Journal of Advances in Medicine and Medical Research

Background: The overall aim of this work was to study the impact of combined aerobic and anaerobic training in relation to hemodynamic response (heart rate, systolic blood pressure, and double product), serum oxidative stress markers (lipoperoxides, nitrites-nitrates) and platelet ATP synthase activities in patients with coronary heart disease.
Materials and Methods: Ten subjects, 9 male and 1 female, (mean age 57.7±7.2 years) with coronary heart disease participated in this study. Patients performed combined aerobic and anaerobic exercise for 24 sessions (three times a week).
Results: The results suggest myocardium adaptations, manifested in the reduction of heart rate with increased workloads and increased double product [(heart rate) x (systolic blood pressure)] according to the intensity, frequency and duration of training. The ATP synthesis rate was significantly increased at session 3 (post-exercise) compared to session 1 (pre exercise). Furthermore, rate of ATP hydrolysis was significantly decreased at session 24 (post-exercise 3) compared to session 1 (post-exercise 1). Serum lipid peroxidation products and nitric oxide catabolites were significantly diminished at session 24 (pre-exercise).
Conclusion: In some patients hemodynamic responses showed improvements in response to exercise. The exercise sessions induced lower levels of lipid peroxidation products, nitric oxide catabolites and ATPase activity. Conversely, ATP synthase activity showed higher values at the end of the experiment. These results confirm the beneficial effect of combined aerobic and anaerobic exercise.

Background: National cancer registration reports provide huge potential for identifying patterns and trends of policy, research, prevention and treatment significance. Yet given the range of factors involved in cancer onset, case identification, progression and reporting, pin-pointing this complexity requires systematic thinking and varied strategies of data analysis.

Methods: The study extracts data about incidence rates (IRs) and mortality rates (MRs) of lung, stomach, colorectal and liver cancers for 2004, 2006 and 2009 from relevant China National Cancer Registry (CNCR) reports and analyzes the data using line-graphs, ratios and logistic growth modeling.

Results: The study shows that: a) all line graphs of age-specific IRs and MRs of the 4 cancers characterized typical S-shape with substantial differences in terms of smoothness, height and proximity; b) MR lines mimicked and located below the corresponding (of the same cancer, population group and year of reporting) IR lines for almost all the age groups except 1 to 2 oldest ones; c) colorectal cancer witnessed the lowest MR/IR ratios on average followed by gastric and lung cancers and all such ratios featured an increasing trend along the age spectrum; d) urban vs. rural ratios in IRs or MRs showed an increasing trend along the age axis for 3 out of the 4 cancers but a typical v-shaped curves for stomach cancer; e) the lines of recent vs. early ratios in cumulative IRs or MRs for urban areas located apparently closer than that for rural areas; f) all the age-specific IRs and MRs fitted very well with logistic growth models (goodness of fit> 0.91) and the integrations and ages when the models reached 5%, 50% or 95% of their highest values yielded interesting features.

Conclusion: The study provides useful perspectives for analyzing age-specific IRs and MRs and reveals a number of interesting patterns and trends with cancer counts reported by CNCR.

Background: Evaluation of jaundice patients should include proper history and examination, laboratory investigation and imaging investigations (non invasive like Ultrasound (U\S), CT and MRI or invasive like ERCP and PTC).
Aim of Study: The aim of this prospective study is to evaluate the diagnostic reliability of U\S and MRI-MRCP in patients of obstructive jaundice in clinical practice.
Materials and Methods: This is a prospective study performed on 60 patients (31 male and 29 female) with an average age of 55.53 +/- 17.57 years presented with obstructive jaundice for whom abdominal ultrasound (U\S) and magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) on 3 Tesla was performed in the departments of radiology in Max super speciality teaching hospital, saket, Delhi, India from May 2012 to May 2013. The final diagnosis was achieved by endoscopic retrograde cholangiopancreatography (ERCP) and \or surgery and confirmed by histopathology.
Results: The most common cause of obstructive jaundice in our study was common bile duct stones (51.65%) followed by tumors (33.3%) then benign strictures (10.0%), choledochal cyst (3.33%). In this study, MRI-MRCP could differentiate surgical from medical jaundice in all cases, while U\S could differentiate surgical from medical jaundice in 91.25% of cases. MRI-MRCP correctly defines the level of obstruction in all cases (100%). While U\S correctly define the level of obstruction in only 78% of the total cases. MRI-MRCP correctly suggests the most possible cause of obstruction in 96.25% of cases. While USG is correctly suggests the most possible cause in only 76.3%.
Conclusion: So that USG as a screening modality is useful to confirm or exclude biliary dilatation & to choose patients for MRCP examination. MRI-MRCP is a useful non-invasive and essential method in the preoperative evaluation of patients with obstructive jaundice. In addition MRI-MRCP was superior to U\S or ERCP in studying the extent & staging of malignant lesions.

