Open Access Case Study

Malignant Retroperitoneal Extra-Gastrointestinal Stromal Tumor: A Case Report

Reshalaiti Abuduwayite, Aidibai Muhemaiti, Hadeti Biekemituofu, Patamu Mohemaiti

Journal of Advances in Medicine and Medical Research, Page 142-149
DOI: 10.9734/BJMMR/2012/832

Context: Extragastrointestinal stromal tumors (EGIST) are extremely uncommon neoplasm. To the best of our knowledge, only one retroperitoneal EGIST case has been reported in Oncolgy, in 2005(PubMed search result).
Case Report: A 67-year old female patient presented with epigastric discomfort, dyspepsia, and anemia. Ultrasonographic examination of the abdomen showed the location of the tumor was between the tail of the pancreas and the spleen (retroperitoneal), it was variable in size of 12.3cm×7.2cm×14cm. Color Doppler Flow Imaging (CDFI) showed no flow signals with arterial-venous doppler spectrum in the masses.Contrast-enhanced computed tomography of the abdomen revealed a heterogeneously enhancing mass (8.23cm×14.2cm) and abundant blood supply of the tumor. The patient underwent gastroscopes-guided biopsy from the fundus of stomach for pathologic diagnosis and the result indicated chronic superficial gastritis. A complete gross excision was performed. Retroperitoneal tylectomy, left hepatic lobectomy, enterolysis, and liver biopsy were performed. Two weeks post operation, the patient was discharged without any postoperative problems. The final diagnosis of retroperitoneal EGIST was confirmed by histopathological examination and immunohistochemical findings (CD117 positivity).
Conclusion: We report a very rare case of retroperitoneal EGIST. Although the Ultrasonographic examination, computer tomography and endoscopy examination did not confirm the final diagnosis, they are complemented to each other in order to identify the exact location of the tumor. EGIST should be considered in the differential diagnosis of solid masses of abdomen on cytology and immunohistology.

Open Access Case Study

An Experience of Intravaginal Auto Lymphocyte Therapy in Treatment of Female Patients with Infertility: A Case Report

E. V. Esina, N. Yu. Logina, O. S. Alyautdina

Journal of Advances in Medicine and Medical Research, Page 150-156
DOI: 10.9734/BJMMR/2012/904

Aim: Application of a new method – intravaginal auto lymphocyte therapy in treatment of female infertility.
Place and Duration of Study: I.M. Sechenov, First Moscow State Medical University, the study was performed in 2010.
Results: A case report concerning treatment of a female patient with infertility by use of a new method of intravaginal administration of auto lymphocytes is presented. To prepare the patient to infertility treatment with help of intravaginal fertilization (IVF), 5 performances of intravaginal auto lymphocyte therapy were made. A pregnancy resulted simultaneously after the treatment course and finished by operative childbirth.
Conclusion: In the case presented here the method of intravaginal auto lymphocyte therapy demonstrated its efficiency in treatment of infertility. We hope that in immediate future this method will provide us with a possibility to improve female infertility treatment results.

Open Access Case Study

X-ray Diffraction Analysis to Clarify the Unusual Origin of an Intraocular Foreign Body

Francisco J. Ascaso, Javier Blasco

Journal of Advances in Medicine and Medical Research, Page 228-234
DOI: 10.9734/BJMMR/2012/1016

Purpose: To clarify the origin of a metallic intraocular foreign body (IOFB) due to a firecracker injury and to show the utility of X-ray diffraction analysis in the identification process.
Methods: Interventional case report using X-ray diffraction technique.
Results: We report a mechanism of firecracker ocular injury not previously described in the published literature. It involved penetration into the eye by a ground particle of calamine (originated from the area of detonation) and not, as it could be suspected, by a firecracker fragment.
Conclusion: X-ray diffraction analysis showed environmental debris in the area of detonation can be injected as foreign material into the eye.

