Open Access Case Report

Management of Ankylogossia by Frenectomy- A Case Report

Meghna Singh, Ashish Saini, Pranav Kumar Singh, Charu Tandon, Snehlata Verma, Tanu Tewari

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/BJMMR/2016/28162

Background: The tongue is an important oral structure that is responsible for speech, swallowing, positioning of the teeth, and taste. Ankyloglossia or “tongue-tie” is due to an abnormally thick and shortened lingual frenum causing difficulty in speech articulation and breast-feeding because of limited tongue movement. Management of this condition has been controversial with different specialties having opposing views regarding its clinical significance and management.

Surgical Procedure: A 17 year-old-male with ankyloglossia and a chief complaint of difficulty with underwent frenectomy under local anaesthesia using a standard surgical technique that was followed with speech therapy.

Results: One month follow up showed marked improvement in tongue movements with no signs of recurrence.

Conclusion: Early diagnosis and prompt surgical intervention generally helps the patient to avoid long-term effects of these problems. (The patient was 17 years old so there was no early diagnosis and surgical intervention as he needed speech therapy.) A better conclusion might be that early childhood treatment might avoid difficulty with speech and the need for therapy later in life.

Open Access Case Report

A Rare Presentation of Signet Ring Squamous Cells in Ectocervical Squamous Epithelium Causing Diagnostic Difficulty in Reporting Cervical Intra-Epithelial Neoplasia

K. M. Rajyaguru, Ahmad Zakuan, S. I. Shahruddin

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/29591

We present a case of cervical intraepithelial neoplasia Grade II having many areas full of signet ring squamous (SRS) cells in 6-7 parabasal layers, covered by the layers of koilocytotic changes in outermost layers, with a brief review of the literature. Such presentation is extremely rare. A cone biopsy of the cervix was sent to the laboratory after pap smear preparation and small biopsy from the aceto-white area during colposcopy examination, which revealed few malignant cells. We grossed the specimen and selected the tissue from 1-12 o’clock positions and processed for paraffin blocks. H&E stained sections showed SRS cells at the majority of 1-12 positions. These SRS cells were negative for Alcian blue, Mucicarmine, Periodic acid–Schiff (PAS) and PAS-D stain and positive for cytokeratin. This presence of SRS cells has created difficulty in diagnosing the cervical intraepithelial neoplasia (CIN) case.

Open Access Short Research Article

Identification of Candidate Biomarkers and Cancer Genes AHNAK2 and EPPK1 in Pancreatic Cancer

Alex Smith, Logan Poole, Kavita Dhanwada, Nalin C. W. Goonesekere

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/28034

Aims: The lack of specific symptoms at early tumor stages, together with a high biological aggressiveness of the tumor contribute to the high mortality rate for pancreatic cancer (PC). Improved screening for earlier diagnosis, through the detection of diagnostic and prognostic biomarkers provides the best hope of increasing the rate of curatively resectable carcinomas. The aim of this study is to provide new targets for use as biomarkers in PC.

Study Design: In a previous study, we identified novel candidate cancer genes and biomarkers that were significantly upregulated in PC, through a meta-analysis of large number of microarray datasets, using bioinformatics methods.  In this study, we analyzed the expression of these genes in a panel of pancreatic cancer cell lines by quantitative Reverse Transcription-PCR (qRT-PCR). 

Place and Duration of Study: Department of Chemistry and Biochemistry and Department of Biology, University of Northern Iowa, USA, between June 2014 and Dec 2015.

Methodology: We analyzed the expression of three genes, AHNAK2, EPPK1 and IGHG3 in a panel of seven standard PC cell lines, AsPC-1, BxPC-3, Capan-2, CFPAC-1, HPAF-II, PANC-1, and SW 1990 by Relative Quantification. qRT-PCR experiments were conducted in triplicate, and each experiment was replicated twice using different passages. 

Results: AHNAK2 was significantly upregulated in all PC cell lines tested, with P values < 0.005 except for PANC-1 (P < 0.05). EPPK1 too was significantly upregulated (P < 0.05) in six of seven PC cell lines tested. While IGHG3 was nominally upregulated in all PC cell lines, upregulation was significant (P < 0.05) in only four PC cell lines.

Conclusion: Our results confirm that AHNAK2 and EPPK1 are novel candidates for use as biomarkers in pancreatic cancer. IGHG3 does not appear to be a suitable candidate, due to its low levels of expression in both PC and control cell lines.

