Willingness to Patronize Traditional Bone Setters Among Patients Attending General Out-Patient Department of Federal Teaching Hospital Abakaliki, Nigeria

                                         http://austinpublishinggroup.com/austin-orthopedics/

The practice of traditional bone setting has been of old and it is found in almost all communities of the world. For instance, an approximate 10-40% of patients with fractures and dislocations globally are managed by unorthodox practitioners. Also, there is evidence that bone setters were in practice in England in the 16th and 17th centuries. Incidentally as it is stillobtainable in Africa today, the methods of that practice was handed over by oral tradition from father to son and in most cases continued within the same family. In-fact, one of the founding fathers of orthopaedics in the United Kingdom was the son of a traditional bone setter.

Asexpected, the practice of traditional medicine has been in Africa long before the introduction of orthodox medicine. Its vastness necessitated the emergence of several specialized areas including traditional bone setting, traditional birth attendant and herbal healing. In Nigeria, it has been ascertained that traditional bone setters enjoy more trust and patronage than the other groups of traditional care givers. The popularity of traditional bone setters in Africa is enhanced by the claim by its practitioners that they have supernatural influences. The result is that in Nigeria, majority of the people rank the bone setters far ahead of orthopedic surgeons in the treatment of musculoskeletal injuries. For example, in Eastern Nigeria, it was reported that 85% of patients who presented with femoral fractures in an orthopaedic hospital visited the traditional bone setters first before presenting at the hospital. Perhaps spurred by this high level of societal recognition, the bone setters have ventured into other areas like treatment of congenital anomalies and management of patients with bone infections and tumors.

Role of Proximal Fibular Osteotomy in Medial Joint Osteoarthritis of Knee

                                  http://austinpublishinggroup.com/orthopedics-rheumatology/

Osteoarthritis(OA) of knee joint is a common disease that causes significant disability. Most patients can be managed conservatively in the outpatient setting. The global prevalence of radio graphically confirmed symptomatic knee OA in 2010 was estimated to be 3.8%. It was higher in females (4.8%) than in males. In the USA, 33.6% people aged more than 65 years were found to have osteoarthritis of knees. [3] In south Asian region the prevalence of OA of knees is 1.8% in males and 3.1% in females. With the aging of the world’s population, especially in Low & Middle Income Countries (LMIC), the number of people living with knee OA is anticipated to increase substantially over coming decades. Osteoarthritismanagement in the developed countries is focused on developing patient-specific surgical instrumentation for knee arthroplasty, post-operative supervised exercise programs, and other potentially expensive healthcare modality. In the LMIC, lacking of appropriate healthcare infrastructure or inability to fund expensive treatment of arthroplasty for osteoarthritis can hardly afford to  benefit from such advanced method. In the high income country (HIC) treatment modalities often include arthroplasty techniques. Patient specific instruments are unproven and not widely used.

Computerguided knee replacement is used in some centres but the benefit is not really proven. Unfortunately, ongoing registered trials, largely, are not being conducted to address the research gaps that could have a worldwide influence. However, this issue may not be the fault of individual orthopedic investigators. The researchers in orthopaedics and related fields should heighten efforts to increase awareness and promote better screening of osteoarthritis, in the attempt to initiate treatment sooner and delay the progression of the debilitating effects of the disease.

Is Long-Term Dienogest Treatment Tolerable in Korea?

                                 http://austinpublishinggroup.com/obstetrics-gynecology/

Endometriosis is defined as the presence of endometrial glands and stroma outside the uterine cavity. The prevalence rate of endometriosis is approximately 5-10% of all women of reproductive age, it reduces the patient’s quality of life through the occurrence of pain, including dysmenorrhea, dyspareunia, and lower back pain.

