the four basic mechanisms of bone grafting and help bone tissue to regenerate completely. A bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs, and sternum. An ideal bone graft substitutes should be biologically inert, readily available, must possess osteogenic, osteoinductive and osteoconductive properties, provide mechanical support, easily adaptable in terms of size, shape, length and substituted by the host bone. Bone banks are the source of bone grafts and implants and necessary for providing biological material for a series of orthopedic procedures. Bone grafts and implants can be selected as per clinical problems, the equipment available and the preference of the surgeon. A search for an ideal bone graft is on and may continue time to time.

    Keywords

    Application; Bone; Bone graft; Bone replacement; Bone bank; Principle.


  • 2020, April

    observational study

    Micropulse Transscleral Cyclophotocoagulation: Our ExperienceOpen Access

    Syed S. Ahmad*, Shuaibah A. Ghani, Ghuncha Khatoon, Sumera Sagheer and Juwairiya Ilyas
    DOI: http://dx.doi.org/10.17140/OOJ-4-120
    Provisional PDF353.67 KB 353.67 KB
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    Abstract [+]

    Introduction

    Traditionally, ciliary body destruction has been used to treat uncontrolled intraocular pressure (IOP) following maximally tolerable medical therapy. This is due to the large number of complications seen with this procedure. However, recently a new technique of sub-threshold laser or micropulse laser, is able to provide selective destruction of the ciliary body in a controlled manner. This avoids most of the complications seen with other modalities. We have performed a small case descriptive pilot study to assess the effectiveness of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in lowering IOP.

    Methods

    This pilot study was conducted on four patients in the age range 55-70-years with intractable glaucoma. Two patients had primary angle closure glaucoma, one-each had steroid-induced glaucoma and neovascular glaucoma. Mean baseline IOP was 32±2.4 mmHg. Mean number of glaucoma medications were 2.5±1.5. All patients underwent 180° MP-TSCPC. Absolute success was defined as IOP<20 mmHg without acetazolamide.

    Results

    Following the procedure the patients were followed-up at days 1,7,30 and 90. At the last follow-up of the study, mean IOP was 18.2±1.2 mmHg in all four patients. Mild anterior chamber inflammation was the only complication noted. Mean number of glaucoma medications reduced to 1.5±1.0 following the procedure. Thus, absolute success was achieved in all patients.

    Conclusion

    This small pilot study validates other studies which show effectiveness of MP-TSCPC as an efficient and safe procedure to lower IOP. This procedure can be used over a wide variety of cases, though the indications for such procedures are still evolving. More extensive and long-term studies will clarify the position of this procedure in our glaucoma management practices.

    Keywords

    Glaucoma; Micropulse laser; Cyclophotocoagulation.


  • 2020, April

    opinion

    The Catalytic Framework: Africa’s Weapon to End Acquired Immune Deficiency Syndrome by 2030Open Access

    Benjamin Djoudalbaye*
    DOI: http://dx.doi.org/10.17140/HARTOJ-7-131
    Provisional PDF289.29 KB 289.29 KB
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  • 2020, May

    original research

    An In-Depth Analysis of Our Myositis Cohort Following the Example of the EuroMyositis RegistryOpen Access

    Stylianos Tomaras* and Jörn Kekow
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-114
    Provisional PDF437.57 KB 437.57 KB
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    Abstract [+]

    Background

    To describe our myositis cohort in-depth.

    Methods

    From January 2006 to December 2018, all newly diagnosed myositis patients were retrospectively enrolled in the study. We performed a subtype reclassification using the 2017 EULAR/ACR criteria, following the example of the EuroMyositis registry. Disease activity and damage were measured by the newest standardized assessment-tools for clinical studies. Comparisons between myositis subgroups were conducted using Fisher’s exact test.

    Results

    We enrolled 32 patients (25 were female): six patients with dermatomyositis, six with polymyositis, eleven with overlap myositis, six with antisynthetase syndrome, one with autoimmune necrotizing myopathy, one with juvenile antisynthetase syndrome and one with juvenile dermatomyositis. The overall median follow-up period was 23-months (9-44.75). Interstitial lung disease (ILD) was most frequently seen in patients with antisynthetase syndrome. Patients with overlap myositis were more likely to have polyarthritis mimicking rheumatoid arthritis, reduced capillary density in the nail fold capillaroscopy and Raynaud syndrome. Ovarian cancer during the follow-up period occurred in two patients (one with polymyositis and one with dermatomyositis). Myositis-related death was reported in two patients: acute respiratory failure in autoimmune necrotizing myopathy and dysphagia-related complications in polymyositis. Cyclophosphamide, methotrexate and rituximab demonstrated a significant steroid-sparing effect. In 22 of 32 patients, the myositis subgroup classifications made on the basis of our opinion and the new EULAR/ACR classification criteria were different, showing strong disagreement, especially in the subtype polymyositis.

    Conclusion

    Our analysis highlights the heterogeneity in myositis subgroups and shows the steroid-sparing effect of cyclophosphamide, methotrexate and rituximab.

    Keywords

    Myositis; Idiopathic inflammatory myopathy; Dermatomyositis; Antisynthetase syndrome; Overlap myositis; Rituximab.

    Abbreviations

    CCP: Cyclic Citrullinated Peptide; CK: Creatine kinase; CYC: Cyclophosphamide; IIM: Idiopathic Inflammatory Myopathy; ILD: Interstitial lung disease; IMACS: International Myositis Assessment and Clinical Studies Group; MDI: Myositis Damage Index; MMT8: Manual muscle test 8; MTX: Methotrexate; MYOACT: MYOsitis disease ACTivity; RTX: Rituximab; TIF-1γ: Transcriptional factor-1γ.


  • 2020, May

    systematic review

    Optimizing Cardiovascular Outcome in Type 2 Diabetes Mellitus with Better Control of Diabetes Mellitus with Empigliflozin and Hypertension with Renin Angiotensin System Inhibitors and Manidipine Preferably of the DihydropyridonesOpen Access

    Kulvinder Kochar Kaur*, Gautam Allahbadia and Mandeep Singh
    DOI: https://dx.doi.org/10.17140/OROJ-7-141
    Provisional PDF555.43 KB 555.43 KB
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    Abstract [+]

    Aim: Obesity is increasing globally by leaps and bounds and thus the incidence of type 2 diabetes mellitus (T2DM) along with it so much so that the term diabesity had to be coined. Earlier we had reviewed how to treat the both together and the role of empagliflozin to improve cardiovascular outcome trials (CVOT). Similarly T2DM and hypertension are pathophysiologically-related diseases which co-exist with a broader complex of metabolic diseases which co-exist possessing similar set of risk factors. Hence it is important to consider which antihypertensives are suitable that possess a positive effect on metabolic factors in cases of T2DM who require an antihypertensive.

    Method: A systematic review was carried out using the PubMed search engine with the MeSH terms: “T2DM”; “essential hypertension; “cardiovascular (CV)”; “Complications of diabetes mellitus (DM) and antihypertensive”; “Antihypertensive preferred in T2DM subjects”; “Renin-angiotensin–aldosterone system inhibitors”; “Angiotensin converting enzyme inhibitors (ACEi)”; “Angiotensin receptor blockers (ARBs)”; “Dihydropyridine calcium channel blocker”; “β2 blockers”; “Diuretics”.

    Discussion: Most diabetes mellitus (DM) subjects need a minimum of two antihypertensive drugs, combining a renin-angiotensinaldosterone system (RAS) inhibitor with a dihydropyridine calcium channel blocker seems to be the most indicated approach. But not all dihydropyridine calcium channel blockers have equivalent effects on metabolic parameters. Hence manidipine that causes positive effect on insulin resistance (IR) seems to be an effective option. We have reviewed how manidipine is superior to amlodipine with regards to improving IR, not seen with amlodipine, along with not causing excessive sympathetic nervous system (SNS) activation, pulse pressure and ankle edema or to much lesser extent than amlodipine. Therefore, manidipine needs to be the first addition to RAS inhibitors in case of DM’s having hypertension of the dihydropyridines calcium channel blockers. Further good blood pressure (BP) control been correlated with good CVs outcomes.

    Conclusion: A RAS inhibitor is the first line of choice of drugs in a subject with T2DM who needs to be treated with empagliflozin for better CVOT outcome, and when a 2nd drug has to be added it is manidipine that is preferred over amlodipine. Plant products are proving to be having a lot of beneficial effects in DM, obesity and hypertension. Thus need for developing agents from plants will prove to be more cost effective in these chronic diseases where compliance is difficult to achieve with the use of common antiDM drugs and antihypertensives with the cost factor along with their side effects.

    Keywords

    Type 2 diabetes mellitus (T2DM); Diabesity; Antihypertensives; Renin-angiotensin-aldosterone system (RAS) inhibitor; Dihydropyridines calcium channel blockers; Plant products.


  • 2020, May

    editorial

    A New Mindset: Artificial Intelligence in Digital Hearing AidsOpen Access

    Neha Taneja*
    DOI: https://dx.doi.org/10.17140/OTLOJ-6-e007
    Provisional PDF278.46 KB 278.46 KB
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  • 2020, May

    editorial

    Neurofibromatosis 1 Somatic Mutation Triggering Cellular Apoptosis to Prevent Neurofibromatosis 1 ProgressionOpen Access

    Vincent M. Riccardi*
    DOI: https://dx.doi.org/10.17140/NOJ-7-e011
    Provisional PDF278.33 KB 278.33 KB
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  • 2020, May

    opinion

    Cancer DynamicsOpen Access

    Daniel Gandia* and Cecilia Suárez
    DOI: http://dx.doi.org/10.17140/CSMMOJ-6-130
    Provisional PDF298.99 KB 298.99 KB
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  • 2020, May

    case report

    An Unusual Case of Nausea and Vomiting in Pregnancy: A Case ReportOpen Access

    Babu Karavadra*, Medha Sule and Christine-Antoinette Portelli
    DOI: https://dx.doi.org/10.17140/GOROJ-7-152
    Provisional PDF299.70 KB 299.70 KB
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    Abstract [+]

    Malrotation of the gut is rare in adults. We discuss the case of a 30-year-old primiparous woman who presented to the acute gynecology ward at 19-weeks’ gestation with ongoing nausea and vomiting throughout pregnancy. She attended on a number of occasions with the same symptoms and was trialed on a number of different antiemetics. Initial biochemical investigations were unremarkable, however, the patient started to develop signs of ‘abdominal obstruction’. A magnetic resonance image (MRI) of the pelvis showed evidence of duodenal obstruction secondary to malrotation which may be secondary to a fibrous (Ladd’s) band. She was treated laparoscopically via a Ladd procedure and had an uneventful recovery. Interestingly, the patient presented again in her second pregnancy with very similar symptoms and underwent another Ladd procedure, but via a laparotomy. This is an interesting, rare and unusual case of nausea and vomiting in pregnancy.

    Keywords

    Ladd bands; Pregnancy; Nausea; Vomiting; Hyperemesis; Volvulus.


  • 2020, May

    original research

    Correlation of 18F-Fluorodeoxyglucose Glucose Uptake by Liver Cancer and Transcriptional Regulation of the Warburg Effects in ATT-MYC Mouse Model of Liver CancerOpen Access

    Mahmoud Elalfy* and Juergen Borlak
    DOI: http://dx.doi.org/10.17140/LROJ-3-112
    Provisional PDF463.83 KB 463.83 KB
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    Abstract [+]

    Background

    It was previously reported that diethylnitrosamine (DEN) enhanced liver cancer progression in ATT-MYC mouse model of liver cancer. Radiogenomics is a new tool in advanced science technology that gives information on tumor biology, non-tumor surrounding tissue, the degree of tumor size and presence of necrosis of cells especially with joined micro computed tomography – positron emission tomographys (CT/PETs).

    Aim

    To evaluate the correlation of gene expression and non-invasive microPET information of the liver tumors at different points of the stage of growth.

    Methods

    Exon array expression of the liver of ATT-MYC mice treated with DEN or butylated hydroxytoluene (BHT) compared to control non-transgenic mice were analyzed by array track and the current data were also compared to microarray expression of liver tumor of ATT-MYC mice.

    Results

    The expression of genes responsible for glucose transport such as glut1, 3, 4, hk1, slc1a5, slc1a1, slc1a4, slc1a2, gp6c and gpc-1-3-4 were up-regulated significantly in DEN-treated transgenic mice immediately after end of treatment (p≤0.05), while glut2 (fold change 0.9503, p-value 0.4385) and hk2 (fold change 3.0589, p-value 0.0565) genes were increased not significantly immediately after end of treatment. Additionally, at 4.5-months of observation after the end of treatment slc1a5, slc38a2, glut1, glut4 and gpc3-4 genes had a significant fold change in liver tumor tissue in DEN treated mice when compared to BHT or control transgenic or non-transgenic one. While hk1, 2, slc5a1, slc1a4, glut2, glut3, g6pc and gpc-1 genes were increased non-significantly in the liver of treated mice when compared to control group at 4.5-months of observation after the end of treatment. Notably, c-myc, hif-1 and aldoa glycolytic genes were expressed significantly both time points of 4 and 8.5-months while ldhb, hk-2 and PKM2 were increased non-significantly in DEN treatment when compared to BHT/control non-transgenic animals.

    Conclusion

    There is a definitive correlation between genes responsible for glucose transport and 18F-Fluorodeoxyglucose (FDG) uptake in the early and advanced degree of liver carcinogenesis. This study of glucose pathway in Hepatocellular carcinoma (HCC) at different stages of early and advanced one is the potential for therapeutic anticancer therapy.

    Keywords

    18-FFluorodeoxyglucose (FDG); MicroPET; Exon array expression; Hepatocellular carcinoma (HCC); Att-myc transgenic mice; Diethylnitrosamine (DEN), Butylated hydroxytoluene (BHT); Glucose metabolism.


  • 2020, May

    case report

    Cutaneous Polyarteritis Nodosa in Adult PatientOpen Access

    Cristiana S. Santos*, Samuel S. Álvarez and González Moran
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-115
    Provisional PDF363.61 KB 363.61 KB
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    Abstract [+]

    Cutaneous polyarteritis nodosa is a rarer variant of classic polyarteritis nodosa with unknown etiopathogenesis. It presents with skin, articular and nervous involvement, after systemic involvement is ruled out. This work reports the case of a 41-year-old male patient diagnosed with cutaneous polyarteritis nodosa with skin lesions, polyarthralgia and sensory axonal polyneuropathy.

    Keywords

    Skin; Polyarteritis; Vasculitis; Biopsy; Immunofluorescence; Histology.


  • 2020, June

    original research

    Clinical and Ultrasonographic Evaluation of the Pelvic Floor in Primiparous Women after Normal Vaginal Delivery with Episiotomy and without EpisiotomyOpen Access

    Nora H. K. Elabady*, Ahmed M. Awara, Amr M. El-Badry and Nareman El-Hamamy
    DOI: https://dx.doi.org/10.17140/GOROJ-7-153
    Provisional PDF391.81 KB 391.81 KB
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    Abstract [+]

    Objective

    The aim of this prospective study is clinical and ultrasonographic evaluation of the pelvic floor in primiparous women after normal vaginal delivery with episiotomy and without episiotomy.

    Methods

    This is a cross-section study of primiparous women with a history of delivery at Tanta University Hospital from August 2018 to August 2019. The sample power was calculated based on avulsion (major and minor) in two groups (vaginal delivery with episiotomy and without episiotomy) of total forty-primiparous women with an interval after delivery (20 cases after normal vaginal delivery with episiotomy and 20 cases after normal vaginal delivery without episiotomy).

    Results

    Twenty-four hours of delivery there was a highly significant difference between group A (with episiotomy) and group B (without episiotomy) regarding to ultrasound abnormalities, degree of tear, blood loss, hemoglobin concentration and clinical findings, while no difference regarding levator ani weakness. Two months later from delivery there was no significant difference between group A and group B regarding to ultrasound abnormalities and levator ani weakness while there was a difference between the two groups in regarding with clinical findings.

    Conclusion

    Normal vaginal delivery without episiotomy in primiparous women is better than normal vaginal delivery with episiotomy as there is no perineal tenderness, no dyspareunia. Low incidence of urinary, rectal incontinence, tear and perineal infection.

    Keywords

    Clinical and ultrasonography; Primiparous; Normal vaginal delivery; Episiotomy.


  • 2020, June

    letter to the editor

    Pancreas and Coronavirus Disease-2019Open Access

    Lorenzo Dioscoridi*
    DOI: http://dx.doi.org/10.17140/POJ-4-111
    Provisional PDF293.93 KB 293.93 KB
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  • 2020, June

    systematic review

    The Use of Artificial Intelligence in Computed Tomography Image Reconstruction: A Systematic ReviewOpen Access

    Theresa Lee* and Euclid Seeram
    DOI: https://dx.doi.org/10.17140/ROJ-4-129
    Provisional PDF489.52 KB 489.52 KB
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    Abstract [+]

    Background

    Current image reconstruction techniques in computed tomography (CT) such as filtered back-projection (FBP) and iterative reconstruction (IR) have limited use in low-dose CT imaging due to poor image quality and reconstruction times not fit for clinical implementation. Hence, with the increasing need for radiation dose reductions in CT, the use of artificial intelligence (AI) in image reconstruction has been an area of growing interest.

    Aim

    The aim of this review is to examine the use of AI in CT image reconstruction and its effectiveness in enabling further dose reductions through improvements in image quality of low-dose CT images.

    Method

    A review of the literature from 2016 to 2020 was conducted using the databases Scopus, Ovid MEDLINE, and PubMed. A subsequent search of several well-known journals was performed to obtain additional information. After careful assessment, articles were excluded if they were not obtainable from the databases or not available in English.

    Results

    This review found that deep learning-based algorithms demonstrate promising results in improving the image quality of low-dose images through noise suppression, artefact reduction, and structure preservation in addition to optimising IR methods.

    Conclusion

    In conclusion, with the two AI-based CT systems currently in clinical use showing favourable benefits, it is expected that AI algorithms will continue to proliferate and enable significant dose reductions in CT imaging.

    Keywords

    Computed tomography (CT); Artificial Intelligence (AI); Image reconstruction (IN); Machine learning (ML); Deep learning (DL); Dose reduction.

    Abbreviations

    AI: Artificial intelligence; CT: Computed tomography; ML: Machine learning; DL: Deep learning; FBP: Filtered back-projection; IR: Iterative reconstruction; MBIR: Model-based iterative reconstruction; LDCT: Low-dose computed tomography; FDA: U.S Food and Drug Administration; ANN: Artificial neural network; DNN: Deep neural network; CNN: Convolutional neural network; CNR: Contrast-to-noise ratio; SNR: Signal-to-noise ratio.


  • 2020, June

    observational study

    The Digital Stethoscope in Telemedicine: A Health Camp StudyOpen Access

    Imran Pathan, Ravi K. Chittoria*, Saurabh Gupta, Chirra L. Reddy, Padmalakshmi B. Mohan, Shijina Koliyath, Nishad K and Mohamed Ishaq Z
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-111
    Provisional PDF398.09 KB 398.09 KB
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    Abstract [+]

    India is a vast country with limited human resources. People living in remote areas often have limited access to healthcare facilities. To address this need and to increase healthcare awareness, health camps have been established. These camps are often supervised by junior physicians. Telemedicine, and in particular use of a digital stethoscope may provide better diagnosis and better consultation to the patient by senior physicians located remotely. This article highlights the clinical use of a digital stethoscope in such a health camp.

    Keywords

    Health camp; Telemedicine; Digital stethoscope.


  • 2020, June

    review

    Diversity and Recruitment of Minorities in Clinical Trials: An Unmet NeedOpen Access

    Nathalie Vives*
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-112
    Provisional PDF338.00 KB 338.00 KB
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    Abstract [+]

    Patient centricity has led to the idea that drugs should answer medical needs not only defined by the medical bodies but relevant for the patients themselves. This implies that the diversity of the patients should be represented in clinical trials. Disparities in representation of diverse populations in clinical trials have been well-documented for several pathologies like arterial hypertension, diabetes but also in oncology. Today, Caucasian patients included in clinical trials represent at least 75% of the clinical trials population even in pathologies where minorities are largely more affected than Caucasians. Filling the gap in diversity is an important matter to ensure ethics, good practices, regulatory compliance, patient safety and scientific validity. To achieve their recruitment goals and being patient centric, sponsors and investigational sites need to pay attention of this problem and put in place specific strategies. Mistrust of patients of minority groups toward clinical research is one of the main barriers along with lack of access to clinical trials (low awareness, communication barriers, distance to investigational sites). Adapted communication, community-based strategies are some of the useful strategies directed to the patients. Investigators may not encounter diverse populations in their area or may not be aware of unconscious bias when identifying patients suitable for a clinical trial. Looking for referrals and raising awareness of the risk of bias with training on culturally sounded approaches could help investigators to recruit more diverse populations. Lack of awareness and costs may prevent sponsors to focus on diversity but ethics, benefits of data acquisition and patient centricity should be enough motivators to modify this trend. Patients, investigators and sponsors have their own barriers to tackle the lack of diversity in clinical trials. The cultural background of all stakeholders is an important factor in those barriers. Only multidisciplinary approaches including human sciences would help to define patient recruitment strategies that would mitigate the current lack of diversity.

    Keywords

    Clinical trials; Patient recruitment; Diversity, Minorities.