Background: Pelvimetry is a poor predictor of obstetric outcome. The predictive value of clinical pelvimetry remains limited except in extreme pelvic contracture or an excessively large fetus.
Objective: To determine the attitudes of primigravidae to routine clinical pelvimetry.
Subjects and Methods: This was a cross-sectional study of primigravidae at the University of Nigeria Teaching Hospital (UNTH), Enugu between January 1^st and December 31^st, 2009. Self-administered, structured, and pre-tested questionnaires were distributed to the consenting selected women by trained medical interns. Data was analyzed using SPSS version 16. P< 0.05 was considered statistically significant.
Results: A total of 195 primigravidae were selected at random for this study. One hundred and thirty eight primigravidae (138/195, 70.77%) were aware of clinical pelvimetry while 29.23% (57/195) were not aware of clinical pelvimetry. One hundred and twenty five primigravidae (90.58%, 125/138) desired clinical pelvimetry to continue while thirteen (9.42%, 13/138) did not desire clinical pelvimetry to continue. There was statistically significant difference between those who were aware and unaware of pelvimetry in their desire for pelvimetry [X²=18.903, p=0.0001, OR 5.2, 95% confidence interval=2.20 to 12.44].
Conclusion: There is profound awareness and the desire to continue clinical pelvimetry among primigravidae at the UNTH, Enugu, Nigeria, where majority of the women showed strong preference for it.

Inflammatory bowel disease (IBD) (ulcerative colitis and Crohn's disease) is a chronic intestinal inflammatory disease characterized by tissue edema, increased gut epithelial permeability, and extensive infiltration of the gut by leukocytes. Statins, in addition to their cholesterol-lowering activity, have pleiotropic effects, including immune-modulatory and anti-inflammatory effects. Simvastatin is a commonly prescribed statins with antioxidant and anti-inflammatory properties Thus; the aim of this study is to compare effect of simvastatin (5 mg/kg) and simvastatin (50 mg/kg) as an early treatment of experimentally induced ulcerative colitis in mice. For the first time in the current study, Simvastatin was administered after the appearance of signs and symptoms of the disease as an early treatment model. Twenty four mice were divided into four groups; control group, non treated DSS-induced colitis group, simvastatin (5 mg/kg/d) -treated DSS-induced colitis group, simvastatin (50 mg/kg/d) -treated DSS-induced colitis group. simvastatin at dose of (5 mg/kg/d) reduced MDA and TNF-α .While simvastatin at dose of (50 mg/kg/d ) showed a significant increase in colon length of mice,a significant decrease in NO and MDA levels and a significant increase in r GSH level. Simvastatin (5 mg/kg/d) and (50 mg/kg/d) reduced the percentage of DAI by 25% and 41% respectively. The sums of histopathological scores were improved after simvastatin treatment.
It can be concluded that effects of simvastatin treatment was mostly dose dependant. Unfortunately the high dose has no clinical application in human due to toxicity. So it is advised to use simvastatin with a dose of 5mg/kg as an early treatment of dss induced colitis model.

