Open Access Case Report

Stabilization of Prostate Cancer with Amanita phalloides: Intervals with 5-Alpha-Reductase Inhibitors and Melatonin to Circumvent Resistance: Case Report

Isolde Riede

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/27895

Aims: Amanita phalloides contains alpha-amanitin, inhibiting RNApolymeraseII. Due to overexpression of switch genes in tumor cells, RNApolymeraseII is used to full extent there. Partial inhibition with amanitin influences tumor cell - but not normal cell - activity. A patient with diagnosed prostate cancer was treated successfully for six years with Amanita alone, prostate specific antigen levels increased slowly. However, the necessary dose for stabilization of the level increased during this time. To circumvent further habituation or resistance, other therapeutics were applied in intervals.

Presentation of Case: Inhibitors of 5-alpha-reductase were applied in intervals of pausing Amanita. They can further stabilize the prostate antigen level, but tumor cells became resistant to this drug after a few months. The patient suffered under severe side effects. Melatonin was applied in one interval together with Amanita. It shows no additional side effect, but no additional advantage for the patient occurs.

Discussion and Conclusion: Amanita is the drug for long term stabilization of a tumor patient. Fast occurrence of resistance was never observed so far. 5-alpha-reductase inhibitors can be applied in shorter intervals, with speedy development of resistance. Melatonin has no advantageous effect for this patient. Consequent monitoring for all therapy steps is recommended.

Open Access Original Research Article

Insulinomimetic, Antihyperlipidemic and Antioxidative Properties of Azadirachta indica. Possible Mechanism of Action

A. S. Adekunle, T. I. Adelusi, Kamdem Jean-Paul, A. Ishmael, B. B. Akintade

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/BJMMR/2016/26897

Currently available synthetic drugs for management of diabetes mellitus have been reported to cause side effects, hence searches for safer, readily available and cheaper sources among medicinal plants. One hundred and thirty rats weighing average of 94g were used for the studies. In the first study, Azadirachta indica (AZI) was assessed for its hypolipidemic property, in the second AZI was assessed for its antihyperglycaemic potential while in the third study; it was assessed for its antidiabetic, antilipidemic and antioxidative properties. The potency of 2 different doses of AZI was compared with that of glibenclamide (a reference drug). AZI exhibited hypoglycemic, antihyperglycemic, antihyperlipidemic and antioxidative properties which were comparable to that of glibenclamide. Different doses of AZI reversed weight loss due to streptozotocin-induced diabetes mellitus. AZI extract caused increased synthesis of liver glycogen when compared with diabetic rats. Conclusively, antidiabetic property of AZI may imitate blood glucose regulatory action of insulin.

Open Access Original Research Article

The Efficacy of Quality of Life Therapy on Mental Health in the Families of Patients with Chronic Psychiatric Disorders

Kamal Solati

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/27211

Background and Aim: Caring for and living with patients with chronic psychiatric disorders may cause high levels of stress for their families. The aim of this study was to investigate the efficacy of quality of life therapy (QOLT) on mental health in the families of patients with chronic psychiatric disorders.

Methods: In this semi-experimental, controlled study with pretest-posttest, 60 family members of patients with chronic psychiatric disorders were randomly selected from the centers affiliated with the State Welfare Organization of Shahrekord, southwest Iran. First, these people were matched and then assigned to two groups of 30 each, controls and cases. The General Health Questionnaire-28 (GHQ-28) was filled out by the participants before and after the intervention. The experimental group attended eight two-hour sessions of the QOLT a week, but the controls did not participate in any interventions. The data were analyzed by t-test in SPSS 18.

Results: The QOLT helped to improve mental health in the families of patients with chronic psychiatric disorders, such that physical complaints, anxiety and sleeplessness, social functioning, and depression, as mental health subscales, were significantly different between the two groups after the intervention (P>0.05).

Conclusion: The QOLT can be an approach to improve mental health among the families of patients with chronic psychiatric disorders.