  • 2020, June

    commentary

    Towards a More Sustainable Response: Strengthening the Social Agenda in the Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome EpidemicOpen Access

    Jennifer Knight-Johnson*
    DOI: http://dx.doi.org/10.17140/HARTOJ-7-132
    Provisional PDF258.48 KB 258.48 KB
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  • 2020, June

    case report

    Agenesis of the Thyroid Isthmus: A Case ReportOpen Access

    Ivan P. Mani* and Niharika Raju,
    DOI: https://dx.doi.org/10.17140/OTLOJ-6-160
    Provisional PDF396.44 KB 396.44 KB
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    Abstract [+]

    Agenesis of the thyroid isthmus is a rare entity with a incidence rate of 0.5 and 10%. Thyroid isthmus agenesis could be associated with ectopic thyroid tissue or agenesis of the thyroid lobes. We discuss a case of a multinodular goitre which presented with morphological variations which was not detected on ultrasonography of the neck.

    Keywords
    Thyroid; Head and neck; Isthmus.


  • 2020, June

    case report

    A Rare Case of Giant Cell MyocarditisOpen Access

    Althea C. G. Neblett*
    DOI: https://dx.doi.org/10.17140/HROJ-7-154
    Provisional PDF662.00 KB 662.00 KB
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    Abstract [+]

    Giant cell myocarditis is a rare condition first described in 1905. It has a reported incidence range from 0.007% to 0.051%. It affects female and male individuals, equally, and usually occurs in young and middle-aged persons. The underlying aetiology of giant cell myocarditis is unknown but it is thought to be mediated by T-lymphocytes. Diagnosis is made via histological examination of myocardial tissue and is characterized by a mixed inflammatory cell infiltrate with multinucleated giant cells and cardiomyocyte necrosis, predominantly affecting the ventricles. The following report describes a rare case of giant cell myocarditis in a 71-year-old man with a history of hypertension and heart failure, who died while waiting to be seen in the emergency department. Autopsy findings revealed an enlarged, dilated heart with histologic features in keeping with giant cell myocarditis, along with features of heart failure. Diagnosis of giant cell myocarditis is less common in the elderly age group, possibly due to a less severe disease process in this age group and it may be misdiagnosed because older individuals may have other cardiovascular diseases (CVDs).

    Keywords

    Myocarditis; Giant cell myocarditis; Autopsy; Elderly, Cardiovascular.


  • 2020, July

    original research

    Combining Ability Analysis in Sweet Corn (Zea Mays Saccharrata L.) Using Line by Tester DesignOpen Access

    Abdullah Khan, Hidayat Ur-Rahman*, Ashfaq Ahmad, Muhammad Iqbal, Sajid Kamal, Sohail Khan and Junyao Bu
    DOI: https://dx.doi.org/10.17140/AFTNSOJ-6-168
    Provisional PDF343.12 KB 343.12 KB
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    Abstract [+]

    Aim

    The purpose of this study was to investigate the different combination of testcrosses for morphological and yield relating traits and to investigate general combining ability of the inbred lines.

    Materials and Methods

    This research was conducted at The University of Agriculture Peshawar, Pakistan during 2016. Line x-tester analysis was used to test general combining ability (GCA) effects of 24 S4 lines of sweet corn. Alpha lattice design with two replications and two checks was used during the experiment. Research data were recorded on various flowering, morphological and yield parameters.

    Results

    Highly significant variations were recorded among the testcrosses for the studied traits except anthesis silking interval (ASI), 100-kernel weight. Minimum days to tasseling (48-days) and silking (53.5-days) was exhibited by pop-syn-swt (9-4)×synthetic sweet. GCA effect was -2.14 for tasseling and -2.00 for silking. Maximum value (3.5-days) for ASI was recorded for Pop-synswt 1(8-3)×synthetic sweet, while GCA effect for ASI was -0.71. Lowest plant height (129.8 cm) was recorded for pop-syn-swt 1(3-3)×synthetic sweet, while GCA effect for plant height was observed to be -14.79. Maximum cob length (16.6 cm) was revealed by pop-syn-swt 1(12-2)×synthetic sweet. For cob length GCA effect of 1.01 was recorded. Maximum 100 kernel weight (31.3 g) was estimated for pop-syn-swt 1(2-1)×synthetic sweet. GCA effect of 1.85 was recorded for 100-kernel weight. Highest mean (7143.9 kg ha-1) for grain yield was recorded for pop-syn-swt 1(9-4)×synthetic sweet. GCA effect for grain yield was found to be 1370.93.

    Conclusion

    Generally a low GCA value, either positive or negative indicates that the mean of a parent does not largely vary from its offsprings. In contrast, high GCA value suggests that parent is either superior or inferior to the general mean and it has high heritability and less environmental effects. Based on the findings in this research, the above mentioned testcrosses can be included in future sweet corn breeding programs where early flowering and yield attributes is desired.

    Keywords

    Sweet corn; General combining ability; Inbred lines; Line by tester; Yield; Flowering.


  • 2020, July

    original research

    Cross-Sectional Associations between Physical Activity and Internet Addiction among Undergraduate Students in TaiwanOpen Access

    Yen-Jung Chang* and Jia-Ji Sun
    DOI: https://dx.doi.org/10.17140/OROJ-7-142
    Provisional PDF312.24 KB 312.24 KB
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    Abstract [+]

    Purpose

    Internet addiction is a major health concern among undergraduate students; however, few studies have addressed modifiable behavioural factors associated with internet addiction in the context of Taiwan. This study aimed to investigate associations between physical activity and the risk of internet addiction among undergraduate students in Taiwan.

    Methods

    In 2017, we recruited 320 undergraduate students from Northern Taiwan to participate in a cross-sectional questionnaire-based survey. Physical activity was measured by the Taiwanese short-form version of the International Physical Activity Questionnaire, which evaluates an individual’s weekly levels of vigorous-intensity aerobic physical activity (VPA) and moderate-intensity aerobic physical activity (MPA). Internet addiction was measured by the Chen Internet Addiction Scale (CIAS).

    Results

    For the 320 surveyed students, the average CIAS score was 53.3, and 18.13% of participants were at risk for internet addiction (defined as CIAS score >64). The results of the multiple regression analysis indicated that a routine of at least 150 min of MPA per week was negatively associated with risk for internet addiction (β=−4.39, 95% CI=[-8.10, -0.66]). No significant associations were observed between internet addiction and 75 min of VPA or 150 min of total physical activity per week. Among the 5 dimensions of the CIAS scale, MPA was negatively associated with tolerance symptoms, time-management problems, and interpersonal and health-related problems when a routine of 150 min per week was adopted.

    Conclusion

    A routine of 150 min of MPA per week was associated with a lower risk for internet addiction. Intervention efforts aimed at reducing undergraduate students’ problematic internet use should promote recommended levels of MPA. We also recommend longitudinal research on the effects of engaging in physical activity on the risk of internet addition.

    Keywords

    Physical activity; Internet addiction; Undergraduate students.


  • 2020, July

    perspective

    Innovation in Clinical Trials is Possible: The Hidden Opportunity in the Coronavirus Disease-2019 EmergencyOpen Access

    Valeria L. Scarano* and Davide Smaldone
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-113
    Provisional PDF341.84 KB 341.84 KB
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    Abstract [+]

    The coronavirus disease-2019 (COVID-19) emergency has clearly shown the need to discover, test and produce a new vaccine but also in general the fragility of the current chain of clinical trials. Through this emergency, is it possible to look at the current clinical trial processes with new eyes? Is it possible to seize the opportunity for change and to have confidence in the possibility of their improvement? In this short article the authors wanted to give an optimistic answer to this question by pushing on the possibilities of innovation nowadays.
    Keywords
    Clinical trials; Innovation; Covid-19; Digital transformation.


  • 2020, July

    commentary

    How a Network Came Together to Manage a Large Research Program During the PandemicOpen Access

    Tamara Friedman*, Elli G. Paleoudis, Avery Freed, Susan Adler, Cheryl Fittizzi and Ihor Sawczuk
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-114
    Provisional PDF300.51 KB 300.51 KB
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    Abstract [+]

    Hackensack Meridian Health, a large New Jersey network comprised of 17 hospitals, a medical school, and 200 ambulatory care centers, executes a large research program with approximately 1000 active human subjects studies. With the arrival of the coronavirus disease-2019 (COVID-19) pandemic, the Office of Research Administration was confronted with a series of challenges. These included minimizing face-to-face contact among research participants and staff, allocating limited resources to handle the influx of COVID-19 related proposals, providing human subjects protection training to the physicians and staff who were needed to run the clinical trials, adjusting bio-repository activities to meet the increased demand for samples, and disseminating all of the new regulatory and operational information to the thousands of researchers in the network. The network’s success in modifying its research program quickly and effectively to adapt to the changing landscape can be attributed, in large part, to the centralized nature of the research administration.
    Keywords
    Research administration; COVID-19; Network.


  • 2020, July

    mini review

    The Time is Now for Disruptive Innovation in Pre-Exposure Prophylaxis Adherence MonitoringOpen Access

    Giffin Daughtridge*, Elijah Kahn-Woods, Casper Enghuus and Shane Hebel
    DOI: http://dx.doi.org/10.17140/HARTOJ-7-133
    Provisional PDF358.80 KB 358.80 KB
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    Abstract [+]

    Monitoring adherence to pre-exposure prophylaxis is a critical component of reaching ending the human immunodeficiency virus infection (HIV) epidemic goals in the US. Currently, providers still depend on “self-report” pre-exposure prophylaxis (PrEP) adherence, whereby providers ask their patients about their recent pill taking habits. There appears to be growing consensus across the HIV prevention community that “self-report” is an inadequate method of identifying that is in-need of additional adherence support services. In a recent survey, 97% of providers report utilizing self-reported adherence because it is convenient, but only 10% of these providers believe it is accurate. While “self-report” is convenient, evidence and testimonials from diverse stakeholders across the HIV prevention landscape indicate that there is a desire for more accurate, effective adherence monitoring methods. In this mini-review, we will briefly synthesize the emerging evidence and propose a solution to ensure all patients receive the support needed to protect them from HIV acquisition.
    Keywords
    Pre-exposure prophylaxis; HIV; Adherence; Prevention; Self-report.


  • 2020, July

    review

    The Potential of Amniotic Fluid-Derived Extracellular Vesicles to Treat Severe Acute Respiratory Syndrome Coronavirus 2 Infection Versus Hydroxychloroquine in Human PatientsOpen Access

    Ian A. White*
    DOI: https://dx.doi.org/10.17140/EPOJ-5-118
    Provisional PDF395.85 KB 395.85 KB
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    Abstract [+]

    Recently a lot of attention has been focused on fast-tracking repurposed drugs for the treatment of a novel coronavirus; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent leading to the devastating coronavirus disease-2019 (Covid-19). One of the first and most well-known examples is hydroxychloroquine (HCQ), which has been used for years as a treatment for malaria, rheumatoid arthritis and lupus. HCQ was rolled out as a miracle treatment for Covid-19, which was inexpensive, effective and causing few side-effects. However, its effectiveness in treating Covid-19 has recently been questioned leaving doctors and patients confused and desperate. Here the proposed mechanisms of action of HCQ are discussed and compared with an inexpensive, safe and effective alternative, which is derived from natural, healthy amniotic fluid.
    Keywords
    Covid-19; SARS-CoV-2; Amniotic fluid; CytoSomes.


  • 2020, July

    case study

    The Role of Negative Pressure Wound Therapy with Instillation and Dwell Time in the Preparation of Wound BedOpen Access

    Nishad Kerakada, Ravi K. Chittoria*, Saurabh Gupta, Chirra L. Reddy, Padmalakshmi B. Mohan, Imran Pathan, Shijina Koliyath and Neljo Thomas
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-115
    Provisional PDF374.58 KB 374.58 KB
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    Abstract [+]

    Introduction
    Although the negative pressure wound therapy (NPWT) is a time tested method of wound preparation, the role of NPWT with instillation and dwell time (NPWTi-d) in decreasing the downtime of wound preparation needs to be evaluated.
    Objective
    The objective of this study is assess the role of NPWTi-d in wound bed preparation.
    Materials and Methods This study was conducted in a tertiary care center, after getting informed consent and ethical clearance. NPWTi-d was done on a 36-years-old female with no known co-morbidities admitted with infected raw area over the right below knee amputation stump and exposed bone who was not responding well to conventional wound dressing. NPWT was applied with the help of sterile polyurethane sponge and two tubes. The antimicrobial solution used was ionic silver solution, just enough to wet the sponge completely and up to the point when the transparent occlusive covering begins to lift. Negative pressure was applied at 125 mmHg. The wound was bathed with ionic silver solution and it was allowed to stay in the wound for 10-minutes, after every 2-hours of negative pressure application. This was continued for 1-week. The dressing was opened at the end of 1-week, wound irrigated with normal saline, exudate swabs for culture taken and debrided, following which fresh NPWTi-d was applied. This was repeated for the next 3-weeks.
    Result
    By the end of third week, the wound became clean, fully covered with healthy granulation and the wound bed was ready to undergo the definitive wound cover procedure.
    Keywords
    Negative pressure wound therapy (NPWT); Negative pressure wound therapy with instillation dwell time (NPWTi-d); Ionic silver solution; Wound bed preparation; Amputation stump.


  • 2020, August

    original research

    Model Liposomal Delivery System for Drugs and VaccinesOpen Access

    Farrhana Z.Firdaus, Zeinab G. Khalil, Robert J. Capon, Mariusz Skwarczynski, IstvanToth* and Waleed M. Hussein*
    DOI: https://dx.doi.org/10.17140/VROJ-1-117
    Provisional PDF467.78 KB 467.78 KB
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    Abstract [+]

    Background

    Liposomes have been used for drug delivery since their discovery 60-years-ago. The advantages they provide as carriers have been recognised and exploited to improve the delivery of numerous drugs and eliminate harmful side-effects. Liposomal delivery has been tested for anticancer drugs, anti-tuberculosis drugs, variety of vaccines, just to list a few.

    Methods

    We developed a series of liposomal formulations with the addition of cholesterol and polyethylene glycol. The uptake of these formulations by human epithelial prostate cancer (PC-3) cells and mouse macrophages was examined and analysed by flow cytometry and confocal microscopy.

    Results

    Among the liposomes tested, small anionic liposome vesicles (≤200 nm) prepared with egg phosphatidylglycerol as the main lipid were most effectively taken up by PC-3 cells and macrophages.

    Conclusion

    We produced a liposome formulation that can be used as a model system for the delivery of drugs and vaccines.

    Keywords

    Liposomes; Drug delivery; Vaccines delivery; Egg phosphatidylglycerol; Polyethylene glycol.


  • 2020, August

    short communication

    Current Emerging Therapy for Amyloidosis NeuropathyOpen Access

    Yung-Chih Cheng*
    DOI: https://dx.doi.org/10.17140/NOJ-7-134
    Provisional PDF324.94 KB 324.94 KB
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    Abstract [+]

    Peripheral neuropathy is a type of neurological disorder in which patients with complex inherited neurological defects present significant phenotype in the peripheral nervous system. Hereditary amyloidogenic transthyretin (hATTR) neuropathy is typical polyneuropathy caused by single-nucleotide variants in the gene encoding transthyretin (TTR) and leads to transthyretin misfolding and systemic deposition of amyloid. One of the clinical hallmarks of hATTR neuropathy is polyneuropathy of the destruction of the somatic and autonomic peripheral nervous system, leading to loss of autonomy. Progressive amyloid accumulation also causes multi-organ dysfunction and death. There are many therapeutics that have been proposed and developed in these years. These therapies aim to reduce or eliminate hATTR from the plasma, stabilize the hATTR to prevent deposition, and dissolute the amyloid misfolding matrix. Recently, gene therapy strategy is being deployed to treat recessive genetic disorders by eliminating the expression of the mutated genes. Thus, gene-silencing approaches have been used to manage this amyloidosis neuropathy in the broad stages and produce some degree of improvement of this disease. Food and Drug Administration (FDA) approved Inotersen (an antisense oligonucleotide (ASO)) and patisiran (a small interfering ribonucleic acid (siRNA) for the treatment of hATTR polyneuropathy to suppress hATTR expression. Inotersen, a 2’-O-methoxyethylmodified ASO, which acts by reducing the production of transthyretin, and has been demonstrated to improve the quality of life in early hereditary transthyretin amyloidosis polyneuropathy. I here focus on the RNA-targeted therapy with particular emphasis on the molecular mechanisms by which antisense oligonucleotide can be designed to modulate transthyretin RNA function for being a novel therapy for hereditary amyloidosis neuropathy.
    Keywords
    Peripheral neuropathy; Amyloidosis; Antisense oligonucleotide (ASO).


  • 2020, September

    opinion

    Wound Care and HealthcareOpen Access

    Lydia A. Corum*
    DOI: http://dx.doi.org/10.17140/EMOJ-6-154
    Provisional PDF251.74 KB 251.74 KB
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  • 2020, September

    brief research report

    Effectiveness of Identafi® in Evaluation of Precancerous Oral LesionsOpen Access

    Vural Fidan*, Handan Koyuncu, Emine Sakalar and Bengisu Turfan
    DOI: https://dx.doi.org/10.17140/OTLOJ-6-161
    Provisional PDF303.01 KB 303.01 KB
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    Abstract [+]

    Aim
    To examine the role of the Identafi® device in early diagnosis of the nature of oral lesions.
    Results
    Buccal mucosal lesions that diagnosed Kreatosis were the most seem lesion in oral area.
    Conclusion
    It has been observed that the indentative device provides convenience to the physician in the early diagnosis of precancerous oral
    lesions and some tissue formations that may be overlooked can be reached.
    Keywords
    Identafi®; Oral lesion; Precancerous; Early diagnosis; Tobacco; Alcohol.


  • 2020, September

    review

    Anastasis: Cell Survival MechanismOpen Access

    Abolaji S. Olagunju*, Folashade G. Olorunfemi, John O. Teibo and Abiodun M. Adewolu
    DOI: http://dx.doi.org/10.17140/CSMMOJ-6-131
    Provisional PDF515.40 KB 515.40 KB
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    Abstract [+]

    Equilibrium between cell survival and death is important for normal cell homeostasis and development and also for inhibiting pathologies particularly cancer. Anastasis is a natural cell recovery phenomenon that rescues cells from the brink of death or a mechanism by which cells recuperate from apoptotic lesions and return to its normal active and functioning state. Programmed cell death (apoptosis) was known to be an intrinsically irreversible cascade that commits cells to a rapid destruction. However,
    recent studies have demonstrated the possibility of recovering dying cells even at the late stages. Anastasis uses the usual pro-metastatic and pro-survival factors to inhibit apoptotic progression. Epithelial mesenchymal transition (EMT) activation and its related modulators is not only linked with cellular metastasis and survivability but also widely associated with the stemness of cancer cells.
    Keywords
    Anastasis; Programmed cell death; Cancer; Pro-metastatic factor; Pro-survival factor; Genetic instability; Cell cycle arrest.


  • 2020, October

    original research

    The Effect of Internal Locus of Control and Social-Emotional Learning on Life and Relationship SatisfactionOpen Access

    Sibylle Georgianna* and Jennifer Jagerson
    DOI: https://www.doi.org/10.17140/PCSOJ-6-157
    Provisional PDF527.91 KB 527.91 KB
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    Abstract [+]

    Objective

    The current study examined the impact of a non-governmental organization’s academic tutoring and mentoring program on the social-emotional learning (SEL) and subjective well-being of 240 marginalized young women.

    Participants

    One-hundred-fifty-nine currently enrolled 7-12th grade students with a mean age of 16.39, SD=1.55; 40 students who were enrolled in college with a mean age of 20.25, SD=1.57, and 25 who had graduated from college with a mean age of 22.48, SD=2.16 and their leaders participated.

    Methods

    All participants completed in a survey that assessed the degree of participants’ locus of control, expectations of success (self-efficacy), current goals and career-related aspirations and their satisfaction with their relationships and life in general. Twenty-one of the participants and all leaders also were interviewed.

    Results

    Regression analyses revealed that both the participants’ self-management and the leader’s locus of control were significant predictors of the participants’ internal locus of control. Congruent with interview findings, latent structural equation analysis revealed that three manifest variables of social-emotional learning, “self-management”, “social awareness”, and “self-efficacy” had direct positive effects on participants’ subjective well-being (i.e., their satisfaction with life and relationships).

    Conclusion

    Culturally sensitive approaches to mentoring and training are needed and helpful. Future research should be carried out to mitigate design limitations and further the current study’s addition to the body of research on social-emotional learning and well-being.

    Keywords

    Self-management; Self-efficacy; Social awareness; Social-emotional learning (SEL); Internal locus of control; Life satisfaction; Relationship satisfaction; Subjective well-being (SWB).


  • 2020, October

    mini review

    Halting Coronavirus ReplicationOpen Access

    Kira Smith*
    DOI: https://dx.doi.org/10.17140/EPOJ-5-119
    Provisional PDF318.44 KB 318.44 KB
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    Abstract [+]

    Sirtuin 1 (SIRT1) inhibitors can reduce replication of many viruses with certain characteristics similar to those of coronaviruses, while the p53 protein is another important factor in the down-regulation of viral growth. Tenovin is a class of small molecules that inhibit Sirtuin 1 and 2, in addition to activating the p53 protein, by means of regulating the interactions used by coronaviruses as a self-defense mechanism. By blocking virus growth and continuous replication, with already tested antiviral medicines, the promise of coronavirus disease 2019 (COVID-19) eradication exists.
    Keywords
    COVID-19; Coronavirus replication; SIRT1 inhibitors; p53; Tenovin.