It is known that the primary treatment of endometriosis is surgery. The European Society of Human Reproduction and Embryology (ESHRE) guidelines state that surgical treatment is warranted for an ovarian endometrioma of larger than 3 cm, and that laparoscopic stripping of the cyst wall is considered the gold standard for treatment. Because the surgical excision of lesions has shown to improve the level of pain and enhance fertility, ovarian cystectomy is preferable to oophorectomy, and most women who undergo endometriosis are of childbearing age. However, a pooled analysis of 23 studies estimated the recurrence rates as 40% to 50% 5 years after the primary surgery. Medical treatment for the relief of symptoms and the prevention of recurrence after surgery include Gonadotropin-Releasing Hormone (GnRH) analogs, progestin, danazol, and estrogen/progestin combinations. However, these treatments have adverse.

effects including impaired hepatic function associated with danazol, as well as a decrease in bone mineral density, which may be caused by GnRH analogs. Thus, their long-term use is limited. Dienogest (Visanne, Bayer HealthCare, Berlin, Germany) is a selective progestin that has been approved for treating endometriosis at a low oral dose of 2 mg/day. Dienogest has many beneficial pharmacological uses, such as a potential progestogenic effect, moderate suppression of estrogen, and low concern for increased androgen and corticoid levels. Progestogenic effects lead to an effective reduction in endometrial lesions, and no significant androgenic, mineralocorticoid, or glucocorticoid activity. 

Obesity and Cancer Progression

                                   http://austinpublishinggroup.com/obesity-metabolic-syndrome/

Obesityis defined as increased adipose mass arising from energy imbalance. Currently all over the world, obesity is an epidemic associated with altered whole-body physiology and hormonal balance that promote risk of developing number of cancers with poor survival outcome. Adipose tissue is a dynamic endocrine organ that maintains energy homeostasis. Obesity has been identified as a significant risk factor for the development of various cancers. Obesity, which is a stateof excess of nutrients, chronically activates cellular growth factor and metabolic signalling pathways and stimulates neoplastic transformation. Pathophysiological effects of hyperadiposity have been found to be associated with development and progression of tumor predominantly in metabolically and hormonally driven cancers. Obesity at the time of diagnosis of the cancer is associated with advanced state of the disease affecting progression of the disease, response to the therapeutic agents and disease-free survival. Researchers also observed strong association between increased body mass index and cancer-related mortality, but no exact consensus linking obesity with the pathogenesis of cancer. Among breast cancer women with BMI more than 40Kg/m², mortality rate is three times more than lean women suggesting obesity as a poor prognostic factor.

Goodwin et al observed significant association of higher BMI with increased risk of early and late distant recurrences and death in breast cancer women. Excess of adiposity has been identified as a risk factor for recurrence, reduced effectiveness and complications of the treatment, development of second primary tumor and mortality.

Acquired Sturge Weber Syndrome due to Methotrexate Induced Folic Acid Deficiency in an Adult Patient

                                            http://austinpublishinggroup.com/austin-neurology/

  

The64 years old female patient presented to the emergency room with blurred vision, impaired visual field and episodes of migraine aura like fortification illusions, and persistent headaches with decreasing intensity over the past days. Three years ago, patient admitted to hospital with headache and suspected brain infarction. A cerebral CT showed a small, wedge-shaped hypo density with superficial cortical calcifications in the right occipital lobe. The contra lateral occipital lobe showed slight hypo dense areas within the sub cortical white matter. The patient’s history, additionally, included rheumatoid arthritis since 2007, which was treated with methotrexate (MTX, 15mg weekly) subcutaneous. The patient, however, revealed, that she was not utterly adherent to her intake of folic acid after MTX application.

Atcurrent admittance, neurological examination showed visual extinction phenomenon to the lower left and mild optic ataxia to the left. There were no nevi on the patient’s face or in her eyes. An intellectual disability or hemi paresis could not be observed. Family history showed no neurological diseases. The blood tests on admission showed low levels of folic acid (3.9μg/ml). Levels offolic acid were not measured prior to presentation at hospital. Blood samples from the past years showed continuously increased values for Mean Corpuscular Volume (MCV) and Mean Corpuscular Hemoglobin (MCH) up to 103fl and 35pg, respectively. Anti-gliadin antibodies were negative. EEG showed abnormal slow brain activity with delta waves over the right parieto-occipital lobe.

Potential Susceptibility to Liver Dysfunction Induced by a Therapeutic Dose of Acetaminophen in Rats Submitted to Gestational and Lactational Protein Malnutrition

                                         http://austinpublishinggroup.com/nutritional-sciences/

Acetaminophen,also known as paracetamol, is widely used as analgesic and antipyretic medication in the world and is considered to be safe at therapeutic dosages. It is widely accepted that an overdose of acetaminophen can induce severe liver damage in humans and in experimental animals; it is important to note that hepatic injury induced by therapeutic dose has been reported however there are few studies in order to identify potential triggers for this condition. There are several evidences suggesting that hepatotoxicity of compounds might be related to protein malnutrition condition, for example, Kwashiorkor seems to be associated with exposure to aflatoxins.