Open Access Original Research Article

Pattern of Chest Injuries Following RTA – A Study from a Nigerian Tertiary Health Institution

Olaejirinde O. Olaofe, William O. Odesanmi, Kayode A. Adelusola, Akinwumi O. Komolafe, Donatus Sabageh, Oluwole O. Odujoko

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/28177

Background: Worldwide, road traffic accidents are a leading cause of death. Severe chest injuries from such accidents are frequently fatal due to the presence of vital organs within the chest cavity. This study seeks to review these injuries and their implications for the safety of road users.

Study Design: Descriptive retrospective study.

Place and Duration of Study: Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. 1st January 2000 to 31st December 2009.

Methods: This was a descriptive retrospective analysis of the postmortem autopsy findings from cases of road traffic accidents with chest injuries at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria over a 10-year period. Analysis was performed using the IBM SPSS version 15.0 (P is significant at <0.05)

Results: A total of 75 cases were reviewed. The male to female ratio was 5.8:1 while the age range was from 6 to 80 years. The most frequently involved age-group was the 30 to 40-year age-group which accounted for 24 cases (32.0%). The most common anatomic finding in the chest was fracture of the ribs which occurred in 70 (93.3%) cases while 44 cases (58.7%) showed haemothorax and 19 cases (25.3%) had laceration of the lungs. The least affected chest structure was the diaphragm with only one case (1.3%). Most (81.3%) of the deaths were due to multiple injuries involving other regions of the body. About 40 victims (53.3%) died at the accident scene. About 54.7% of the victims were passengers while 32.0% were drivers and 13.3% were pedestrians. Minivans and saloon cars were involved in 42.7% and 24.0% of cases respectively.

Conclusion: Chest injuries in road traffic accident fatalities are more frequent in males and in the active young adult population. The ribs are the most frequently injured structures in the chest. Injuries to intra-thoracic organs and vertebrae are very uncommon. Majority of deaths are due to multiple injuries.

Open Access Original Research Article

Knee Injuries: A Burden of Schoolboy Rugby Players

T. J. Ellapen, H. J. Van Heerden, R. Taylor, A. Trend, H. Van der Merwe

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/21898

Background: School rugby injuries are a great concern to all rugby loving nations. There have been anecdotal reports by sport medical professionals that deviant quadriceps angle are associated with rugby knee injuries. This study aimed to document the nature of acute musculoskeletal rugby knee injuries among schoolboys participating in the Rugby A-League of the Upper Highway area of Kwa Zulu-Natal over a 12 month period (July 2013-June 2014).

Materials and Methods: Data were collected from 115 high school rugby players via voluntary parental informed consent and player assent. Players completed a self-report musculoskeletal injury and exercise history questionnaire probing the nature of acute rugby knee injuries, predisposing risk factors (quadriceps angle, injury and exercise history). Probability was set at p≤ 0.05.

Results: Twenty-four players sustained acute musculoskeletal knee injuries (p<0.001). The mechanisms producing the acute musculoskeletal injuries, were tackling (52.1%), diving/falling (43.47%) and rapid rotational movement at high velocity (4.34%) (p<0.05). The intrinsic risk factor predisposing rugby players’ to knee injury was deviant quadriceps angles (p<0.05). Exercise history did not predispose the players’ to knee injury (p<0.05).

Conclusion: Players sustained a high prevalence of knee injuries associated with deviant quadriceps angles.

Open Access Original Research Article

Cephalometric Characteristics of Down Syndrome in Brazilian Population

Jefferson David Melo de Matos, Alerico Dias Vieira, Jéferson Martins Pereira Lucena Franco, Sérgio Eberson da Silva Maia, Natã Cavalcante Pereira, Carolina Carvalho de Oliveira Santos, Thiago Fonseca-Silva

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/28513

Objective: This study aimed to compare cephalometric characteristics between individuals with Down syndrome (DS) and non-syndromic subjects.

Methods: Teleradiography of 15 patients with Down syndrome and 15 nonsyndromic individuals matched by age and gender were analyzed. Statistical analysis was performed comparing cephalometric measurements between groups using Mann-Whitney test.