Open Access Case Study

Sudden Bilateral Blindness Following Massive Uterine Bleeding: Reports of 2 Cases

Chinyere Nnenne Pedro-Egbe, Elizabeth Awoyesuku

Journal of Advances in Medicine and Medical Research, Page 254-259
DOI: 10.9734/BJMMR/2012/1000

Background: Most cases of sudden blindness are due to vascular causes. Ischemic optic neuropathy is a rare cause of blindness reported most commonly in association with collagen-vascular diseases, infectious processes, and systemic hypotension related to massive exsanguinating hemorrhage.
Aim: To report 2 cases of bilateral complete visual loss following massive uterine hemorrhage.
Case Reports: Case 1 is a 23 year-old unmarried female student who first presented at our Eye Clinic on account of bilateral visual loss of 5 months duration. She had, had a septic abortion and profuse bleeding per vaginum for over a week before visual loss. Case 2 is a 39 year-old unmarried school teacher who presented on account of sudden bilateral visual loss of two months duration following myomectomy. Postoperatively, patient was transfused 4 pints of blood.
Conclusion: Since sudden visual loss could follow non-ocular surgical procedures, surgeons must always be on the alert and ensure they avoid conditions that could predispose a patient to optic nerve ischemia; conditions such as perioperative drops in systemic blood pressure and hematocrit values. Normotension during and after surgery, is therefore vital in preventing optic nerve ischemia.

Open Access Original Research Article

Researches on Gastric Interdigestive Pressure Activity: Methods, Analysis and Interpretation

Yan Rongguo, Guo Xudong, Ji Da, Han Xuefei, Xu ChangQin

Journal of Advances in Medicine and Medical Research, Page 122-131
DOI: 10.9734/BJMMR/2012/883

Aims: To give researches on gastric interdigestive pressure activity, including gastrointestinal (GI) physiological motility recording method, data processing and analysis method, as well as to give reasonable interpretation on how to generate such gastric pressure activity.
Study design: Basic application study.
Place and Duration of Study: School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology (USST), between June 2010 and October 2011.
Methodology: We introduced a telemetric method to get the gastric physiological pressure activity inside the GI tract and the general process for processing such gastric Migrating Motor Complex (MMC) pressure activity including the process of abnormal value removing, medians of five-three-Hanning (53H) weighted average smoothing, and the fluctuation frequency estimation.
Results: Using the process of abnormal value removing, medians of five-three-Hanning (53H) weighted average smoothing, and the fluctuation frequency estimation, we well obtained gastric interdigestive pressure activity (MMC).
Conclusion: The methods introduced in the paper including abnormal value removing, the 53H weighted average smoothing, and the fluctuation frequency estimation were helpful for researches on gastric interdigestive pressure activity.

Open Access Original Research Article

Dexamethasone as a Means Not Only for Controlling Vascular Pain Caused by the Administration of Oxaliplatin Via the Peripheral Vein But Also for Controlling Oxaliplatin-Induced Hypersensitivity Reactions

Yoichiro Yoshida, Seiichiro Hoshino, Naoya Aisu, Hironari Shiwaku, Richiko Beppu, Syu Tanimura, Yuichi Yamashita

Journal of Advances in Medicine and Medical Research, Page 132-141
DOI: 10.9734/BJMMR/2012/918

Background and Aims: With the recent development of capecitabine and oxaliplatin (XELOX) therapy, implantation of a Central Venous (CV) port can be now avoided. However, vascular pain occasionally requires switching of the drip infusion route. Some investigators reported that addition of steroids to oxaliplatin drip infusion is useful in controlling vascular pain. However, the pharmacological use of steroids can make oxaliplatin unstable due to the elevation of pH; further, the effectiveness of steroid in this therapy is unknown. This study was undertaken to evaluate the effectiveness of dexamethasone (DEX) for controlling vascular pain caused by the administration of oxaliplatin via the peripheral vein.
Study Design: Retrospective study.
Place and duration of the Study: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, between April 2010 and November 2011.
Methodology: The study included 69 patients who received XELOX + bevacizumab therapy for advanced or recurrent colorectal cancer. In all the patients, oxaliplatin (130 mg/m2) was administered in combination with DEX (6.6 mg) via the peripheral vein.
Results: Vascular pain developed in 47 patients (68.1%), but it was transient. No patients required CV port implantation. Grade 3 or higher hemotoxicity was noted in 14.5% of the patients, and grade 3 or higher nonhematological toxicity was noted in 20.3% of the patients. The response rate was 59.4%. One patient experienced hypersensitivity reactions to oxaliplatin.
Conclusions: The recorded response rate combined with the use of DEX suggests that DEX probably does not exert adverse effects on the therapy, ie, it does not affect the stability of oxaliplatin by elevating the pH. DEX may be useful not only for controlling vascular pain caused by the administration of oxaliplatin via the peripheral vein but also for controlling oxaliplatin-induced hypersensitivity reactions.

