Contribution to the Knowledge of the Blidinje Lake Sediment

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Lake sediments are considered as an archive of physical, chemical and biological conditions in lakes and their drainage basin. Under relative steady sedimentation process and in the absence of bio-turbation, depositional sequence of lake sediments provide a temporal composition pattern, therefore the onset, rate and variations in present and past environmental conditions could be assessed. In this sense, environmental impacts caused by human activities, mainly those related to the release of persistent pollutants, can be identified by appropriate analyses of sediment archives.

Lake Blidinje with area of some 2.5 km2 (on average) is the biggest mountain lake in Bosnia and Herzegovina. It is located at an altitude of 1185 m (N 43o36`; EO 17o29`), between Čvrsnica and Vran mountains. The lake is very shallow with an average depth of about 0.5 m, and under the strong influence of meteorological conditions. The lake has variable volume and surface area. Lake Blidinje is an integral part of the Nature Park “Blidinje” founded in 1995. Nature Park “Blidinje” (364 km2) includes the Čvrsnica massif (2228 m), the Vran Mt. (2074 m), the valley Dugo polje and the western part of the mountain ridge Čabulja named Debelo brdo, (1500 m).

Geologicalbase is very heterogeneous, made up of limestone from upper and middle Triassic, and has a young Jurassic limestone, werfenian layers of red sandstone, sandy shale, limestone plate marl, porous limestone and dolomite. On the surface most of the Nature Park “Blidinje” lithosphere breaks through the ground and form a single larger or smaller blocks to the tops form a rocky massif.

Splenic Abscess

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A 66- year old man, who has undergone open prostatectomy three months earlier presented to the abdominal department with general malaise, left upper abdominal pain, and intermittent fever. On physical examination, he was noted that these symptoms have started three weeks after open prostatectomy. The physical examination of the abdomen was normal. At the admission erythrocyte sedimentation was 140 mm/h (normal value 3 mm/h), C-reactive protein was 128 mg/L (normal value 1.0-6.0 mg/L), leukocytes were 13.2 X 10³/μL (normal value 4.0- 10.0 X 10³/μL), and creatinine was 156 mmol/L (normal value 70-108 mmol/L).

The CT- scan of the abdomen revealed splenomegaly (17 X 8 cm), suspicious splenic infarction and suspicious splenic abscess in progression (Figure 1). After the admission, we have started to treat a patient by imipenem- cilastatine, a broad-spectrum antibiotic. Three days after admission patient underwent surgery with the aim to remove the septic source and the diseased organ. About 90% of spleen parenchyma was destructed due to abscess. Spleen was like bag filled with pus, and an open splenectomy was performed (Figure 2). From splenic abscess has been isolated enterococcus faecalis. The patient was discharged on the seventh postoperative day. Fourteen days after splenectomy, a patient has been vaccinated by pneumococcal, meningococcal, and Haemophylus Influence (Hib) vaccines. A month after splenectomy patient was in very good condition.

Splenic abscess is a rare entity, with high mortality rate, up to 47%. The most common causes of splenic abscesses are haematogenous spread originating from an infective focus elsewhere in the body, urinary tract infection, infective endocarditis, pneumonias, pelvic infections etc. Splenic infarction resulting from systemic disorders such as hemoglobinopathies (especially sickle cell disease), leukemia, polycythemia, or vasculitis, can become infected and evolve into splenic abscess. Splenic abscess can be treated by percutaneous drainage or surgical interventions open or laparoscopic splenectomy.

Psychometric Properties of Malay Version of Summary of Diabetes Self-Care Activities Measures among the Malay Adults with Type 2 Diabetes Mellitus in Kelantan, Malaysia

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Self-managementis defined as the knowledge and skills necessary for an individual to take care of oneself, manage crises, and change lifestyle to manage illness successfully. Self-management is an important part of daily life for people with diabetes. It has been reported that approximately 95% of diabetes care is self-treatment or self-management. To control diabetes, individuals must monitor their daily lifestyle behaviour, and often they must change long-held habits. Therefore, although self-management is vital in people with type 2 diabetes mellitus (T2DM), it is not always as effective as health professionals would like. Thus, it is important that individuals adhere to self-management, to prevent further complications associated with diabetes to maintain or achieve a positive quality of life.

