Open Access Case Study

Harlequin Ichthyosis: Case Report of a Rare Type of Ichthyosis

Ali Irfan Güzel, Aytekin Tokmak, Aydan Sezer Kara, Ahmet Yalınkaya

Journal of Advances in Medicine and Medical Research, Page 557-560
DOI: 10.9734/BJMMR/2015/12584

Aims: The purpose of this study is to present a case of Harlequin fetus, which is extremely rare.
Presentation of Case: A 27-year-old woman, gravida 3 para 1, was referred to the clinic with a diagnosis of preterm premature rupture of membranes. Upon ultrasound examination, a fetus with oligohydramnios at 30 weeks of pregnancy was determined. Fetal cardiac activity was present. The fetal nose and ears could not be visualized. The fetal mouth was opened wide and the lips were invisible. The wrists of the upper extremities were edematous. A cesarean section was performed, and a female fetus weighing 1140 g, 44 cm in length, and with 1st and 5th minutes Apgar scores of 6–8 was delivered. The fetal body was covered with dense keratin plaques, her eyes were in ectropion, and her nose and ears were also covered by thick keratin plaques. Eclabium lips, edematous wrists on the extremities, and the hands and feet in flexion were observed. The fetus died 24 hours later in the neonatal intensive care unit. The mother said that her second baby had the same conditions and died on postpartum day one.
Discussion and Conclusion: Harlequin ichthyosis is extremely rare and is a severe congenital anomaly that has autosomal recessive inheritance patterns. Prenatal diagnosis can be based on the ultrasound findings and parents’ family history; this can contribute to our understanding of the disease and progress of pregnancy.

Open Access Study Protocol

The Design of a Practice-based Study of Attendees at Chiropractic Offices in Western Australia

Lyndon G. Amorin-Woods, Lee Nedkoff, Gregory F. Parkin-Smith, Colleen Fisher

Journal of Advances in Medicine and Medical Research, Page 539-556
DOI: 10.9734/BJMMR/2015/13083

Introduction: This paper presents the protocols for a pilot study that will provide a design critique and collect information to describe the patients who attend chiropractors in Western Australia.
Aims and Objectives:
1. Provide a critique of the research design and methodology, including enrolment and recruitment, data collection, and sample size calculations.
2. Describe the patient demographics, reason for consultation and baseline health status of patients that present to chiropractic practices in Western Australia.
Methods/Research Design: This will be a prospective, cross-sectional, practice-based pilot study of patients seeking chiropractic services in Western Australia. A minimum of seven (7) independent private chiropractic practices across urban, regional, rural and remote settings will be recruited. Consecutive adult patients that self-present to these practices for the first time will be invited to participate. Data for analysis will be collected in participating clinics using a computer-based online questionnaire. Data collected will include; patient demographics; age, gender, primary language, occupation, payment source, presenting complaint, prior treatment, pre-existing health conditions, medications, attendance at other health practitioners, lifestyle choices, previous use of chiropractic and human quality of life measures (HQoL’s; SF-12 and PIQ-R). Priori sample size estimation indicates a total sample of 320 would be sufficient to achieve a study power of >80% (assumed effect size 0.2, α=0.05, assumed df=5).
Conclusion: Innovative electronic and internet portals for gathering practice-based data are to be assessed. Information describing patients who attend allied and complementary practitioners is critical to facilitate appropriate and effective health system planning and administration in Western Australia.

Open Access Short Communication

Levels of Zinc and Copper in Seminal Plasma of Sudanese Infertile Males

Yosra M. Altaher, AbdElkarim A. Abdrabo

Journal of Advances in Medicine and Medical Research, Page 533-538
DOI: 10.9734/BJMMR/2015/11195

Background: Human semen contains high concentrations of zinc (Zn) and copper (Cu). The presence of abnormal levels of these trace elements may affect sperm production, maturation, motility and fertilizing ability.
Objective: To evaluate the levels of Zn and Cu in seminal plasma of Sudanese infertile male and their effect on reproductive capacity.
Methods: The concentrations of Zn and Cu were measured in 150 semen samples from normozoospermic, oligozoospermic, and azoospermic men using the atomic absorption spectrometry and data was analyzed using the statistical software package SPSS version 17.
Results: Results showed that the mean values of seminal plasma Zn concentrations were significantly decreased in the two groups of infertile male subjects, azoospermic (p=0.02), and oligozoospermic (p=0.03) compared with fertile males, while there was insignificant decrease in seminal plasma Cu concentration of azoospermic patients compared to control (p=0.21), and insignificant increase in oligozoospermic patients compared to control (p=0.06).
Conclusion: On the basis of the observations of the present study, seminal zinc may contribute to fertility through its effects on semen parameters.

