Introduction: Stem cells (sc) are the foundation cells for every organ, tissue and cell in the body. They are self sustaining and can replicate themselves for long periods of time. Stem cells can differentiate into different types of cells. Women below the age of forty and showing ovarian function loss are defined to have premature ovarian failure (POF). It is associated with sex steroid deficiency, amenorrhea, infertility, and elevated serum gonadotropins. Aim: To evaluate the therapeutic potential of autologous Mesenchymal sc (MSC) transplantation in women suffering from POF. Out of 112 high risk patients for POF(cases with amenorrhoea befor the age of forty), diagnosis was confirmed in10 cases. The ten POF patients were scheduled for MSC transplantation at Al- Azhar University Hospitals. MSC preparation from the bone marrow of the iliac crest was laparoscopically injected into the ovaries. Endometrial fractional biopsy was histopathologicaly (HP) and Immunohistochemically (IH) stained and evaluated according to Edessy stem cells score (ESS). Ovarian reserve was evaluated according to Edessy ovarian reserve score (EORS). Results: Showed that after transplantation two cases (20%) (ESS = 5 and 6) resumed menstruation after 3 months, one of them (10%) (Case no 5) (ESS = 6) got pregnancy after 11 months and delivered a healthy full term baby (Zeinab).Ten months after transplantation EORS of patient who developed pregnancy (case no 6) was found to be 7 after being 0 before therapy. EORS of the other menstruating case (case no 10) was 5 after being 0. The 2 menstruating cases showed focal secretory changes after being atrophic endometrium in case 5 and distorted proliferative endometrium in case 10. Conclusion: Stem cell transplantation is a good procedure and regarded as a real and hope to get healthy pregnancy and baby for cases of POF. It showed good clinical, HP and IH outcome.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Aim of Work: To compare between the effects of clomiphene citrate, tamoxifen and letrozol as ovulation induction agents on endometrial thickness and blood flow as non-invasive parameters of endometrial receptivity in women with polycystic ovaries. Patients and Methods: One hundred and fifty cases meeting the selection criteria were prospectively randomized into three groups 1^st Group took 100 mg clomiphene citrate, 2^nd Group took 5 mg letrozol and 3^rd group took 40 mg tamoxifen. Transvaginal ultrasound and Doppler were done to measure endometrial thickness and endometrial blood flow both pulsatility index (PI) and resistance index (RI) at the day of the maximum follicular growth or at day 20 in the absence of the dominant follicle in the three groups. Results: Significantly thinner endometrium in the clomiphene citrate group as compared to the other two groups and lower impedance in the spiral arteries in both letrozol and tamoxifen groups (P value less than 0.001). Conclusion: Endometrium was thicker with lower impedance in the spiral arteries in both letrozol and tamoxifen groups as compared to clomiphene citrate group. Ovulation and pregnancy rates were not significantly different. Other studies are needed to measure the cumulative results of six cycles, increasing the dose in non-responders and the incidence of miscarriage.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Purpose: The aim is to study the diversity in the composition of kidney stones and its association with the basic biochemical metabolic panel in patients with kidney stone disease (KSD). Methods: A cross-sectional prospective study enrolling consecutive patients with KSD attending a tertiary care hospital in Mangalore (India) was undertaken. Mineral compositions of kidney stones were analyzed using attenuated total reflection-Fourier transform infrared spectroscopy. Kidney stones were classified into different groups according to the composition. Metabolic status was assessed to analyze possible association with the kidney stone. Results: A total of 369 patients (male 305 and female 64) in the age group of 43.05 ± 14.3 years were included in the study and showed a high diversity of kidney stone types with >50% with mixed compositions. A significant association was found between pure stone type and gender as well with age group (P < 0.001). Serum calcium levels in the calcium oxalate stone formers were significantly higher (P < 0.001) than others. Similarly, uric acid stone formers showed higher random blood sugar, blood urea, uric acid, and serum creatinine levels (P < 0.001). Urine pH was also found to be a contributing factor for the stone formation (P < 0.001). Stone recurrence did not differ significantly concerning stone composition as well as metabolic status. Conclusion: The study reports a high diversity of the kidney stone types among patients. This finding highlights the increased cases of mixed stones that may be because of various lifestyle factors resulting in altered metabolic status. This finding warrants mechanistic studies to understand the etiology of stone formation. This will enable to develop novel noninvasive interventional strategies and proper preventive strategies to reduce the risk of KSDs.