Results: The analysis of measurements showed the anterior and posterior shortening of the cranial base (SN and SBa length) in individuals with DS (p<0.05). Regarding the skeletal sagittal plane, it was noticed a reduction of SNA and SNB angles in cases with DS (p<0.05). The parameters ANB, Co-A and Co-Gn of individuals with Down syndrome were significantly reduced when compared to non-syndromic individuals (p<0.05). The 1U-NA angle presented was increased in cases with DS (p=0.001).

Conclusions: Individuals with Down syndrome have shortening of anterior and posterior cranial base, maxilar and mandibular retrognathia and protrusion and proclination of upper incisors.

Open Access Original Research Article

A Comparative Study of 2 Screening Tools for Locomotive Syndrome (The “Loco-check” and the “GLFS-25”): An Orthopedic Outpatient-based Survey

Youngji Kim, Yoshiyuki Suehara, Midori Ishii, Takayuki Kawasaki, Kiyoshi Matsuoka, Taketo Okubo, Naoko Okubo, Yu Tanabe, Keisuke Akaike, Kenta Mukaihara, Daisuke Kubota, Yuichiro Maruyama, Tsuyoshi Saito, Kazuo Kaneko

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/BJMMR/2016/28194

Background: In 2007, the Japanese Orthopaedic Association (JOA) proposed the term “locomotive syndrome” (LS) to designate a condition in high-risk groups with musculoskeletal diseases who are highly likely to require nursing care. The JOA developed two screening tools for LS: The 25-question Geriatric Locomotive Function Scale (“GLFS-25”) and the “Loco-check”. The present study represents the first comparison of these tools.                         

Methods: To compare the diagnostic abilities and characteristics of the two diagnostic tools, we investigated the associations of LS with clinical information including the general status, orthopedic diseases (degenerative diseases), past history (general diseases) and exercise activities using a questionnaire survey employing both diagnostic tools at Juntendo University Hospital (Tokyo, Japan) from April to June 2014.

Results: 664 of 1,027 patients answered both questionnaires. Three hundred nineteen (48.0%) and 251 (37.8%) were diagnosed with LS according to the “Loco-check” and “GLFS-25”, respectively. Our survey indicated that the “Loco-check” had a 10.2% higher detection rate than the “GLFS-25”. The correlation between the scores was investigated. The Spearman’s rank coefficient was r=0.454 and the area under the curve (AUC) value was 0.8181, which indicated a moderate correlation. We then investigated the associations between LS and the clinical factors of the patients. The results showed that female gender, advanced age, a high BMI, lumbar spondylosis and heart disease were significantly associated with a diagnosis of LS with both of the diagnostic tools.

Conclusions: We investigated the associations between the prevalence of LS and ortho-clinical information in an outpatient cohort based on both the “Loco-check” and the “GLFS-25”. These analyses are the first to report compared statistical associations between both tools. These analyses also provide critical information to help clinicians determine whether to use the “Loco-check” or “GLFS-25” in various situations.

Open Access Original Research Article

Panax ginseng and Ergogenic Profile: Randomized, Placebo Controlled Study

Hayder M. Al-Kuraishy, Taissir Lateef Ali

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/28168

Introduction: Ginseng is a herbal plant that is known for its therapeutic medical importance for many diseases; it acts as a tonic and provides energy with significant reduction in mental and physical fatigue.

Objectives: The aim of the present study was evaluating the ergogenic effect of Panax ginseng on normal healthy volunteers.

Subjects and Methods: Randomized selection of 35 healthy volunteers with age ranged 20-30 years, they are randomly divided into two groups for assessment of the ergogenic effects of Ginseng compared with a placebo effect. Tunturi bicycle Ergometer (for assessment of exercise tolerance) was used for evaluating the ergogenic effects before and after two weeks of treatment with Ginseng or placebo. Group A: include 10 healthy volunteers regarded as a control group that treated with 500 mg/day of starch capsule as a single dose. Group B: include 25 healthy volunteers that received Ginseng capsule 500 mg /day.