Open Access Original Research Article

Cardiac Dysfunction in Patients with Sepsis, Severe Sepsis and Septic Shock

Tom Devasia, Hashir Kareem, Y. G. Ashok Kumar, R. Padma Kumar, Saumya Jose, Sharmila Sadanand Prabhu, Umesh Pai, Krishnanand Nayak, Tulsee Sitapara, Ashok Thakkar

Journal of Advances in Medicine and Medical Research, Page 427-433
DOI: 10.9734/BJMMR/2015/12334

Aims: Patients with severe sepsis and septic shock often exhibit significant cardiovascular dysfunction. We designed the study with an aim to determine the severity of cardiac dysfunction in the different group of sepsis patients.
Study Design: Single-center, cross-sectional study
Place and Duration of Study: The study was carried out at Department of Cardiology, Kasturba Medical College and Hospital, Manipal from June 2011 to December 2012.
Methodology: A total of 74 patients who were diagnosed with sepsis were enrolled in the study. All patients were subjected to routine analysis, laboratory test and echocardiogrphic assessment.
Results: The patients were divided into 3 groups: sepsis group (n = 11), severe sepsis group (n = 37) and septic shock group (n = 26). The mitral E/A value is significantly higher in patients with septic shock than that of the patients with sepsis (P = 0.04). The indices of right ventricular dysfunction did not show any significant difference in the patients with septic shock and that of sepsis.
Conclusion: Left ventricular dysfunction may be considered prevalent in sepsis as per the significant E/A values. However, the other echocardiographic parameter should also be considered. This may even infer that cardiac dysfunction may not correlate with the severity of sepsis.

Open Access Original Research Article

Assessment of Cardiac Function Using Pressure-Volume Loops as Cardiac Hypertrophy Develops from Iron Deficiency

Herbert G. Chew Jr, Jacqueline Zadra, Ashley Weigel

Journal of Advances in Medicine and Medical Research, Page 434-443
DOI: 10.9734/BJMMR/2015/13376

Aims: Cardiac hypertrophy develops from prolonged, severe iron deficiency (ID), but little is known about its function. We hypothesized that 4 weeks of ID would result in enhanced cardiac function, but would transition to loss by 9 weeks.
Study Design: 38 rats were fed either control or ID diets for 4, 6, or 9 weeks, then subjected to a pressure-volume loop protocol to assess cardiac function.
Place and Duration of Study: Biology Department, Western Wyoming College, between January 2013 and December 2013.
Methodology: Rats were anesthetized with ketamine/xylazine, catheters placed in femoral and jugular veins. A pressure-conductance microcatheter was inserted through the right carotid artery, to the left ventricle. Baseline data was collected for 10 minutes, followed by occlusion of the inferior vena cava to reduce venous return. Hypertonic saline was infused through the jugular vein to allow for parallel conductance subtraction. Rats were sacrificed, and hearts and blood collected for mass and volume calibration, respectively.
Results: Cardiac output was increased (P = .01) with ID after 4 weeks, but was not increased after 6 or 9 weeks. The increase was due to enhanced stroke volume (P = .02), but not heart rate (P = .48). Stroke volume was increased due to enhanced contractility with ID (P = .03), along with a decrease in the pressure at which ejection begins (afterload, P = .001). By 9 weeks, contractility was decreased (P = .01), but afterload remained lower. Cardiac efficiency was enhanced after 4 weeks (P = .002), which was lost by 9 weeks of ID. No diastolic parameters of cardiac function were altered by ID.
Conclusion: An adaptive compensation of cardiac function develops within 4 weeks of severe ID, but is lost within weeks, at which time, the ID heart is in a state of pathological decompensation.