  • 2020, October

    original research

    Study of Analysis the Sensitivity of the Computational Environment for Radiological Research Field Size Based on Two Dimensional Dose Distribution for Water Phantom CasesOpen Access

    Yati Hardiyanti*, Thareq Barasabha, Choirul Anam, Novitrian Novitrian, Freddy Haryanto and Abdul Waris
    DOI: https://dx.doi.org/10.17140/ROJ-4-130
    Provisional PDF656.66 KB 656.66 KB
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    Abstract [+]

    Purpose

    This study analysed the sensitivity of the field size from variations in the target volume dimensions, depth, and position. The variations in the target volume analysis were used to determine the width of the field size. Thus, the quality control of the radiation beam can be obtained.

    Materials and Methods

    The computed tomography (CT) image of the IBA Dose 1 type of water phantom consists of 350 slices. Variations in the dimension of the target volume were modelled in 10×10×10 cm3, 10×12×10 cm3, 10.2×10×10.2 cm3, and 15×15×15 cm3. Beam parameters use one beam of irradiation on the central axis 0°, 6 MV energy, 100 cm source-skin distance (SSD), beamlet delta x, and y set to 0.1 cm. Dose distribution in the form of the XZ isodose curve and dose profile was used to observe the field size.

    Results

    In this study, the isodose curve was successfully displayed in the XZ isodose curve. The field size’s sensitivity has been successfully reviewed from variations of the target volume, depth, and position. The target X and Z direction analysis is used in determining the width and length of the field size.

    Conclusion

    The analysis related to the field size sensitivity study was obtained from a relatively valid calculation. The field size was evaluated with variations in depth of 1.5 cm, 5 cm, 10 cm, and variations in positions of 10 cm, 12 cm, 14 cm, 18 cm, and 20 cm. This study will be used as a reference to validate the distribution of computational environment for radiotherapy research (CERR) dose in the future. Thus, the accuracy of the dose calculation can be obtained.

    Keywords

    2D Dose Distribution; Sensitivity; Quality control; Treatment planning system; Radiation therapy dosimetry.


  • 2020, October

    review

    Dietary Recommendation in Diabetes Care: Carbohydrate Counting and Caloric Content of Nigerian FoodsOpen Access

    Taoreed Azeez*, Patience Chimah, Abdul F. Hassan, Adedeji Moradeyo, Ubong Umoren and Emmanuel Eguzozie
    DOI: https://dx.doi.org/10.17140/AFTNSOJ-6-169
    Provisional PDF414.19 KB 414.19 KB
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    Abstract [+]

    The prevalence of diabetes mellitus is rising globally and even more in low and middle-income countries such as Nigeria. Optimal management of the disease is important to improve survival and prevent or delay its complications. Lifestyle management is a standard universal approach in optimizing the care given to diabetic patients. Dietary management is the central link in lifestyle modifications of individuals living with diabetes. Medical nutrition therapy (MNT) is a systematic therapeutic approach of assessing the nutritional needs of an individual, determining nutritional goals, counselling the clients on how to achieve the goals, prescribing and monitoring meal plans to achieve the goals. It is evidence-based, effective and highly recommended. All carers of the diabetes patient, including the health workers and the family members of the patients, need to have basic understanding of medical nutrition therapy but the efforts should be coordinated by licensed dietitians. There are evidences that adherence to prescribed calories is effective in the control of cardiovascular risk factors such as blood glucose, weight, lipid profile and blood pressure. However, prescription of calories should be based on thoughtful consideration of the nutritional needs, weight goal, personal preferences and tastes and cultural practices of individuals living with diabetes mellitus. Food pyramids give a graphical illustration on the recommended classes and servings of food. Six to eleven servings per day of carbohydrates, 3-5 servings per day of vegetables, 2-4 servings per day of fruit, 2-3 servings per day of dairy products and 2-3 servings per day of fish are the recommended proportions of the different classes of foods for an adult on an average of 2000 calories. Carbohydrate counting, taken with appropriate insulin dosing and physical activity, has been demonstrated to be effective in optimizing the glycaemic control of patients on multiple daily insulin injections. There are challenges in doing this in Nigeria due to lack of food labels. The caloric contents of common Nigerian foods are highlighted so as to help in achieving dietary goals.
    Keywords
    Diabetes care; Dietary approach; Carbohydrate counting; Caloric content of Nigerian foods.


  • 2020, October

    retrospective research

    Cesarean Section Rate at Lumbini Zonal Hospital, Nepal: An Analysis Using the Robson Ten Group Classification SystemOpen Access

    Bishnu Gautam*, Shree D. Acharya, Vishnu Prasad Sapkota, Raut B. Batsal, Laxmi Bhattarai, Maria Jose and Kiran Paudel
    DOI: https://dx.doi.org/10.17140/GOROJ-7-154
    Provisional PDF363.56 KB 363.56 KB
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    Abstract [+]

    Background
    Caesarean section (CS) rates have increased globally. The World Health Organization (WHO) recommends the use of the Ten-Group Robson classification as the global standard for assessing appropriateness of CS. Nepal has higher-than-global average rates of CS requiring further investigation into appropriateness.
    Aim
    This study aims to investigate the caesarean section rates at tertiary care center in Nepal and make analysis based on the group-10 classification.
    Methods
    A retrospective cross-sectional study was carried out from 2016 April -2017 March in Lumbini Zonal Hospital, Butwal, Rupendehi, Nepal. 3,817 women who birth over a 12-month period were analyzed using this classification. The caesarean rate, its indications were calculated and categorized into groups according to Robson’s 10-group classification.
    Results
    Women with previous CS (Group 5) comprise the largest proportion (9.4%) of the overall 26.41% CS rate. The second largest contributor was a singleton nulliparous woman with cephalic presentation at term (6.6% of total 26.41%). Caesarean section rates in single breech pregnancies were very high (>65%). Robson’s Group 5 was the highest contributors to overall CS rate contributing 35% of all C-sections, followed by Group 2 (24%), and Group 1 (13%).
    Conclusion
    The ten-group classification helped to identify the main groups of the subjects who contribute the most to the overall caesarean section rate. This study results suggest that women with previous CS are at risk for having another CS delivery in subsequent pregnancies and therefore there is an urgent need for a dedicated vaginal birth after caesarean section (VBAC) clinic to support this such women to ensure CS are only done when indicated. Furthermore, reducing the CS rate for nulliparous i.e. Group 1 and 2 would, in the long-term, also reduce the size of Group 5 in the future.
    Keywords
    Cesarean rate; Caesarean section; Robson’s group classification.


  • 2020, October

    case report

    Implant-Supported Removable Partial Denture: An Approach to Rehabilitate Maxillary Kennedy Class IOpen Access

    Imed Ouni*, Sinda Ammar, Hiba Triki, Imen B. Afia, and Lamia Mansour
    DOI: https://dx.doi.org/10.17140/DOJ-6-142
    Provisional PDF475.41 KB 475.41 KB
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    Abstract [+]

    Patients with maxillary Kennedy Class I are frequent visitors to the dental office, the missing of posterior teeth makes the control of the movement of removable partial dentures difficult due to the axis of rotation and the different resiliencies between the supporting structures. The use of implants in association to the conventional metal frame denture provides favorable long-term stability and retention, good clinical outcomes in terms of occurrence of complications and maintenance. In this clinical case, a patient with a maxillary Kennedy Class I was rehabilitated using a 3 implants to support metallic removable partial denture. A three dimensional (3D) surgical guide was used for the well-placement of the strategic implants and ball attachments were tightened as connectors between implant and denture. The patient was satisfied after 4-years of follow-up and reported good occlusal stability, esthetic and functional satisfaction.
    Keywords
    Dental implant; Distal extension removable partial denture; Kennedy Class I; Attachment denture.


  • 2020, October

    case report

    Electrical Injury and Prolonged Cardiac Arrest: A Case Report of Complete Neurological RecoveryOpen Access

    Uma Hariharan* and Vinoth Natarajan
    DOI: http://dx.doi.org/10.17140/EMOJ-6-155
    Provisional PDF280.10 KB 280.10 KB
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    Abstract [+]

    Introduction
    Sudden cardiac arrest continues to have a high mortality rate. Out of hospital cardiac arrest (OHCA) has a poor outcome compared to those occurring in a healthcare setup due to lack of awareness and appropriate resources. The most common rhythm abnormality in OHCA is ventricular fibrillation which requires early defibrillation, ideally on the location.
    Case Report
    A 19-years male was witnessed by lay bystanders to have become unresponsive following contact with an electric lighting pole on the road median in Chandigarh. A passer-by medical resident detected no pulse and initiated chest compression. Since there was no immediate return of spontaneous circulation and aetiology suggested a defibrillate rhythm. The patient was taken in the car and rushed to a tertiary care centre, 10-minutes away. Cardiopulmonary resuscitation (CPR) was interrupted during transport for lack of adequate personnel. Ventricular fibrillation was noted and shock was delivered along with inotropes. Around 26-minutes into the resuscitation, the patient had the return of spontaneous circulation. After post-cardiac arrest care in intensive care unit (ICU), he was extubated and discharged home in 1-week with full neurological recovery.
    Discussion
    Recovery of full neurologic function could be explained by the alternating presence of stable and unstable cardiac rhythms and in part at least brought about by immediate attempts at resuscitation. The report seeks to review these aspects of emergency care besides highlighting the need for both immediate and accurate emergency medical services such as lay responder training, public access defibrillation and responsive transport systems for such patients.
    Keywords
    Sudden cardiac arrest; Out of hospital cardiac arrest; Ventricular fibrillation; Early defibrillation; Electrical injury.


  • 2020, October

    editorial

    Laparoscopic Sleeve Gastrectomy for the Surgical Treatment of Obesity: Is It an Easy Procedure?Open Access

    Emilio Manno*
    DOI: http://dx.doi.org/10.17140/SROJ-6-e004
    Provisional PDF175.72 KB 175.72 KB
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  • 2020, October

    observational study

    Accuracy of Bioimpedance Modalities for Fluid Assessment in Hemodialysis Patients: A Randomized Observational StudyOpen Access

    Jacob C. John*, Graham T. Gipson, Christopher D. King, Timothy E. Bunchman and Oliver Karam
    DOI: https://dx.doi.org/10.17140/NPOJ-6-124
    Provisional PDF507.74 KB 507.74 KB
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    Abstract [+]

    Aim
    Fluid overload is a major contributor to mortality in critically ill patients but is difficult to estimate clinically. Bioimpedance has been used to estimate fluid volumes with three different methods of analysis:1. single-frequency; 2. multi-frequency; 3. bioimpedance spectroscopy. The aim of this study is to assess the accuracy of different types of bioimpedance analysis in detecting changes in fluid volumes.
    Methods
    Prospective observational study, in end-stage renal disease patients requiring dialysis, in a tertiary care center. During hemodialysis, we assessed the correlation between change in estimated total body water volumes, as measured by all three methods of bioimpedance, and fluid volumes removed, as measured by changes in body weight.
    Results
    Twenty-four pediatric and adult patients were included in the study (median age 42.4 years) with a total of 30 study assessments performed. There was a weak correlation between change in body weight and change in estimated total body water volumes (R=0.15, 0.41, and 0.38, respectively). In the Bland-Altman analysis, the mean biases along with their associated 95% confidence limits of agreement were -0.23 L (-4.1 to 3.5 L) for single-frequency; -1.1 L (-4.1 to 1.9 L) for multi-frequency; and -0.6 L (-6.1 to 4.8 L) for bioimpedance spectroscopy.
    Conclusion
    In this study of end-stage renal disease patients requiring dialysis, the accuracy of bioimpedance measurement to evaluate fluid changes was poor, regardless of bioimpedance modality.
    Keywords
    Body composition/physiology; Body fluid/physiology; Electric impedance; Extracellular fluid/metabolism; Renal dialysis.


  • 2020, October

    original research

    Calculation of Photons Reaction Rate Resulting at 120 kVp X-ray Tube Voltage and 1 mAs as Function to Digital Imaging and Communications in Medicine Pixel Numbers Using Monte Carlo N-Particle Transport and a Voxel Model of a 29-Year-Old PatientOpen Access

    Tawfik A. Shdeed*
    DOI: https://dx.doi.org/10.17140/ROJ-4-131
    Provisional PDF784.94 KB 784.94 KB
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    Abstract [+]

    Purpose
    To read the digital imaging and communications in medicine (DICOM) images of brain and extract intensity values and build a three dimensional model for Monte Carlo n-particle transport (MCNP) code input file in purpose to study the average particle flux and deposited energy of X-Ray photons resulting at 120 kVp and 1 mAs (form point source) as function to DICOM pixel numbers in the brain tissues for a 29-year-old female patient using MCNP code and Matlab program to read the DICOM images.
    Method
    The matrix laboratory (MATLAB) program was used to read the DICOM images and extract the intensity values in each pixel of the DICOM image corresponding to certain slice of the brain. These color levels are characteristic of different tissue, and have been relied upon to create the specific material in each volume element in MCNP input file.

    Conclusion
    Values of the deposited energy at surface of skin are high, so it is always necessary to be cautious when performing the examination to obtain acceptable images from the first time and without having to repeat the imaging again for the same case unless there are necessities for it.

    Keywords
    Computed tomography (CT); X-ray; Voxel phantom; MCNP Code; Average particle flux; Matlab.

     


  • 2020, November

    original research

    Influence of Nutritional Awareness on Grocery Shopping by Kuwaiti Parents in Relation to Children NutritionOpen Access

    Dalal Al-Roumi, Dina Abu-Abdo,Mariam Al-Khulaifi, Sara Al-Khadhari, Eman Al-Awadhi and Farouk El-Sabban*
    DOI: https://dx.doi.org/10.17140/AFTNSOJ-6-170
    Provisional PDF400.88 KB 400.88 KB
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    Abstract [+]

    Background
    Caregivers, specifically parents, are ultimately responsible for the nutrition of children living in the household, in spite of the children’s preferences for food items. There have been no studies on the relationship between the nutritional knowledge level of Kuwaiti parents who grocery shop and their children’s nutrition. Therefore, this study was carried out to explore grocery shopping patterns of Kuwaiti parents in relation to their children’s eating habits.
    Methods
    A questionnaire was administered by 4 of the authors through face-to-face interviews with 100 Kuwaiti parents who grocery shop for their families. The questionnaire was designed to cover three main categories: demographics, parents’ nutritional knowledge, and children’s nutrition. Subjects were interviewed at random at 6 supermarket locations. Data were analyzed utilizing a SPSS statistical package and the Chi–Square test was used to examine the association between variables at the p<0.05 level of significance.
    Results
    Demographic data of respondents showed that 92% were married, 66% were females, 61% were university graduates, and 84% allowed children to choose food items while shopping. Children’s age ranged from 2 to 18-years. Results indicated that the media was the main source of nutrition knowledge of participants. About 50% were familiar with food labels, 74% were shopping for nutrition claims and most parents (60%) were shopping for low-fat products. Analysis of data revealed several associations among demographics, nutrition knowledge of parents and nutrition of children.
    Conclusion
    This study is the first of its type to be carried out in Kuwait. It revealed several important aspects of parents’ background and awareness of nutrition as influencing factors on their grocery shopping. It is hoped that this line of research will be expanded, for the benefit of children’s health and avoidance of future nutrition-related diseases.
    Keywords
    Children; Health; Kuwait; Nutrition interest; Nutrition knowledge; Parents.


  • 2020, November

    original research

    The Athletic Intelligence Quotient and Performance in the National Football LeagueOpen Access

    James K. Bowman*, Thomas R Boone, Leonard Zaichkowsky, Scott Goldman and Alex Auerbach
    DOI: https://dx.doi.org/10.17140/SEMOJ-6-180
    Provisional PDF488.70 KB 488.70 KB
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    Abstract [+]

    Introduction
    In the realm of competitive athletics, numerous variables have been examined for predictive utility with respect to player selection/development and outcomes on the field. Notwithstanding important advances, the current predictors only account for a modest amount of variance in outcomes of relevance in the National Football League (NFL).
    Objective
    The primary objective of this study was to investigate the predictive validity of a new measure of athletic intelligence, the Athletic Intelligence Quotient (AIQ), which is based on the empirically supported Cattell-Horn-Carroll (CHC) Theory of Intelligence. The predictive validity of the AIQ was determined in relation to performance metrics from 146 NFL players across several seasons.
    Results
    Hierarchical regression analyses indicate that specific AIQ factors accounted for a statistically significant increase in the explanation of variance beyond the current level of evaluation for several performance metrics (e.g., career approximate value; sacks, tackles, rushing yards). Further, specific factors of the AIQ are related to position specific statistics, offering the possibility that performance prediction can be focused in for the specific skills required by a given position.
    Discussion
    Given the recent impact of analytics in professional sports, and the significant findings noted in the current investigation, the authors discuss the potential importance of the AIQ in the selection and coaching processes.


  • 2020, November

    systematic review

    Revision of Maryland Minor Consent Law on Human Immunodeficiency Virus Infection Prevention: An Outcome of AdvocacyOpen Access

    Oluwatosin Olateju*, Deb Dunn, Patricia McLaine and Sharon Barrett
    DOI: http://dx.doi.org/10.17140/HARTOJ-7-134
    Provisional PDF438.06 KB 438.06 KB
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    Abstract [+]

    Objectives
    To date, only few United States (US) states have explicit regulations that allow minors to independently give consent for human immunodeficiency virus infection (HIV) prevention treatments. This manuscript will reflect upon key advocacy efforts leading to the revision of the Maryland Minor Consent Law, evaluate current human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) prevention laws for minors in U.S. states, and highlight resources for health advocacy.
    Methods
    Between 2018-2019, public health professionals in Baltimore, Maryland reviewed the Maryland Minor Consent Law and other adolescent consent laws within the U.S. The professionals advocated for a legal review of the gap by the State Senate and the Office of Attorney General.
    Results
    In May 2019, the public health advocates were successful in their effort for a revision of the Maryland Minor Consent Law to include Treatment for the Prevention of HIV-Consent by minors. Upon their review of all adolescent consent laws within the U.S., they found that only eleven states currently have explicit language indicative of an adolescent’s ability to give consent for pre-exposure prophylaxis (PrEP).
    Conclusion
    This inquiry can change upstream factors such as laws, regulations, policies and institutional practices.
    Keywords
    HIV, Prevention, Pre-exposure prophylaxis, Adolescents, Minor consent law.


  • 2020, November

    research protocol

    Coronavirus Disease-2019, Diabetes and Dialysis: An Internal Medicine Conundrum Proposal for a Suitable and Easy-to-Handle Prevention ProtocolOpen Access

    Felice Strollo, Ersilia Satta, Carmine Romano, Carmelo Alfarone, Teresa D. Corte*, Giuseppina Guarino and Sandro Gentile
    DOI: http://dx.doi.org/10.17140/DROJ-6-147
    Provisional PDF503.80 KB 503.80 KB
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    Abstract [+]

    Background
    Frail populations burdened with chronic diseases can get more severe forms of coronavirus disease-2019 (COVID-19) and have a higher mortality rate.
    Aim
    To test the efficacy of a severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) containment protocol in patients with endstage renal disease (ESRD) diabetes mellitus (DM) requiring dialysis, who are a typical example of the above category.
    Methods
    The protocol included: (i) daily telephone COVID-19 related triage for patients and their general practitioners (GPs); (ii) social distancing; (iii) environment sanitization, including ambulances, transfer vans, medical equipment, patient/health personnel clothing, and individual protection devices; (iv) adoption of quota systems for patients allowed to the dialysis room, and increased time lags among dialysis shifts. Eight hundred twenty-five (825) patients on dialysis (315 with and 510 without DM), and 381 healthcare providers (HCPs) were monitored continuously from the start of the pandemic until the end of the lockdown.
    Results
    No HCPs were infected, while only two patients on dialysis were positive for SARS-CoV-2: one with DM, who died in intensive care, and one without DM, who recovered at home. The adopted contagion containment protocol proved to be effective for both HCPs and patients.
    Conclusion
    Therefore, we propose it as a useful model for any internal medicine or ESRD specialized units dealing with patients on dialysisoriented with or without DM.
    Keywords
    COVID-19, Dialysis, Diabetes, Prevention, Contagion.


  • 2020, November

    case study

    Role of Low-Level Laser Therapy as an Adjunct in the Management of Diabetic UlcerOpen Access

    Shijina Koliyath, Ravi K. Chittoria*, Chirra L. Reddy, Padmalakshmi B. Mohan. Imran Pathan, Neljo Thomas and Nishad Kerakada
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-116
    Provisional PDF328.58 KB 328.58 KB
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    Abstract [+]

    Diabetes mellitus (DM) is a chronic debilitating condition affecting people worldwide and diabetic foot ulcers are also a common problem. The treatment of diabetic ulcers requires a multimodal approach. Adjuvant low-level laser therapy (LLLT) may be useful in lesions with protracted healing course but the evidence is still limited. In this study, we share our experience regarding the use of low-level laser therapy as an adjuvant treatment modality in a patient with diabetic foot ulcer.
    Keywords
    Low-level laser therapy; Diabetic ulcer.


