Open Access Case Study

Case Report of Ring Chromosome 13: 46,XX,r(13)(p13q34)/46,XX,dic r(13;13)(p13q34;p13q34)

Maurício Assis Rodrigues, Renata Vasconcelos Moreira, Patrícia Damasceno Ribeiro

Journal of Advances in Medicine and Medical Research, Page 123-128
DOI: 10.9734/BJMMR/2015/11666

Aims: To report a case of ring chromosome 13 in a female child.
Presentation of Case: Female, Caucasian, born in Southeast of Brazil, 6 years old. Born by cesarean section, the physical examination at 6 years and 1 month old has shown: weight of 19.100 grams and 105 centimeters tall, developmental delay, bushy eyebrows, epicanthic folds and broad nasal bridge, cardiovascular and respiratory systems were normal and no abnormalities in the limbs. Chromosome analysis was performed by GTG banding of peripheral blood and the karyotype was 46,XX,r(13)(p13q34)[97]/46,XX,dic r(13;13)(p13q34;p13q34) [3]. Analysis of 100 metaphases following G-banding revealed 97% cells with a ring chromosome 13,3% with dicentric ring chromosome of two 13s. Aneuploidy was not detected. Her parents had a normal karyotype.
Discussion: Some researchers relate the clinical presentation of ring chromosome 13 with the extension of the deleted chromosomal region and instability. Others suggested that phenotypes of patients can be categorized in groups, according to the breakpoint on 13q.
Conclusion: The classification of cases in groups based on breakpoints and chromosomal instability is still inaccurate, with variable phenotypes. Thus, the analysis of a greater number of cases and molecular analysis are important to establish more precise correlation between genotype and phenotype.

Open Access Case Study

Upward Displacement of Prosthetic Aortic Valved Conduit after Modified Bentall Procedure for Type A Acute Aortic Dissection

Massimiliano Sperandio, Francesca Nicolò, Armando Fusco, Emanuele Bovio, Mario Raguso, Giovanni Simonetti

Journal of Advances in Medicine and Medical Research, Page 129-133
DOI: 10.9734/BJMMR/2015/13127

Aim: Role of non-invasive coronary artery computed tomography (CACT) in diagnosis of complications of aortic root surgery in patients with chest pain.
Introduction: Dehiscence of an aortic valved conduit or pseudoaneurysm development is a rare, but serious and potentially life-threatening complication after aortic root surgery.
Case Presentation: We report an interesting case of a 61-year-old man with chest pain and dyspnea, previous history of modified Bentall procedure for type A acute aortic dissection and coronary stenting, that shows a complete detachment and upward displacement of a composite tubular graft with mechanical valve prosthesis detected by a CACT angiography.
Discussion: Generally, in the few survivors, the diagnosis is made by means of echocardiography. This is the first case of CACT diagnosis of a prosthetic aortic valved conduit displacement after a modified Bentall procedure for type A acute aortic dissection. With the use of this imaging technique was possible a complete evaluation of the coronary stents and the native coronary arteries, avoiding the coronary artery angiography that adds an elevation of the risk for this kind of patients.
Conclusion: In symptomatic patients with a previous history of treated aortic dissection and coronary artery disease without evidence of recurrent ischemia, the CACT angiography can be considered a good diagnostic option. It provides detailed informations about the coronary arteries and the aorta allowing an accurate diagnosis.