Open Access Original Research Article

Factors Influencing Outcome of Management of Sigmoid Volvulus in Northern Uganda: A Prospective Observational Study

David Lagoro Kitara, Richard Wismayer

Journal of Advances in Medicine and Medical Research, Page 444-456
DOI: 10.9734/BJMMR/2015/12283

Aims: To determine the factors that influence outcome of management of sigmoid volvulus in Northern Uganda
Study Design: A prospective observational study was conducted on 103 sigmoid volvulus patients admitted and surgically managed in 19 hospitals in northern Uganda and followed-up postoperatively for 30 days.
Place and Duration of the Study: This study was conducted in 19 hospitals in Northern Uganda from January 2012 to December 2012.
Methodology: One hundred and three patients with sigmoid volvulus were consecutively recruited and admitted in 19 of the 20 hospitals in Northern Uganda and were surgically managed by resection and primary anastomosis or Hartmann’s procedure or double barrel colostomy. Patients 13 years and above with sigmoid volvulus and who had consented/Assented were included in the study and followed up to the 30th postoperative day. Ethical approval for the study was obtained from the Institutional Review Committee of Gulu University Medical School. Data analysis was carried out using STATA/IC version 12.1. The outcome events observed were uneventful recovery, morbidity and mortality.
Results: Eighteen patients (17.48%) developed complications including wound sepsis 10(9.7%); wound dehiscence 8(7.7%) and anastomotic leak 8(7.7%). There were 8 deaths, thus giving a mortality rate of 7.7%. The factors associated with a high risk of morbidity and mortality were hypernatraemia (RR=14.9; 95% CI: 1.46-152.9) and ileosigmoid knotting (RR=4.94; 95% CI: 1.30-18.78). Resection and primary anastomosis had a better outcome compared to the Hartmann’s procedure (RR=0.15; 95% CI: 0.02-0.099).
Conclusion: The risk factors associated with morbidity and mortality of sigmoid volvulus management were preoperative hypernatraemia and ilio-sigmoid knotting. Hartmann’s procedure was associated with a higher risk of morbidity and mortality than resection and primary anastomosis.

 

Note: This paper has been investigated by Uganda National Council for Science and Technology for ‘authorship dispute’. Uganda National Council for Science and Technology informed the editorial office of the journal by a letter, dated 19th January, 2015, as "We confirm that Dr. Richard Wismayer conducted the studies, wrote and submitted to us his Master thesis entitled, "Incidence and factors influencing outcome of sigmoid volvulus in northern Uganda: a prospective observational study", from which the articles were derived. Our attempt, as evidenced by the attached/enclosed letter to Dr. David Lagoro Kitara to obtain any other relevant information from him in respect of the disputed publication was futile. We therefore have no evidence, so far, that Dr. David Lagoro Kitara sought authorship consent from Dr. Richard Wismayer." This journal waited another six months to get any further communication from Uganda National Council for Science and Technology. As we have not received any other communication from the apex body of Uganda, we therefore consider the letter received on 19th Janyary-2015 as final ruling. Therefore on 17th July-2015 this manuscript has been retracted by following "SDI Correction and retraction policy". We thank all related persons/organization for kind cooperation, patience and support during this process.

Open Access Original Research Article

Increased Complement Deposition on Red Blood Cells in Children with Sickle Cell Trait

Walter Otieno, Benson B. A. Estambale, Michael M. Odera, Collins O. Odhiambo, Joash R. Aluoch, Bernard Guyah, Stacey M. O. Gondi, José A. Stoute

Journal of Advances in Medicine and Medical Research, Page 457-465
DOI: 10.9734/BJMMR/2015/9438