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Objectives: To compare insulin-like growth factor binding protein-1/alpha-fetoprotein (IGFBP-1/AFP) to placental alpha microglobulin-1 (PAMG-1) for diagnosis of premature fetal membranes rupture (PROM). Methods: 220 pregnant women ≥ 37 and <39 weeks gestation studied and classified into two groups; study group (PROM) and control group (no PROM). Examination of the studied women followed by abdominal ultrasound (TAS) and sterile vaginal speculum examination to visualize amniotic fluid leaking and for collection of samples for fern, nitrazine, AmniSure^® and AmnioQuick^® Duo⁺ tests on admission. Results: The sensitivity and specificity of AmnioQuick^® Duo⁺ test to detect PROM was 93.6% and 86.4%; respectively compared to 95.5% and 89.1%; respectively for AmniSureR test, 72.7% and 80.9%; respectively for fern test and 76.4% and 83.6%; respectively for nitrazine test. PPV, NPV and accuracy of AmnioQuick^® Duo⁺ test to detect PROM were 87.3%, 93.1% and 90%; respectively compared to 89.7, 95.1% and 92.3%; respectively for AmniSureR test, 79.2%, 74.8% and 76.8%; respectively for fern test and 82.4%, 77.97% and 80%; respectively for nitrazine test. AmnioQuick^® Duo⁺ and AmniSure^® tests had higher sensitivity, specificity, predictive values and accuracy to detect PROM compared to conventional diagnostic tests. Conclusion: AmnioQuick^® Duo⁺ test for detection of IGFBP-1/AFP was rapid, accurate bedside test better than the individual conventional diagnostic tests and has same accuracy and performance like AmniSure^® test.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Introduction: Non-invasive selection of developmentally human oocytes may increase the overall efficiency of human assisted reproduction. Morphologic abnormalities in the oocyte are relevant for determining its developmental fate. The objective is to evaluate the influence of MII oocyte morphology on intra cytoplasmic sperm injection (ICSI) outcomes. Material and Methods: 132 patients undergoing ICSI cycles and having female factors of infertility and unexplained infertility. Couples having male factors of infertility were excluded. A total of 1200 oocytes were retrieved from 132 ICSI cycles, of which 1056 MII oocytes were evaluated. The criteria for morphological evaluations were: (i) Normal MII oocytes showing clear cytoplasm with uniform texture and homogenous fine granularity, a round or ovoid first polar body with a smooth surface, and perivitelline space of normal size. (ii) MII oocytes with extra cytoplasmic abnormalities (first polar body and perivitelline space abnormalities). (iii) MII oocytes with cytoplasmic abnormalities (dark cytoplasm, granular cytoplasm, inclusion body and presents of vacuoles). (iv) MII oocytes with combined abnormalities. Result: From 1056 MII oocytes, 180 (17.04%) had normal morphology while 876 (82.95%) had at least one demonstrable morphological abnormality. Cytoplasmic abnormalities were observed in 516 (58.9%) of the oocytes. Extra cytoplasmic abnormalities were observed in 104 (11.87%) while combined abnormalities were responsible for the remaining 256 (29.22%). There were no significant differences in fertilization, cleavage, and embryo quality between the groups but there was a highly significant difference in implantation rate which was higher in the group of normal oocytes morphology than abnormal oocytes morphology, oocytes with cytoplasmic, extracytoplasmic and combined abnormality 11.11%, 7.33%, 9.03%, 2.3%, and 4.34% respectively. Conclusion: MII oocyte morphology did not affect fertilization, cleavage, and embryo quality, but affecting implantation rate.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Introduction: IgG4-related disease is now considered to result from an imbalance in the regulatory immune system, and it is diagnosed on the basis of clinical and histopathologic evidence such as the presence of lymphoplasmacytic infiltrates, especially increased IgG4-positive plasma cells and fibrotic sclerosing tissue. Case report: We report herein a 45-year-old male patient with mediastinal mass with IgG4-related disease. IgG4-related disease can involve any organ but the most frequently involved sites include pancreato-hepatobiliary tract, salivary glands, and kidneys, generally manifesting as a mass in one or more sites mimicking a neoplasia. In the thoracic region, IgG4-related disease manifests as interstitial lung disease and fibrosing mediastinitis. Mediastinal lesion in our patient was quite resemble to mediastinal tumor derived from anterior mediastinum. This is the first case with mediastinal mass in a patient with this disease. Conclusion: Although very rare, we should rule out this disease as differential diagnosis in patients with anterior homogeneous density mediastinal mass simulating mediastinal tumor.