  • 2020, November

    original research

    Prevalence and Economic Significance of Hydatidosis on Cattle Slaughtered at Nekemte Municipal Abattoir, Western EthiopiaOpen Access

    Tuge Temesgen*
    DOI: https://dx.doi.org/10.17140/VMOJ-5-150
    Provisional PDF349.75 KB 349.75 KB
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    Abstract [+]

    Aim
    The study was conducted to determine the prevalence of hydatidosis, to identify the association between expected risk factors and occurrence of the disease, to investigate economic importance and to evaluate fertility and viability of the hydatid cyst in cattle slaughtered at the abattoir.
    Materials and Methods
    A cross-sectional study, which involves both ante-mortem and post-mortem examination, was conducted at Nekemte municipal abattoir from November 2015 to March 2016.
    Results
    A total of 355 local cattle breed was randomly sampled and examined for the presence of hydatid cysts in the organs of the animals using the standard meat inspection procedures, 66 (18.6%) animals were found harboring hydatid cysts. Statistical analysis showed that there was a significant difference (p<0.05) between the prevalence of bovine hydatidosis in all risk factors with exception of sex of the animals. Among 207 hydatid cysts recorded, 93 (44.92%) were from lungs, 65 (31.40%) from livers, 4 (1.93%) from heart, 3 (1.44%) from kidney, 1 (0.48%) from spleen and 41 (19.8%) were in two organs from lung and liver. Fifty-seven (57) of these 207 cysts were randomly selected and subjected to fertility and viability test which revealed 19 (33.33%) as fertile, 25 (43.86 %) sterile and 13 (22.81%) calcified. Viability test proved 7 (12.28%) of 19 fertile cysts as viable and 12 (21.05%) of 19 fertile cysts as non-viable. Viability of cysts in different organs revealed that 5 (16.1%) and 2 (10%) of cysts from lungs and liver, respectively. The estimated financial loss during the study period both due to condemnation of organs and an in direct carcass weight loss from hydatidosis was 2,190,143.52 ETB.
    Conclusion
    The results of this study revealed that bovine hydatidosis was an economically important disease of cattle which need serious attention for prevention and control actions in and around Nekemte. Hence, establishment of well-equipped standardized abattoirs, prohibition of backyard slaughter, creation of public awareness, deworming and control of stray dogs are of paramount importance.
    Keywords
    Abattoir; Cattle; Economic loss; Hydatidosis; Nekemte; Prevalence.


  • 2020, November

    original research

    Histopathological Analysis of the Pro-Arrhythmogenic Changes in a Suspected Chagas Disease Sudden DeathOpen Access

    Héctor O. Rodríguez*
    DOI: https://dx.doi.org/10.17140/HROJ-7-155
    Provisional PDF767.30 KB 767.30 KB
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    Abstract [+]

    Background
    Sudden death is the principal cause of fatality in Chagas disease, afflicting to non-symptomatic patients younger than 50-years. For this, sudden death associated with chagasic malignant arrhythmias is underdiagnosed and their pathophysiological basis is poorly understood.
    Aims
    In this sense, this work aimed to analyze the histopathological alterations in cardiac structures specialized in the generation/conduction of action potential in an anatomopathological case of non-diagnosed sudden death living in a Chagasic endemic area.
    Methods
    The donor was a woman, 62-year-old, which ingressed without vital signs to the emergency room of “Antonio María Pineda” hospital, without any apparent antecedents of cardiac disease. The gross examination was normal, with no external evidence of structural/ischemic disease.
    Results
    Microscopic examination revealed nodal like cell depopulation, microvascular disturbances, chronic myocarditis with mononuclear and mast cell infiltrate plus extracellular matrix reaction, and profuse damage of neural structures placed in nodal region. amastigote nest of Trypanosoma cruzi (T. cruzi) was detected.
    Conclusion
    These findings suggest a complex association among parasite persistence, sinus disease, micro-ischemia foci, and neural inflammation in the genesis of malignant arrhythmias of Chagas disease despite the absence of structural disease or massive necrosis. It is important to perform a protocol of examination for no explained sudden death cases in chagasic endemic countries, to avoid misdiagnosed of sudden death associated with Chagas disease.


  • 2020, November

    original research

    Seventy Cases of Partial Gastric Pull-Up According to the Schärli Technique for Esophageal Replacement in PediatricsOpen Access

    Martín Rubio, Mariano Boglione*, Carlos Fraire, Silvia Takeda, Cristian Weyersberg, Fermín Prieto and Marcelo Barrenechea
    DOI: https://dx.doi.org/10.17140/PNNOJ-7-131
    Provisional PDF336.82 KB 336.82 KB
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    Abstract [+]

    Introduction
    Esophageal replacement (ER) is indicated in patients with long gap esophageal atresia (LGEA) or failure of the primary anastomosis. Also, severe caustic or peptic strictures, resistant to conservative treatment with medication and dilations, may require an ER. Numerous techniques with different organs and routes have been described, all with satisfactory results.
    Objective
    Our objective is to describe the experience obtained with partial gastric pull-up according to the Schärli principles (SGPA).
    Materials and Methods
    Medical records of patients who required a SGPA between October 1995 to June 2018 were reviewed. The analysis was observational, longitudinal, retro-prospective and descriptive. Epidemiological data, surgical aspects and postoperative complications of the patients were considered.
    Results
    Seventy ER were performed with SGPA. The indication was esophageal atresia (EA) in 58 cases (44 long gap and 14 failure of the anastomosis), 10 caustic strictures, one peptic stricture resistant to conservative treatment and the other due to a retained foreign body. The age of the ER was on average 2-years and 9-months. The route was: posterior mediastinal (35), retrosternal (29) and transpleural (6); without a thoracic approach in 59 patients. The duration of the procedure was 4.7-hours on average. There were 13 cases of intraoperative complications, 8 cases of pneumothorax, 5 bleeding injuries (3 in the spleen, 1 liver and 1 cervical), and one injury to the cervical trachea. Anastomotic dehiscence was observed in 37 patients (52%), which closed spontaneously after an average of 17.8-days in all except one patient. Thirty-one patients (44%) developed anastomotic stenosis, requiring redo anastomosis in 6 cases; 37% developed dumping and 23% gastroesophageal reflux disease. There were 3 deaths (4.2%): all in EA patients with associated malformations, following a morbid postoperative period with infectious complications in intensive care at 10-days, 7 and 8-months after ER. Follow-up was an average of 8-years. All 67 living patients are currently tolerating oral feeding.
    Conclusion
    In our experience with ER using SGPA, we observed a high incidence of complications, generating a longer post-operative evolution and with greater morbidity than that described in other techniques. Given these results, we changed our strategy to complete gastric transposition, in order to reduce morbidity and improve the evolution of this complex group of patients.
    Keywords
    Esophageal replacement; Partial gastric pull-up; Esophageal atresia; Caustic stricture.


  • 2020, November

    letter to the editor

    Review of the article on “The Rate of Underascertainment of Novel Coronavirus (2019-nCoV) Infection: Estimation Using Japanese Passergers Data On Evacuation Flights”Open Access

    Eric Lin*
    DOI: https://dx.doi.org/10.17140/EPOJ-5-120
    Provisional PDF282.30 KB 282.30 KB
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  • 2020, November

    systematic review

    The Association of Dietary Fatty Acids and Gut Microbiota Alterations in the Development of Neuropsychiatric Diseases: A Systematic ReviewOpen Access

    Kulvinder Kochar Kaur*, Gautam Allahbadia, and Mandeep Singh
    DOI: https://dx.doi.org/10.17140/OROJ-7-143
    Provisional PDF856.53 KB 856.53 KB
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    Abstract [+]

    Aim
    Having reviewed earlier the role of probiotics in obesity and other associated metabolic disorders like non-alcoholic fatty liver disease (NAFLD), engineering probiotics for cholera and other neuronal diseases like Alzheimer’s, Parkinson disease with incidence of obesity and diabetes mellitus (DM) so much on the rise, Here the aim of this systematic review is to highlight the influence of dietary patterns, like fatty acids, other lipids on role of maternal stress and the neuropsychiatric disease (NPD) formation along with influence of probiotics in reverting them.
    Method
    A systematic review was carried out using the PubMed, Web of Science, Medline, Embase, Cochrane reviews, and Google Scholar, Search engine with the MeSH Terms; “Impaired lipid metabolism”; “Oxidative stress”; “inflammation”; “Gut Microbiota (GM)”; “NPD”; “Schizophrenia (SCZ)”; “Autism Spectrum Disorder (ASD)”; “Bipolar disorders (BD)”; “Gamma amino butyric acid (GABA)”; “5-hydroxy tryptamine (5HT)”; “Brain derived neutrotrophicfactor (BDNF)”; “Polyunsaturated fatty acids (PUFA)”; “Saturated (SFA)”; “Depression”; “Resolvins”; “Protectins”; “Short chain fatty acids (SCFA)”; “Probiotics”; “Fecal Transplantation” from 1990 till June 2020.
    Results
    We found a total of 900 articles under various subheadings of GM and NPD and probiotics with NPD and SCZ, ASD. One hundred ninety-two (192) articles got selected for this comprehensive review. No meta-analysis was conducted.
    Conclusion
    We observed a marked correlation among dietary habits, like utilization of Western diet (WD) with marked escalation of intake of high fat, high sugar rich diet escalated n6 PUFAS over n3 PUFAS and influence on GM that is not helpful in digestion of the nondigestible fibers in form of starch along with generation of butyrate aiding in certain beneficial effects and on formation of various neurochemicals like escalation of BDNF while increased GABA, reduced 5HT formation alteration of tryptophan metabolism is seen in these WD food and we have tried to detail the role of SCFA formation, generation of resolvins and how they work in the formation of various NPD besides maternal diet during pregnancy and how it determines infants microglial priming and later determinants of early stress.
    Keywords
    Dietary fat; Western diet; Microbiota to brain communication (MBC); Polyunsaturated fatty acids (PUFA); Gut microbiota (GM); Schizophrenia (SCF); Autism spectrum disorder (ASD).


  • 2020, November

    mini review

    Avianomics: The Beginning at the EndOpen Access

    Mary Komp, Rebecca Bowie, Jean-Rémi Teyssier, Brooke C. Bodle, Alison Ferver, Richard A. Mudarra, Bin Zuo, Travis Tabler, Derrell T. Lee, Craig W. Maynard, Garrett Mullenix and Sami Dridi
    DOI: https://dx.doi.org/10.17140/AFTNSOJ-6-171
    Provisional PDF452.60 KB 452.60 KB
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    Abstract [+]

    The research-teaching nexus is the pinnacle of academic activity. As a scientist and educator, my overall objective is to give students access to cutting-edge research and help them develop high order inquiry skills. In addition, as research and thesis writing frequently involves the development of new complex reading skills associated with comprehension and synthesis of a tremendous volume of information, along with in-depth critical analysis, evaluation, and elegant academic writing style, I decided to assign this editorial to my 2020-Biochemical Nutrition graduate students. As my students have diverse educational and cultural backgrounds and have been exposed to a variety of tech-based learning, we decided to summarize here recent advances in omics research in avian species to facilitate the discussion by asking new questions, which may help open new vistas for future investigations. By following the “scaffolded” approach, my students highlighted progress in Transcriptomics (Komp M and Bowie R), Proteomics (Tabler T and Lee T), Kinomics (Hernandez RM and Zuo B), Epigenomics (Ferver A), Metabolomics (Maynard C and Mullenix G), and Microbiomics (Teyssier JR and Bodle B). I would like to thank my students for their motivation, dedication,
    determination, perseverance, connection, consistency, and support. I would also like to thank AFTNS-OJ for inviting me to write this editorial and I hope by getting my students involved would promote their curiosity, help them understand complex questions, explore more sources, stimulate their independent thinking, and create research- and question-mindsets.


  • 2020, November

    case report

    Radio Histological Treatment of Endometrial Hyperplasia: A Case ReportOpen Access

    Priscila F. Berganza*, Maria D. Molina, María A. P. Dahinten and Mariela S. Ramos
    DOI: https://dx.doi.org/10.17140/ROJ-4-132
    Provisional PDF440.52 KB 440.52 KB
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    Abstract [+]

    Endometrial hyperplasia is defined as the pathological condition caused by hyper plastic changes at the level of the glandular and stromal structures of the endometrium that are part of the lining of the endometrial cavity. Atypical endometrial hyperplasia can cause an essential problem because it is considered a precursor of endometrial cancer. The early diagnosis of precancerous endometrial
    lesions and the exclusion of pre-existing endometrial carcinomas are necessary for patients’ optimal management. The following is a case of a 50-year-old Guatemalan patient with a three-day history of vaginal bleeding. The transvaginal ultrasound reports endometrial thickening suggestive of endometrial hyperplasia. The diagnosis was confirmed with histology. The treatment offered was surgery without indicating any medication.
    Keywords
    Endometrium; Endometrial hyperplasia; Biopsy; Histological; Echography; World Health Organization (WHO).


  • 2020, December

    mini review

    Nebulized Tranexamic Acid for HemoptysisOpen Access

    Veerle Leenaerts*
    DOI: http://dx.doi.org/10.17140/EMOJ-6-156
    Provisional PDF269.91 KB 269.91 KB
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    Abstract [+]

    The synthetic antifibrinolytic drug, tranexamic acid, is widely used intravenously, orally and topically to treat various bleeding complications. In recent years, there has been increasing evidence of its use as inhalation drug for hemoptysis. In this review, the available literature about aerosolized tranexamic acid is listed.


  • 2020, December

    mini review

    The Effects of Societal and Structural Barriers on Participation among Individuals with Physical DisabilitiesOpen Access

    Nathan Perkins*
    DOI: https://dx.doi.org/10.17140/SEMOJ-6-181
    Provisional PDF316.79 KB 316.79 KB
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    Abstract [+]

    The 2008 Physical Activity Guidelines recommend that the more than 53 million people living with a physical disability in the United States to participate in regular physical activities consisting of both aerobic and anaerobic components, if possible. Also, if individuals with physical disabilities are unable to meet the recommended physical activity guidelines, they are encouraged to do as much as their physical disability permits. Despite the recommended guidelines, several individuals with physical disabilities do not participate in regular physical activities. Prior research suggests that several societal and structural barriers in sport and exercise environments often negatively affect individuals with physical disabilities. Thus, it is essential for family members, healthcare practitioners, rehabilitation/recreational teams, and community leaders to encourage individuals with physical disabilities to conquer barriers that restrict participation.


  • 2020, December

    brief research report

    Anti-Platelet-Derived Growth Factor Receptor-Beta Therapy Does Not Trigger Retinal Endothelial Cell ToxicityOpen Access

    Zachary K. Goldsmith, Andrew S. Irvine, Matthew W. Wilson and Vanessa M. Morales-Tirado*
    DOI: http://dx.doi.org/10.17140/OOJ-4-121
    Provisional PDF563.01 KB 563.01 KB
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    Abstract [+]

    Background

    Retinoblastoma (Rb) is a highly angiogenic tumor, for which anti-vascular endothelial growth factor (VEGF) therapies have shown limited success in clinical setting. Recent investigations demonstrated upregulation of ancillary axis including the platelet-derived growth factor (PDGF) when VEGF is inhibited. This illustrates the need for novel therapeutics. Previous work from our lab showed inhibition of the platelet-derived growth factor receptor-beta (PDGFR-β) by imatinibmesylate (IM), inhibited Rb cells proliferation in vitro. Novel therapies ideally are tumor-specific, leaving normal non-cancerous cells a stroma to perform their homeostatic functions. Rb treatments induce apoptosis of the retinal endothelial cells, causing the release of pro-inflammatory cytokines and chemokines to the microenvironment.

    Aims

    We investigated the role of the PDGFR-β in the tumor microenvironment and how inhibition of this signaling pathway, as a potential targeted therapy, impacts angiogenesis in human retinal microvascular endothelial cells (hRECs), specialized neurons arborizing the retinal microvasculature.

    Results

    Our results demonstrated that inhibition of the PDGFR-β signaling pathway by IM affects the proliferation of the Rb cells, but not hRECs. PDGFR-β signaling is not required for hRECs angiogenic activity, although it reduces the percentage of VEGF-Aproducing cells.

    Conclusion

    These results illustrate a lack of functional activity PDGFR-β signaling in hRECs and points to a more tumor-specific therapeutic option. This is of critical importance as success of treatment also depends on the ability of the normal tissues to remain healthy after sensitization and/or killing of the Rb tumor.

    Keywords

    Retinoblastoma; Retinal endothelial cells; Ocular oncology; Imatinib mesylate.


  • 2020, December

    case report

    Macroscopic White Blood Cell Casts: An Extremely Rare Presentation of Klebsiella PyelonephritisOpen Access

    Larry B. Mellick* and Kimberly Rathbun
    DOI: http://dx.doi.org/10.17140/EMOJ-6-157
    Provisional PDF307.44 KB 307.44 KB
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    Abstract [+]

    In this case report, we present a patient with severe pyelonephritis who presented complaining of passing worm-like tissue from his penis. This patient was passing macroscopic ureteral white blood cell casts resulting from a severe pyelonephritis caused by Klebsiella pneumoniae.
    Keywords
    Acute pyelonephritis; White blood cell casts; Urinary tract infections; Urinary tract infection (UTI); Ureteral casts.


  • 2020, December

    case series

    Natural Honey as a Safe and Efficacious Alternative to Skin Grafting Post-Surgical Excision for Necrotizing Fasciitis at Primary Care Level: A Preliminary StudyOpen Access

    Badryia Al Lenjawi, Rasheed Prieiyl, Diovanni Mendoza, Lowlwa Al Meslamani and Hashim Mohamed*
    DOI: https://dx.doi.org/10.17140/DRMTOJ-5-143
    Provisional PDF563.09 KB 563.09 KB
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    Abstract [+]

    Necrotizing fasciitis is a soft tissue bacterial infection that spreads rapidly resulting in the destruction of muscles, skin, and underlying tissue. Necrotizing fasciitis is defined as a fast and progressive inflammatory infection of the fascia leading to secondary necrosis of the subcutaneous tissue moving along the facial plane. Fournier gangrene is a type of necrotizing fasciitis involving the scrotum and perineal area. Patients suffering from acute necrotizing fasciitis require an effective regimen which includes surgical removal of devitalized tissues, systemic antimicrobials and mitigating underlying systemic disease processes. The burden of treating wounds following surgical debridement, on the other hand, can be challenging especially in the third world where resources are scarce resulting in suboptimal wound coverage and function. At primary care level we had the opportunity of using natural honey in 5 patients with non-healing wounds in either the lower limb or scrotum due to acute necrotizing fasciitis. This natural noninvasive approach offers a cost-effective and efficacious alternative to dermatotraction, skin grafting and negative pressure wound therapy. In these patients, the use of natural honey led to the restoration of the appearance and function of the fasciotomy wound especially in patients with co-morbidities or those refusing skin grafting due to cost, religious factors, etc. The authors present the clinical results followed by a discussion on the therapeutic properties of natural honey. This case series demonstrates the efficacy of topical raw honey as a catalyst for speeding the healing process by secondary intention thereby offering a safe and efficacious
    alternative for managing various wounds resulting from acute necrotizing fasciitis.
    Keywords
    Natural honey; Necrotizing fasciitis; Primary care; Wounds.


  • 2020, December

    opinion

    The Right to Abortion in North MacedoniaOpen Access

    Daniela Antonovska*
    DOI: http://dx.doi.org/10.17140/WHOJ-6-139
    Provisional PDF274.79 KB 274.79 KB
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    Abstract [+]

    Equitable access to safe abortion is part of the corpus of human rights. Providing women with access to safe abortion means protection and realization of one of their fundamental human rights. However, around the world, even nowadays, women face not only legal obstacles, but as well stigmatization and conviction against fulfillment of the right to abortion. In North Macedonia there a multiple type of barriers and large inequalities related to the accessibility and availability of reproductive healthcare
    services. Women with low socio-economic status are mostly affected. The need for contraception has not been met and reproductive healthcare services are unevenly distributed across the country.
    Keywords
    Laws; Abortion; Safe; Women’s sexual and reproductive rights; Healthcare services.


  • 2020, December

    research protocol

    Coronavirus Disease-2019, Diabetes and Dialysis in Southern Italy: The Second Wave Follow-upOpen Access

    Felice Strollo, Ersilia Satta, Carmine Romano, Carmelo Alfarone, Teresa Della Corte*, Giuseppina Guarino, Maria Pasquarella and Sandro Gentile
    DOI: http://dx.doi.org/10.17140/DROJ-6-148
    Provisional PDF593.61 KB 593.61 KB
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    Abstract [+]

    Background
    After the official coronavirus (severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)) pandemic declaration by the World Health Organization (WHO), Italy had the second-largest number of confirmed cases, after China. The Italian government introduced progressive infection-mitigation measurements, thus dramatically reducing social interactions and preventing virus spread. During the summer, infection containment measures progressively loosened until, due to an unjustified interpretation of some permissions and the excessive utilization of public transportation at school reopening, the contagion rate progressively increased until causing a severe challenge for our National Health Service (NHS) again.
    Aim
    To assess the efficiency of our previously described protocol in 18 Campania region-located Nefrocenter Consortium dialysis centers (DCs) as further adapted to new knowledge under the new ubiquitous contagion conditions and to identify SARS-CoV-2-infection mortality rate and risk factors.
    Methods
    381 HCP members underwent regular monitoring on April 1 and November 13, 2020. Dialysis patients did so too during that period according to the expected shifting prevalence over time (mean±SD:853±30 per month; range 825 to 873) vs (11.8% in April, and 14.8% in November vs. a pre-coronavirus disease-2019 (COVID-19) 12.0% rate in January).
    Results
    More patients got infected in November (10.19%) than in April (0,24%), and 22 patients of the 89 from the SARS-CoV-2 November positive subjects required hospitalization for moderate-severe symptoms (24.72%), with death unavoidably coming in 19 (86.36% of hospitalized and 21.35% of infected patients) compared to the only one recorded in April (0.12%). The pandemic’s two periods
    showed a strong association between mortality rate and often co-existing comorbidities, primarily represented by arterial hypertension, type 2 diabetes mellitus (T2DM), and chronic kidney disease (CKD).
    Conclusion
    The previously efficient contagion containment measures adopted by our DCs were not enough in November to fight the global infection risk pending on the whole Italian social community around. The author, discuss possible reasons and put forward further suggestions for the best handling of any future infection waves.
    Keywords
    COVID-19; Dialysis; Diabetes; Prevention; Contagion; COVID second round.