Proteinmalnutrition can affect the pathways of acetaminophen metabolism. Acetaminophen is metabolized by different pathways such as sulfation, glucuronidation, and some isoforms of hepatic microsomal cytochrome P450s, such as CYP1A2 and CYP3A. The P450 system can generate the reactive metabolite, N-Acetyl-P-Benzoquinone Imine (NAPQI), which is subsequently detoxified through conjugation with Glutathione (GSH) by Glutathione S-Transferase (GST). However, at higher doses, saturation of conjugation pathways and the consequent depletion of GSH can increase NAPQI levels NAPQI is able to bind to several hepatic proteins, and this binding is associated with development of centrilobular necrosis. Moreover, administration of hepatotoxic doses of acetaminophen can reduce GSH levels in liver and kidney. It is important to note that malnutrition per se induced a reduction in the GSH content.

Review of Avitaminosis Fever and Its Clinical Significance

                                     http://austinpublishinggroup.com/nutritional-disorders/

Feveris a common clinical sign in many kinds of diseases. The most common cause is malnutrition related infections, such as tuberculosis, pneumonia, or gastrointestinal disorders. Their treatments invariably depend on antibiotics. However, fever could be resulted directly from severe deficiency of some nutrients themselves, such as berlberi fever, ariboflavosis fever, or pellagra fever. They were observed in a population with terribly hard labor and hunger, such as in a labor camp 1958-1962 before and during Nationwide Hunger. This paper introduces the follows: 1. Avitaminosis fevers due to deficiency of thiamin, riboflavin, or niacin themselves might be found in cases with prolonged severe labor and hunger 2. Thiamin deficiency fever was very violent and often involved multiple organs and endocrine glands from different systems and often leading to death. Its diagnosis was very complicated and confused, which could be collectively termed as dysautonomia 3. High dose of parenteral thiamin could surely bring down high fever in avitaminosis fever, however unexpectedly, high fever due to different microbial infections including virus and bacteria or even lymphoma could be normalized with it. Therefore, high dose thiamin injection may be a physiologic anti-microbial agent comparable or superior to the current best antibiotics.

Mr. GONG KM was a 26-year-old laborer who suffered from frequent cramps and persisting numbness of the extremities for 3 years. After arduous labor for several days, he experienced sudden onset of high fever and severe headache as if hit on the head with a hammer on a day of Feb 1959. He complained also tightening of the chest. The temperature rose to 41˚C even under penicillin from the beginning and followed by herbal medicine.

A Cross-Sectional Study of Midwives’ Proactive Behavior in Midwifery Practice

                                  http://austinpublishinggroup.com/nursing-research-practice/

Researchersof this study focused on possible tools supporting midwives in the process of continuous changes in midwifery practice. A previous concept analysis by Mestdagh et al. revealed possible benefits of proactive behavior in midwifery. Midwives behaving proactively notice changes as an opportunity, are always one step ahead, anticipate future possible barriers, adapt easily, work autonomously and in a constant quest for efficient, effective and qualitative care strongly leaning to the state-of-the-art. Additionally proactive behavior could result in an increased job satisfaction, work-efficiency, commitment and higher coping strategies in increasing resistance of stress. On top of that, improved team productivity and organizational success may occur. Proactive behavior is possibly associated to several individual and/or contextual antecedents who were recently tested in a pilot study within a group (n = 98) of midwifery students. Two antecedents, being control appraisal and role breadth self-efficacy, were identified as important predictors of proactive behavior. This study aims to confirm and/or supplement recent insights on antecedents of proactive behavior by studying a group (n = 133) of midwives and compare their characteristics and their antecedents on proactive behavior with the results of our earlier study with student-midwives as population.

Healthcare practice is characterized by rapid evolutions, the need for cost-effective and accessible health care and constantly changing practices. In recent years, the context of midwifery practice presents a growing complexity, due to rapid evolutions, such as centralization of care, medicalization of childbirth as well as an overflow of new insights, innovations and availability of evidence on interventions. Births also became increasingly complex.