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Objective: Scientists are to develop novel antibacterial therapeutics in order to eliminate medically significant pathogens resistant to antibiotic. Lysostaphina zinc metalloprotease with the sub-atomic weight of 27kDa and particularly tic action against Staphylococcus aureus degrades the S. aureus by hydrolyzing the pentaglycine cross-links introduce in its cell wall. Because of such potential, lysostaphin will be a decent agent for treatment of antibiotic-resistant staphylococcal infections. Also, due to the broad needs of society to increase localization of sciences, the national production of this drug in research laboratories would be necessary. Materials and Methods: First, with the aid of articles we identified Lysostaphin sequences without signal peptide via Gene Bank data base. In order to achieve the correct protein sequence, we add the entrokinase cutting site to our sequence. To ensure the correct cloning process, the entire process of cloning and protein expression was evaluated in silico. The sequence obtained for the synthesis was sent to the Biomatik Company in Canada (BIOMATIK). After the primer design and synthesis of the DNA fragment of the gene, we amplified the gene using PCR. The mature lysostaphin gene was cloned in plasmidpET28a and expressed in E.coli with the carboxyl terminal hexa-histidine fusion tag under the transcriptional control of T7/lac promoter/operator. Result: The transformed E.coli BL2 (DE3) cells produced catalytically active recombinant lyso staphin after being induced by IPTG. Conclusion: This study shows that the E. coli expression system is suitable for expression of recombinantly so staphin and according to the conducted bioassay in this study, the expressed protein can be considered as an effective therapeutic agent against antibiotic resistant staphylococcus aureus.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background and Aims: Current advances in the researches on the stem cells has opened new approaches for their apply in tissue engineering and clinical trials. The most common sources of stem cells are adult and embryonic stem cells. Due to ethical issues, embryonic stem cells use in research has been hotly debated. Unlike embryonic stem cells, adult stem cell have not ethical problem for clinical and research. The purpose of present study was to stem cells isolation and proliferation from the human dipose tissue. Materials and Methods: In this study, stem cells were successfully isolated from human adipose tissue by digestion with type I collagenase enzymes. In summary, adipose tissue were digested by type I collagenase enzyme. Subsequently, the cell solution was centrifuged for mature adipocytes and debris elimination and obtained sedimentation was cultured in culture medium contains Dulbecco's Modified Eagle's Medium (DMEM) via 1% penicillin/streptomycin antibiotics and 10% fetal bovine serum (FBS) at 37°C, 5% CO2 and 95% humidity. Results: in this study, ADSCs were successfully isolated and proliferated. Human ADSCs were able to divide in our culture mediums. Conclusion: The results of the current study were suggesting that this adipose-derived stem cell isolation protocol provides an effective and improved method for isolation and proliferation of these cells in order to tissue engineering application.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Objectives: Anemia is one of the world's leading causes of considerable perinatal morbidity and mortality. This study designed to compare the efficacy and safety of Heme iron polypeptide (Proferrin^®-ES) versus iron saccharate complex (Ferrosac) in treatment of iron deficiency anemia during pregnancy. Methods: Two hundred and sixty (260) pregnant women with hemoglobin level below 10 gm/dl due to iron deficiency anemia were included in this study and randomized to receive either; intravenous Iron Saccharate (IV group) or oral Proferrin^®-ES (PO group) for correction of iron deficiency anemia during pregnancy. Treatment efficacy checked by comparing pre-treatment values of hemoglobin, serum ferritin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and reticulocytes count by the 3-months` post-treatment values. Results: The 3-months` post-treatment hemoglobin level increased compared to the pre-treatment level without any significant difference between the two studied groups (from 8.5 ± 3.5 to 11.3 ± 1.3 gm/dl in PO group and from 8.7 ± 2.5 to 11.7 ± 0.9 gm/dl in IV group). In addition; the 3-months` post-treatment ferritin level, increased compared to the pre-treatment level without any significant difference between the two studied groups (from 19.4 ± 4.9 to 118.8 ± 7.1 ug/l in PO group and from 15.3 ± 5.6 to 122.3 ± 6.4 ug/l in IV group). 