  • 2021, January

    commentary

    Challenges Related to Antimalarial Abuse in Coronavirus Disease-2019 Treatment in the Democratic Republic of CongoOpen Access

    Anselme Manyong* and Ange Landela
    DOI: https://dx.doi.org/10.17140/EPOJ-5-121
    Provisional PDF256.33 KB 256.33 KB
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    Abstract [+]

    Malaria is endemic to many African countries and geographies and remains the leading cause of morbidity and mortality on the continent. Ongoing efforts by health authorities to reverse the scale of malaria are often faced to the challenges of drug resistance often generated by therapeutic abuses relating to self-medication, sub-therapeutic under dosages and poor storage and handling of drugs throughout the pharmacy supply chain system.
    Keywords
    Malaria; Covid-19; Morbidity and mortality; Abuse antimalarial; Drug resistance.


  • 2021, January

    case series

    The Promise of Small Data for Telemedicine in Chronic Condition Management: A Real-World Case SeriesOpen Access

    Steven M. Schwartz*, Brigid Byrd, Helen Dempster and Tim Payne
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-117
    Provisional PDF578.99 KB 578.99 KB
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    Abstract [+]

    Connected care is defined as the “real-time, electronic communication between a patient and a provider, including telehealth, remote patient monitoring, and secure email communication between clinicians and their patients” (Alliance of Connected Care). Connected care can create a high-value interaction strategy with patients when it makes thoughtful use of commercially available digital health technologies with demonstrated both clinical and economic effectiveness. Karantis360™, is a home sensor technology that enables real-time tracking, data analytics and predictive care for personal (at home) care powered by IBM Watson Health. IndividuALLyticsTM is a telemedicine platform driven by a patent-pending an N-of-1 analytical engine and related digital dashboards that provides individual, patient level evaluation of treatment response. The underlying technology combines disparate digital health technology data with the best evidence-base guidelines with N-of-1 methodology. The output allows for creation of personalized treatments empirically tested at the patient level over time (aka over the course of care). When aggregated both within and across persons,
    the time-ordered data can build predictive pathways of behavior and ensure the relevant care and medical treatments are in place to support effective medical and self-management of chronic illness. This case-series report describes the implementation of a joint home sensor technology (big data) and an N-of-1 analytic engine (small data) with three elderly consented volunteer customers-patients of Karantis360™. Each person underwent successive, 2-week behavioral change treatment phases to determine usability, utility regarding medical and self-management and any proximal effects on health risks.
    Keywords
    Telemedicine; Small data; n-of-1; Internet of things; Chronic conditions; Self-management; Predictive analytics.


  • 2021, January

    case report

    Prolonged Cardiac Arrest in Severe Bupropion Intoxication: Everything You Should Know About Anti-Arrhytmics, Transesophageal Echocardiography Guided Resuscitation and Extracorporeal Membrane OxygenationOpen Access

    Caitlin Celis, Melvin Willems, Ben Pellens and Stefanie Vandervelden*
    DOI: http://dx.doi.org/10.17140/EMOJ-7-158
    Provisional PDF474.59 KB 474.59 KB
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    Abstract [+]

    A 30-year-old woman was admitted to the emergency department one and half hours after severe bupropion extended-release intoxication, estimated to be between 18 and 36 g. She initially presented with seizures and later developed signs of cardiotoxicity with persisting sustained ventricular tachycardia. Despite multiple defibrillation attempts and the administration of sodium bicarbonate,
    calcium gluconate and magnesium, restoration of sinus rhythm was found unsuccessful. In another attempt to treat this refractory ventricular tachycardia lidocaine was given followed by deterioration to asystole. During cardiopulmonary resuscitation (CPR), the quality of chest compression was assessed and optimised using transoesophageal echocardiography. Eventually venoarterial extracorporeal membrane oxygenation (VA-ECMO) was needed to achieve hemodynamic stability. In this case report we discuss the successful use of VA-ECMO after bupropion intoxication, which has only been reported in 3 other cases but should be considered as one of the treatment options in severe overdose cases. Also, the rare complication of asystole after lidocaine administration and the value of transoesophageal echocardiography during CPR will be discussed.
    Keywords
    Bupropion; Intoxication; Extracorporeal membrane oxygenation; TEE guided resuscitation; Antiarrhythmic therapy.


  • 2021, January

    original research

    The Effect of L-Carnitine, Green Tea Extract and Lotus Leaf Extract on the Body Fat Percentage in High Energy Diet-Induced Obese RatsOpen Access

    Chu Wan-Li* and Lin Wen-Chuan
    DOI: https://dx.doi.org/10.17140/OROJ-7-144
    Provisional PDF365.20 KB 365.20 KB
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    Abstract [+]

    Background
    Obesity has become a public health issue of global concern. Obesity is often associated with the occurrence of many diseases, and will also increase mortality; it not only affects personal health, but also increases healthcare costs, thus reducing social productivity and causing negative social and economic impacts. Therefore, ameliorating obesity is an issue worth attention and effort. The development of a natural and safe anti-obesity combination is worthy of further research. It is known that L-carnitine, green tea and lotus leaves have anti-obesity potential, but there is no research and discussion on this novel combination to improve body fat.
    Objective
    This study explored how the dietary supplement formula containing L-carnitine, green tea extract and lotus leaf extract (CGL) lowered the body fat accumulation in rats induced by high-energy diet.
    Design
    The test used 60-week-old male Sprague Dawley® white rats, which were first divided into the control group (12 rats were given normal feed) and the experimental group (48 rats were given high energy diet; HE). The HE group was further divided into H2O and CGL groups (296, 593 and 1186 mg/kg, to be designated as CGL-L, CGL-M, CGL-H respectively). The rats were first fed with feed for five-weeks, and then fed with different doses of CGL by gavage starting from the sixth-week. After nine-weeks of feeding, the rats were sacrificed to obtain their body weight, feed intake, body fat, serum biochemical indices and liver lipid measurements.
    Results
    The results show that the final body weight of HE+CGL-L (578.8±41.6 g) was significantly lower than that of HE+H2O (634.9±42.2 g), and the body fat amount of HE+CGL-L (36.6±9.8 g) was significantly lower than that of HE+H2O (49.4±13.8 g). Feed efficiency and calorie efficiency of HE+CGL-L were also significantly lower than that of HE+H2O (p<0.001). HE+CGL-M and HE+CGL-H were also able to significantly reduce the final body weight, body fat amount and serum-free fatty acid concentration (p<0.05).
    Conclusion
    CGL can significantly reduce the final body weight, body fat amount, body fat ratio, feed efficiency and calorie efficiency. CGL has the potential as a new dietary supplement for weight loss. However, the significance of these results on humans taking the supplement for prolonged periods of time is unknown and should be a focus for future investigations.
    Keywords
    Obesity; L-Carnitine; Green tea extract; Lotus leaf extract; Weight loss.


  • 2021, January

    editorial

    Nothing is SimpleOpen Access

    Mark Wesson*
    DOI: https://dx.doi.org/10.17140/EPOJ-6-e002
    Provisional PDF198.30 KB 198.30 KB
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  • 2021, January

    original research

    Barriers to Community Integration for Older People in Malaysia: A Qualitative Study from Occupational Therapist PerspectivesOpen Access

    Yau Y. Hui, Nathan Vytialingam and Sangeeta K. Singh*
    DOI: https://dx.doi.org/10.17140/PHOJ-6-152
    Provisional PDF383.46 KB 383.46 KB
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    Abstract [+]

    Introduction
    Existing research has addressed the importance of community integration (CI) and its benefits of dwelling in a community but has yet to address the methods and efficiency of improving these activities among older people. Thus, it is vital to understand how healthcare workers can integrate the benefits of CI among older people, especially with the use of occupational therapists (OTs). The latter are actively working to improve ageing individuals mobility within the community.
    Objective
    This study aims to identify Malaysian OTs’ perspectives on CI’s and its implication on older people.
    Method
    Occupational therapist from different states of Malaysia participated in a semi-structured interview, through a virtual medium (Zoom Cloud Meetings). The interview guide encapsulated the theory of critical incident technique (CIT).
    Results
    Thematic content analysis, over fourteen participants from 13 states of Malaysia, provided insights into CI’s barriers for older people in Malaysia. The findings revealed that multifaceted factors from an individual, organisational and socio-environmental perspective limit older people’s active CI engagement.
    Conclusion
    South-East Asia hierarchal and collectivist culture play a significant role in influencing all factors of CI. OTs must understand and incorporate appropriate cultural norms during CI practice development for the older population in Malaysia.
    Keywords
    Occupational therapist; Critical incident technique; Older people; Community integration; Qualitative study; Societal norms; Cultural norms.


  • 2021, January

    mini review

    Coronavirus Disease-2019 Clinical Trial Case Studies Within the Biotechnology and Clinical Research Organizations IndustryOpen Access

    Melanie K. Pearce and Nathanael E. Hughes*
    DOI: : http://dx.doi.org/10.17140/CTPOJ-1-118
    Provisional PDF290.07 KB 290.07 KB
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NOTE: The DOIs of the In-Press Articles will only function after the final publication of the articles and once they are uploaded to the Current Issues.
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Current Issue

  • 2015, March

    research

    Microbial Safety of Foods in the SupplyOpen Access

    Mohamed T. Elkhishin, Ravi Gooneratne and Malik A. Hussain
    DOI:
    PDF980.81 KB 980.81 KB
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  • 2015, September

    editorial

    Hepatitis C UpdateOpen Access

    Omar Massoud*
    DOI:
    PDF297.12 KB 297.12 KB
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  • 2016, July

    original research

    Comparisons between Portosystemic Shunting Modalities in Patients with Liver Cirrhosis and Portal HypertensionOpen Access

    Firuz Gafurovich Nazyrov, Castro-Benitez C, Andrey Vasilyevich Devyatov, Azam Khasanovich Babadjanov*, Umid Ravshanovich Salimov and Laziz Lappasovich Mardonov
    DOI:
    PDF1.48 MB 1.48 MB
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  • 2017, January

    mini review

    Iron and Copper Toxicity in Rat Liver: A Kinetic and Holistic OverviewOpen Access

    Rosario Musacco-Sebio, Christian Saporito-Magriñá, Juan M. Acosta, Alberto Boveris and Marisa G. Repetto*
    DOI:
    PDF775.76 KB 775.76 KB
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  • 2017, May

    short communication

    Pediatric Acute Liver Failure: Current PerspectivesOpen Access

    José Colleti Jr., Rafael Teixeira Azevedo and Werther Brunow de Carvalho
    DOI:
    PDF342.40 KB 342.40 KB
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  • 2018, May

    original research

    Training of Future Surgeons in Minimally Invasive Surgery Needs Intensification: A Multicentre StudyOpen Access

    Srinath Ranjit, Farhan Rashid, Sami Mansour, Khaleel Fareed, Neda Farhangmehr, Bruno Lorenzi and Alexandros Charalabopoulos*
    DOI:
    PDF1.19 MB 1.19 MB
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  • 2018, August

    editorial

    New Ideas on Limitations to VO2max: Five Major Determinants for VO2maxOpen Access

    Masahiro Kohzuki*
    DOI:
    PDF398.63 KB 398.63 KB
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  • 2018, September

    case report

    A Case Report on Vogt-Koyanagi-Harada Disease Seen at a Tertiary Hospital in the PhilippinesOpen Access

    Tathiana T. Marcelo*, Eleonore B. Iguban*
    DOI:
    PDF337.99 KB 337.99 KB
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  • 2018, October

    review

    Dementia and Oral Health: Is There A Connection?Open Access

    Suellan Go Yao and James Burke Fine*
    DOI:
    PDF387.93 KB 387.93 KB
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  • 2018, December

    case report

    Cranial and Spinal Subdural Hygroma Following Lumbar Epidural for Labour AnalgesiaOpen Access

    Elizabeth Thompson*, Nicholas Haden and David Hutchins
    DOI:
    PDF322.01 KB 322.01 KB
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    Abstract [+]

    Intracranial hygroma is a rare and probably missed complication of epidural analgesia secondary to accidental dural breech. The patient presented had a presumed spinal cerebrospinal fluid leak with symptoms of intracranial hypotension. Unusually the patient had both an intracranial subdural hygroma and rarely reported extensive spinal intradural (extra-arachnoid) collection following a lumbar epidural, administered in labour. Given the potential for progression to symptomatic neurological deficits, anesthetists should consider subdural hygroma when encountering patients with features of intracranial hypotension, or altered neurology following epidural. Pathophysiology, imaging and management are discussed.

    Keywords

    Subdural hygroma; Epidural; Dural puncture.


  • 2019, January

    editorial

    Pediatric and Neonatal Malnutrition: A Collaborative, Family-Centered Approach Improves OutcomesOpen Access

    Dena L. Goldberg* and Holly A. Van Poots
    DOI:
    PDF315.00 KB 315.00 KB
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  • 2019, January

    original research

    Determinants of Canine Rabies in Morocco: How to Make Pertinent Deductions for Control?Open Access

    Mounir Khayli*, Youssef Lhor, Sami Derkaoui, Yassir Lezaar, Mehdi El Harrak, Latifa Sikly and Mohammed Bouslikhane
    DOI:
    PDF529.13 KB 529.13 KB
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  • 2019, January

    original research

    Prevalence of Anaemia among Pregnant Women Attending 82 Division Nigerian Army Hospitals, EnuguOpen Access

    Chukwunonso Collins Ejiofor*, Rosemary Ujunwa Ozokono and Joshua Izuchukwu Ugwu
    DOI:
    PDF361.78 KB 361.78 KB
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  • 2019, February

    editorial

    Review on Artificial Intelligence and Applications in HealthcareOpen Access

    Ravish Huchegowda*, Srinivas Huchegowda, Jyothi R. Jain, Manoj Parthasarathy, Tharika Shraddha, Nagalakshmi C. Sathyanarayanshetty, Bharat V. Poojary, Farhan Zameer, Chetan H Gowda, Naveen H. Gowda and Huskur N. Venkatesh
    DOI:
    PDF376.42 KB 376.42 KB
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  • 2019, February

    original research

    Compliance with Tobacco Control Policies and Global Youth Tobacco Survey: A Cross-Sectional Comparison between GYTS 2000 and 2015 in Maharashtra, IndiaOpen Access

    Mangesh S. Pednekar*, Prachi P. Kerkar, Sameer S. Narake, Dhirendra N. Sinha and Surendra S. Shastri
    DOI:
    PDF536.76 KB 536.76 KB
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  • 2019, February

    letter to the editor

    “The Moustache Sign”: A Common Morphological Characteristic in Cardiovascular Disease TreatmentOpen Access

    Vineet Bhatia*, Parneesh Arora, Anunay Gupta, Suman Bhandari and Upendra Kaul
    DOI:
    PDF730.37 KB 730.37 KB
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  • 2019, February

    original research

    Reirradiation of Recurrent Tumors in Central Nervous System in Children and AdolescentsOpen Access

    Jose Alert*, Ivon Chon and Ramon Ropero
    DOI:
    PDF407.63 KB 407.63 KB
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  • 2019, March

    mini review

    Burden, Access, and Disparities in Kidney DiseaseOpen Access

    Deidra C. Crews*, Aminu K. Bello, Gamal Saadi and for the World Kidney Day Steering Committee**
    DOI:
    PDF466.97 KB 466.97 KB
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  • 2019, March

    retrospective study

    The Causes of Marginal Discrepancy of Fixed Dental Prostheses: A Cross-Sectional StudyOpen Access

    Asma Ismail, Yosra Gassara, Dalenda Hadyaoui and Mounir Cherif*
    DOI:
    PDF466.02 KB 466.02 KB
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  • 2019, March

    mini review

    Vision in the Hearing-Impaired: Enhanced or Deprived?Open Access

    Jaikishan Jayakumar*
    DOI:
    PDF329.07 KB 329.07 KB
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  • 2019, March

    editorial

    Challenges Facing Pediatric Dentistry Diplomates and the American Board of Pediatric Dentistry: Setting the Bar for Minimal Competency vs. ExcellenceOpen Access

    John E. Nathan*
    DOI:
    PDF248.71 KB 248.71 KB
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  • 2019, April

    editorial

    A Decision Support System is Needed for Rapid Triage of Chest Pain Patients Using High Sensitivity Troponin Testing-Based AlgorithmsOpen Access

    Chien-Chang Lee*, Cheng-Heng Liu, Sih-Shiang Huang and Cho-Han Chiang
    DOI:
    PDF300.13 KB 300.13 KB
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  • 2019, April

    editorial

    Engaging African Americans in Breast Cancer Prevention Strategies: A Partnership Between a Community Cancer Center and the African American Community in DelawareOpen Access

    Jennifer Sims-Mourtada*, Zohra Ali-Khan Catts, Patricia Swanson and Nora Katurakes
    DOI:
    PDF266.76 KB 266.76 KB
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  • 2019, May

    original research

    Deep-Ultraviolet Raman Spectroscopy for Cancer Diagnostics: A Feasibility Study with Cell Lines and TissuesOpen Access

    Nicole M. Ralbovsky, Vladimir Egorov, Eugene Moskovets, Paromita Dey, Bijan K. Dey and Igor K. Lednev*
    DOI:
    PDF593.90 KB 593.90 KB
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  • 2019, May

    letter to the editor

    Endoscopic Treatment of Refractory Variceal BleedOpen Access

    Shreyas Saligram*, Marina Roytman, Helen Wong and ThimmaiahTheethira
    DOI:
    PDF307.70 KB 307.70 KB
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  • 2019, May

    case report

    Anesthetic Considerations in Bilateral Congenital Anophthalmia: A Rare Clinical EntityOpen Access

    Lalit Gupta* and Manisha Manohar
    DOI:
    PDF317.55 KB 317.55 KB
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    Abstract [+]

    Congenital anomalies planned for ocular surgeries range from the rare to atypical to common. Many of this rare ophthalmopathy are associated with clinical syndromes and have important anesthetic implications. Not only is it important to know the syndrome we are dealing with, but it’s also the more important to understand the systems that are involved, the extent of involvement, potential anesthetic complications, right from the cerebrovascular, cardiovascular, endocrine, metabolic, neuromuscular, genitourinary systems to airway. Understanding these aspects becomes more important in rare clinical scenarios as it helps to plan the case, anticipate and treat the complications. Congenital anophthalmia is one of the rare conditions with an incidence of <3/1000 with microphthalmia reported in up to 11% of blind children, hence we report a rare case of bilateral congenital anophthalmia planned for excision of right ocular swelling.

    Keywords

    Ophthalmopathies; Congenital anophthalmia; Microophthalmia; Ocular surgery.


  • 2019, May

    case report

    Hardware Causing Hard Times: Use of the SuperNO2VA™ Nasal PAP Device to Address Airway Challenges Caused by Eroding Mandibular HardwareOpen Access

    Michael Marotta* and Geoffrey S. Kilgore, Jr
    DOI:
    PDF361.87 KB 361.87 KB
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    Abstract [+]

    Background

    Maintenance of the airway and adequate ventilation are essential for the anesthetized patient and may be compromised in patients with pan-facial trauma, abnormal dentition, abnormal mandibular space, or presence of dental hardware. We present an unusual case of a patient with a lack of natural mandibular structure and exposed mechanical hardware with fistula complicating intubation and ventilation prior to surgery.

    Case Presentation

    A 35-year-old male with a history of a self-inflicted gunshot to the left submandibular region approximately 6 years prior was scheduled for urgent mandibular hardware removal, closure of left facial fistula, and removal of several teeth. Pre-oxygenation and ventilation were complicated by extruding hardware and eroded skin, causing interference with a conventional facemask seal. The patient was pre-oxygenated using the SuperNO2VA™ nasal mask with which an adequate seal was achieved without use of a nasal trumpet and with a modified grip. Tracheal intubation via oral video laryngoscopy was successful, and the case proceeded uneventfully.

    Conclusion

    Adequate ventilation and airway maintenance can be difficult to achieve in patients with abnormal facial structure or mandibular mechanical hardware using conventional methods. The SuperNO2VA™ nasal mask can address airway issues for these patients peri-operatively.

    Keywords

    Anesthesiology; Airway management; Difficult airway; Airway devices; Difficult intubation; Ventilation; Oxygenation; Facial trauma; Mask ventilation.


  • 2019, May

    case report

    Pneumocephalus Caused by an Epidural Ozone Injection for Treatment of Disc ProlapseOpen Access

    Surath Manimala Rao*, Laxmi Kotgire and B.V. Savitr Sastri
    DOI:
    PDF319.44 KB 319.44 KB
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    Abstract [+]

    Pneumocephalus is a complication seen either after head trauma or post-neurosurgical procedure. It can be life-threatening if it turns into tension pneumocephalus. The presence of intracranial air indicates the presence of an open communication of cerebrospinal fluid. Air enters dura matter even without connection. Thin air flows upstream along the cerebrospinal fluid (CSF) pathway. Herein, we report a case of pneumocephalus in a 62-year-old female after epidural injection of Bupivacaine and Ozone for the treatment of a prolapsed disc. She was shifted to our hospital post-epidural injection for the management of severe headache. Though it is a rare complication, keeping this in mind will help to quickly diagnose, if need arises.

    Keywords

    Pneumocephalus; Head trauma; CT; Thunderclap headache.