The Effect of Local Cold Compression upon Pain and Movement Restriction among Patients with Knee Osteoarthritis

                                                   http://austinpublishinggroup.com/nursing/

Treatmentand care of musculoskeletal system diseases, which increases with aging, play a crucial role in maintaining health and improving quality of life. One of these diseases is osteoarthritis prevalence of which is very high-particularly- among those over 50 years. OA is the most common form of arthritis and is defined as degenerative joint disease caused by inflammation, stiffness, and eventually by cartilage loss. Knee OA is a widely prevalent joint disease over the world. In the USA, OA affects nearly 40 million women and men. It is estimated that this ratio, which almost makes up 15% of the general population, will rise to 18.2% by 2020; in other words, 59.4 million Americans will be affected. It is alsoestimated that by 2030 there will be 67 million people diagnosed with OA in the United States. “Turkey Osteoarthritis Study (2005)”, is considered as the most extensive study in Turkey on this issue, it is stated that one man versus three women is OA patient. However, the study done with 3755 OA patients in nine provinces does not shed light on the ratio of the population affected by OA. The knee osteoarthritis rate in Turkey is reported to be 14.8%. The most crucial clinical signs of knee OA are pain, movement restriction and joint stiffness. 

The aim of knee OA treatment is to control pain, movement restriction and other symptoms; to slow disease progression; to increase and to maintain patients’ movement function. It is widely accepted that no methods can prevent the disease completely. Therefore, patients should protect themselves from side effects of the treatments. In many cases, pharmacological and non-pharmacological methods can be employed together as these are the best ones in pain control. Local hot or cold compression, which is a non-pharmacological method, has been used for a long time for reducing pain, stiffness and swelling among OA patients. Generally; physiological effects of hot are vasodilatation, increase in capillary permeability, acceleration of cell metabolism, muscle relaxation, acceleration of inflammation, reducing pain by relaxing muscles, sedative effects and reducing joint stiffness by decreasing synovial fluid. In a study done by Mazzuca et al. heat-retaining knee sleeve was compared to cotton elastic knee sleeve and the difference between was found statistically insignificant. In this study, patients continued pharmacological treatment. Physiological effects of cold are vasoconstriction, slowing down in cell metabolism, local anesthesia, reduce in blood flow, oxygen, metabolite flux to the site and waste products. Therefore, local cold compression exerts such effects as reducing/terminating pain, preventing edema and slowing down inflammation process by providing local anesthesia therapeutically. Therefore,importance of cold compression among arthritis patients has been emphasized.

The Potential Anti-Diabetic Effects of Saskatoon Berry in Experimental Mouse Models

                                     http://austinpublishinggroup.com/nutrition-food-sciences/

Currentdietary guidelines from several countries recommend regular consumption of fruits and vegetables to improve quality of life. Fruits and vegetables are nutrient-dense foods with significant amounts of phytochemicals. Phytochemicals are chemical compounds naturally available in plant-derived foods. These health-promoting substances belong to a number of chemical families.

Berries are generally implied to “small fruits” and include blueberries, raspberries, blackberries, Saskatoon berries, cranberries and others. All of these fruits are known for their high concentrations of antioxidant phytochemicals. reported that high tocol contents of seed oil from blueberries, black raspberries and blackberries are responsible for the antioxidant properties of the seed oils. Another recent study reported significant antioxidant and anti-inflammatory properties of methanolic extracts of Goji berry, blueberry and cranberry in both in vitro and in vivo settings. Similarly, blueberry anthocyanins reduced the oxidative stress status in endothelial cells. Furthermore, orally-administered blueberry extract prevented the development of Dextran Sodium Sulfate (DSS)-induced ulcerative colitis in mice. Anti-inflammatory and antioxidant activities of blueberry derived pterostilbene were reported to be responsible for prevention of corneal epithelial cell injuries in an in vitro model. Consumption of blueberries at 8% (w/w) over 16 weeks was associated with prevention of Diethyl Nitrosamine (DEN)-induced hepatic cirrhosis and pre-neoplastic lesions in rats; this effect was thought to be mediated through antioxidant properties of blueberries.