Aims: Immune-mediated mechanism, such as deposition of complement (C3b) on erythrocytes leading to enhanced receptor-mediated uptake by macrophages has been proposed to contribute partly to the destruction of non-infected cells leading to anaemia. The extent of complement deposition on RBC (red blood cells) may therefore influence an individual's resistance or susceptibility to severe malarial anaemia. Our objective was to see if RBC of sickle cell trait individuals have increased susceptibility to deposition of complement in vivo. Under oxygenated and deoxygenated conditions, cytofluorometry was used to determine susceptibility of RBC from individuals with normal haemoglobin and those with heterozygous sickle cell trait to complement deposition.
Methods: Children aged 0-192 months (n=116) were enrolled in the nested case controlled study and were stratified into HbAS (n=47) and HbAA (n=69). The 47 HbAS individuals were matched to the 69 HbAA individuals of similar age (± 2 months or ± 24 months for those below or more than 192 months, respectively) at a ratio of 1:1 or 1:2. We measured the red cell C3b by flow cytometry under normal and reduced oxygen saturation. Individuals who were positive for malaria were treated and blood was collected when they were free of parasitemia. Analysis of variance was used to identify independent variables associated with the complement C3b positive red cells and Hb level.
Results: The mean complement C3b-positive cells for the HbAS was significantly higher than HbAA (P=0.0191). This was also true when this was repeated under deoxygenated conditions (P=0.00065). When the study volunteers were grouped by age cohorts into 0-12, 13-48 and 49-192 months, it was noted that generally; the mean complement C3b positive red cells was higher in the HbAS compared to HbAA but was not statistically significant. Under deoxygenated conditions, the trend was the same. However, between the ages of 49-192 months, the difference was statistically significant.
Conclusion: Increased complement C3b deposition on red cells of HbAS cells may predispose the HbAS individuals to increased RBC destruction and therefore protection from severe manifestations of malaria.

Open Access Original Research Article

The Effect of Body Mass Index and Waist Circumference on Blood Pressure

Odokuma Emmanuel Igho

Journal of Advances in Medicine and Medical Research, Page 466-471
DOI: 10.9734/BJMMR/2015/9663

This study was aimed at determining the pattern of some assessors of obesity including body mass index (BMI) and waist circumference (WC) and the effect of these parameters on blood pressures in the studied population. The sample consisted of three hundred and fifty (350) undergraduate female students of Delta State University, Abraka, Delta State Nigeria, with ages between 18-26 years. The study showed that 32.56% were overweight and while over 10.00% were obese. A total of 6.39% were undernourished and there was a recorded steady rise in blood pressure as the BMI increased. The BMI was observed to correlate positively with both systolic and diastolic blood pressures (p < 0.01; 0.23, 0.18) with an observed significant correlation between WC and both diastolic (DBP) and systolic blood pressures (SBP) (p < 0.01; 0.25, 0.26). Both systolic and diastolic pressures showed a significant relationship with WC and this correlation was significant at 0.01 levels of significance. This study further established that BMI and WC were significantly correlated with DBP and SBP. These non invasive parameters are therefore reliable indicators of obesity and associated hypertension.

Open Access Original Research Article

Incidence of Sigmoid Volvulus in Northern Uganda: A Cross-Sectional Study Design

David Lagoro Kitara, Richard Wismayer

Journal of Advances in Medicine and Medical Research, Page 472-479
DOI: 10.9734/BJMMR/2015/12451

Aims: To determine the incidence of sigmoid volvulus in Northern Uganda.
Study Design: A cross-sectional (2 years retrospective and one year prospective) study design was conducted on patients’ medical records and those admitted, surgically managed or referred from the 19 hospitals in Northern Uganda.
Place and Duration of the Study: This study was conducted in 19 hospitals in Northern Uganda from January 2010 to December 2012.
Methodology: A cross sectional study design with a two year retrospective and one year prospective studies were conducted to determine the incidence of sigmoid volvulus in Northern Uganda. All patients’ records with a diagnosis of sigmoid volvulus in 19 hospitals were included in the study. Ethical approval was obtained from the IRB of Gulu University Medical School and Uganda National Council for Science and Technology (UNCS&T). Data analysis was conducted using STATA/IC version 12.1.
Results: The incidence of sigmoid volvulus in Northern Uganda was 251.8 per 100,000 surgical populations in 2 years. Most cases occurred in the dry season particularly from December to April and least observed from May to November. Middle aged and elderly male were the most commonly affected.
Conclusion: The incidence of sigmoid volvulus in Northern Uganda was 251.8 per 100,000 surgical populations in 2 years. The proportion of bowel obstructions due to sigmoid volvulus in Northern Uganda was 23.4% and similarly comparable with the proportion found in other African countries and higher than those in developed countries.