1.6% (2/124) of the studied women developed gastrointestinal intolerance and upset with oral Proferrin^®-ES (insignificant difference and excluded from the study) and no other side effects recorded with oral Proferrin^®-ES. Conclusion: HIP (Proferrin^®-ES) is an effective, safe, well tolerable oral iron preparation as well as intravenous iron saccharate complex for treatment of iron deficiency during pregnancy; it increases the hemoglobin and replaces the depleted iron store.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Drug promotional literature (DPLs) is an integral part of pharmaceutical marketing strategy. This marketing approach influences, a physician to prescribe definite variety of medicine from a particular company. Many physicians bank on exclusively in DPLs. This research was intended to appraise the DPLs available in Bangladesh for accuracy, consistency, and validity of the information in accordance with the WHO rules and regulations. Materials and Methods: This was a cross-sectional study was conducted in Uttara Adhunik Medical College, Dhaka, Bangladesh after collecting DPLs from the different outpatient department. The data was analyzed Microsoft Excel 2016. Results: None of the national and multinational DPLs fulfilled all the WHO criteria. Among the national and multinational DPLs, 94.7% and 100% presented with claims respectively. Out of 284 national and multinational DPLs references citation were presented in 82.04% and 100% respectively. Among the DPLs of national and multinational companies' relevant, irrelevant, and partially relevant pictures were presented in 48.79%, 24.65%, 26.76% and 31.58%, 26.32%, and 42.11%, respectively. Conclusion: DPLs of Bangladesh did not comply with the WHO guidelines while promoting their products. Evidence provided in those DPLs were mostly biased and persuasive since it is focusing mainly on the positive aspect of drug therapy. Accordingly, studied DPLs were principally aiming to maximizes industries' financial benefit rather than fulfill the educational aspects. The Government of Bangladesh should develop very stringent policy and practices regarding DPLs based on science and the WHO guideline as the literature very often act as a primary source of information among medical doctors.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Objective: Habitual squatting in humans is associated with modifications of ankle especially the neck of the talus (squatting facets) and its trochlear surface (trochlear extensions) that characterize the strong pressure and traction forces on ankle joints in state of hyperdorsiflexion. Present study was done to find out variations and incidences of various types of modifications of neck of talus thoroughly and to determine regional peculiarities of these modifications in Indians. Material and Methods: 300 dry (150 right and 150 left) adult tali were taken for present study. Each talus was examined for the presence of various patterns of articular facets on neck of talus and extensions of its trochlear surface. Statistical analysis of data was performed by using Fisher exact test with 95% confidence limits. Results: Lateral squatting facet was found in 136 tali (45.3%). Incidences of medial, combined & continuous gutter like squatting facets were 7.7%, 3.3% & 4.3% respectively. Lateral and medial extensions of trochlear surface were found in 22.3% and 23.7% respectively. Conclusions: Modifications of the neck of talus (squatting facets and trochlear extensions) are result of prolonged squatting positions which is common habit of Indian population and incidences of these variations can be used as an anthropological marker for racial and regional diff erentiation of unidentified bones.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Analysis of positive and negative symptoms of schizophrenia has been increasingly needed for a systematic management plan. Unfortunately, this type of study was lacking in Bangladesh. Aims: The study aims were to find out the predominant symptom pattern and associating factors in schizophrenia. Methods: This was a cross sectional, analytical and descriptive study done in a tertiary care hospital with a sample size of 78. The SCID-I and pre designed socio demographic questionnaire was applied. Positive and negative symptoms were assessed by using the Positive and Negative Symptom Scale (PANSS). Statistical analysis was done through SPSS version 17. Results: Among 78 patients, schizophrenics with positive symptoms (57.7%) were predominant over schizophrenics with negative symptoms (42.3%). Delusion (64.1%) and blunted affect (55.1%) were the most frequent positive and negative symptoms respectively. Negative symptoms were significantly associated with poverty, unemployment and lack of education. Limitations: Single centered cross sectional study with small sample size. Conclusions: Schizophrenic patients with positive symptoms visit clinicians more readily than those with negative symptoms.