Iron Deficiency Anaemia and Zinc Protoporphyrin Levels

                                        http://austinpublishinggroup.com/nutrition-metabolism/

Zinc protoporphyrin (ZPP) is found in erythrocytes when haem is inhibited by lead and/or lack of iron. Instead of incorporating a ferrous ion, to form haem, protoporphyrin IX, the immediate precursor of haem, incorporates a zinc ion to form ZPP (Zinc protoporphyrin!) The reaction to insert a ferrous ion into protoporphyrin IX is catalyzed by ferrocheletase. Ferrochelotase is an enzyme. Measurement of ZPP can be used as a screening test for lead poisoning or iron deficiency. In this article we are more Interested in iron deficiency than lead poisoning. There are a number of clinical situations in which ZPP values may be useful. These include; Lead poisoning Iron deficiency Sickle cell anaemia Anaemia of chronic disorders Vanadium (a heavy metal) exposure ZPP as a screening test is of value in all these disorders. 

But our focus is on iron deficiency per se. The fluorescent properties of ZPP in intact erythrocytes allows the ZPP/haem ratio to be measured effectively, efficiently and at a low cost. Cost is of major concern as we cannot incur major expenses. Only a small sample is needed. One can use a micropipette to aliquot the sample. Protoporphyrin compounds containing zinc have been known since the 1930s. They became of major academic interest with the discovery in 1974 that ZPP was the major non-haem porphyrin formed in red cells as the result of iron deficiency or lead poisoning. It was already known at this time that non-haem iron Protoporphyrin IX levels were elevated in these conditions, but prior investigators had used extraction methods that converted ZPP to unbound Protoporphyrin IX. The early literature is a bit confusing and results are difficult to compare. Results may refer to Free Erythrocyte Protoporphyrin (FEP) or Erythrocyte Protoporphyrin (EP or EPP). ZPP is also abbreviated ZP and ZnPP. The current trend is to report the molar fraction of ZPP to haem as Micromole/mole!  Zinc protoporphyrin may be a unique and cost effective way of determining iron deficiency anaemia!

The Imaging and Dosimetry for Targeted Ra-223 Treatment for Metastatic Castration-Resistant Prostate Cancer

                                 http://austinpublishinggroup.com/nuclear-medicine-radiotherapy/

Prostate cancer at stage IV spreads to bone frequently, which occurs in up to 90%. Bone metastasis is a substantial source of morbidity since it is related to bone pain and skeletal-related events. 223Ra selectively targets bone metastases with alpha particle. 223Ra was approved for the treatment of metastatic castration-resistent prostate cancer patients (CRPC). 223Ra also releases gamma rays accompanying alpha or beta rays. However, the therapeutic effect and its radiation dose assessment have not yet been adequately studied. The side effects and therapeutic effects of 223Ra radiation therapy by using radiation dosimetry for patients with castration - resistant prostate cancer needs to be evaluated.

Firstly we performed the investigation of phantom study using four types of collimators including low-energy general purpose, extendent low energy general purpose, middle energy general purpose and high energy general purpose type (Figure 1). We observed that middle energy general purpose image was more efficient than a dedicated alpha detector which showed remarkably decreasing counting rates. We therefore constructed procedures and standards for handling 223Ra in clinical practice.

Brain Activity during the Concentration Task in Normal Male Subjects by Functional Magnetic Resonance Imaging

                               http://austinpublishinggroup.com/neuropsychiatry-cognitive-science/

Visuospatialcognitive functioning is very important in everyday activities. However, in psychiatric diseases such as schizophrenia and dementia, this function is impaired, and patients with these diseases are inconvenienced in daily life.Various visuospatial tasks were used to investigate the brain function in previous studies. Using the Trail Making Test (TMT), Shibuya-Tayoshi, et al. reported that this task activates the prefrontal cortex during Near-Infrared Spectroscopy (NIRS), and Nakahachi, et al. suggested that this task is appropriate for examining the visuospatial working memory and functionallocalization. Using a task related to spatial positioning of a dot, Silver, et al. examined visuospatial working memory and noted that working memory in schizophrenia was impaired, and Lee, et al. compared trials with errors in maintaining spatial working memory between normal subjects and schizophrenic patients using functional Magnetic Resonance Imaging (fMRI) and NIRS.

Theyreported a reduced functional asymmetry of the prefrontal cortex during a spatial working memory task in schizophrenic patients. In addition, Henseler, et al. used fMRI and reported that schizophrenic patients showed impairments in activation of the superior parietal cortex and in maintaining visuospatial information. Kirsch, et al. also reported that during a maze task, both sides of the prefrontal cortex were activated on fMRI. A variety of tasks, such as the Wisconsin Card Sorting Test and visual object contracting tasks are used to investigate the visuospatial cognitive function. These tasks have been psycho physiologically examined, the localization of the brain function and the validity of these tasks have been demonstrated, and their use as markers of psychiatric disorders is expected in the future.