Open Access Short Research Article

Considerations in the Measurement of Testosterone in Saliva and Serum Using ELISA Procedures

Richard J. Bloomer

Journal of Advances in Medicine and Medical Research, Page 116-122
DOI: 10.9734/BJMMR/2015/12773

Background: ELISA procedures are widely available and used for the measurement of saliva and blood (serum and plasma) testosterone. Suggestions for strong correlations between these two fluids have been made but differences in assay format, as well as in the collection procedures, storage, and processing of samples can influence results.
Methods: The present study compared saliva and serum free testosterone concentrations in 20 healthy men (31.0±11.0 years; mean ± SD) using ELISA procedures. Men provided both a saliva and blood sample on the same day in the morning hours following an overnight fast. Special care was taken in the collection, storage, and processing of samples. Following complete thawing and mixing of samples, both fluids were analyzed in duplicate using commercially available ELISA kits, both prior to and following centrifugation.
Results: Saliva testosterone values were 440.6±238.2 pg∙mL-1 and 348.8±210.0 pg∙mL-1 without and with centrifugation, respectively. Serum testosterone values were 9.0±4.2 pg∙mL-1 and 8.3±3.7 pg∙mL-1 without and with centrifugation, respectively.
Conclusion: If utilizing ELISA procedures, saliva and serum testosterone values cannot be used interchangeably, at least when utilizing the ELISA procedures employed in the present study. This is evidenced by the approximate 10-100 times higher testosterone concentration in saliva as compared to serum. Moreover, processing samples via centrifugation leads to a significant (~23%) loss in testosterone in saliva, with a much smaller loss (~7%) in serum. Investigators and clinicians should take note of these findings if planning to measure saliva or serum testosterone using ELISA procedures.

Open Access Original Research Article

Obesity and Physical Fitness among Moscow Schoolchildren: 6-years Follow-up

Alevtina N. Oranskaya, Konstantin G. Gurevich, Vladimir A. Orlov, Ekaterina V. Burdukova, Dmitrii A. Pustovalov

Journal of Advances in Medicine and Medical Research, Page 23-31
DOI: 10.9734/BJMMR/2015/12246

Aim: To assess study the prevalence of obesity and physical fitness among Moscow schoolchildren.
Subjects and Methods: During the 2004-5, 2007-8, and 2010-11 school years, about 20% of Moscow schoolchildren were studied in all districts of the town. Both anthropometric and physical fitness data were collected. Obesity was determined according to international recommendations, observed physical fitness in accordance with national norms.
Results: During the observation period the number of schoolchildren with obesity increased 1.5 times and reached about 20%. Obesity was observed 1.6 times more frequently in boys than in girls. In the 2004-5 school years a total of 66% of boys and 58% of girls undertook vigorous physical fitness. By the 2010-11 school years the number of schoolchildren undertaking vigorous physical fitness had decreased by 10%. The number of boys undertaking vigorous physical fitness was 1.8 times lower in the obesity group than in the normal weight group. The corresponding difference for girls was 1.4 times.
Conclusion: Findings of this study suggest an increase in the prevalence of obesity among Moscow schoolchildren which could be attributed to their low level of physical fitness.

Open Access Original Research Article

Small-bore Single Laparoscopy-assisted Trans-vaginal Ovarian Cystectomy for Benign Ovarian Diseases

Young-Sam Choi, Ji-No Park, Yun-Sang Oh, Geun-Soo Kim, Tae-Eel Rhee, Ho-Sun Choi

Journal of Advances in Medicine and Medical Research, Page 32-40
DOI: 10.9734/BJMMR/2015/12646