Open Access Original Research Article

Discrepancies in Guidelines for Allergy Management in Asia-Pacific

Weiling Soon, Jia-Li Kwek, Sock-Yuen Kwek, Xiang-Xuan Tan, Peiting Xie, Zihui Yang, De-Yun Wang

Journal of Advances in Medicine and Medical Research, Page 157-171
DOI: 10.9734/BJMMR/2012/782

Objectives: We have conducted this study to assess (1) the existence of prevention programmes for AR as developed by professional and health care organizations in Asia-Pacific countries; (2) any discrepancies in local guidelines in comparison to ARIA, or within and across these countries.
Study Design: Web search study.
Methodology: We have conducted a study using Web search in accordance with the perspective of physicians or patients for the relevant prevention and pharmacotherapy guidelines in the management of AR as developed by professional and health care organizations in Asia-Pacific countries/regions.
Results: National allergy (AR and/or asthma) preventive programs are found in only 6 out of 17 (22.2%) countries (excluding Japan and South Korea). There exist several aspects of discrepancies in existing educational programs such as in (1) allergic disease (asthma or AR) that the guidelines focus on; (2) targeted age groups (children or adults); and (3) breadth and depth of coverage, such as for particular inhalant allergens or food allergies only. Based on the information provided by MIMS website (updated in 2011 by UBM Medica, London, United Kingdom) and the MIMS proven by the country’s local health authority, controversies exist in recommended minimum age, doses and potential side-effects of many commonly used 2nd-generation antihistamines and intranasal corticosteroids.
Conclusion: This is the first study that demonstrates discrepancies and a lack of public education programmes for AR prevention and management in Asia-Pacific countries/regions.

Open Access Original Research Article

MicroRNAs Indirectly Regulate Other MicroRNAs in Ovarian Cancer Cells

Shubin W. Shahab, Lilya V. Matyunina, Vinay K. Mittal, Lijuan Wang, Christopher G. Hill, L. DeEtte Walker, John F. McDonald

Journal of Advances in Medicine and Medical Research, Page 172-194
DOI: 10.9734/BJMMR/2012/804

MicroRNAs (miRNAs) are a class of regulatory RNAs that control the expression of genes critical to cell function. Ectopic expression of miRNAs has been shown to result in genome-wide changes in patterns of gene expression. While the reasons for these global alterations in gene expression patterns have been attributed to the ability of miRNAs to target multiple genes, and/or to induce indirect effects downstream of target genes, the molecular basis of indirect effects of miRNA regulation remains poorly understood. In this study, we demonstrate the potential of miRNAs to regulate other miRNAs. Using miRNA microarray analysis, we show that over 70 different miRNAs are differentially expressed (≥1.4 fold, FDR≤5%) in human ovarian cancer cells after transfection with a single miRNA (miR-7). We present evidence that a major component of miR-7 induced changes in levels of miRNAs is the indirect consequence of miR-7 mediated alterations in levels of protein coding genes (e.g., transcription and splicing factors) that exert trans-regulatory control on miRNAs.

Open Access Original Research Article

Comparison between Ferrous Ascorbate and Colloidal Iron in the Treatment of Iron Deficiency Anemia in Children from Kolkata, India

Sutapa Ganguly, Bhupesh Dewan, Nisha Philipose, Tryambak Samanta, Dilip Kumar Paul, Radheshyam Purkait

Journal of Advances in Medicine and Medical Research, Page 195-205
DOI: 10.9734/BJMMR/2012/900

Aim: To compare the efficacy and safety of ferrous ascorbate and colloidal iron in children with iron deficiency anemia.
Study Design: An open, randomized, comparative, parallel-group study.
Place and Duration of Study: Department of Pediatric Medicine of ‘Nilratan Sircar Medical College and Hospital’, Kolkata, India, between January 2009 and February 2010.
Methodology: Children between the age group of 6 months to 12 years were included if they had anemia defined as hemoglobin <10 gm%. Children received treatment with either ferrous ascorbate or colloidal iron for 12 weeks. Each child received elemental iron 3 mg/kg body weight/day. Follow-up assessments were performed at the end of week 4, week 8 and week 12.
Results: Out of the 137 children screened, 80 were included in the analysis. The mean rise in hemoglobin at the end of the 12 weeks was significantly higher in ferrous ascorbate group than colloidal iron group [3.24 ± 1.66 gm% vs. 1.42 ± 2.04 gm%; p <0.01]. Responder rate (hemoglobin ≥11.5 gm%) after 12 weeks of therapy was 53.57% in ferrous ascorbate group versus 10.34% in colloidal iron group; p<0.01.
Conclusion: The study provides evidence for the role of ferrous ascorbate as an efficient oral iron supplement in the treatment of iron deficiency anemia in children.