  • 2019, June

    original research

    Changes on Electrocardiographic Patterns and Associated Factors among Chronic Obstructive Pulmonary Disease PatientsOpen Access

    Wondu Reta Demissie*, Samuel Tadessa, Elsah Tegene and Tewodros G. Mariam
    DOI:
    PDF449.30 KB 449.30 KB
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  • 2019, June

    original research

    Antihyperglycemic Mechanisms of Allium sativum, Citrus sinensis and Persea americana Extracts: Effects on Inhibition of Digestive Enzymes, Glucose Adsorption and Absorption on Yeast Cells and Psoas MusclesOpen Access

    Boris Gabin Kingue Azantsa*, Guy Roussel Takuissu, Etienne Junior Tcheumeni, Martin Fonkoua, Edwige Ruth Kemadjou Dibacto, Judith Laure Ngondi and Julius Enyong Oben
    DOI:
    PDF583.28 KB 583.28 KB
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    Abstract [+]

    Mechanisms by which some plants with antihyperglycemic effects reduce postprandial hyperglycemiaare not fully elucidated. This study was designed to investigate some action mechanisms of extracts from stem bark of Citrus sinensis, seeds of Persea americana and bulbs of Allium sativum including in vitro inhibition of α-amylase and invertase; glucophagic capacity, absorption capacity on yeast cells and psoas tissues.


  • 2019, June

    brief report

    The Praxitype: An Improved Interpretation of Genotype-Phenotype VariationOpen Access

    Vincent M. Riccardi*
    DOI:
    PDF336.22 KB 336.22 KB
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    Abstract [+]

    There is a need for an understanding of the genomic reality that realizes a connector between the genotype and the phenotype by addressing HOW the genotype actually manifests as the phenotype, as a function of the locus or the allele, mutated, variant or wildtype. That understanding is encompassed by the notion of the PRAXITYPE, which assembles and presents the available answers to the HOW!


  • 2019, June

    brief research report

    Compliance with Highly Active Antiretroviral Therapy (HAART) does not Prevent Human Papilloma Virus (HPV)- Related Cancers in Women Infected with Human Immunodeficiency Virus (HIV)Open Access

    Katherine Rogg and William R. Robinson*
    DOI:
    PDF358.08 KB 358.08 KB
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    Abstract [+]

    Introduction
    Cancer is one of the leading causes of death in people with human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS), due to behavioral choices and overlapping risk factors.

    Aim
    The purpose of this report is to determine the long-term incidence of human papilloma virus (HPV)-associated cancer in women with pre-invasive cervical neoplasia, and compliance with medication and cancer screening recommendations.

    Methods
    HIV-infected women diagnosed with pre-invasive cervical neoplasia and an HPV-associated malignancy between 1995-2008 were identified. Data collected includes: demographics, HIV treatment/response, malignancy treatment/response, other healthcare utilization, use of health navigators, and compliance.

    Results
    Seventy-one subjects were identified with HIV infection, cervical dysplasia, and at least ten years’ follow-up. 17/71 (24%) were identified with an HPV-related malignancy. The mean age of those diagnosed with HPV-related malignancy was 39-years. Malignancies included: Cervix-9, Vulva-7, Anal-4, Vagina-3, Uretha/Bladder-2, Oropharyngeal-3. Eight also had in-situ neoplasms: Cervix-4, Vulva-3, Oropharyngeal-1. Four subjects had 3 separate malignancies, and two others had 2 malignancies. Compliance with HAART correlated strongly with immunocompetence, response to therapy, use of patient navigators, and survival. Sixty out of saventy one (84.5%) subjects underwent screening mammography, 57/71 (80.3%) underwent colonoscopy, and 67/71 (94.3%) underwent pap smear testing. Compliance with screening compared favorably with the general population, and overall survival was similar.

    Discussion and Conclusion
    The long-term incidence and mortality from cancer in women with HIV and cervical dysplasia appears to be comparable to that seen in the general population, with the possible exception of oropharyngeal cancers. Compliance with cancer screening recommendations appears to be higher than in the general population. This suggests that structured primary care programs for HIV-infected women are effective in prevention/early diagnosis of cancer. Standardized screening programs for oropharyngeal cancers should be considered in this population.

    Keywords
    Human immunodeficiency virus (HIV); Cancer; Human papilloma virus(HPV); Women; AIDS;
    Highly active anti-retroviral therapy (HAART).


  • 2019, June

    original research

    The Effectiveness of Inferior Turbinoplasty in Children with Nasal ObstructionOpen Access

    Balegh H. Abdelhak*, Ahmed A. Sadek, Rasha A. Abdel Moneim and Zein A. Saad
    DOI:
    PDF366.88 KB 366.88 KB
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    Abstract [+]

    Objective
    To evaluate the effectiveness of medial flap inferior turbinoplasty for the treatment of nasal obstruction in children.

    Patients and Methods
    This study was conducted at the ear nose throat (ENT) Department at Minia University Hospital, Minia, Egypt which include 40 children with bilateral nasal obstruction due to bilateral hypertrophied inferior turbinates that did not respond to medical treatment for 3 successive months in the form of (systemic antihistamines, systemic and local decongestant drugs and local corticosteroid spray) who attended the ENT outpatient clinic. All patients were subjected to turbinate reduction through medial flap inferior turbinoplasty.

    Results
    Forty patients with bilateral hypertrophied inferior turbinates were assessed. Ninety days after surgery, 90% of patients transformed from severe or moderate degrees of nasal obstruction “pre-operatively” to mild degree or completely with no nasal obstruction; 80% of patients had grade I improvement in nasal obstruction and 14 patients had only grade II improvement; only
    10% of patients had crustation.

    Conclusion
    Medial flap inferior turbinoplasty is safe and effective in the treatment of nasal obstruction in children with almost no complications was recorded.

    Keywords
    Inferior turbinate hypertrophy; Inferior turbinoplasty; Nasal obstruction; Children.


  • 2019, June

    letter to the editor

    Coexistence of Tuberculosis and Metastatic Undifferentiated Carcinoma of Nasopharynx in Cervical Lymph NodeOpen Access

    Sameh Mezri*, Sameh Sayhi, Marwa Ben Amira, Issam Msakni, Besma Laabidi, Rania Ben M'hamed and Khemaies Akkeri
    DOI:
    PDF588.41 KB 588.41 KB
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    Abstract [+]

    The coexistence of a head and neck cancer and a lymph node tuberculosis is rarely described. The problem is essentially diagnostic. We report the case of a patient with cervical lymphadenopathy and non suspect swelliing of nasopharynx. Histopathological study of lymph node reveled an association of a tubercular adenitis and a metastasis of a squamous cell carcinoma.


  • 2019, June

    original research

    Changes in Estimated Glomerular Filtration Rate, Biochemical and Hematological Profile of Workers in Spray Painting Industry: A Cross-Sectional StudyOpen Access

    Christopher E. Ekpenyong* and Nseobong N. Nkereuwem
    DOI:
    PDF480.31 KB 480.31 KB
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    Abstract [+]

    Introduction

    There is a global increase in occupational exposure to solvents, some of which are suspected to cause acute or chronic toxic nephropathies in humans. However, limited studies have been done to evaluate the systemic effects of exposure to some of the commonly used solvents such as paints.

    Aim

    The aim of the present study was to assess the effect of chronic exposure to paint fumes on renal and hepatic functions of industrial spray painters. Methodology In this cross-sectional study, 49 occupationally exposed male industrial spray painters who had served for greater than 5 years were evaluated for changes in renal, hepatic and hematological indices using standard instruments and results were compared with levels in the unexposed (sex and age-matched) participants.

    Results

    Significant changes in markers of renal, hepatic and hematological functions were observed in the exposed compared with unexposed participants including significant decrease in estimated glomerular filtration rate (eGFR) and serum levels of potassium (K+) and chloride (Cl-), and significant increases in serum levels of creatinine (Cr), sodium (Na+), urea (Ur) and uric acid (UA) in the exposed compared to levels in the unexposed group. Abnormal serum levels of hepatic enzymes (AST, ALT and ALP) and hematological indices (PCV, total-RBC, nuetrophils, basophils, monocytes and lymphocytes) were also observed in the exposed compared to levels in the unexposed participants.

    Conclusion

    Prolonged exposure to paint fumes may be associated with a significant risk for hepato-renal dysfunction and hematotoxicity. Preventive measures should include limiting exposure and using antioxidant medications.

    Keywords

    Spray painting; Toxicity; Workers; Kidney; Liver; Blood cells.
    Abbreviations ALT: Alanine transaminase; ALP: Alkaline phosphatase; AST: Aspartate transaminase; eGFR: Estimated glomerular fitration rate; C-G: Cockroft-Gault; MDRD: Modification of diet in renal disease; Na+/K+/ATPase: Sodium potassium adenosine triphosphatase; PH: Hydrogen Concentration; PCV: Packed cell volume; RBC: Red blood cells; ROS: Reactive oxygen species; UA: Uric acid; Ur: Urea.


  • 2019, July

    original research

    Loss of Pancreatic β-cell Secretory Function During Disease Progression in Type 2 Diabetes Mellitus – A Small Cross-Sectional StudyOpen Access

    George B. Kudolo*
    DOI:
    PDF517.99 KB 517.99 KB
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    Abstract [+]

    Introduction: Overt type 2 diabetes mellitus (T2DM) is a chronic progressive disease which is produced by the collusion of three metabolic defects-increased hepatic glucose production, impaired pancreatic β-cell insulin secretion and decreased insulin action. The measurement of plasma glucose 2 hours post-ingestion of 75 g of glucose during the oral glucose tolerance test (OGTT) may be used to classify individuals as normal glucose tolerant (NGT), impaired glucose tolerant, T2DM and T2DM with pancreatic β-cell failure.
    Objectives: This study was undertaken primarily to show the importance of assessing the pancreatic β-cell function especially during the care of the diabetic patient.
    Methods: A standard 75 g glucose tolerance test (OGTT) was administered to four groups of 8 subjects (4 male, 4 female). Blood was drawn every 15 minutes for 2 hours for the measurement of glucose, insulin and C-peptide and the measurement of the area under the curve (AUC(0→2)) over the 2-hour period.
    Results: American Diabetes Association (ADA) criteria were used to classify the subjects. The normal glucose tolerant (NGT), had 2 h glucose 111±11 mg/dL, those with impaired glucose tolerance (IGT) had 2 h glucose 160±13 mg/dL. The 2 h glucose for the T2DM group was 258±27 mg/dL and those for the T2DM-PE group was 260±42 mg/dL. The AUC(0→2) for NGT group were 254±40 mg/dL/h, 112±61 μU/mL/h and 10.2±4.6 ng/ml/h for glucose, insulin and C-peptide, respectively. The AUC(0→2) for the IGT group were 394±32 mg/dL/h, 160±48 μU/mL/h and 19.8±7.7 ng/ml/h for glucose, insulin and C-peptide, respectively. The AUC(0→2) for the T2DM group were 474±62 mg/dL/h, 194±40 μU/mL/h and 13.4±4.7 ng/mL/h for glucose and insulin, and C-peptide, respectively. The AUC(0→2) for the T2DM-PE group were 481±80 mg/dL/h, 51±29 μU/mL/h and 7.2±2.8 ng/mL/h for glucose, insulin and C-peptide, respectively. There was no significant difference between the diabetic groups with respect to the glucose AUC(0→2) but a significant difference existed in the insulin AUC(0→2), (p<0.0001) mirrored by the fasting plasma insulin levels (30±8 μU/mL vs 14+8 μU/mL, for T2DM and T2DM-PE, respectively, p<0.0005). Although there was about a 300% increase in fasting insulin between the IGT and T2DM groups, the corresponding fasting C-peptide levels were only about 15%. This is probably due to differences in hepatic and renal functions in those two groups, the processes that control insulin and C-peptide levels in the body.
    Conclusion: Although measurement of blood glucose appears adequate in the diagnosis of the diabetes, it seems that plasma insulin/C-peptide measurements could guide physicians in their choice of medications for the treatment of diabetic patients, especially when the pancreas begins to fail. To that end, larger studies are warranted to study the effects of hypoglycemic agents on hepatic insulin extraction and renal C-peptide excretion to ascertain the reliability of the plasma insulin and C-peptide levels.
    Keywords
    Type 2 diabetes mellitus; Pancreatic β-cells; Oral glucose tolerance test; Pancreatic exhaustion.


  • 2019, July

    original research

    Exploring the Everyday Lived Experience of African American People Living with HIV/AIDS (PLWH) in the Rural SouthOpen Access

    Jill E. Rowe*
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    Aims/Objectives

    Despite previous findings attesting to the syndemic nature of human immunodeficiency virus (HIV), chronic disease and mental illness coordination of these issues remains a significant barrier to initiating and maintaining the delivery of mental and physical health care to persons living with HIV (PLWH). These inequities are even greater when applied to rural settings, particularly in areas that are medically underserved. To date, there is scarce research regarding the lived experiences of African American PLWH
    in rural settings. Constructivist grounded theory was used to analyze this qualitative data set. These discourses provide a rich narrative regarding effective systems of care, the context in which these processes take place and related constraints or limitations of the current systems.

    Methods

    In-depth interviews with 24 African American PLWH both inside (N=20) and outside (N=4) of care in rural Northwestern Virginia were conducted. Rural African American PLWH were queried about their perceptions of the provision of HIV health care services, barriers to linkages to care, retention of PLWH in care, and recommendations for improving HIV health care services for rural PLWH.

    Results

    Participants offered insights on the linkages to health and mental health care consistent with the pattern recommended by the cascade of care (i.e. pre-screening, testing, refer to treatment, treatment and sustain treatment). Participants identified contextual factors, including traumatic events, medication (side effects), other chronic health issues, issues with the current health and mental health system, stigma, and lack of social support. We highlight PLWH’s recommendations for linking rural PLWH into care and sustaining that care.

    Conclusion

    We discuss the implications of these findings for programmatic development in the rural context.

    Keywords

    Rural African Americans living with HIV; Barriers to HIV health care; Rural South; HIV lived experience.


  • 2019, July

    retrospective study

    Outcomes of Vocal Fold Immobility After Pediatric Cardiovascular SurgeryOpen Access

    Anatoli F. Karas, Aniruddha Patki, Marisa A. Ryan, Patrick A. Upchurch, Rose J. Eapen and Eileen M. Raynor*
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    Objectives
    Cardiovascular surgery is increasingly performed in children for congenital malformations of the heart and great vessels. Observed as vocal fold immobility, recurrent laryngeal nerve injury is a well-described complication. As overall outcomes improve and patients live longer, the sequelae of vocal fold immobility amplify insignificance. Families are often unaware of the longterm issues related to vocal fold immobility especially with regard to need for alternative alimentation routes. We report on the incidence of use of feeding tubes, the timing of vocal fold function return and need for additional aerodigestive interventions.
    Methods
    We reviewed 65 patients <2-years who underwent cardiovascular surgery at a tertiary center from 2008-2013 and were diagnosed post-operatively with vocal fold immobility by fiberoptic examination.
    Results
    Patent ductus arteriosus and hypoplastic left heart syndrome were the most common of the cardiovascular anomalies included. The majority (92%) had unilateral left immobility. Recovery of motion was observed in 29% ranging from 1-month to 3-years. Hypoplastic left heart syndrome had a significant negative correlation with recovery. Forty-six percent required gastrostomy tube placement either to supplement their oral intake or to completely meet their nutritional needs. Forty-eight percent required subsequent aerodigestive surgery including direct laryngoscopy/bronchoscopy (22%), tracheostomy (8%) and vocal fold injection (5%).
    Conclusion
    Counseling of families and primary care providers regarding the impact of pediatric vocal fold immobility after cardiac surgery should include the high potential requirement for supplemental alimentation as well as the need for feeding and speech therapy. Longitudinal otolaryngology and speech pathology care is imperative with vocal fold immobility since the majority of these patients do not experience functional recovery and may require further interventions over time.
    Keywords
    Vocal cord paralysis; Pediatric cardiovascular surgery; Pediatric aerodigestive disorders; Voice; Swallow; Gastrostomy.


  • 2019, July

    original research

    Why do HIV PrEP Patients Become Lost-to-Care and How Can We Improve PrEP Retention?Open Access

    Sahana Jayaraman*, Linden Lalley-Chareczko, Sarah Williams, Devon Clark, Caitlin Conyngham and Helen C. Koenig
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    Objectives

    To assess reasons for patients being lost-to-care (LTC) at an urban health center (Philadelphia, PA, USA) that provides access to oral tenofovir/emtricitabine(TDF/FTC) as pre- exposure prophylaxis(PrEP) to patients ages 13-30 years through a drop-in model of care.

    Methods

    Ninety-nine patients were identified as LTC based on not visiting a clinician in ≥4 months during the period April 2016-January 2017. Patients were contacted by phone/email to participate in a voluntary telephone survey regarding reasons for falling out of care. Results were analyzed descriptively.

    Results

    Of the 99 patients preliminarily identified as LTC, 19 completed the survey. Reason(s) for becoming LTC included: 47%(9) relocation, 11%(2) transportation difficulties to/from clinic, 26%(5) financial/insurance problems, 5%(1) perceived medication side effects, 16%(3) trouble remembering to attend appointments regularly, 5%(1) difficulty with daily medication adherence, and 0% social stigma. Furthermore, 21%(4) remain at high-risk of HIV/STI acquisition after becoming LTC. The main study limitations are selection bias and small sample size, where the small sample size did not allow for statistical significance.

    Conclusion

    While the major cause for becoming LTC was relocation, these findings suggest 37% of LTC incidences may be preventable with additional/up-front support. Because 21% of LTC patients remain at high-risk of HIV/STI acquisition, proactive re-engagement initiatives are potentially useful.

    Keywords

    HIV/AIDS; Pre-exposure prophylaxis; Retention and care; Socioeconomic factors; Adolescent Health; Lesbian/Gay/Bisexual/Transgender Persons.


  • 2019, July

    case report

    Transcatheter Arterial Embolization in Postpartum Hemorrhage: A Case ReportOpen Access

    Alka Chhabra*, Anil Bhiwal, Neha Pandey, Sitaram Barath and Sunanda Gupta
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    Background

    Postpartum haemorrhage is the leading cause of maternal mortality and morbidity. The significant impact of postpartum haemorrhage (PPH) on maternal mortality can be reduced if timely measures are implemented. Transcatheter arterial embolisation (TAE) is an alternative therapeutic strategy for PPH.

    Case report

    We report a case of postpartum haemorrhage which was managed by transcatheter arterial embolization in lieu of hysterectomy to preserve fertility and menstruation in a 27-year-old patient.

    Conclusion

    The critical role of obstetrician, anaesthesiologist and interventional radiologist as a team, improve the quality of care and patient safety.

    Keywords

    Postpartum hemorrhage (PPH); Peripartum hysterectomy; Transarterial embolisation.


  • 2019, July

    original research

    In Need of Care but Providers of Care: Grandparents Giving Fulltime Care to their Grandchildren in Rural UgandaOpen Access

    Neema Stella* and Nankwanga Annet
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    Background

    In most African countries, the elderly face challenges that affect their health and wellbeing and are more pronounced because of the systemic factors of inadequate health care, food insecurity and the general care. Increasing population of the elderly persons in Uganda is raising concern than ever before. The purpose of this paper to ascertain care available to the rural elderly persons and their role as carers for their grandchildren and implications on their wellbeing.

    Methods

    This was a qualitative study conducted among the rural elderly aged 60 years and above in eight purposively selected district that included Lira, Nebbi, Kampala, Luwero, Pallisa, Jinja, Mbarara, and Ntungamo. The study sample consisted of 101 elderly person from whom in-depth interviews were conducted. Data was analysed using qualitative thematic content analysis.

    Results

    Rural elderly in Uganda face a lot of constraints that include access to healthcare and information, poor economic status, food insecurity and poor nutrition, and poor accommodation and housing conditions. Two broader themes emerged inductively from the analysis that include care available for the rural elderly and providing care to grandchildren. These themes generated several subthemes. Taking care of grandchildren crippled the elderly and reduced the economic benefits. That said some rural elderly were happy and felt fulfilled to care of the grandchildren despite the lack of resources.

    Conclusion

    The rural elderly in Uganda are living in doleful conditions with limited care and support. They need care but are the providers of care to the grandchildren. They are frails and may not afford to provide adequate care. They care for grandchildren many of whom are orphans and vulnerable yet they themselves need care. It is important the government and the community re-enforce this care not to put strain on elderly. The rural elderly unique challenges necessitates special targeting and mobilization of resources at the household, local, district and national levels.

    Keywords

    Grandparents; Care; Orphans; Grandchildren; Skip-generation; Uganda.


  • 2019, July

    original research

    Uptake of the BI-RADS Ultrasound Characterization of Breast Masses: Perceptions among Staff at Mulago National Referral Hospital, UgandaOpen Access

    Alex Onono and Aloysius Gonzaga Mubuuke*
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    Introduction

    The Breast Imaging-Reporting and Data System (BI-RADS) is a classification system aimed at standardizing risk assessment during breast ultrasound to ensure patient safety. BI-RADS is currently used in Uganda so as to standardize breast ultrasound reporting and enhance patient management.

    Objective

    This study aimed at exploring staff perceptions towards the use of the BI-RADS ultrasound characterization of breast masses.

    Methodology

    It was an exploratory qualitative study that involved staff who perform breast ultrasound at Mulago Hospital in Uganda. Focus group discussions and individual interviews were conducted.

    Findings

    All staff used the BI-RADS system, however, some of them had a negative attitude towards BI-RADS. The three major themes that emerged were: standardization of breast ultrasound reporting for patient safety; need for more Continuous Professional Development (CPD) and challenges with the BI-RADS system.

    Conclusion

    The study demonstrated that the staff generally had positive perceptions and attitude of the BI-RADS system and felt that it was an efficient system for ensuring patient safety and further reduce mortality from breast cancer.

    Keywords

    Breast imaging-reporting and data system (BI-RADS); Breast; Ultrasound; Staff perceptions.