Aims: To evaluate the feasibility of small-bore single laparoscopy-assisted trans-vaginal ovarian cystectomy.
Study Designs: A retrospective study was performed through a review of the medical records of women who had undergone laparoscopy-assisted trans-vaginal ovarian cystectomy for benign conditions.
Place and Duration of Study: Department of obstetrics & gynecology of Her women’s clinic and Chonnam National University Hospital, Between January 2010 to January 2014.
Methodology: 148 women had undergone small-bore (3-5mm) single-port laparoscopy-assisted trans-vaginal ovarian cystectomy for benign adnexal mass. The technique consists of small bore single laparoscopic inspection phase, trans-vaginal operative phase, and laparoscopic checking phase. Age, parity, body mass index (BMI), bilaterality, dimensions of mass, location, total operative time, hemoglobin change, and complications were measured.
Results: 148 procedures were successfully completed without the need for extra-umbilical puncture. The mean±SD of total operative time and the largest dimension of the mass were 46.9±21.5min and 6.9±4.1cm, respectively. Spillage of cystic contents was minimal, and if it did occur, it was localized to the posterior cul-de-sac with no related complication. The median decline in the hemoglobin level from before surgery to postoperative day 1 was 1.7±0.8g/dL. The pathologic diagnoses were as follows: dermoid cyst, 82; endometriotic cyst, 31; corpus luteal cyst, 12; serous cystadenoma, 5; mucinous cystadenoma, 9; parovarian or paratubal cyst, 9.
The postoperative courses were uneventful in most patients, but four had a transient fever greater than 38ºC and 8 women had small operation site hematoma. All of them recovered following conservative management.
Conclusion: We believe that small-bore single laparoscopy-assisted trans-vaginal ovarian cystectomy ensures the advantages of trans-vaginal surgery and the safety of the laparoscope.

Open Access Original Research Article

Sexually Transmitted Diseases among Italian Women in 1991-2011

Maria Cristina Salfa, Vincenza Regine, Andrea Hubertina Lena Bruning, Maurizio Ferri, Laura Camoni, Mariangela Raimondo, Barbara Suligoi, The Italian STD Surveillance Working Group

Journal of Advances in Medicine and Medical Research, Page 41-49
DOI: 10.9734/BJMMR/2015/7311

Objective: The objectives are to identify variations in trends in single sexually transmitted diseases (STDs) over time and to monitor the prevalence of HIV infection among women with a diagnosis of STD.
Methods: Data were obtained from the Italian Sentinel STD Surveillance System in the period 1991-2011. This system collects information on diagnoses provided by a network of 12 specialised clinical centres, which offer treatment and care to STDs patients and are located in large cities.
Results: From January 1991 to December 2011, the system received detailed information on 27,350 new cases of STDs among women. The most frequently diagnosed STDs were ano-genital warts (33.2%), non-gonoccocal non-chlamydial infections (31.3%), and latent syphilis (11.2%). Of the 17,561 (64.2%) women with a STD who underwent HIV testing, the HIV prevalence was 4.4% (95% CI: 4.1%-4.7%). Of the 778 HIV-positive women with a STD, 28.5% (95% CI: 25.4%-31.8%) was unaware of being HIV-infected.
Conclusion: The results obtained should contribute to increasing the commitment of governments and institutions to the prevention and control of STDs, promoting policies, laws, and initiatives for effective control (e.g., by developing information and education campaigns on STDs).

Open Access Original Research Article

Vitamin D Status in Moroccan Patients with Pemphigus

M. Bouaddi, I. Bouaddi, K. Jouid, H. Benzzi, R. Abouqal, F. Allali, N. Hajjaj-Hassouni, B. Hassam

Journal of Advances in Medicine and Medical Research, Page 50-56
DOI: 10.9734/BJMMR/2015/5596

Objective: The aim of this study was to assess the vitamin D status and the factors that may influence this vitamin in Moroccan patients with pemphigus.
Study Design: case-control study.
Place and Duration of Study: Department of Dermatology at the University Hospital of Rabat-Salé between 2012 and 2013.
Methods: In this case-control study, 30 patients with pemphigus were included. Sixty healthy persons were recruited to serve as controls. The patients underwent anthropometric assessment and clinical evaluation. Serum 25 hydroxyvitamin [25(OH) D] D2 and D3 were measured using radioimmunoassay. Hypovitaminosis D was defined as serum 25(OH) D <30 ng/ml.
Results: The average age of participants was 56 years ± 11.4. Hypovitaminosis D was observed in 100% of patients. The prevalence of hypovitaminosis D was higher (p <0.001) in patients than in controls. Serum 25(OH) D levels were associated with disease duration (r=0.34, p=0.05), ESR (r=-0.31, p=0.05) and PTH (r=-0.66, p<0.001). No relationship was found between serum 25(OH) D levels and the other characteristics related to patients or pemphigus.
Conclusions: Our study suggested that serum levels of vitamin D were significantly lower in Moroccan patients with pemphigus. Future studies with a larger population are needed to confirm our results.