 

Note: This paper has been investigated by Uganda National Council for Science and Technology for ‘authorship dispute’. Uganda National Council for Science and Technology informed the editorial office of the journal by a letter, dated 19th January, 2015, as "We confirm that Dr. Richard Wismayer conducted the studies, wrote and submitted to us his Master thesis entitled, "Incidence and factors influencing outcome of sigmoid volvulus in northern Uganda: a prospective observational study", from which the articles were derived. Our attempt, as evidenced by the attached/enclosed letter to Dr. David Lagoro Kitara to obtain any other relevant information from him in respect of the disputed publication was futile. We therefore have no evidence, so far, that Dr. David Lagoro Kitara sought authorship consent from Dr. Richard Wismayer." This journal waited another six months to get any further communication from Uganda National Council for Science and Technology. As we have not received any other communication from the apex body of Uganda, we therefore consider the letter received on 19th Janyary-2015 as final ruling. Therefore on 17th July-2015 this manuscript has been retracted by following "SDI Correction and retraction policy". We thank all related persons/organization for kind cooperation, patience and support during this process.

Open Access Original Research Article

Comparing the Metal Concentration in the Nails of Healthy and Cancer Patients Living in the Malwa Region of Punjab, India with a Random European Group – A Follow up Study

Eleonore Blaurock-Busch, Yvette M. Busch, Albrecht Friedle, Holger Buerner, Chander Parkash, Anudeep Kaur

Journal of Advances in Medicine and Medical Research, Page 480-498
DOI: 10.9734/BJMMR/2015/13124

The cancer prevalence in the Malwa region of Punjab (1089/million/year) is much higher than the national average cancer prevalence in India (800/million/year). In our previous study on hair metal analysis, we located a high metal burden in Punjabi cancer patients and their live-in relatives, suggesting that an excessive metal exposure is a factor in the pathogenesis of cancer. The present study focused on nail metal analysis, a biological material similar to hair. Previously, we had used ICP-MS spectroscopy to confirm high exposures to aluminium (Al), barium (Ba), manganese (Mn), lead (Pb), uranium (U and other metals in the hair of Punjabi cancer patients and their healthy relatives (Blaurock-Busch et al. 2014). In this study, we used nail metal analysis to confirm the results of our previous study. We compared the nail metal concentration of healthy Punjabis (N=83) with randomly selected healthy Europeans (N=83) and found highly significant differences between the European and Punjabi groups, including the healthy and the cancer groups.In comparison, our European group showed a low percentage (0 to 13%) of pathological values for aluminium (Al), barium (Ba), cadmium (Cd), iron (Fe), manganese (Mn), nickel (Ni), lead (Pb), strontium (Sr), titanium (Ti) and uranium (U), while the healthy Punjabi groups showed between 13% and 99% pathological values for these elements. (Explanation: A test value above the 95% reference range is considered a pathological value.)The greatest metal burden was found in the breast cancer group (N=13), showing 100% pathological values for Al, Fe, Mn and U. This study supports previous research, which demonstrated a significant metal burden in Punjabi people. Water, soil, and phosphate fertilizers may be the cause of this excessive exposure.

Open Access Original Research Article

Iranian adolescents with Scoliosis: Effects of Brace Treatment on Self-esteem, Body Image Concern and Quality of Life

Shahriar Shahidi, Narjes Toktam Jannesari

Journal of Advances in Medicine and Medical Research, Page 499-508
DOI: 10.9734/BJMMR/2015/12935

Objective: The purpose of the present research was to measure quality of life, body image concern and self-esteem in 237 Iranian adolescents aged 12 to 18 years as these variables seem to be very important in patients’ psychological well being as well as compliance to treatment.
Methods: Participants were divided into those with scoliosis under full time brace treatment; those with scoliosis but not under brace treatment those without scoliosis. Participants completed questionnaires measuring self-esteem, concern for body image and quality of life (QoL).
Results: Results showed that adolescents with scoliosis reported lower scores in self-esteem compared to normal adolescents and adolescents who were using brace reported significantly lower QoL and greater body image concern compared to the other groups. In the latter measure, there was no significant difference between normal adolescents and adolescents with scoliosis who were not under brace treatment. Sex differences in scores of self-esteem indicate that girls reported significantly lower self-esteem compared to boys. There were no significant sex differences in scores of body image concern. As far as QoL was concerned, girls wearing brace reported significantly less satisfaction with life than all the other groups.
Conclusions: Results are discussed in terms of the importance of psychological aspects of wearing brace in the prevention and treatment of scoliosis and the need to design intervention programs in order to provide psychological support for adolescents suffering from scoliosis.