Open Access Original Research Article

New Experimental Model of Brain Tumors in Brains of Adult Immunocompetent Rats

Vladimir P. Baklaushev, Vadym M. Kavsan, Olena V. Balynska, Gaukhar M. Yusubalieva, Maxim A. Abakumov, Vladimir P. Chekhonin

Journal of Advances in Medicine and Medical Research, Page 206-215
DOI: 10.9734/BJMMR/2012/1072

Aims: Xenograft models, namely heterotransplantation of human cancer cells or tumor biopsies into immunodeficient rodents are the major preclinical approach for the development of novel cancer therapeutics. However, in these models the animals must be used only after the severe systemic immune suppression in order to ensure graft survival. Thus, additional new human brain tumor models without immune suppression of the recipient rodent may be required.
Place and Duration of Study: Laboratory of Immunochemistry, V.P. Serbsky National Research Centre for Social and Forensic Psychiatry and Department of Nanobiotechnology, N.I. Pirogov Russian State Medical University and Department of Biosynthesis of Nucleic Acids, Institute of Molecular Biology and Genetics between June 2009 and July 2010.
Methodology: Brain tumor modeling was performed by intracerebral stereotactic implantation of cells to the healthy adult rats without any artificial immunodepression. Cells were implanted to the striatum region of ketamine-anesthetized rats at specific coordinates according to Swanson's rat brain atlas. Tumor growth was monitored weekly via registration of neurological signs and in vivo Bruker MRI system.
Results: On the 21st day after implantation of C6 glioma, U251 or 293_CHI3L1 cells severe neurological deficit appeared in rats. Huge intracerebral tumors were found in each animal under investigation while no tumor growth was observed for at least 8 weeks in rats injected with empty vector-transfected 293 cells. Tumors contained the dense superficial cell layer and prominent lobules with central newly ingrowing blood vessels. Histological assay revealed displacement of median cerebral structures and hydrocephalus in contralateral hemisphere. All tumors were surrounded by numerous GFAP-positive reactive astrocytes.
Conclusion: Positive results with transplantation of 293_CHI3L1 cells into adult rat brains without any immunosupression show the validity of this animal model. In all experiments such implantations provoked malignant tumor formation while there were no visible tumors in control rats. We believe this to be the first animal model of human brain tumor that displays the possibility to study various biologic features of and host therapeutic response to brain tumor in an immunocompetent host.

Open Access Original Research Article

Assessment and Classification of Acute Respiratory Tract Infections among Egyptian Rural Children

Nadia Montasser, Randah Helal, Rasha Rezq

Journal of Advances in Medicine and Medical Research, Page 216-227
DOI: 10.9734/BJMMR/2012/1038

Aim: To study the problem of ARI (Acute respiratory tract infection) according to IMCI (integrated management of childhood illness) guidelines and find its relation with different related factors.
Study Design: Cross sectional study followed by comparative study to the different classifications of ARI.
Place and Duration of Study: Met-Mazah Integrated Hospital in Met-Mazah village, Dakahlia governorate, Egypt. The study carried out on one hundred children below 5 years selected by systematic sampling through a period of 6 months.
Methodology: A questionnaire was used to assess different factors such as sociodemographic factors, feeding habits and immunization history then detailed general and pulmonary examination of patients was done.
Results: The majority of ARIs cases were below two years. Severe pneumonia or very severe disease was slightly higher among male children and those had birth order 6 and more with no significant difference. More than half (60%) of those with family size ≥ 6 had severe pneumonia or very severe disease with significant statistical difference (p=0.005). About half of the children with very low social score were classified as pneumonia (46%) with no significant statistical difference. Total cases of ARIs and those classified as severe pneumonia or very severe disease were higher among those receiving mixed breast feeding and artificial feeding, among weaned children receiving starchy food and among those had partial immunization. All the children who had measles were classified as severe pneumonia or very severe disease with no significant differences. The majority of ARIs cases received hospital treatment and referred to specialist, also the majority of those referred to hospital were classified as pneumonia and severe pneumonia or very severe disease (44%) for both with significant statistical difference (p<0.001).
Conclusion: ARIs were significantly related to the age of the child, family size, and history of immunization.