Open Access Original Research Article

Evaluation of the Knowledge, Attitude and Practice of the Use of Insecticide- Treated Nets (ITNs) in Aba, Nigeria

O. R. Ezeigbo, M. C. Osuagwu, Z. O. Ibegbulem, N. G. Agomoh

Journal of Advances in Medicine and Medical Research, Page 57-64
DOI: 10.9734/BJMMR/2015/11510

Background: Over the past decade, significant gains have been made in the implementation of malaria preventive measures in sub-Saharan Africa, including the distribution of insecticide treated nets (ITNs). These have been shown to cause a reduction in the incidence of malaria and other mosquito borne diseases.
Methods: Knowledge, attitude and practices of the use of ITNs were critically evaluated in Aba, south eastern Nigeria from February to July, 2013. A cross-sectional study was conducted in four communities in Aba. A total of 500 household heads or their representatives were surveyed using a pre-tested structural questionnaire administered through house-to-house interview.
Results: Out of the 500 respondents interviewed, 460 (92.0%) associated malaria with mosquito bites. On home management practices used to prevent mosquito bites, 299 (59.8%) use ITNs, 100 (20.0%) use insecticide sprays, 45 (9.0%) use window/door nets while 32 (6.4%) use repellants. The use of ITNs based on age showed that people between ages 26 and above had the highest percentage (51.8%), while ages 15-20 had the least (9.3%). Based on levels of education, 179 (66.5%) of those with tertiary education use ITNs, 65 (21.0%) of those with secondary education and only 3 (1.0%) of the illiterate group use ITNs.
Conclusion: Despite increased access to this intervention over time, the use of ITNs still remains low. There is a need therefore to create more awareness of the anti-malarial significance of ITNs, through intensified health education programmes. The main objective of this work is to evaluate the knowledge, attitude and practice of the use of insecticide-treated nets (ITNs) in Aba, south-east, Nigeria.

Open Access Original Research Article

Low Concentration DMSO Stimulates Cell Growth and In vitro Transformation of Human Multiple Myeloma Cells

Jianguo Wen, Yijiu Tong, Youli Zu

Journal of Advances in Medicine and Medical Research, Page 65-74
DOI: 10.9734/BJMMR/2015/5276

Aims: To evaluate the effect of Dimethyl sulfoxide (DMSO) on multiple myeloma (MM) cells.
Study Design: Experimental study.
Place and Duration of Study: Department of Pathology and Genomic Medicine, the Methodist Hospital, Cancer Pathology Lab, the Methodist Hospital Research Institute, between 2011 and 2013.
Methodology: We treated RPMI 8226 and Dox-40 MM cells with DMSO. The cell growth, proliferation, apoptosis, and colony formation were examined.
Results: Exposure of RPMI 8226 and Dox-40 myeloma cells to low concentrations of DMSO resulted in a marked increase in cell growth as detected by viable cell counts and cell proliferation analysis. This DMSO-stimulated cell growth showed a dose-dependent pattern and could reach a maximal 3.57 fold-increase in the presence of 0.2% DMSO. In contrast, other common solvents including methanol and ethanol had little or no effect on cell growth. In addition, the in vitro cell transformation assay by colony formation in soft agar culture revealed that the presence of low concentrations of DMSO significantly enhanced potential of oncogenesis of myeloma cells.
Conclusion: Taken together, the findings demonstrate that DMSO could stimulate growth and the in vitro transformation of myeloma cells. However, further work is needed to understand the effect of DMSO on the pathogenesis and progression of MM.