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: An estimate of 250,000 children are born annually with sickle cell disease (SCD) worldwide and 75%–85% of the affected children are born in Africa; where mortality rates for those under age 5 years range from 50% to 80%. Objective: The present study was conducted to estimate the prevalence of SCD among children in Plateau State Specialist Hospital (PSSH), Jos, Nigeria. Methodology: Ethical approval was obtained from the Health Research Ethics Committee of the Hospital. Secondary data on age, gender, and region from the case notes of infants, children and/or adolescents; who received medical care in PSSH from 2012 to 2014 were used. Data were analyzed using frequency tables and Chi-square statistics. Results: The findings revealed that the prevalence of SCD in PSSH, Jos from 2012 to 2014 was 26.9/1000 population of pediatric patients. There was a gradual increase in the prevalence rate from 25.8/1000 in 2012 to 26.8/1000 in 2013 and 28.1/1000 in 2014. However, the case fatality rate of SCD gradually decreased from 15.4% in 2012 to 11.1% in 2013 and 10.3% in 2014. Chi-square test shows that the prevalence of the disease in relation to sex, age, and residence was not statistically significant (P > 0.05). Even though the case fatality rate of the disease decreased, its prevalence increased during the study. Conclusion: Therefore, preventive measure for SCD such as premarital genetic screening and counseling should be emphasized, especially in the southern and central geopolitical zones of Plateau state, where the prevalence was found to be higher.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Multiple research articles were continuously emphasizing that constructive effects of empathy improve patient care. Medical professional bodies often talk that medical doctors need to be competent in clinical skills and empathetic. There was enormous demand from patients that doctors should be empathetic and motivate listeners. Therefore, medical educators became highly concern about the issue whether their students possess empathetic qualities. The Aim of the Study: To measure the empathy level among the medical students and to perform validation and reliability study of the Toronto Empathy Questionnaire (TEQ). Materials and Methods: This was a cross-sectional study among medical students of the Defence University of Malaysia to measure empathy level. The TEQ was utilized to collect data. The data were collected in early second half of 2017. The universal sampling method was adopted, and data were analyzed with IBM SPSS Software. Results: The current study population holds an average level of empathy. Female medical students had statistically significantly (P = 0.001) higher scores than their male friends. There no statistically significant differences observed in the TEQ score between the year of study (P = 0.948) and type of admission (P = 0.065). Conclusion: The current study respondents possess an average level of empathy. Educational intervention can be incorporated to enhance empathy level which sequentially promotes patient care.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

The successful arrest or cure of tuberculosis (TB) depends largely on early case detection and proper treatment. Currently, several promising diagnostic tools with improved sensitivity and speed are available. Old microscopic and culture based technologies have been revisited and new molecular technologies have been developed. In recent years, World Health Organization (WHO) evaluated and endorsed different TB diagnostic tools and published various policy statements. These policy statements address improvements in smear microscopy, use of commercial and non-commercial culture based techniques and rapid molecular assays. This is the first comprehensive review compiling pros and cons of WHO recommended TB diagnostic tools for effective implementation in TB endemic regions.