Open Access Original Research Article

Methanol Leaf Extract of Persea americana Protects Rats against Cholesterol-Induced Hyperlipidemia

O. T. Kolawole, S. O. Kolawole, A. A. Ayankunle, I. O. Olaniran

Journal of Advances in Medicine and Medical Research, Page 235-242
DOI: 10.9734/BJMMR/2012/933

Aim: To investigate anti-hyperlipidemic activity of methanol leaf extract of Persea americana (MEPA) in cholesterol-induced hyperlipidemic rats.
Methodology: The animals were randomly divided into five groups of 5 rats each. Group1 served as the normal control (NC) and received distilled water. Group 2, the cholesterol-induced hyperlipidemic control (CHOL) was given cholesterol diet (20% groundnut oil, 1% cholesterol and 0.5% cholic acid mixed with rat pellet) orally. Groups 3 and 4 received oral administration of cholesterol diet and MEPA at a dose of 20 and 40 mg/kg body weight respectively, while group 5 was treated orally with cholesterol diet and cholestyramine (0.26g/kg body weight). Cholesterol diet, MEPA and cholestyramine were administered daily for a period of eight weeks.
Results: The changes observed in the plasma levels of total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL) of hyperlipidemic control rats were reversed by MEPA in a dose-dependent manner. At 20 mg/kg body weight, MEPA significantly (p<0.05) reduced TC, TG and LDL plasma levels by 54.2%, 46.2% and 65.6% respectively, and increased HDL plasma level by 60.0%. At a higher dose of 40 mg/kg, MEPA reduced TC, TG and LDL levels by 60.4%, 69.2% and 87.5% respectively while HDL was increased by 80.0%. There was a significant increase of change in body weight of hyperlipidemic rats compared to the change in normal control. MEPA caused a reduction of change in body weight to nearly that of the normal control. MEPA also dose-dependently caused significant reduction (p<0.05) of plasma lipid peroxidation in the rats. The anti-hyperlipidemic effect of MEPA was comparable to that of the standard drug, cholestyramine.
Conclusion: The results of this study showed that Persea americana could be a source of good alternative remedy for hyperlipidemia. Further studies are needed to fully understand the mechanism of action of the plant.

Open Access Original Research Article

Evaluation of Mycobacterium tuberculosis 16 and 71 Heat Shock Proteins in the Cerebrospinal Fluid of Tuberculous Meningitis Patients

Seema D. Shekhawat, Rajpal S. Kashyap, Snehal S. Wanjari, Khushboo J. Nagdev, Hemant J. Purohit, Girdhar M. Taori, Hatim F. Daginawala

Journal of Advances in Medicine and Medical Research, Page 243-253
DOI: 10.9734/BJMMR/2012/1002

Aims: To evaluate the efficiency of two potential Mycobacterium tuberculosis (M. tb) heat shock proteins (Hsps) towards the improvement of tuberculous meningitis (TBM) diagnosis.
Study Design: The patients were divided into TBM (confirmed and suspected) and non TBM group. The cerebrospinal fluid (CSF) was collected and evaluated for M. tb Hsp 16 and 71.The Indirect ELISA results of M. tb Hsp 71 were compared with polymerase chain reaction (PCR).
Place and Duration of Study: Biochemistry Research Laboratory, Central India Institute of Medical Sciences, Nagpur between June 2009 and July 2010.
Methodology: 29 TBM and 22 non TBM CSF samples were collected. Indirect ELISA was performed for evaluating the, M. tb Hsp16 and Hsp71 in the collected samples, individually as well as in combination. The ELISA method for detection of M. tb Hsp 71 was also compared with in house PCR technique for TBM diagnosis.
Results: The data analysis was done with MedCalc® Software. M. tb Hsp16 showed positivity of 58.62% and negativity of 68.18%. Similarly for M. tb Hsp71, positivity is 89.65% and negativity is 68.18%.The results of ELISA for M. tb Hsp71 was compared with PCR technique and concordance was also calculated. Of the Hsp ELISA positive group for M. tb Hsp71, 24 were PCR positive and 2 were PCR negative with the 92.30 % concordance in TBM patients and in non TBM patients the concordance was observed to be 93.30%. Use of the monoclonal antibody Hsp 71 appear preferable over individual use of M. tb Hsp 16 and combined use of both Hsp and yield optimum results.
Conclusion: Our data suggest that the detection of M. tb Hsp 71 in the CSF sample of TBM patients can be useful for the diagnosis of TBM patients. These predictors, however, need further work to validate reliability.