Open Access Original Research Article

Mechanical Ventilation in Neonates: Experience at a Tertiary Care Center in Eastern Nepal

Basant K. Shah, Gauri Shankar Shah, Om Prakash Mishra

Journal of Advances in Medicine and Medical Research, Page 75-80
DOI: 10.9734/BJMMR/2015/8207

Aims: To study the diagnoses and survival of neonates receiving mechanical ventilation.
Study Design: Prospective observational study.
Place and Duration of Study: Department of Pediatrics and Adolescent Medicine; B. P. Koirala Institute of Health Sciences, Dharan, Nepal, from February 2012 to January 2013.
Methodology: All the neonates who received mechanical ventilation in neonatal intensive care unit (NICU) during the study period were included. We excluded the neonates with surgical malformations. Data were entered in a pre-designed pro forma and statistical analysis was done using SPSS version 17 for Windows.
Results: A total of 88 neonates were ventilated during the study period of which 65 met the inclusion criteria. Birth asphyxia (34%), neonatal sepsis (31%), meconium aspiration syndrome (MAS) (20%), congenital pneumonia (11%) and hyaline membrane disease (HMD) (5%) were the diagnoses of babies who received mechanical ventilation at our center. Overall survival rate was 50.8%, as 33 patients survived. The highest survival rate was seen in babies admitted with birth asphyxia (68.2%) and the lowest survival rate was seen in neonates with an admission diagnosis of sepsis (30%). Mean Downes score for respiratory distress at intubation in non-survivors was significantly higher compared to Downes score in non-survivors (P value = .003). Mean oxygen saturation before intubation in non-survivors was significantly lower than the oxygen saturation in survivors (P value = .001).
Conclusion: Birth asphyxia, sepsis and meconium aspiration syndrome were the common diagnoses of neonates who received mechanical ventilation. Neonates with lower Downes score and higher oxygen saturation at the time of admission were associated with decreased mortality rate.

Open Access Original Research Article

Simultaneous Bilateral Anterior Inguinal Herniorrhaphy with Polypropylene Mesh Application and Open Prostatectomy

Nourizadeh Davoud, Amjadi Mohsen, Joodi Javad, Jabbari Abbas

Journal of Advances in Medicine and Medical Research, Page 81-87
DOI: 10.9734/BJMMR/2015/11930

Aims: Lower urinary tract symptoms (LUTS) are common in aging men. Benign prostatic hyperplasia (BPH) develops with advancing age. The incidence of inguinal hernia also increases with age. A significant number of elderly men with symptoms of BPH have inguinal hernia at the same time. Simultaneous preperitoneal inguinal hernia repair with other pelvic surgeries has been described, but it was not popular among urologists and general surgeons mainly because of high recurrence rate.
Study Design: Prospective study.
Place and Duration of Study: Department of Urology, Tabriz University of Medical Sciences, Imam Reza Hospital, between March 2010 and September 2013
Methodology: We evaluated the outcomes and complications of 37 patients who underwent open transvesical prostatectomy and simultaneous bilateral preperitoneal herniorrhaphy with application of polypropylene mesh.
Results: Twelve patients with bilateral direct hernia, 24 patients with bilateral indirect hernia and one patient with right side direct and left side indirect inguinal hernia were enrolled in our study. Four patients (10.8%) had bilateral recurrent hernias and 2 others (5.4%) had recurrent hernia on one side and primary hernia on the other side. Mean operation time was 86 minutes (71-110). The mean blood loss during surgery was 578 (240-1250)ml. The median clinical follow-up time was 13.7 months. During follow-up period surgical site infection, hematoma, chronic pain and recurrence were not detected. One (2.7%) lymphocele formation was detected. In all patients, the surgical outcomes were satisfactory.
Conclusion: Simultaneous prostatectomy and preperitoneal herniorrhaphy with mesh application, is a convenient and safe procedure which can be performed easily by urologists. This procedure is both cost effective and time-saving and achieves long term beneficial outcomes for patients.