  • 2019, August

    review

    The Use of Single-Cell Transcriptomics’ to Detect Cellular Transition through Notch Signaling and Receptor Expression in Differentiated Kidney Collecting Tubule Cells in Adult Mice: A ReviewOpen Access

    Matthew A. Cornacchia*, Soroush Nomigolzar, Giovanni Charles, Himax Patel and Kenneth Luberice
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    Transcriptomics has allowed for a better understanding of disease, and the sequencing of individual genes is becoming a leading approach to discovering novel germ lines. A newly defined cell type, described as transitional cells, was characterized based on their expression of key marker genes that define principle cells (PC) and intercalated cells (IC). Gene expression patterns suggested that a Notch signaling pathway was activated during the transition from IC to PC. An experimental model studying the transition in an inducible transgenic mouse demonstrated that Notch signaling and receptor expression is sufficient to drive cell transition in differentiated adult kidney collecting tubule. The identification of novel cell lines allows for a more accurate diagnosis of kidney disease and precise staging of disease. Molecular profiling and precision therapy will continue to revolutionize the field of medicine and warrants further exploration.

    Keywords

    Transcriptomics; Kidney disease; Principle cell; Intercalated cell; Notch signaling; Gene sequencing.

    Abbreviations

    PC: Principle cell; IC: Intercalated cell, DNA: Deoxyribonucleic acid; RNA: Ribonucleic acid; mRNA: Messenger ribonucleic acid.


  • 2019, August

    case report

    A Case of Pleomorphic Adenoma Metastasising to Contralateral Supraclavicular Lymph NodeOpen Access

    Esmail Abdulahi Ahmed*, Kamil Akdag, Onur Üstün, Ayça Başkadem Yılmazer, Pınar Özay Nayır, Zeynep Aydodu and Yavuz Uyar
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    Introduction

    Pleomorphic adenomas are the most common benign parotid tumours in all populations. Management always consists of a curative superficial parotidectomy. However, rare cases described, in which these histological benign tumors metastasize to distant sites. We present an example of a recurrent parotid pleomorphic adenoma with a contralateral supraclavicular lymph node metastasis after several surgical interventions.

    Case report

    In this case, we reported reported a case of 29-years male with extensive metastasis in submandibular, submental and also very rarely seen contralateral supraclavicular lymph node metastasis. Parotidectomy with preservation of facial nerve and radiotherapy was given to the patient since the lesions were very aggressive.

    Conclusion

    The patient had several surgical interventions, so it is essential to do meticulous resection in the first surgery to prevent local recurrence and distant metastasis.

    Keywords

    Pleomorphic adenoma; Metastasizing pleomorphic adenoma; Salivary gland benign neoplasia.


  • 2019, August

    review

    Anticancer Natural Products: A ReviewOpen Access

    Ranwa A. Elrayess and Heba N. Gad El-Hak*
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    Historically, natural products played a forceful role in human treatment ailments. Nowadays, natural products include a large part of current pharmaceutical agents, mostly in the field of cancer therapy. The main aim of this review is to provide a comprehensive summary of the most known natural product used as anticancer globally, including various other natural products. Many of these natural product appears to act through an anticancer mechanism. Overall, natural product research is a vigorous tool to discover novel biologically active components with unique mechanisms of action. Given the diversity of nature, it is sensible to indicate that chemical leads can be produced that are able to interact with most therapeutic targets. This review creates a solid foundation for further study these natural products with additional research and study.

    Keywords

    Anticancer; Natural product; Plant compounds; Marine flora; Microorganisms; Venom.


  • 2019, August

    review

    Stroke Prevention: Extra-Cranial Carotid Artery TherapyOpen Access

    Christopher J. White* and Jose David Tafur Soto
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    A patient-centered approach is reasonable in candidates for carotid revascularization. The patient and their physician should discuss the available treatment options, including revascularization (either carotid artery stenting (CAS) or carotid endarterectomy (CEA)) with their physician. There remains uncertainty regarding the value proposition for revascularization (either CEA or CAS) in asymptomatic patients as a strategy to prevent stroke. Investigation continues into characterizing high-risk carotid plaque subsets, but until that data is available, physicians and patients should continue to strive to achieve the best outcomes with the information that is currently available. The other consideration in asymptomatic patients is that there is a cumulative benefit to revascularization that is dependent on life expectancy. However, the magnitude of the benefit of revascularization, over the longer term in the setting of multifactorial medical therapy, including statins, is not known.

    Keywords

    Carotid endarterectomy; Carotid stent; Angioplasty; Embolic protection devices.


  • 2019, August

    case series

    Malignant Restenosis and Progression of Disease in Psoriatic Patients Undergoing Coronary Interventions: Is it the Koebner’s Phenomena to Blame?Open Access

    Vineet Bhatia*, Parneesh Arora, Vineet Relhan and Upendra Kaul
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    Severe psoriasis is associated with an enhanced risk of cardiovascular (CV) diseases. The potential impact of psoriasis on the prognosis following coronary revascularization (percutaneous coronary intervention (PCI) or surgical) is not well studied and sparse data available in literature points towards a grim long-term prognosis. The following two cases highlight this phenomenon. We also discuss the plausible reasons responsible for the poor prognosis and propose some possible mechanisms for the same.


  • 2019, August

    original research

    Ovine Network between Fatteners and Breeders in Middle Atlas of Morocco: Where to Act to Prevent the Spread of Epidemics?Open Access

    Lezaar Yassir*, Khayli Mounir, Caroline Coste, Renaud Lancelot and Bouslikhane Mohammed
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    Objective

    This cartographic and analytical study, using the social network analysis method, aims to characterize sheep mobility from breeders producing lambs in the Middle Atlas Mountains to the fattening centers, passing through livestock markets in order to describe the exchange network, to identify the main mobility hubs and to secure the production of fattening lambs by improving the efficiency of the epidemiological surveillance system for “peste des petits ruminants” (PPR) in lambs producers of the Middle Atlas in Morocco.

    Design

    Descriptive cross-sectional study within the framework of active epidemiological surveillance. It was carried out at a regional level, for mapping the movements of sheep and to analyze the network of exchange relating to this species by the Social Network Analysis (SNA) method in the middle atlas massif and in the zone of sheep fatteners to guide epidemiological surveillance efforts. A total of 807 breeders producing lambs, sheep fatteners and traders were surveyed, including 54 fatteners in fattening workshops (sampling fraction of 48.6%), 150 breeders and traders in livestock markets of Middle Atlas and 603 producing lamb breeders of this massif (sampling fraction at the massif level of 6.64%).

    Results

    The study revealed a very strong commercial relationship between middle Atlas breeders and fattening zone breeders whose longrange outflows mainly converge towards urban consumption centers. The major strategic livestock markets of the middle Atlas proved to be key points in the articulation of the flows, as was the commune gathering the fatteners. Centrality indicators were used to identify the main trade hubs that contribute to the spread of diseases and to quantify their importance in the influence of sheep movement, while network cohesion parameters have shown that network is vulnerable to the spread of epidemics.

    Conclusion

    The results of this survey revealed the main commercial hubs at the Middle Atlas level and at the level of the province of fatteners, which represent a great risk of spreading sheep diseases over long distances rather quickly in event of an epizootic, but also representing the ability to control the spread through the control of the movement of animals at their level.

    Keywords

    Ovine network; Epizotic of (Peste des Petits Ruminants); Mapping; Social network analysis; Hub; Betweenness; Degree; Strong component; Cutpoint.


  • 2019, August

    case series

    Oligo-Metastatic Carcinoma Cervix: A Few Do Extremely WellOpen Access

    Pallavi Nair and Francis V. James*
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    The consequence of metastatic carcinoma cervix is regarded to be poor. We present three patients with carcinoma cervix who relapsed in the paraaortic nodes, lungs and vertebra. All of them had oligometastatic disease and were treated with chemotherapy to the lung lesion and radiotherapy to the bone lesion and paraaortic nodes. After more than 5-years they are disease free and on regular follow-up.

    Keywords

    Carcinoma; Cervix; Oligometastasis; Paraaortic lymph nodes; Chemoradiation; Chemotherapy.


  • 2019, August

    review

    Prothrombin Complex Concentrates in Post-traumatic Hemorrhage: A ReviewOpen Access

    Ozgur Karcioglu*, Ebru Yilmaz, Selman Yeniocak and Hakan Topacoglu
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    Prothrombin complex concentrates (PCC) has long been used to reverse vitamin K antagonists (VKA)-induced coagulopathy rapidly and safely. However, its use in trauma-induced coagulopathy (TIC) in patients not using VKA drugs is yet to be elucidated. This article is a narrative review and analysis of the most recent literature to analyse consequences, and intended effects associated with this treatment modality in TIC. Utilization of PCC was addressed in the literature data found by searches of databases. The indications, efficacy and outcomes associated with the use of the product were reviewed in the articles. Some studies point out promising results with respect to PCC use to overcome the VKA-related coagulopathy in victims of trauma. PCC may be a viable option for resuscitation in emergency and critical care in the management of severe hemodynamic deterioration induced by trauma, despite contradictory findings in the literature.

    Keywords

    Blood coagulation factor; Trauma; Hemorrhagic shock; Exsanguinating hemorrhage.


  • 2019, September

    retrospective study

    Exploring the Association between Demographic Factors and Breast Cancer Diagnosis at a Holistic Breast Imaging Clinic in Cairo, EgyptOpen Access

    Hanan S. Gewefel*, Sophia Michelen, Bodour Salhia, Iman Ewais, Mona Fouad and Sejong Bae
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    Background

    Breast cancer is among the most common cancers affecting women worldwide, including Egypt. Age is a well-known determinant of breast cancer risk; however, more data is needed to better understand the importance of age on incidence of breast cancer in the Middle East. Being overweight or obese are also known risk factors—especially for post-menopausal women–however, these data are not available for women in developing countries.

    Purpose

    The purpose of this study was to qualitatively explore the association between age, breast density, and demographic factors of breast cancer patients, across a spectrum of radiological breast diagnoses at a large Breast Imaging Clinic in Cairo, Egypt.

    Materials and Methods

    We explored the association between age, demographic factors, and Breast cancer incidence among 6,711 women undergoing mammographic screening over a consecutive period of 6-years. Data was collected from March 2007 until March 2013 and extracted

    from an electronic data base system.

    Results

    A total of 6,711 participants were included in this study. The median age of all patients was 46.1. Mean body mass index (BMI) of 28.5, where 34% of the patients were overweight and 32.4% were obese. Older women were more likely to be obese compared to younger women (38.4% vs 18.1%, p<0.001). Older females were more likely to have less dense breasts (ACR: A) compared to younger females (18.1% vs 8.7%, p<0.001). Women older than 40 had a higher confirmed number of breast cancer diagnoses compared with the younger age group (10.7% vs 3.5%, p<0.001). Women with breast cancer were more obese (p<0.001), had denser breasts (p<0.001), were post-menopausal (p=0.002), and more likely to be Muslim (p=0.0021). In the multivariate analysis, aforementioned factors were significant predictors for confirmed diagnosis.

    Conclusion

    To our knowledge this is the largest study to examine the association of radiological breast assessments on breast cancer incidence, obesity and demographic factors in Egypt. Although data shows the global burden of breast cancer is shifting to the developing world and affecting younger women at alarming rates, our data demonstrated a very low occurrence of breast cancer in both age groups.

    Keywords

    Breast cancer; Breast radiological diagnoses; Phenotypic variations; Breast imaging-reporting and data system (BI-RADS).


  • 2019, September

    letter to the editor

    Call Me Anything but Thoughtless or Misguided in IBD ManagementOpen Access

    Nicholas V. Costrini*
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  • 2019, September

    review

    Do You Still Use Topical Antibiotics after Intravitreal Injections?Open Access

    Banu Turgut Öztürk*
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    Nowadays intravitreal drug injection is the most frequent treatment for retinal diseases. Despite widely use endophthalmitis is already most feared complication of every intravitreal injection in each patient. In clinical setting topical antibiotics have been widely used as a precaution to prevent endophthalmitis however recent published evidence showed it to be unnecessary. Furthermore repeated use of topical antibiotics might give rise to antibiotic resistance in conjunctival flora and thus more aggressive endophthalmitis. Strict asepsis has been awarded as the main rule for endophthalmitis prophylaxis intravitreal injection.

    Keywords

    Intravitreal injection; Steroid; Anti-vascular endothelial growth factor (VEGF); Topical antibiotic; Enodphthalmitis; Antibiotic resistance.


  • 2019, October

    systematic review

    Complications Related to Implants Used in Anterior Bleb Forming Glaucoma Surgery: A Systematic Review of the LiteratureOpen Access

    Alejandra Salinas*, Fabián Rodríguez and Javier Bardavío
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    Purpose

    To make an account of published implant-related complications (IRC) by a systematic review of the literature.

    Methods

    A systematic search of Pubmed and Scopus databases and Google Scholar engine was performed with selection criteria to detect papers on IRC. We excluded unrelated papers and reviewed selected ones. We considered papers that did not explicitly state about occurrence or not occurrence of IRC as non-IRC reporting. Main outcome measures were the number of papers reporting on complications, IRC, and types of IRC.

    Results

    After the search, selection, and addition, we studied 109 papers. Incidence of IRC was 4.5%, half required explantation. While 26 implant studies found IRCs (23%), 13 case reports on surgical complications, 8 (61.5%) of them reported IRC. Frequent complications were conjunctival erosion, blockage of the tube, migration to anterior chamber or damage to surrounding tissues.

    Conclusion

    Most papers did not report on IRC. Length or nature of studies may skew finding IRC. The incidence of IRC was 4.5%. Hard and sharp implants carry a greater risk of IRC and explantation.

    Keywords

    Implant-related complications (IRC); Glaucoma surgery; Anterior bleb forming.


  • 2019, October

    original research

    A Study to Explore the Impact of Endometriosis in the United Kingdom: A Qualitative Content AnalysisOpen Access

    Babu Karavadra*, Paul Simpson, Edward Prosser-Snelling, Edward Mullins, Andrea Stöckl and Edward Morris
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    Objective

    To gain insight into the areas that impact women with endometriosis.

    Design

    A qualitative content analysis of an online survey.

    Setting

    Online questionnaire via Endometriosis UK.

    Population

    Women diagnosed with endometriosis of any age range.

    Methods

    Free-text online questionnaire through Endometriosis UK completed by women. Results were analysed using NVivo version 9, qualitative analysis software. The software creates links between common words (codes), and these links allow data to be placed in nodes (called themes) which are then developed into categories. Content analysis was used to understand this data.

    Main outcome measures

    Impact of endometriosis on women’s lives.

    Results

    In total, 1872 questionnaires were returned but not everyone was able to identify ten separate features that affected them. As such, 1872 women provided at least one area that affected them, 1800 provided two areas, 1770 provided three areas and 1600 provided four areas. The results show that the main areas of concern for these women were pain (53%), heavy menstrual bleeding (11%), low mood (8%) and the perceived lack of understanding displayed by other people (7%). Other important factors were fertility concerns, impact on employment, problems with the medical team and uncertainty. These then impacted on their daily life whereby some women felt “guilty” for not ‘being a normal mother’. A key term that resonated was that endometriosis is an “invisible disease”.

    Conclusion

    This analysis provides us with insight into the complex psycho-social factors that interact with bio-physical symptoms. Further research is required in sub-population groups such as teenagers and ethnic minority women to explore any differences in impact and how care can be guided accordingly.

    Keywords

    Endometriosis; Impact; Qualitative methods; Quantitative methods; Online survey.


  • 2019, October

    original research

    Sirtuin Inhibitor as a Novel Cell Cycle Checkpoint and Regulator of the TP53-MDM2 Pathway in Uveal MelanomaOpen Access

    Zachary K. Goldsmith, Matthew W. McEwen, Mercy W. Kibe, Kelley Yuan, Hua Yang, Qing Zhang, Sumana R. Chintalapudi, Bradley T. Gao, Monica M. Jablonski, Benjamin King, Ryan P. Lee, Abigail Lepsch, Neel Patel, Xiang Di Wang, Hans E. Grossniklaus, Matthew W. Wilson*, Vanessa M. Morales-Tirado*
    DOI:
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    Purpose

    The liver is the most common site of uveal melanoma (UM) metastasis with approximately 50% of UM patients being affected. With no proven therapies that mitigate metastases the mortality rate is 85% within the first year after detection of the liver disease. In this study, we provide a mechanistic understanding of the de-regulation of the TP53-MDM2 pathway in UM, which plays a central role in tumor biology.

    Methods

    We investigated the TP53-MDM2 signaling pathway in the microenvironment of liver metastases taken from both a murine orthotopic xenograft and post-mortem metastatic UM human liver. These findings were studied in-depth using both primary and metastatic UM cell lines treated with the MDM2 antagonist Nutlin-3a and the sirtuin inhibitor and transcriptional activator of TP53, Tenovin-6.

    Results

    De-regulation of the TP53-MDM2 signaling pathway is specific to the liver microenvironment, providing a survival mechanism for UM metastases. Tenovin-6, not Nutlin-3a, reduced UM cell survival by increasing the percentage of cell death and reducing the percentage of proliferating cells. Tenovin-6 increased acetylation of p53, reduced ubiquitination of the protein, and acted as a cell cycle regulator.

    Conclusion

    Our findings suggest that in patients with metastatic UM de-regulation of TP53-MDM2 signaling pathway promotes growth of the liver metastases and provides pre-clinical information on the potential of targeting of the TP53-MDM2 signaling pathway via Tenovin-6.

    Keywords

    Uveal melanoma; Ocular tumors; Nutlin-3a; Tenovin-6; TP53; MDM2.


  • 2019, October

    opinion

    The Phenotype Landscape of Cancer in the Genotype EraOpen Access

    Daniel Gandia*
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  • 2019, October

    review

    Pulmonary Artery Hypertension in Children Living with Sickle Cell AnaemiaOpen Access

    Barakat A. Animasahun* and Moriam O. Lamina
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    PDF328.61 KB 328.61 KB
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    Pulmonary artery hypertension (PAH) ultimately leads to straining of the right ventricle and increases the risk of heart failure in affected patients. Its clinical presentation is similar to that of many other diseases thus delaying the diagnosis until the disease is far advanced. It remains one of the leading causes of death in adults with sickle cell anaemia (SCA) worldwide. It confers a high risk of death with two-year mortality rates as high as 40-50% even at modest elevation of pulmonary artery pressure. Median survival age after detection of the disease is said to be 25.6-months. Early detection of elevated pulmonary artery pressure in childhood and appropriate intervention by optimization of anti-haemolytic therapy may prevent the progression of this complication. The current writes up is a review of literatures on pulmonary artery hypertension among children with sickle cell anaemia. This will give information which will aid early diagnosis and treatment of pulmonary artery hypertension among children with sickle cell anaemia. This will ultimately improve the quality of life of children with sickle cell anaemia and reduce morbidity and mortality from the disease in adults and children living with sickle cell anaemia.

    Keywords

    Sickle cell anaemia; Pulmonary artery hypertension; Children.


  • 2019, November

    opinion

    What IBD Physicians Can Learn from Major League Baseball ManagersOpen Access

    Nicholas V. Costrini*
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  • 2019, November

    review

    The Evolving Field of Stereotactic Body Radiation Therapy in Pancreatic CancerOpen Access

    Maged Ghaly*, Emile Gogineni and Muhammad W. Saif
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    Pancreatic cancer remains a devastating disease with dismal outcomes despite the development of novel chemotherapeutic regimens and radiation techniques. Stereotactic body radiation therapy (SBRT) offers an advantage both in image guidance and radiation dose delivery to direct ablative doses to tumors with acceptable toxicity compared to conventional techniques. Recent literature is clustered with data pertaining to SBRT in patients with resectable, borderline resectable and locally advanced pancreatic tumors. We here present a summary of the current data and highlight the limitations and potential for future growth. Further clinical study in the form of multi-institutional trials is warranted to establish the role of SBRT in combination with new chemotherapeutic agents as well as a non-invasive alternative to surgery.

    Keywords

    Pancreatic neoplasms; Pancreas cancer; Radiosurgery; Stereotactic; Stereotactic body radiation therapy (SBRT); Radiation; Radiotherapy.


  • 2019, November

    editorial

    Challenges Ahead for Advanced Training Programs in Pediatric Dentistry in the Area of Sedation for Pediatric Dentists and the Commission on Dental AccreditationOpen Access

    John E. Nathan*
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  • 2019, November

    original research

    Robot Assisted Comprehensive Surgical Staging for Endometrial Cancer: A Validation StudyOpen Access

    Nitin A. Wadhwa*, Dennis Mauricio, Isabel Eisner, Ruchi K. Wadhwa and Pankaj Singhal
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    Objective

    The study sought to evaluate the historical surgical-pathological trends in Gynecologic Oncology Group (GOG) 33 in a cohort of patients who underwent robot-assisted staging of uterine carcinomas.

    Materials and Methods

    This is a retrospective study from June 2016 through December 2018 at Catholic Health Services Hospitals in Long Island (CHSLI), NY, USA. All patients underwent robotic surgical staging with hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymphadenectomy. Fifty patients were included, and patients were separated into cohorts with endometrioid or non-endometrioid histology for analysis. Patients were staged using the International Federation of Gynecology and Obstetrics (FIGO) 2009 classification.

    Results

    For all patients undergoing surgical staging, the rate of pelvic and para-aortic nodal metastases occurred at 10% and 8%, respectively. Sixty percent of the grade 1 endometrioid tumors had less than 50% myometrial invasion. No patients had positive paraaortic lymph nodes in the absence of pelvic node involvement. High-risk histologies were associated with nodal disease thirteen percent of the time. A correlation between increasing depth of invasion and positive lymph nodes was demonstrated. Increasing grade of tumors was correlated with the frequency of nodal metastasis. Intraperitoneal spread was highly correlated to metastatic lymph nodes. Deep invasion was positively correlated with nodal disease.