Aims: To investigate urinary cytological abnormalities among adult residents of a urinary schistosomiasis endemic community.
Study Design: Ethical approval, consent from the village Head/villagers, parasitological survey and cytological analysis of urine.
Place and Duration of Study: Adim Community in Cross River State, Nigeria between May and November 2014
Methodology: Urine samples from 160 sex matched adults aged 18–85 years were examined using standard parasitological techniques for the presence of ova of Schistosoma haematobium. The urine smears were stained with Papanicolaou and Alcian Blue (PH 2.5) staining techniques and examined for cytological abnormalities and the presence of Hyaluronic acid respectively.
Results: 18 (11.3%) subjects were infected. Subjects in the age groups >35 – 45 years had the highest prevalence rate 9(20.5%) while those in the age group >75 – 85 years had the lowest prevalence rate 0(0%) and the difference was statistically significant (P = 0.359). The infection rate was higher among females 11(12.5%) than the males 7(9.7%) but the difference was not statistically significant (P = 0.580). Males had a higher mean egg count (18±25.7 egg/10 ml of urine) than the females (17±15.5 egg/10 ml of urine). Subjects in the age group >35–45 years had the highest level of abnormal epithelial cells 1(11.1%). Males had a higher prevalence of abnormal cells 3(42.9%) than the females 1(9.1%). There was a positive correlation between the occurrence of infection and abnormal epithelial cells (r = 0.5). 3(1.9%) of the subjects were positive for hyaluronic acid. Male subjects had a higher level of epithelial cells positive for hyaluronic acid 2(2.8%) than the female subjects 1(1.14%) but this was not statistically significant (p<0.05).
Conclusion: This study has reconfirmed the endemicity of urinary schistosomiasis and has also revealed the presence of abnormal epithelial cells as an indicator for bladder cancer in the urine of residents in Adim community.

Introduction: Limb injuries by sharp objects commonly result in tendon or neurovascular damage. The aim of this study is (1) to determine the incidence of significant neurological, musculotendinous or vascular injury; (2) to explore the cause of such wounds; (3) to determine the incidence of missed injuries; and (4) to assess the prognosis of neurological, vascular and musculotendinous injuries.
Methods: Fifty eight adult patients were evaluated in the Emergency Department of our institution for incised wounds sustained to upper and lower extremities. Major trauma with obvious musculotendinous, vascular and neurological injuries was excluded. An injury was characterized as being missed if a patient had received inappropriate treatment or had returned due to persistent symptoms despite being examined, treated and discharged. Only wounds of less than 24 hours duration were included. Non-accidental injuries were excluded.
Results: Fifty one (89%) patients sustained upper extremity wounds while only seven (11%) sustained injuries to the lower limb. Neurovascular and tendon injuries occurred exclusively in the upper limb. Twenty one (36%) patients sustained tendon, nerve and/or vascular injuries (41.2%). Glass injury was found to be the most common cause (41.3%) followed by Knife injuries (15.5%). Fifteen patients were offered an admission to hospital by the Trauma service for definitive treatment. Four of these patients signed DAMA (Discharge against Medical Advice). Six patients did not warrant admission and were discharged from the Emergency Department following appropriate treatment. Thirty seven patients were treated by Emergency Physicians and subsequently discharged. A missed tendon injury was reported in one patient (1.7%).
Conclusion: A thorough clinical examination and accurate injury documentation in the Emergency Department is fundamental in recognizing tendon injuries.

Aims: To evaluate the protective effects of the aqueous extract of the fruit pulp of Adansonia digitata (AEFAD) in sodium arsenite (SA) and cyclophosphamide (CP) induced hepatotoxicity and clastogenicity in rats.
Study Design/Methodology: Fifty four male Wistar rats were distributed into nine groups (A-I) of six animals each. Group A received distilled water and normal diet, Groups B received SA at 2.5 mg/kg body weight, Group C received CP at 10 mg/kg body weight, Groups D –I received the extract alone and with SA or CP.
Results: A statistically significant (P <0.05) higher levels of: mean γGT, ALT and AST activities, number of micronucleated polychromatic erythrocytes (nMPCEs) scored in the bone marrow cells, proliferation of hepatic cells and lipid peroxidation were observed in rats exposed to (SA) or (CP) as compared with the control. Treatment with AEFAD along with SA or CP significantly (P <0.05) reduced the effects of the toxins on the above indices. Observations made with histological analysis of the liver sections revealed lesions ranging from general congestion, mild periportal cellular infiltration and hepatic necrosis to severe congestion in the treated groups.
Conclusion: Findings from this study therefore reaffirmed the hepatoxicity and clastogenicity of SA and CP and revealed that AEFAD can ameliorate these toxicities in rats.