Open Access Original Research Article

Risk Factors of Coronary Artery Disease in Palestinian Patients Undergoing Coronary Angiography: A Case–Control Study

Ashraf Eljedi, Mohammed Mushtaha

Journal of Advances in Medicine and Medical Research, Page 88-97
DOI: 10.9734/BJMMR/2015/12348

Aims: To identify the most significant risk factors of coronary artery disease (CAD) in Palestinian patients undergoing coronary angiography.
Study Design: A retrospective case control design.
Place and Duration of Study: The study was conducted in the only two cardiac catheterization centers in Gaza strip, Palestinian territories (European center in the south and Julis center in the mid-zone) from June to September 2010.
Methodology: Based on coronary angiography results, we recruited a systematic random sample of 100 cases formally diagnosed with CAD matched with sex to 100 controls who had normal findings and were free from the disease. Data was collected using a questionnaire which included socio-demographic data and health profile. Chi square, univariate and multivariate logistic regression were used to test the differences between cases and controls and to determine the predictors of CAD.
Results: Most cases were male (72.9%), ≥50 years old (70%) and living in refugee camps (57.9%). The most common risk factors were physical inactivity (OR 3.96, P=0.002), hypertension (OR 2.73, P<0.001), diabetes (OR 2.21, P=0.006), LDL/HDL ratio ≥3 (OR 3.76, P<0.001), smoking (OR 1.96, P=0.031), positive family history (OR 2.12, P=0.012), multigravida (OR 10.5, P=0.034) and living in refugee camps (OR 1.92, P=0.023). Coronary artery disease was not significantly correlated with age, body mass index, unemployment and monthly income.
Conclusion: Sedentary lifestyle, high LDL, low HDL, hypertension, diabetes, positive family history, smoking and multigravida remain the major modifiable risk factors of CAD among the Palestinians. Living in the refugee camps imposes more risk to have CAD. Gender differences indicated that the prevalence of CAD in males is more than females. Community-based interventions to promote exercise, family planning and smoking cessation in addition to improving the refugee life conditions may be crucial in decreasing the burden of coronary artery disease in Gaza strip.

Open Access Original Research Article

Self Esteem among Adolescents in Nigerian Secondary Schools: A Neglected Issue

Josephat M. Chinawa, Herbert A. Obu, Pius C. Manyike, Ikechukwu E. Obi, Odetunde O. Isreal, Awoere T. Chinawa

Journal of Advances in Medicine and Medical Research, Page 98-106
DOI: 10.9734/BJMMR/2015/12492

Background: Self esteem among adolescents is a neglected issue in pediatrics, especially in this part of the world. Females ages fourteen to seventeen seemed to have positive self-esteem and so do the males but self esteem is low at middle ages. Females tend to have a low self esteem than males
Objectives: The objective of this study is to determine the pattern of self esteem among adolescents and associated factors.
Methods: The study was carried out among adolescents attending secondary schools from two cities; (Enugu and Abakiliki located in south eastern part of Nigeria) within age range of 10-19 yr. A structured self administered questionnaire developed from self esteem scores was used for data collection.
Pearson’s chi-square was used to test for relationship between categorical variables while student t- test was used to test significant relationship between continuous variables. Test of significance was set at p<0.5.
Results: The self esteem questionnaire used was classified into two major questions with several sub questions. The first group is about self confidence, self fulfillment and self worth and confidence, the second group include depression, hopelessness, loneliness, and suicidal thoughts. We enrolled 507 adolescents in this study. The mean age of all participants was 16.3 (1.2) yr. Total mean self esteem score for all respondents is 15.77±2.769. Low self esteem was observed in 3.6% of the respondents with 4.3% of females and 2.5% of Males. Low self esteem is mostly seen in older adolescents aged 18-19 (44%) and rare among (adolescents less than 11 yr (0%). Low self esteem was more common among the female respondents in all the age ranges.
Conclusion: Self esteem is high among adolescents, though this is may be overemphasized as more research is needed in this area.