Open Access Original Research Article

Comparison of N-terminal Pro-B type Natriuretic Peptide and Tissue Doppler in Diagnosing Diastolic Heart Failure

C. S. Thejanandan Reddy, D. Rajasekhar, V. Vanajakshamma, K. Latheef

Journal of Advances in Medicine and Medical Research, Page 509-517
DOI: 10.9734/BJMMR/2015/12087

Background: Heart failure (HF) has become a main cardiac problem. Doppler echocardiography has been used to examine left ventricular (LV) diastolic filling dynamics. Limitations of this modality suggest the need for other objective measures of diastolic HF.
Aim of the Study: The hypothesis of this study is to assess the utility of N-terminal pro-B type natriuretic peptide (NTproBNP) in the diagnostic evaluation of diastolic HF in comparison with tissue Doppler imaging (TDI) recordings.
Methods: A prospective study was carried out between May 2010 and December 2011. Patients with signs and symptoms of HF with normal LV systolic function by 2D-echocardiography were recruited. M-mode and 2-dimensional images, left atrial volume index (LAVI), spectral and TDI of the mitral annulus were obtained for all the patients. NTproBNP levels were measured with a bedside immunoassay.
Results: We found linear correlation between NTproBNP levels and grade of diastolic dysfunction (DD), LAVI, ratio of mitral velocity to early diastolic velocity of the mitral annulus (E/E’) [r=0.72, p<0.001]. Patients with elevated left ventricular end diastolic pressure, defined as E/E’>15 (n =18), had the highest NTproBNP levels (3028±2674pg/mL). NTproBNP levels (4146±2887.43 pg/mL) were highest in patients with grade III DD. A receiver operator characteristic curve showed NTproBNP value, 286 pg/mL, the best cut-off for diagnosing diastolic HF with a sensitivity of 89% and a specificity of 100%.
Conclusions: Plasma NTproBNP levels can reliably estimate LV filling pressures in patients with HF and normal systolic function which might help to reinforce the diagnosis of “diastolic HF”.

Open Access Original Research Article

Inorganic and Organic Mercury Levels in the United States National Health and Nutrition Examination Survey (NHANES) 2005-2010

B. M. Y. Cheung, A. J. Cheung

Journal of Advances in Medicine and Medical Research, Page 518-524
DOI: 10.9734/10.9734/BJMMR/2015/13303

Aims: Mercury is an environmental hazard. Therefore, we studied recent trends in the blood level of organic and inorganic mercury in the United States (US).
Methodology: We analyzed newly available data on blood inorganic mercury levels in NHANES 2005-2010. Organic mercury level was calculated by subtracting inorganic mercury level from the total mercury level. As complex sampling was used in NHANES, appropriate weights were used to adjust for oversampling of minorities and sampling from the same location.
Results: There were 8364, 8161 and 8727 participants in NHANES 2005-6, 2007-8 and 2009-10 respectively. Inorganic mercury levels (geometric mean [95% confidence intervals]) were 0.31 [0.30-0.32], 0.30 [0.30-0.31], 0.28 [0.27-0.28] µg/L and organic mercury levels were 0.24 [0.19-0.30], 0.19 [0.14-0.25], 0.27 [0.22-0.33] µg/L in 2005-6, in 2007-8, in 2009-10, respectively. Inorganic mercury levels showed a significant decreasing trend (P<.05). Organic mercury levels were significantly lower in participants aged <20 compared to those ≥20 years. The adjusted proportion (mean±SE) of participants with a total mercury level ≥5.8µg/L was 3.0±0.2%, 3.5±0.6%, and 4.0±0.4% (P<.05) in NHANES 2005-6, 2007-8, and 2009-10, respectively.
Conclusions: Inorganic mercury level has been decreasing during the study period. Organic mercury level was lower in 2007-2008 but increased in 2009-10. The significant increase in organic mercury level in the US general population in 2009-10 is of concern, suggesting that continual monitoring of mercury levels is needed.