    Conclusion

    The results of this study validate the trends previously known from GOG 33 in a population undergoing robot-assisted surgical staging for uterine carcinomas.

    Keywords

    Gynecologic Oncology Group (GOG) 33; Robotic; Surgery; Uterine cancer; Lymph nodes; Trends.


  • 2019, November

    observational study

    An Observational Study to Evaluate Infection Risk in Two Staff Warming Devices and a Review of Current Literature into Thermal Comfort in the Operating Room and BeyondOpen Access

    Mark Silverberg*
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    Objective

    To compare the degree of bacteria dissemination using two currently available operating room (OR) personnel warming devices. The “off-label” use of 3MTM’s Bair HuggerTM vs. a fairly new device, worn around the torso and under a scrub warm-up jacket or surgical gown, the OPERATIONHEATJAC® transformer only (TRO) powered by a transformer and controlled by a 4-level controller, and best for anesthesia providers and perfusionists.

    Methods

    Initially, staff members in scrubs sat in a room for 3 and 6-hours with agar plates placed in various positions throughout the room. Then staff members sat in the same room under the same conditions for 3 and 6-hours, and placed the hose from 3M’s Bair Hugger under their scrubs. Agar plates were positioned in the room in the same positions as in the control. Then staff members sat in the same room under the same conditions for 3 and 6-hours, wearing the OPERATIONHEATJAC® TRO over their scrub shirt and under a scrub warm-up jacket. Agar plates were again positioned in the room in the same positions as in the control. Bacteria colony counts were compared.

    Results

    The bacteria colony counts were 43.78% and 46.18% higher at 3 and 6-hours respectively from placement of the hose from 3MTM’s Bair HuggerTM under scrubs vs. the control. There was no significant difference in bacteria colony counts with using the OPERATIONHEATJAC® TRO vs. the control.

    Conclusion

    ORs are maintained cold, mostly for surgeon comfort. In an attempt to keep comfortable in this environment, peripheral OR staff opt for the “off-label” use of 3M’s Bair Hugger hose placed under scrubs. An increased spread of bacteria throughout the OR can result from this practice. Currently, there are now safer OR personnel warming devices available. In addition, this paper reviews the significance and benefits of keeping staff warm and comfortable.

    Keywords

    Warming devices; OPERATIONHEATJAC®; surgical site infections (SSIs); Operating room (OR); Temperature.


  • 2019, November

    case study

    A Couple’s Personalized-Care Intervention for Weight-Loss and Diabetes based on DNA and Gut Biome Profiles: A Case StudyOpen Access

    Simitha Singh-Rambiritch* Ranjan Sinha, Chandana Reddy, Alicia Nakamoto and Camel Irudayanathan,
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    Introduction

    The global prevalence of obesity has reached epidemic proportions. Given the negative strain that obesity and associated chronic diseases, such as type 2 diabetes, put on the healthcare system and the economy, disease management has begun evolving to help individuals change their behaviors. Obesity is often difficult to treat and even harder to maintain. Past studies have failed to show weight loss maintenance over long periods after interventions. To overcome the complexity of obesity, a multifaceted precision care treatment approach should be adopted.

    Aim

    The aim of this case study was to assess the health benefits and weight loss journey of a cohabiting Caucasian heterosexual married couple using the Digbi Health personalized obesity management program. A personalized integrative nutrition plan is created based on one’s genetic and gut microbiome obesity risk profile and incorporates daily digital tracking and lifestyle coaching. Never before has a program offered personalized data including genetic, gut microbiome and lifestyle coaching to help people understand the best plan to lose weight and keep it off long term.

    Method

    The male subject achieved a total change in weight loss of 15.94%, as well as a reduction in A1C and blood pressure levels and the female subject achieved a 13.65% change in weight loss over a period of four months. The couple have still been able to maintain their weight loss goals four months after completing the program, stating their individual and personalized approach gave them the tools long-term to maintain.

    Conclusion

    A supportive environment for cohabiting couples following a personalized weight loss program based on their genetic and gut microbiome profile may help with weight loss and long-term maintenance.

    Keywords

    Diabetes; Gut microbiome; Obesity; Diet; Physical exercise; Overweight; Body mass index (BMI); Couples; Hypertension.


  • 2019, December

    short communication

    Dealing with Violent Dangerous Patients: The Medicolegal PitfallsOpen Access

    Navin Naidoo*
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  • 2019, December

    case report

    Melorheostosis: A Rare Cause of Limb PainOpen Access

    Matthias Z. H. Lu* and Narlaka Jayasekera
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    PDF398.00 KB 398.00 KB
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    Melorheostosis is a rare skeletal dysplasia, and to date there are no reports of this condition in Australia. This is a case of a lady who presented with dull arm pain with a pathognomonic radiological findings. The plain radiographs obtained of the limb demonstrated a characteristic candle wax appearance in a monomelic distribution. The natural history, presentation, and management are discussed in detail.

    Keywords

    Melorheostosis; Skeletal dysplasia; Central Australia.


  • 2019, December

    editorial

    Why HALO 301 Failed and Implications for Treatment of Pancreatic CancerOpen Access

    Nausheen Hakim, Rajvi Patel, Craig Devoe and Muhammad W. Saif*
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    Survival rates for pancreatic cancer (PC) remain dismal. Current standard of care treatment regimens provide transient clinical benefit but eventually chemoresistance develops leading to poor outcomes. PC is a relatively chemoresistant tumor and one of the explanations for this is attributed to desmoplasia that impedes drug delivery. Based on this, stromal modifying agent such as Pegvorhyaluronidase alfa (PEGPH20) was developed and investigated in phase I-III studies. Although phase I-II studies showed promising results in patients with high hyaluronic acid (HA) expressing tumors, the phase III HALO 301 study failed to miss it’s primary endpoint and further development of PEHPH20 is halted. This failure implies that targeting desmoplasia alone is not sufficient and other intrinsic factors such as lack of significant neoantigens, low tumor mutational burden, and epithelial to mesenchymal transition may be at play. It is also important to consider that although the tumor stroma may be a physical barrier hampering drug delivery, it may also have protective effects in restraining tumor growth and progression. Further studies in molecular biology to better characterize the complex interaction between the microenvironment and cancer cells are warranted.

    Keywords

    Pegvorhyaluronidase alfa (PEGPH20); Desmoplasia; Pancreatic cancer; Chemoresistance; HALO.


  • 2019, December

    editorial

    PARP Inhibitors in Pancreatic Cancer: From Phase I to Plenary SessionOpen Access

    Rajvi Patel, Daniel Fein, Carolina B. Ramirez, Kevin Do and Muhammad W. Saif*
    DOI:
    PDF397.94 KB 397.94 KB
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    Survival rates for pancreatic cancer remain dismal. Current standard of care treatment regimens provide transient clinical benefit but eventually chemoresistance develops. Tumors deficient in deoxyribonucleic acid (DNA) damage repair mechanisms such as BRCA mutants show better responses to platinum based agents, however, such tumors can utilize the poly(adenosine diphosphate [ADP]–ribose) polymerase (PARP) pathway as a salvage mechanism. Therefore, inhibition of PARP pathway could lead to tumor destruction and synthetic lethality in presence of BRCA mutation. Various PARP inhibitors have been approved for treatment of patients with germline or somatic BRCA mutant breast and ovarian cancer. This provides basis of using PARP inhibitors in patients with pancreatic cancer that harbor BRCA mutation. A recent phase III Pancreas Cancer Olaparib Ongoing (POLO) study showed impressive results with near doubling of progression free survival compared to placebo (7.4 vs 3.8 months). These results highlight the importance of germline testing for all patients with pancreatic cancer and inclusion of additional deficiencies in homologous recombination repair (ATM and PALB2) including BRCA variants of uncertain significance should be further explored.

    Keywords

    Pancreatic cancer; Chemoresistance; DNA damage repair; Synthetic lethality; BRCA1/2; Germline mutations; Genomics.


  • 2019, December

    case report

    A Rare Case of Gemcitabine-Induced Pulmonary HypertensionOpen Access

    Janice Shen, Su Yun Chung, Elham Azimi-Nekoo, Jyothi Jose and Muhammad W. Saif*
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    Context

    Gemcitabine is the backbone of systemic treatment of locally advanced and metastatic intrahepatic cholangiocarcinoma. In recent literature, gemcitabine has been linked to various pulmonary side effects.

    Case Report

    We report a case of an 82-year-old male who developed acute pulmonary hypertension after receiving one cycle of gemcitabine for metastatic cholangiocarcinoma. His symptoms began with fatigue associated with shortness of breath and cough that worsened despite dose reduction. He developed new onset bilateral pulmonary effusions and an echocardiogram revealed findings consistent with pulmonary hypertension. A computed tomography (CT) angiogram was negative for pulmonary thromboembolism. Although he was promptly treated with diuretics and steroids, the patient could not tolerate any further therapy.

    Conclusion

    Gemcitabine-induced pulmonary hypertension is rare and can be challenging to diagnose, as it remains a diagnosis of exclusion. However, physicians should be vigilant of new pulmonary symptoms, as delayed treatment can cause significant patient morbidity and mortality.

    Keywords

    Cholangiocarcinoma; Gemcitabine; Pulmonary hypertension.

    Abbreviations

    CT: Computed Tomography; PE: Pulmonary Thromboembolism; GIPT: Gemcitabine-Induced Pulmonary Toxicity.


  • 2019, December

    original research

    Epidemiological Description of a Protracted Cholera Outbreak in Hagadera Refugee Camp and the Surrounding Host Community within Fafi Sub County and Garissa County in Kenya during March-September 2019Open Access

    Kadra N. Abdullahi*, Dorcus Mutindin, Willy Kabugi and Shafe Mowlid
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    Background

    On 27th March 2019, the Hagadera Refugee Camp reported an outbreak of acute watery diarrhea. An investigation was initiated to confirm the causative organism and define the epidemiology of the outbreak to support evidence-based control measures.

    Method

    A suspected case was a resident of Hagadera Refugee Camp or the surrounding community with a sudden onset of acute watery diarrhea and vomiting between March 27 and September 16, 2019. A probable case was defined as a suspected case with a positive rapid test for Vibrio cholerae; a confirmed case was a probable case with a positive stool culture for V. cholerae. We conducted a systematic case finding by visiting health facilities and villages. We reviewed patient records to identify suspected cholera casepatients. We conducted a descriptive epidemiologic study, examining the distribution of the cases. We computed the attack rates by age, sex, and residence. The case fatality rate was calculated as the ratio of the total number of suspected cholera death to the total number of cholera case-patients. We conducted targeted interventions including spraying, handwashing demonstration, distribution of soaps health education and promotion.

    Results

    We identified 667 suspected cholera cases between March and September 2019 of these, 38% (253/667) had a positive rapid diagnostic test for V. cholerae; 6% (43) were negative and 56%(371) rapid diagnostic test (RDT) were not conducted. Out of the 94 rectal swabs for culture, 71% (64/94) were confirmed to be V. cholera O1 serotype Inaba. The epidemic curve exhibited a continuous common-source outbreak with several peaks. The mean age of the case-patients was 15-years (range: 0.2-70-years). Both males and female had an attack rate of 9/10000 respectively. The highest attack rate was in ≥30-years (14 per 10,000).

    Conclusion

    This was a continuous common source cholera outbreak caused by V. cholerae 01 serotype Inaba. We recommended strengthening the surveillance system improving early detection and effective response.

    Keywords

    Cholera; Outbreak; Kenya; Garissa; Protracted; Hagadera; Epidemiological; Descriptive.

    Abbreviations

    RDT: Rapid diagnostic test; WHO: World Health Organization; CTC: Cholera Treatment Centre; AWD: Acute watery diarrhea; TCBS: Citrate bile salt sucrose; CFR: Case fatality rate; OCV: Oral cholera vaccine; IRC: International Rescue Committee; UNHCR: United Nations High Commissioner for Refugees.


  • 2019, December

    case report

    The Importance of Enzyme Substitution Therapy in Early Pancreas Exocrines of InsufficiencyOpen Access

    Biljana Petrovic*
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    Introduction

    Functional disorders of the digestive tract are a common occurrence in the doctor’s office. In addition to functional dyspepsia, 35% of dyspepsia are unresolved dyspepsia, which are a symptom of the early stage of pancreatic exocrine insufficiency.

    Aim

    Based on clinical experience, we can suspect and detect chronic pancreatic insufficiency at an early stage, which is the aim of this paper.

    Method

    To demonstrate the efficacy of enzyme replacement therapy in the early stage of pancreatic exocrine insufficiency using the case report of the patient.

    Results

    Results confirms significance and effectiveness of creon as an enzyme replacement therapy in the treatment of malabsorption and maldigestion.

    Conclusion

    Creon (pancreatin) showed great effect in the treatment of dyspepsia and anorexia nervosa, body mass index (BMI) for 30 days increased from 15.9 to 17.4, which leads us to the conclusion that unrecognized chronic pancreatic insufficiency can be expected in long-term dyspepsia.

    Keywords

    Chronic pancreatic insufficiency; Enzyme; Body mass index (BMI); Digestive tract.


  • 2019, December

    opinion

    Why are Patients Reluctant to View Exercise as a Treatment Plan?Open Access

    Mike Swoboda*
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  • 2020, January

    brief report

    The Skinny on Moisturizers: A Brief ReportOpen Access

    Sreeja R. Kuppam*
    This work is done by a high school student and we are publishing this as it fits into our mission of promoting and encouraging studies in science, technology, engineering and mathematics (STEM) field for our next generation. – Editor-in-Chief, DRMTOJ
    DOI:
    PDF407.59 KB 407.59 KB
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    Objective

    To compare the effectiveness of 5 different skin moisturizers using JELL-O® as a model for the human skin.

    Methods

    In this study five different moisturizers (Equate®, Burt’s Bees®, Suave®, Aveeno® and Vaseline®) were applied to equivalent samples of JELL-O®. Observations were made over a 12-day period and data was collected at 15 different time intervals. The primary outcome was the height (cm) and weight (g) of the JELL-O® sample at each time interval. The study was an ex vivo experiment conducted in a home laboratory. No Institutional Review Board (IRB) approval was required since the research does not involve living organisms.

    Results

    Overall, the JELL-O® sample that had the Vaseline® applied on it had the lowest loss of height and weight. The height stayed at 100% of its original value and the weight only decreased to 97.2% of the original value by the end of the observation period. In contrast, the sample which had Suave® applied to the surface its height and weight decrease the most (42% and 28% respectively). The other moisturizers had effects intermediate between these two extremes.

    Conclusion

    Based on this ex vivo head to head study using JELL-O® as a model for the human skin the 5 moisturizers examined had widely differing levels of effectiveness with Vaseline® appearing to be the most protective against evaporative losses and Suave® appearing to be the least.

    Keywords

    Moisturizers; Dry skin; Different moisturizers; Skin lotions; Vaseline® effectiveness.


  • 2020, January

    review

    Lycopene: Implications for Human Health–A ReviewOpen Access

    Lynda M. Doyle*
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    Lycopene is one of the six major dietary and serum carotenoids, and a potent antioxidant and anti-inflammatory agent. A large and growing body of scientific evidence supports the role of lycopene in multiple areas of health, including cancer, prostate, cardiometabolic, lung, skin, and liver health, and elucidates lycopene’s mechanisms of action. This paper provides an overview of several benefit areas, specifically prostate, testes, cardiovascular, liver and skin health.

    Keywords

    Lycopene; Carotenoids; Cardiovascular disease (CVD); Human health.


  • 2020, January

    letter to the editor

    Squamous Melanocytic Tumour at an Unusual Site: An Uncommon Case and Literature ReviewOpen Access

    Barbara Barbosa*, Salvador J. Diaz-Cano, FRCPath and Alexandre Abramavicus
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    PDF478.58 KB 478.58 KB
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    We herein present a case report of a 60-year-old male patient diagnosed with squamous-melanocytic tumour (SMT) in his anal region, comprised of two intermingled different phenotypic lesions. This dual tumour is quite uncommon and could potentially be challenging on both diagnose and also management. It is the first case reported on this location, moreover, the lack of consensus for these lesions makes it difficult to classify them. We reviewed the literature of similar SMT’s and discussed its histogenesis. As they are rare, their biological behavior and potential metastasis remain unclear. Therefore, close follow-up is advised.

    Keywords

    Combined neoplasia; Squamous-melanocytic tumour; Uncertain; Anal canal.


  • 2020, January

    Case Illustration

    Graves Disease: Successful Cesarean Section and SalpingectomyOpen Access

    Ryan Sanni* and Kinal Bhatt
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  • 2020, January

    illustration

    Necrotizing Fasciitis: Fatal Evolution of Acral MelanomaOpen Access

    El Marfi Abdelhafid*, Samia Mrabat, Kaoutar Laamari, Mohammed El Idrissi, Abdelhalim El Ibrahimi, Abdelmajid El Mrini, Zakia Douhi, Sara Elloudi, Hanane Baybay and Mernissi F. Zahra
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  • 2020, January

    original research

    Characteristics of Effective and Safe Methods of Treatment for Fresh Fracture-Dislocations of the Proximal HumerusOpen Access

    Pavel Kogan*, Dmitrii Chugaev and Leonid Solomin
    DOI:
    PDF452.58 KB 452.58 KB
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    Aim

    The study was aimed to assess the results of treatment for fracture-dislocations of the proximal humerus (PH) within different time frames for optimizing treatment tactics.

    Patients and Methods

    This retrospective cohort study evaluated clinical outcomes of 25 patients with fracture-dislocations of the PH (15 patients were analyzed for short- and medium-term results, and 10 – for long-term results). The follow-up period ranged from 1 to 9-years. All patients underwent: clinical examination, constant score assessment and shoulder X-ray examination. Clinical, radiological and statistical methods were used for analysis.

    Results

    Assessment of the degree of initial displacement of tubercles and its impact on the results of treatment showed that significantly better results were obtained in case of displacement no more than 10 mm (p=0.041). Patients with displacement no more than 10 mm had an average score of 68.0±16.1 points (Mean=69.5), while those with displacement of the tubercle(s) exceeding 10 mm had an average score of 49.5±19.5 points (Mean=44). Analysis of the results of treatment showed that the delay in restoring normal anatomy of the PH or avoiding surgical interventions at all led to functional disorders of the shoulder joint. It was also demonstrated that neither patients, nor doctors were satisfied with the outcomes of the unipolar shoulder replacement (USR). Based on the results of the study, we proposed an algorithm for determining the tactics of surgical treatment in cases when a fracture-dislocation of the PH with complete dislocation of the fragment involving the articular surface of the humeral head is diagnosed.

    Conclusion

    The present study demonstrated some factors affecting the outcomes of treatment for fracture-dislocations of the PH. Current approaches for endoprosthesis replacement in these cases remain debatable and require further investigation.

    Keywords

    Trauma; Fracture; Shoulder joint; Fracture-dislocation of the proximal humerus.


  • 2020, January

    case report

    A Familial Case of Spontaneous Regression of Colloid Cyst of the 3rd Ventricle on Magnetic Resonance ImagingOpen Access

    Deepsha Agrawal*, Athanasios Grivas and Ancy Joseph
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    A 21-year-old male underwent screening for a positive family history of colloid cyst with an MRI scan. This suggested a lesion in the region of the roof of his 3rd ventricle which was confirmed on a computerized tomography (CT) scan as a colloid cyst measuring 6 mm. Seven-years before his evaluation, the patient’s father was found to have an approximately 20 mm colloid cyst with acute hydrocephalus for which he underwent excision. His sister suffered a sudden death at the age of 25. The cause of death was confirmed on autopsy as a colloid cyst which was undiagnosed and associated with acute hydrocephalus. At the time of evaluation, the patient was asymptomatic. On serial imaging in 1-year, there was a definite increase in size of the colloid cyst which now measured 8 mm along its maximum dimension. The colloid cyst also changed in signal intensity appearing more hyperintense on T2-weighted images and fluid-attenuated inversion recovery (FLAIR) sequence. A serial magnetic resonance imaging (MRI) was performed in 18-months as a part of ongoing surveillance with neuroimaging following the first presentation. This demonstrated a decrease in size and change in the shape of the colloid cyst, measuring 5 mm in maximum dimension, with associated decrease in ventricular size and resolution of hydrocephalus suggesting some spontaneous rupture of the colloid cyst. A CT head with unenhanced volume acquisition of the head demonstrated residual partially international organization for standardization (ISO), partially hyperdense colloid cyst seen at the foramen of Monro. This confirmed the findings of MRI with a decrease in size of residual colloid cyst measuring approximately 5 mm in maximal diameter with no residual hydrocephalus.

    Keywords

    Neuroradiology; Central nervous system cysts; Colloid cyst; Magnetic resonance imaging; Third ventricle; Foramen of Monro.


  • 2020, February

    review

    Reproductive Biotechnology Options for Improving Livestock Production: A ReviewOpen Access

    Atsbha Hadgu and Haben Fesseha*
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    Reproductive biotechnology is one of the options which have a role in the improvement of livestock. It is a technology that improves livestock production by improving the reproductive insufficiency of the animal through different techniques. These are artificial insemination (AI), cloning, estrus synchronization, embryo transfer (ET), transgenesis and in vitro fertilization. These techniques are very important techniques to advance livestock production and to meet the people’s demands now-a-day. These reproductive biotechnologies have a dramatic effect on the world’s economy through the improvement of livestock genetics, preventing disease, facilitate transportation, keeping endangered animals and reducing economic loss. Artifici