Open Access Original Research Article

Effect of Aerobic Exercises on Insulin Resistance in Obese Pregnant Women

Ghada E. El-Refaye, Heba M. Ali, Adel F. Elbegawy

Journal of Advances in Medicine and Medical Research, Page 107-115
DOI: 10.9734/BJMMR/2015/12537

Aims: This study was conducted to determine the effect of aerobic exercises on insulin resistance in obese pregnant women.
Methodology: 60 primigravidas women between 20-24 weeks gestation diagnosed as having insulin resistance participated in this study. They were selected from the out Patient Clinic of Obstetrics at Kasr El-Aini University Hospital, Faculty of Medicine, Cairo University. Their age ranged 25-35 years, their body mass index ranged from 30-35 kg/m². Participants were assigned randomly into 2groups, participants of group (A) followed moderate restricted diet (1800-2000 kcal/day) in addition to participation in an aerobic exercise program 3 times weekly until end of 37 weeks gestation, while participants of group (B) followed moderate restricted diet (1800-2000 kcal/day) until end of 37 weeks gestation.
Results: The present study revealed that aerobic exercise program produced a significant decrease (P<.001) in insulin resistance level homeostatic model assessment (HOMA) test, fasting blood glucose level & fasting insulin level than the use of moderate restricted diet.
Conclusion: Aerobic exercises are effective in reducing insulin resistance in obesepregnant female if it continued throughout pregnancy.

Open Access Review Article

Leishmania Amastigotes Induced Remission of Cutaneous Leishmaniasis, Psoriasis, Psoriatic Arthritis and Related Diseases

José A. O’Daly, Joe Gleason

Journal of Advances in Medicine and Medical Research, Page 1-22
DOI: 10.9734/BJMMR/2015/12531

Amastigotes from L(L) amazonensis (La); L(L) venezuelensis (Lv); L(V) brasiliensis (Lb) and L(L)chagasi(Lch) were cultured axenically in a liquid culture medium (O’Daly’s medium). Patients from a cutaneous leishmaniasis (CL) endemic and hyperendemic regions in Venezuela, receiving different treatments were followed up for 6 years. Remission of lesions (weeks) were: Spontaneous remission (SR): 7; Glucantime® (Glu) chemotherapy: 9; Immunotherapy with La, Lv, Lb, Lch amastigotes Tosyl-Lysil-Chloromethyl-Ketone (TLCK) treated and Nonidet P-40 (NP-40) extracted (AS100-1VT): 7. While vaccinating subjects for CL protection, we observed 100% clinical remission of a psoriatic lesion in one subject. In an open trial, 2,770 subjects showed baseline psoriasis area and severity index (PASI) compared with post-treatment values as follows: PASI 100, 23%; PASI 75, 45%; PASI 50, 13%; PASI 10, 9% and <PASI 10, 3% of patients, without serious adverse events. Similar results were obtained with AS100-2 La, Lv, Lb and Lch monovalent vaccines. After treatment with AS100-1VT, subjects with psoriatic arthritis (PsA) decreased in arthritis score, tender joints counts and nail changes; the highest decreased in the PASI 100 group. The vaccines induced cellular immunity with absence of humoral antibody responses. Lymphocyte subsets (LS) in peripheral blood mononuclear cells (PBMC) decrease as PASI increased migrating from the blood to the skin/joints. After vaccine treatment the LS migration is stopped explaining remission of lesions. Purified Leishmania antigenic fractions (AS200) induced linear delayed type hypersensitivity reactions (DTH) in guinea pigs. A DBA-1 mouse collagen induced arthritis (CIA) model with AS200 treatment had the least amount of forepaw inflammation and the lowest arthritis scores, lower than dexamethasone. The vaccines AS100-1VT, AS100-2 and AS200 were not immunosuppressors, but immunomodulators decreasing inflammatory cytokines. The aim of this review is to explain the serendipity discovery of leishmania parasites inducing remission of psoriasis and related diseases, unprecedented discovery in the scientific literature.