Open Access Original Research Article

Erosive Potential of Medicated Syrups on Primary Teeth: An In vitro Comparative Study

K. Jai Kiran, C. Vinay, K. S. Uloopi, R. Chandra Sekhar, V. Madhuri, Rama Krishna Alla

Journal of Advances in Medicine and Medical Research, Page 525-532
DOI: 10.9734/BJMMR/2015/13434

 

British Journal of Medicine and Medical Research, ISSN: 2231-0614,Vol.: 5, Issue.: 4

Original-research-article

 

Erosive Potential of Medicated Syrups on Primary Teeth: An In vitro Comparative Study

 

 

 

K. Jai Kiran1, C. Vinay2*, K. S. Uloopi2, R. Chandra Sekhar2, V. Madhuri2 and Rama Krishna Alla3

1Department of Pediatric Dentistry, Vishnu Dental College, Vishnupur, Bhimavaram -534202, Andhra Pradesh, India.
2Department of Pediatric Dentistry, Vishnu Dental College, Vishnupur, Bhimavaram -534202, Andhra Pradesh, India.
3Department of Dental Materials, Vishnu Dental College, Vishnupur, Bhimavaram -534202, Andhra Pradesh, India.

 

Article Information
Editor(s):
(1) Chan Shen, Department of Biostatistics, MD Anderson Cancer Center, University of Texas, USA.
Reviewers:
(1) Anonymous, Abant Izzet Baysal University, Turkey.
(2) Anonymous, Birjand University of Medical Sciences, Iran.
Complete Peer review History: http://www.sciencedomain.org/review-history/6196

 

Abstracts

 

 

Aims: This in vitro study was designed to investigate the exogenous erosive potential of most commonly used pediatric syrup medicaments on primary teeth.
Place and Duration of Study: Department of Pediatric Dentistry, Vishnu Dental College, Bhimavaram, India, 2012 to 2013.
Methodology: The erosive potential of 17 syrups was assessed by measuring their inherent pH, titratable acidity, viscosity and ability to erode enamel. The inherent pH and titratable acidity of syrups were measured using digital pH meter and viscosity was determined using Brookfield viscometer. Enamel surface changes were evaluated using optical 3D profilometer.
Results: Api –up (appetizer) showed the least pH and Azee (Azithromycin) exhibited the highest pH. The titratable acidity was greater for Api-up (5.40ml) and least for Tonoferron (0.20ml). Asthalin exhibited highest viscosity and Ondem showed least viscosity. All the test syrups caused some degree of enamel loss, however, Api – up caused the greatest and Azee caused the least degree of enamel loss at three time intervals.
Conclusion: The medicated syrups with low inherent pH and high viscosity showed to cause a greater dissolution of enamel. However, certain syrups with low viscosity had shown higher degree of enamel loss due to their inherent acidic pH and those with high viscosity Showed lesser degree of enamel loss due to their basic pH. Hence, these results proved that inherent pH is the most critical factor for erosion.

Open Access Review Article

The Association between Cyclo-oxygenase Inhibitor Medications and Clinical Relapse in Inflammatory Bowel Disease: Review of Current Perspectives

Abigail Hensley, Ian L.P. Beales

Journal of Advances in Medicine and Medical Research, Page 414-426
DOI: 10.9734/BJMMR/2015/13064

Background: Patients with inflammatory bowel disease (IBD) often have associated conditions which may benefit from treatment with non-steroidal anti-inflammatory drugs (NSAIDs) or selective cyclo-oxygenase-2 (COX-2) inhibitors. However, evidence has suggested there may be an association between COX- inhibition and relapse in IBD, which leads to clinicians being reluctant to prescribe these agents.
Aims: The aim of this review is to review the possible biological mechanisms, linking NSAIDs and IBD-relapse and current knowledge on the possible association of NSAIDs and clinical relapse in IBD.
Results: IBD relapse due to NSAID use is most likely due to prostaglandin inhibition via dual COX-inhibition, although the topical effect of NSAIDs on the intestine may also play a role. The evidence for an association between NSAIDs and IBD relapse is contradictory and generally weak, but it is likely a small percentage of patients relapse when taking NSAIDs, but it is not known which patients are at risk. Mixed results have also been obtained from studies examining COX-2 selective agents; although a single randomized controlled-trial showed that celecoxib is safe in ulcerative colitis in the short term.
Conclusions: At present the data are contradictory and most published studies have serious flaws. Overall the association between use of NSAIDs and IBD-relapse seems rather weak, Cyclo-oxygenase inhibitors should not be withheld from stable IBD patients, if clinically indicated and appropriate cautions and monitoring are used. Celecoxib would seem a sensible first choice. Further studies are needed to help identify which patients are at risk of relapse with NSAIDs.