Results: Placebo produces insignificant effects following two consecutive weeks of treatment p>0.05. Ginseng showed more significant effects on the most of ergogenic parameters including pulse, time, distance and calorie consumption p <0.05, but Ginseng therapy showed insignificant effects on speed and maximal oxygen consumption (Vo2max) variables (p>0.05).

Conclusion: Ginseng leads to significant ergogenic effects on normal healthy volunteers compared to placebo.

Open Access Original Research Article

Interrelationship of Serum Uric Acid Levels and Cardiovascular Disease Risk Factors in Bangladeshi Patients Treated with Antihypertensive Drugs

Ishtiaq Mahmud, Dip Bhowmik, Shahdat Hossain, Md. Mesbah Uddin, Sharif Neaz, Arun Das, Nuruzzaman Masum, Shahjalal Hussain, Sohrab Alam

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/BJMMR/2016/27559

Aims: To explore the association between serum uric acid levels and cardiovascular disease (CVD) risk factors in hypertensive subjects treated with (WD) or without lipid-lowering and antihypertensive drugs (WOD).

Study Design: Three groups of subjects with age range 50-70 y were included in the investigation: i) Normotensive healthy control subjects; ii) hypertensive subjects who did not start ‘taking’ lipid-lowering-/antihypertensive drugs and had cardiovascular-risk factors such as high blood pressure and high blood cholesterol; and iii) hypertensive subjects, who were already on lipid-lowering-/antihypertensive drugs at least for 3-months.

Place and Duration of Study: Dept. of Biochemistry & Molecular Biology, University of Dhaka, Jahangirnagar University and Tejgaon college; Dhaka Medical College Hospital and Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, between April 2014 and May 2015.

Methods: We included 197 subjects ((40 controls, 59 hypertensive subjects without drugs (WOD) and 98 subjects with drugs (WD)). Anthropometric as well as measurements blood pressure, weight/height and laboratory tests, such as lipid profile, electrolytes, zinc, uric were done.

Results: The hypertensive subjects without drugs (WOD) had significantly (P<.05) higher levels of CVD risk factors, including blood pressure, serum Total cholesterol (TC) and uric acid (UA) [Hypertensive WOD vs. Control subjects: SBP: 169±1.30 vs. 125±2.75 and DBP: 92.3±1.50 vs. 78.5±1.50 mmHg; TC: 378±9.60 vs. 176±3.20 mg/dL; UA: 12.0±0.10 vs. 4.10±0.20 mg/dL). Antihypertensive drugs significantly (P<.05) ameliorated the blood pressure, TC, HDL-C levels, LDL-C/HDL-C and TG/HDL-C ratios. Multiple regression analysis showed serum uric acid levels were positively but independently correlated with LDL-C.

Conclusion: Elevated serum uric acid and LDL-C levels were positively correlated independently of other measured confounders such as body mass index, high blood pressure, triacyglycerol/total cholesterol, electrolytes and zinc. Our results suggest that corrective measures to control hyperuricemia might be one of the approaches to manage damaging effects of uric acid on cardiovascular diseases during hypertension. These predictors, however, need further work to validate reliability on a large number of sample sizes.

Open Access Review Article

Minimal Invasive Dentistry- A Comprehensive Review

Shefally Garg, Munish Goel, Shweta Verma, Vikas Garg, Yuvika Mittal

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/27526

Minimal intervention dentistry initiates from the traditional surgical approach to the elimination of caries lesions seen as radiolucencies in the inner half of the enamel, at the dentin-enamel junction (DEJ), and slightly into dentin, with the removal of the minimal amount of healthy tooth structure. Dental adhesives and restorative materials; changes in remineralisation, caries process and prevalence have revolutionized the caries management from G.V. Black’s "extension for prevention" to "minimally invasive." The benefit for patients from Minimal invasion lies in better oral health, minimizing the restoration cycle and reducing the patient dental anxieties. Minimal invasion includes clinical procedures such as assessment of caries risk, early detection of the disease followed by restoration of fissure caries with maximum retention.