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: The recent engagement of Game base console is emerging in rehabilitation practice and its overall effectiveness has not been yetsubstantially manifested. Objective: To evaluate the effectiveness of Wii based balance interventions among Multiple Sclerosis people. Data Sources: A systemic search was conducted in the PubMed and Scopus data bases electronically up to February 2014. Study Selection: Randomized and non-randomized control trials with Wii intervention on balance as an outcome measure among people with Multiple Sclerosis were included in this review. Data Synthesis: After screening 57 studies, 7 were selected for full-text screening and 5 were included in this review. Three out of five were RCTs and rest were quasi experimental and 2-point crossover pilot studies. Total of 205 medically diagnosed mild to moderate MS people were in the selected studies with less than 6 expanded disability status scale (EDSS). Total of 13 different outcome measures were used on assessment of balance in Multiple sclerosis individuals and the most common outcomes were Berg balance scale (BBS), Center of Pressured (COP), Four Square step test (FSST), Time up and Go test (TUG). Three out of five studies report statistical significant improvement in the Four Square step test (FSST), Berg Balance Scale (BBS) and center of Pressure (COP) between intervention and control groups of MS. Conclusion: Review of the selected studies indicates that the inclusion of Wii game in balance exercise on Multiple sclerosis people improve static balance more effectivelyas compare to dynamic balance in mild to moderate level of disability. However evidence on the mode selection in Wii, treatment setting and frequency lacking. Further studies with large sample size and more homogenize outcome measure and control setting is recommended for future.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Low Back Pain (LBP) is one of the main causes of disability in the whole world. In most cases, its presentation is considered benign and usually managed quite easily. However, in a low percentage of cases LBP is secondary to a serious pathology. Patients with Multiple Sclerosis (MS), for instance, are often affected also by LBP, and LBP could also be an initial symptom of MS. Moreover, patients with MS can present with a w ide range of clinical symptoms, as the Restless Legs Syndrome – RLS. In these specific cases, the ability to recognize a serious pathology is a key component of the physical therapist practice. Both conditions, nonspecific LBP and RLS, have been found in a patient that was referred with diagnosis of bilateral sciatica.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Introduction: Considered as an end-stage for all cardiovascular diseases, cardiac fibrosis leads to the development of heart failure, thus the ultimate goal is to prevent the progression of fibrosis. Indeed, heart can regenerate itself but to a certain limit based upon the number of resident stem cells which is limited. Thus, stem cells transplantation is considered as a promising therapy. This study aims to examine if MSC transplantation can inhibit the progression of myocardial fibrosis in rat model compared to Colchicine treatment; and if the timing of treatment with MSCs or COL affect the progression of fibrosis. Material & Methods: To induce cardiac fibrosis in 48 female albino rats, Isoproterenol hydrochloride was used. These rats were divided into 2 models: COL-treated group that were treated after 1,2,3 weeks of the last ISO injection by colchicine orally. MSC-treated group that were injected intravenously after 1,2,3 weeks of last ISO injection by MSC. Heart rate and Systolic blood pressure were measured and the levels of Creatine phosphokinase, Lactate dehydrogenase, Matrix Metalloproteinase II and Collagen I were assessed. Moreover, cardiac tissues were examined hitopathologically. Results & Conclusion: MSC were proved to enhance the effect of anti-remodeling of extracellular matrix significantly by modulating the expression of matrix metalloproteinases, which is superior to COL treatment.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Introduction: Blastocystis hominis (B. hominis) is an obligate anaerobic protozoan found in the human large intestine, and is the most common eukaryotic organism reported in human fecal samples. Method: Multiple stool samples from 460 children (53.9% male and 46.07% female) were collected and examined for the presence of Blastocystis hominis in Parasitology Laboratory of International Centre for Diarrhoeal Diseases Research, Bangladesh during the period of 9th January to 28th December, 2011. Among them, 255 were diarrheal patients (56.47% male and 43.53% female). Direct microscopy was done for each of the samples and each sample was cultured in vitro for 48 hours and observed again for the presence of the pathogen. The aim of the study was to develop a sustainable technique to identify the pathogen. Results: In culture, several morphological forms were observed. Through microscopy, various morphological forms were clearly observed. Within 5679 tested samples, 795 samples (0.14%) were positive for B. hominis. As multiple forms were observed in the same sample, the most prevalent was cyst (0.125%) whereas