Objective: Metabolic syndrome is a widespread disease associated with cardiovascular pathologies and diabetes mellitus. The underlying mechanisms for development of the metabolic syndrome are currently being intensively discussed. Contradictory data regarding the role of lipid metabolism disorders in trigger mechanisms of metabolic syndrome necessitate thorough analysis of the content of fatty acids in plasma and blood cells. The aim of our study was to examine the content of free and esterified fatty acids and the levels of eicosanoids in metabolic syndrome with various insulin resistance. We evaluate the role of fatty acids and their metabolites in the development of metabolic syndrome.
Study Design: Cross-sectional study.
Place and Duration of Study: Vladivostok Branch of Far Eastern Scientific Center of Physiology and Pathology of Respiration – Research Institute of Medical Climatology and Rehabilitation Treatment, Russia, 2012-2013.
Materials/Methods: The study involved three groups of volunteers: 15 persons without components of the metabolic syndrome, 30 patients with metabolic syndrome and the normal insulin level, 31 patients with metabolic syndrome and diagnosed insulin resistance. We examined the levels of fasting glucose and glucose content after 2 hours of per oral glucose load, insulin, total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, eicosanoids. The content of fatty acids in plasma and erythrocytes was analyzed by gas chromatography. Statistica software was used for data analysis.
Results: We detect reciprocal changes in the content of plasma and erythrocytes fatty acids in metabolic syndrome with and without insulin resistance. Such fatty acids as 18:2n-6, 18:3n-3 are accumulating in plasma, while 18:2n-6, 18:3n-3, 20:4n-6 in erythrocytes are in deficiency. The levels of eicosanoids in metabolic syndrome are elevated.
Conclusion: Our results determined the role of fatty acids and their metabolites in the development of the metabolic syndrome. We propose the concept of metabolic syndrome according to which the trigger for the development of the metabolic syndrome is the modification of the fatty acid composition of blood cells as the result of disorders in their receptor-mediated transport.

Introduction: The study aimed to assess the relationship between early pregnancy Hemoglobin (Hb) concentration and weight gain status in pregnant women and birth weight.
Material and Methods: This is a retrospective study that was carried out on the 1994 under-five-year children. Among 118 villages in Gorgan and Aq-Qala districts, 20 villages were chosen by random sampling. Birth weights, birth stature, means of Hb in early pregnancy and maternal weight gain during pregnancy have been recorded by health care file available from Primary Health Care System. Hb concentration divided in three classifications: Low (Anemia) =Hb<11 g/dl, Normal= 11-12.4 g/dl and High>=12.5 g/dl (11). SPSS 16.0 software was used for statistical data analysis.
Results: The mean and standard deviation of maternal serum Hb, birth weight and weight gain during pregnancy were 12.0±1.1g/dl, 3.3±0.5 kg, and 10.5±4.1kg, respectively. Anemia (Hb<11g/dl) was common in 16.8% (336 cases) of mothers in gestational period. The mean of weight gain in first, second and third trimesters and in eighth and in ninth months in pregnancy have significantly positive association with serum Hb concentration (P=0.001). However birth weight was not statistically significant differences among three Hb groups. Totally, weight gain during pregnancy was 10.50 kg with lower rate in anemic group (11>Hb g/dl).
Conclusion: Low Hb concentration during pregnancy is a main health problem in rural area in the north of Iran. The positive association between serum Hb concentration and weight gain was seen in pregnancy, while it was not significant association with birth weight.