Fungal Infections of the Central Nervous System

                                 http://austinpublishinggroup.com/neurology-neurosciences/

CNSfungal infections are rare. Host’s immune system and fungal virulence factors determine the development of these infections. Route of infection may be hematogenous dissemination from a distant focus such as lung, through direct implantation after trauma or secondary to the local extension from sinonasal, orbital, or spinal infections. Anticipation and aggressive diagnostic approach along with timely initiation of antifungal therapy remains the cornerstone in reducing morbidity and mortality.

Fungal meningitis is often caused by yeast organisms. Cerebrospinal Fluid (CSF) analysis remains the diagnostic gold standard. Neuroimaging helps to confirm suspected meningitis and rule out increased intracranial pressure before lumbar puncture. Leptomeningeal enhancement due to a fungal infection may be smooth or thick, nodular and irregular, long and continuous, poorly demarcated or asymmetric, and may extend into the base of the sulci in contrast to the typical thin, symmetric, linear, and discontinuous lepto-meningeal enhancement. Cryptococcus is most frequently identified causative agent, followed by Aspergillus and Candida. They appear as ill-defined intraparenchymal hypodense lesions on CT imaging. On T1Weighted imaging, fungal cerebritis appears as an iso- or hypo-intense area. T2 Weighted images and FLAIR (Fluid Attenuation Inversion Recovery) sequences show a hyper intense lesion. They typically present with restricted diffusion on diffusion weighted images.

Chronic Pain and the Use of Palmitoylethanolamide

                              http://austinpublishinggroup.com/neurological-disorders-epilepsy/

PEAis a natural occurring lipid belonging to the class of autacoids, we could characterize these molecules as tissue hormones. Autacoids such as PEA may become a new cornerstone in the treatment of chronic pain and inflammation. PEA is not a registered drug, but it is widely available as supplement. I use PEA in my patients suffering from neuropathic pain since 2010, and have done quite some research on it. In the many hundreds of patients I treated, dose-limiting and serious adverse events did not occur. This probably is related to the fact that PEA is an endogenous lipid, produced on demand in the membranes of our cells, and easily metabolized in the cell into metabolites which are than recycled in those membranes. It also implies that dose-reduction in case of liver- or kidney-insufficiency is not required. As more and more patients and doctors become aware of this natural compound, a short introduction might serve both groups.

Theuse of PEA as a painkiller in the first decade of this century was limited to Italy and Spain only, because clinical papers in the English language were missing. In Italy, the compound was used widely by neurologists and pain specialists, due to the work of the Italian Nobel laureate professor Rita Levi-Montalcini, who first clarified its mechanism of action as an Anti-Inflammatory Agent.

Intracranial Acute Subdural Hematoma Induced by Increased Intraperitoneal Pressure: Two Case Reports

                                              http://austinpublishinggroup.com/neurosurgery/

Anon-traumatic intracranial acute subdural hematoma (ASDH) may be caused by vascular malformations such as cerebral aneurysms, cerebral arteriovenous malformations, a dural arteriovenous fistula, brain tumor, and blood coagulation/fibrinolysis abnormalities. We treated two patients with an intracranial ASDH without these factors or a direct head injury, and we speculated that the ASDHs were induced by increased intraperitoneal pressure.

SpinalASDH due to increased pressure of spinal veins was reported to occur when the intrathoracic pressure rises accompanied by an elevation of intraperitoneal pressure. The pressure of intracranial veins, which do not have a valve structure, is not easily increased because of the internal jugular vein valve, even if the central venous pressure rise when the intrathoracic pressure elevates. However, internal jugular vein. valvular insufficiency, which results in an elevation of the intracranial venous pressure accompanied by central venous pressure elevation due to the increase in the intrathoracic and intraperitoneal pressure, has been identified in 25%–45% of healthy individuals. We report two cases of intracranial ASDH which were presumed to be triggered by an elevation of intraperitoneal pressure.