Ina clinic-based study on diabetes self-management in Malaysia, about 99% of the respondents were practising at least two out of four diabetes regimens, which were regular exercise, healthy diet, monitoring blood glucose and monitoring body weight. However, only about half of the respondents (56%) were practicing all these four regimens. Besides, it is common for people withT2DM to have difficulty practicing all the self-care recommended by their health practitioner. People with T2DM must comply with demanding requirements of their treatment regimens, and this can create the fear of failure. These regimens can involve daily behavioral tasks, such as changes in habits on diet and exercise, which people with diabetes should comply for the rest of their life.

Practicessuch as diet, exercise, smoking cessation, and yearly check-ups will help to prevent the incidence of diabetes and delay the progression of its complications in people who are already known to have diabetes. Handley et al. reported that the majority of the 228 participants (75%) from San Francisco, California, with coronary heart disease risk factors, including those diagnosed with diabetes, were carrying out an action plan that focused on diet or exercise for self-management of their illness condition. Moreover, in a qualitative study, the researchers demonstrated that most people with diabetes had selected diet and or exercise for their behavior change. The study that examined people with diabetes attending a Malaysian clinic showed that 94% of these individuals were following a healthy diet. Besides, Anderson et al., suggested that diabetes self-management, such as diet planning, requires a life-long commitment. This can only be sustained with the genuine internalisation of the purposes and the value of good diabetes self-care.

Anti-Candida Activity of the Essential Oil From Elionurus Muticus: A Preliminary Study

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Therapeuticoptions for the treatment of candidiasis are mainly azole, polyene and echinocandin type antibiotics. Unfortunately, the clinical use of these agents has been limited due to their toxicity and resistance factors, contributing to high rates of morbidity and mortality. In recent decades, research on medicinal plants has been an alternative in the discovery of new biocomponents for various applications in folk medicine. The use of essential oils extracted from different types of plants, showed several indications, as antiseptic, antifungal and antibacterial actions.

Thegenus Elionurus presents approximately 45 species. It occurs in Africa, Asia, North America and South America. Elionurus muticus is a grass of the Brazilian pampas known as Brazilian lemongrass. This has aroused considerable interest in the phytochemical industry. It presents antioxidant activity related to the content of its phenolic compounds. It is notable for containing antiseptic, sudoriferous and febrile properties. Produces essential oil in all its extension: in the aerial part, leaves and inflorescences, as in the roots. However, both the composition and the yield are variable according to the region of cultivation and the seasonality.

Despite this, this essential oil may be rich in citral, which is a mixture of two geometric isomers known as geranians and nerals. Some pharmacological properties of citral have been reported in the literature, including antitumor, bronchodilator, antiprotozoal and antimicrobial effects. Based on the literature data, the objective of this work was to evaluate the in vitro antimicrobial activity of Elionurus muticus essential oil on the Candida spp. Strains by determining the Minimum Inhibitory Concentration (MIC) and Minimum Fungicidal Concentration (CFM).

White Spot Lesions: Whose fault it is?

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Fixedorthodontic treatment has many side-effects associated with it, especially Demineralization with a very poor oral hygiene. Demineralization of enamel occurs because of the subsequent release of acidic byproducts of the bacteria in the plaque which leads to the formation of White Spot Lesions (WSL). Caries is another side effect leading to poor esthetics, patient dissatisfaction and legal complications. For an orthodontic point of view, the formation of these white spot lesions is very discouraging as the main goal of orthodontics is to improve the esthetics in the dento facial region.

Orthodonticattachments make oral hygiene maintenance the most difficult job as the small size of these attachments on teeth like brackets, bands, arch wires, ligatures and other orthodontic devices leads to prolonged plaque accumulation and appearance of WSL. So, before starting orthodontic treatment and initiating other preventive measures, one has to assess the saliva, oral hygiene status and caries rate. Patients should be properly educated about the importance of maintaining good dietary compliance and excellent oral hygiene regime.

Clinically,these white spots can be seen around orthodontic attachments within 4 weeks of starting of treatment and their prevalence can be as high as 96%. The most frequently affected area is the labio-gingival area of the lateral incisors and the maxillary posterior segments are the least affected sites with a tendency to be seen in males than in females. A critical evaluation of oral hygiene is recommended during the initial periods as the number of white spot lesions increases in the beginning and keep on increasing at a slower rate.