least prevalent was granular (0.0072%). The highest percentage for all the morphological forms was observed in age group 25-36 months. In direct microscopy from fresh samples, children from 37-48 months showed the highest percentage (22.9%) of infection (p=0.000). In culture, the same age group showed the most infection rate (p=0.000). Among the different morphological forms observed in culture, the highest prevalence of cyst was in age group 37-48 months (p=0.000). The highest prevalence of vacuolar form(5.7%) was observed in the same age group (p=0.015). In contrast, the amoeboid forms were mostly observed in children of 25-36 months (p=0.002). The children aged in between 37 to 48 months are at the most risk of the infection. Conclusion: The sensitivity of direct microscopy was found only 38.46% in respect to in-vitro culture which strongly suggests that in-vitro culture is the gold standard for the diagnosis of this parasite.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Objective: We investigated the association of MTHFR C677T polymorphism with ischemic stroke, its subtypes and hemorrhagic stroke in a South Indian Population from Andhra Pradesh. Methods: Six hundred and twenty ischemic stroke patients, 220 hemorrhagic stroke patients and 620 age and sex matched healthy controls, were included in the present study. The polymorphism was determined using PCR-RFLP technique. Results: The strength of association between genotypes and stroke types was measured by the odds ratio with 95% confidence interval and chi-squared analysis. We found significant association of the CT genotype with ischemic stroke as well as haemorrhagic stroke (p<0.05). Further, evaluating the association of this polymorphism with stroke subtypes, we found significant association with intracranial large artery (p<0.05), lacunar stroke (p<0.05) and undetermined etiology (p<0.05). However, there was no significant difference in genotypic or allelic frequencies between ischemic and hemorrhagic strokes. Conclusion: Our study suggests that MTHFR (C677T) is an important risk factor for ischemic stroke, its subtypes and hemorrhagic stroke in the South Indians from Andhra Pradesh but it cannot help in distinguishing between the two types of stroke.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Introduction: The ischaemic disorders as a complication of intra-aortic balloon pump counterpulsation (IABP) could be deleterious in critically ill patients with myocardial failure and cardiogenic shock. Tis study is a pilot to predict the length of the descending aorta to select the optimum IABP size for Asian patients. Methods: The somatometric features from 80 Chinese patients were used: gender, age, height, body mass index, body surface area, trans-pyloric plane. Moreover, the aortic length from the origin of left subclavian artery to the orifice of the celiac trunk (LSA-CT) measured from tomographic scan examination. The variables to predict the length from the LSA-CT were studied in four types of predictive statistical analysis: nonlinear regression analysis, tree model, linear regression, and loglinear regression. The model was defined by obtaining the R square. Results: Tere were 59 males (mean age 53.9 years SD 13.2, height 170.8cm SD 4.0) and 21 females (mean age 58.7 years SD 7.8, height 160.2 cm SD 6.8). LSA-CT distance was found to be 279.5 SD 31.34 mm. The length of distance from the jugular notch to trans-pyloric plane was 273.8cm SD 12.5. The body mass index was 25.6 Kg/m2 SD 3.8 and the body surface area 1.8 m2 SD 0.1. The tree model for predicting the distance to the left subclavian artery to the celiac axis was chosen due to obtained an R2 square of 0,829. The comparison between the tomographic values and results of the tree model was realized with a nonparametric test. Wilcoxon signed-rank test showed that the values of computed tomograhy scan did not show a statistically significant difference with the results of the tree model (Z = -0.827 p =0.408). Conclusion: The tree model for predicting the distance from the left subclavian artery to the celiac trunk, could be an accurate guide to choosing an adequate catheter length of intra-aortic balloon pump counterpulsation in Asian patients.