Common Complications during Hemodialysis Session; Single Central Experience

                                            http://austinpublishinggroup.com/nephrology/

ESRD is prevalent disease worldwide. A major public health problem can lead to considerable co-morbidity and mortality, and high expenditure by health services providers. Regular HD is the commonest mode of renal replacement treatment in comparison with peritoneal dialysis and renal transplantation all over the world. It has been also reported by Blagg 2001, and Habas et al. 2012 that more than 500.000 patients worldwide, and about 250.000 patients in USA were on regular HD, and most of ESRD patients have three session of HD per week. It had been estimated that at 2010, HD-dependent patients were about two million and at 2030, more than two million patients will be HD dependent ESRD.

Patients on regular HD develop many complications during the session of HD (Intradialytic), post-HD session, and have long-term complications. The most common intradialytic complications of HD are, hypotension, vomiting, epigastric pain, hypoglycemia, chest pain, tachycardia, muscle cramps, cardiac arrest, shivering, hotness, epistasis, melena, hallucination, restlessness leg, allergic reaction and jaw lock.

Cancer Stem Cells, Tumor Microenvironment and Nanomedicine

                              http://austinpublishinggroup.com/nanomedicine-nanotechnology/

Chemotherapy is one of the current mainstream anticancer therapies using chemicals to induce apoptosis by damaging DNA and/or inhibiting mitotic division to kill rapidly dividing cancer cells. Conventional chemotherapeutic strategy may exhibit initial success, but the eventual relapse of tumor growth is due to a greater resistance which recognized as the primary cause of chemotherapeutic failure for most human cancers. Because of genetic instability in cancer cells, nonrecurring mutations and large genomic alterations generate vast heterogeneity, giving rise to tumors which comprised subpopulations of distinct cells. Some of the tumor cells have been known as intrinsic resistance to the “achievable” doses of anticancer drugs, while other tumor cells are initially sensitive but become resistant during the course of treatment. There are three important chemo-resistant issues: 1) the pharmacological factor, which is the “inadequate” drug concentration at the tumor site, causes chemo-resistance; 2) cellular factor, which is a certain type of cancer cells, such as progenitor Cells/Cancer Stem Cells (CSCs), renders a capability for the subset of cancer cells evading slaughter of a variety of structurally and functionally chemo-agents 3) tumor microenvironment factor, which is dictated in one way or another, by a specific composition for tumor initiation and induction of tumoral angiogenesis, and for invasion and metastatic processes.

CSC and its niches CSCs, a sub population of tumor cells with the capabilities of self-renewal and differentiation potentials, contribute to tumor initiation, progression, and recurrence. CSC has been accepted as the most significant factor for the therapeutic failure. Although the mechanism is poorly understood, the CSCs, in fact, are protected physically by multiple lines of defense to resist chemotherapy. To resemble normal stem cells which generally located at places that are less exposed to potential external attacks, CSCs also take the maximal advantage of the CSC niches they are localized in. CSCs can differentiate into tumor cells under some circumstances, while the non-CSC-tumor cells may dedifferentiate into CSCs. Evidence suggests that CSCs and non-CSCs are not in amotion less but in a dynamic equilibrium state. The chemo-agents can kill the non-CSCs but may not the CSCs, especially those CSCs hidden in the CSCs niches.

Prevalence and Risk Factors of Hyperglycemia among Diabetic and Non-Diabetic Rural Population in North Sudan

                                               http://austinpublishinggroup.com/medical-sciences/

DiabetesMellitus (DM) is a group of metabolic disorders characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action or both. DM is a major health problem with significant morbidity and mortality. The number of patients with type 2 diabetes is increasing rapidly in both developed and developing countries around the world. This emerging pandemic is driven by the combined effects of population ageing, rising levels of obesity and inactivity and changes in dietary habits. glycemic parameters above normal but below diabetes thresholds is a high-risk state for diabetes with an annualized conversion rate of 5%-10%; with similar proportion converting back to norm glycaemia. The prevalence of prediabetes is increasing worldwide and it is projected that >470 million people will have prediabetes in 2030. Prediabetes is associated with the simultaneous presence of insulin resistance and β-cell dysfunction, abnormalities that start before glucose changes are detectable.

Estimated number of people having DM was 415 million in 2015 and is expected to be 642 million in 2040, 5 million adults died from DM in 2015. The proportion of undiagnosed diabetes is 46.5% in the world with the highest proportion being in Africa (66.7%). 