White spot lesions are not only the result of demineralization, however, as fluorosis, hypomineralization /hypomaturation and hypoplasia can also cause lesions. Management of white spots includes the methods of prevention, demineralization and methods used for remineralization of lesions that are already formed. Remineralization is the process of restoring minerals in the form of mineral ions in dental enamels. Demineralization is the process of removing minerals, in the form of mineral ions, from dental enamel.

Physical Medicine and Rehabilitation Surmounting the Hiatus between Disease and Health Related Quality of Life

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Theultimate goal of management of all critical illnesses are to rehabilitate the patient up to optimum functional level and achieving quality of life and quality adjusted life years. Quality health care can be defined as providing the best possible outcome, safety and service. Quality patient care should be the first priority of every rehabilitation specialist. Physiatrist or specialty of physical medicine and rehabilitation has been recognized as a method that can restore the functional capabilities of patients with disabilities or chronic diseases to become participants in their home and community. Successful rehabilitation to the level at which the individual can participate in the society provides is the basis for the restoration of hope and aspiration for creativity. Medicine has been making highly significant progress in providing better health services. Acute medical and surgical services have successfully decreased mortality and extended life expectancy. 

As the success of surgical and medical care’s increases, the proportions of patients survive to aged population group increases. Most of the aged people survive with chronic disease and disability, which require more rehabilitation. With the growing of geriatric population, the health care delivery system will be burdened with patients suffering from chronic diseases of musculoskeletal and neurological system. At the same time physiological reserves also declines in aged population. Due to physiological constraints of kidney, liver and many other organs in aged people, the role of pharmacological agents in ameliorating the symptoms has also become limited. Different modalities of physical treatment including exercise used in physical medicine helps the patients in alleviating pain and disability as well as reduce the vulnerability to detrimental effects of drugs in old age.

Understanding the Role of microRNAs in the Pathogenesis of Intracranial Aneurysms

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Treatmentoptions for the management of intracranial aneurysms (IA) remain associated with significant morbidity and mortality. As a result, there is a need to identify biochemical markers predictive of the presence of IAs and the risk of rupture. Genetic factors play a key role in IA pathogenesis, as evidenced by the increased susceptibility to IA formation and rupture in the familial form of the disease. microRNAs (miRNAs), which modulate gene expression, have been demonstrated to be differentially expressed in multiple disease states. To date, little data exists pertaining to miRNA expression and IAs. We review the literature examining miRNA expression and IA formation, progression, and rupture. The relationship between miRNA expression profiles and the specific molecular and cellular processes driving IA genesis are examined. The potential clinical relevance of miRNA is also discussed, as it relates to improving the means by which the risk of rupture is estimated.

IntracranialAneurysms; miRNA: microRNA; aSAH: aneurysmal Subarachnoid Hemorrhage; mRNA; messenger RNA; miRISC: RNA-Induced Silencing Complex; UTR: Untranslated Region; ECM: Extracellular Matrix; TGF-β: Tissue Growth Factor-β; VSMC: Vascular Smooth Muscle Cell; NF-κB: Nuclear Factor-kappa B; IL-6: Interleukin 6; IL-8: Interleukin 8; ICAM-1: Intercellular Adhesion Molecule-1; VCAM-1: Vascular Cell Adhesion Molecule; MMPs: Matrix Metalloproteinases; TIMPs: Tissue Inhibitors of Matrix Metalloproteinases; VEGF: Vascular Endothelial Growth Factor; NF-κB: Nuclear Factor kappa-B; TNF-α: Tumor Necrosis Factor-α; IL-1β: Interleukin-1β; MCP-1: Monocyte Chemo Attractant Protein-1; qPCR: Quantitative PCR; AAA: Abdominal Aortic Aneurysms.

Intracranialaneurysms (IAs) affect 3-6% of the general population and have an annual rupture rate of 1-3%, resulting in approximately 27,000 aneurysmal subarachnoid hemorrhages (aSAH) in the United States each year. The morbidity and mortality of aSAH remains high, with as many as 50% of cases resulting in death, and up to 50% of survivors suffering significant permanent disability. Current microsurgical and endovascular treatment of IAs remains associated with significant risk, which may exceed the annual risk of rupture. Thus, there is a need for both an improved understanding of factors contributing to rupture and the development of noninvasive means by which to identify those aneurysms with a higher risk of rupture.