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Introduction: Chronic kidney disease (CKD) patients are considered a high risk group of cardiovascular disease in which vascular calcification plays central role. A pivotal role in the inhibition of calcification is played by fetuin-A. The measurement of inflammatory markers such as high sensitivity C-reactive protein (hs-CRP) and homocysteine which promotes atherosclerosis is helpful in predicting cardiovascular disease in ESRD patients on regular dialysis. Material and Method: The study included 40 adult CKD patients divided into 30 ESRD patients on conventional hemodialysis, 15 with CVD and 15 without CVD, as well as 10 CKD patients on conservative treatment. Ten healthy subjects served as a control group. Enzyme-linked immunosorbent assays were used for fetuin-A, hs-CRP and homocysteine. Results: ESRD patients showed a significant increase in serum hs-CRP, homocysteine and decrease in fetuin-A compared to control group. In addition, ESRD patients with CVD and without CVD showed a significant increase in hs-CRP, homocysteine and only those with CVD had significantly decreased fetuin-A in relation to CKD patients. The study revealed increased levels of hs-CRP and decrease in fetuin-A in ESRD patients with CVD compared to ESRD patients without CVD. Fetuin-A showed a negative correlation with hs-CRP and homocysteine in ESRD patients with and without CVD. Conclusion: The combined use of hs-CRP at a cutoff of (10 mg/dL) with either fetuin-A at a cutoff value of (0.26 g/L) or alternatively with homocysteine at a cutoff value of (48.23 μmol/L) proved to be effective for discrimination of CVD patients from other ESRD or CKD patients.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Introduction: There is increasing awareness and facilities provided by various government and non government organizations regarding antenatal care and safe delivery practices but it is still a public health concern due to high maternal and perinatal mortality. The aims of present study is to assess the availability of manpower which provided services to the mothers in the peripheries, role of demographic characteristics, educational status, common pregnancy complications and there maternal and fetal outcome along with the hospital stay. Material and Methods: It was a retrospective study carried out in the Teerthanker Mahaveer Medical College. All the patients who were admitted through casualty were analysed with respect to Age, parity, Socioeconomic status, antenatal check-up, reason for referral from periphery, maternal and fetal condition at the time of admission, mode of delivery, maternal and fetal outcome along with NICU admission & hospital stay. Result: It has been observed that most of the patients with poor obstetrical outcome are multiparous or grand multiparous with low socio economic status not receiving any antenatal care. The common obstetrical emergencies came out were PIH (18%), obstructed labor (10.3%) followed by APH (8.2%), fetal mal-presentation (7.5%) and anemia (7.2%). Conclusion: Illiteracy and ignorance of female regarding healthcare requirements came out to be a major contributor of poor pregnancy outcome. Early diagnosis and management of high risk pregnancies is one of the measures which can reduce poor pregnancy outcomes. It is to be emphasized that majority of the maternal death from pregnancy are preventable by sample priority intervention. Co-ordination between healthcare providers at gross root level to tertiary care centre is the need of time. Health care providers at PHC and CHC levels should have adequate knowledge of antenatal requirements and importance of immunization. There must be referral of high risk cases for their early and timely management. There must be adequate transport facility and systematic referral system as well as provision of immediate management of referred cases at tertiary care centre. So it is high time for urgent strategic planning and investment for upgrading eff ective obstetric and neonatal care.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: There was an increasing trend for suicide Objective: To examine the trend and relationship between Indian Suicide Rates and Human Development Index (HDI). Method: Trends of Suicide rates and HDI values were evaluated by moving averages time series analysis (ARIMA Model). S. Rate and HDI were subjected to Pearson Correlation Coefficient and Spearman's ρ. Results: There was an increasing trend for both the parameters with minor exceptions in suicide rates. Significant correlation between suicide rates and HDI values were found. Conclusion: The notion that suicide and development were related found support. It warrants further analysis into contribution of individual components of HDI.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Infertility is an emerging major health issue affecting the physical, psychological and social status of the general population across the globe. There are innumerable causes of infertility, viz., ovarian and testicular disorders, advanced maternal age, obesity, chromosomal abnormalities etc. Most of these causes are linked to the genetic disorders. With recent advances in the field of reproductive biology, it has become imperative to have a concise knowledge of the genetic basis of infertility, for better outcome in Assisted Reproductive Techniques (ART).

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]