The number of diabetic patients was estimated to be 35.4 million in Middle East and North Africa region in 2015. The prevalence of diabetes is 7.7% in adults (20-79 years) in Sudan in 2015. Previous studies showed the highest prevalence rates of diabetes in the Northern State compared to other parts of Sudan. The aim of this study was to determine the prevalence of diabetes, its associated risk factors, and the proportion of undiagnosed DM in a rural population in the northern part of Sudan.

Stromal Vascular Fraction does not Ensure a Higher Survival in Autologous Fat Grafting for Breast Augmentation

                                          http://austinpublishinggroup.com/mutagenesis/

Autologous fat grafting has become a popular treatment for volume and contour defects in reconstructive and cosmetic surgeries. Illouz described fat grafting to the breast using liposuctioned adipose tissue first and Bircoll published this approach in 1987. Since then, autologous fat grafting has gradually become popular as an option for cosmetic breast augmentation. Several modifications and refinements regarding fat harvesting, processing, and injection have been made in many ways to increase graft survival and enhance the predictability of this approach. No big impact on outcome following fat grafting has been identified although these techniques have been extensively studied and standardized.

Zuk et al. Isolated mesenchymal stem cells from adipose tissue with the potential to differentiate into mesenchymal, including adipogenic lineages In 2001. Adipose-Derived Stem Cells (ADSC) also displays angiogenic properties through the release of mediators in a paracrine fashion. ADSC have become attractive in regenerative medicine and are capable of being used as a tool to enhance the survival of fat graft due to the ease of isolation and abundant supply. The number of ADSC in adipose tissue is high In vivo. Harvesting fat grafts by liposuction reduces the amount of ADSC.

What’s New in Association between Musculoskeletal Disorders and Quality of Life?

                                    http://austinpublishinggroup.com/musculoskeletal-disorders/

Musculoskeletaldisorders are currently the most common cause of pain and chronic disability. In surveys carried out in Canada, the USA and the Europe, the point prevalence of physical disabilities caused by a musculoskeletal disorder is estimated at 4-5 percent of the general adult population. The prevalence is higher among women and increases markedly with age. Moreover, the pain and physical disability from musculoskeletal disorders affect social functioning and mental health, and diminishes quality of life. According to the International Classification of Diseases (ICD10) musculoskeletal disorders belong to the category of diseases of the musculoskeletal system and connective tissue.

Theyencompass a spectrum of disorders, from those of acute onset and short duration to lifelong dysfunctions. The primary musculoskeletal dysfunctions include osteoarthritis, inflammatory arthritis (principally, rheumatoid arthritis), back pain, musculoskeletal injuries (such as sports injuries), crystal arthritis (such as gout), and metabolic bone disease (principally osteoporosis). Other disorders included in this category are, amongst others, joint derangements, scoliosis, myositis, and fibromyalgia. Musculoskeletal disorders make up two percent of the global economic disease burden. They are a major cause of years lived with disability in all continents and economies. Musculoskeletal complaints are the most common medical causes of long - term absence because of sickness in developed countries. They also are common reasons for people claiming disability pensions.

miR-9a Induces Apoptosis in Shrimp Primary Cells Through Directly Targeting Host Hsc70 Gene

                                      http://austinpublishinggroup.com/molecular-biology/   

WhiteSpot Disease (WSD), which is caused by a double-stranded DNA virus White spot syndrome virus (WSSV) has become the major threat to global crustacean aquaculture industries. To date nearly 100 potential host species for WSD have been identified, including shrimp, crabs, lobsters, prawns, crayfishes, and copepods. However, despite growing understanding of the underlying molecular biology, cost-effective vaccinations or treatments for the disease remain elusive.

Molecularchaperones from the family of 70kDa heat shock proteins (Hsp70s) are conserved among many kinds of organisms. The constitutively expressed members of this family, heat shock cognate proteins (Hsc70s), have been shown to be involved in protein folding in the cytoplasm, protein import into the endoplasmic reticulum, mitochondria and chloroplasts, and trafficking of receptors and coated vesicles. In the case of animal viruses, interactions with Hsc70 appear to be involved in cell entry, virion assembly and disassembly, cell transformation, and DNA replication. Our previous studies showed shrimp Heat shock protein Hsc70 play key roles in WSSV infection, immune evasion, host cell apoptosis and virus package. However, its regulatory mechanism remains unclear.