Open Access Original Research Article

Relationship among Eating Behavior, Effortful Control, and Personality Traits in Japanese Students: Cross-sectional Study

Katsumasa Momoi, Kumiko Ohara, Katsuyasu Kouda, Tomoki Mase, Chiemi Miyawaki, Tomoko Fujitani, Yoshimitsu Okita, Rumiko Murayama, Harunobu Nakamura

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/29729

Purpose: Effortful control is the ability to inhibit a dominant response to perform instead a subdominant response. The Big Five personality traits have been widely used to describe personality in terms of five independent factors. In this study, we investigated the relationships among eating behavior, personality, and effortful control in Japanese university students.

Methods: Participants were 576 Japanese university students (422 males and 154 females). Participants completed a questionnaire measuring effortful control, Big Five personality traits, and eating behaviors.

Results: Restrained eating was positively associated with effortful control in both males and females whereas emotional eating and external eating were negatively associated with effortful control in both genders. Extraversion was positively associated with emotional eating and external eating, whereas other indicators of the Big Five personality traits were negatively associated with emotional eating and external eating.

Conclusion: Our results indicate that eating behaviors are associated with both effortful control and the Big Five personality traits. However, the direction of the associations of effortful control and Big Five personality traits with restrained eating differed from the associations of effortful control and personality with emotional eating and external eating.

Open Access Original Research Article

The Study of Uric Acid Levels in Primary Hypertension without End Organ Damage

A. K. Badrinath, K. Suresh, Harresh .

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/BJMMR/2016/25087

Background: Hypertension is a major risk factor for cardiovascular events. Serum uric acid has been implicated as a risk factor for development of cardiovascular diseases including hypertension. Previous studies have found association between raised serum uric acid levels and primary hypertension. There was always a debate if uric acid was raised due to complications of hypertension or if uric acid was an independent risk factor for development of hypertension.

Objective: To assess the relationship between serum uric acid and hypertension independent of renal function, obesity, diabetes, stroke and alcoholism. To assess the relationship between serum uric acid and hypertension in whom the target organ damage has not yet appeared.

Methodology: This cross-sectional study was done in Sri Manakula Vinayagar Medical College and Hospital. The study period was of 22 months from November 2012 to August 2014. The total study population was 300 patients, of which 150 were cases and 150 were controls. The patients were included if they satisfied the JNC 7 criteria for hypertension. And only those hypertensives without end organ damage were included. Patients with secondary hypertension and those having other conditions associated with hyperuricemia were excluded from the study.

Results: The study showed that serum uric acid levels were raised in patients with hypertension in comparison to normotensives. The mean serum uric acid levels between patients with hypertension and controls were 4.83 ± 1.72 and 3.92 ± 1.28 mg/dl respectively with p value < .001. The mean serum uric acid levels increased with the increase in the stages of hypertension. The mean serum uric acid levels in prehypertension, stage 1 hypertension and stage 2 hypertension were 3.99± 1.13, 4.57± 1.49, 5.50 ± 1.97 mg/dl respectively.

Conclusion: These results indicate that serum uric acid is independently associated with hypertension without other comorbid conditions. Serum uric acid is elevated in hypertensives even in absence of target organ damage. Thus, in future it may be used as an early biochemical marker to predict the development of hypertension.

Open Access Original Research Article

Comparison of PMMA Bone Cement Dosage Used in Vertebroplasty and Balloon Kyphoplasty: A Meta-analysis of Data from Randomized Controlled Trials

Gladius Lewis, Fabian Fiege, Robert McKee

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/BJMMR/2016/30112

Background and Aim: Vertebroplasty (VP) and balloon kyphoplsty (BKP) are widely used to treat patients in whom the pain, arising from vertebral body fracture(s), is refractory to conservative treatment(s). Currently, poly(methyl methacrylate) (PMMA) bone cement is the cement of choice in VP and BKP. The relationship between the volume of the PMMA bone cement used (“PMMA bone cement dosage”) and cement extravasation, a common complication in both procedures, has not been established. The purpose of the present study was to conduct a meta-analysis in order to determine the statistical nature of the difference in cement dosage used in these two procedures.

Methods: Computerized and manual searches of the literature on VP and BKP were conducted to identify relevant articles in the open literature. These articles were scrutinized against a set of exclusion and inclusion criteria, such as type of study (for example, randomized controlled trial (RCT) and case series), for acceptance for use in the meta-analysis.

Results: The final dataset were taken from 6 articles. A larger cement dosage was used in VP than in BKP but the difference is not significant; for example, with a random-effects model, odds ratio = 2.883; 95%CI = 0.419, 19.845; Z = 1.076; p = 0.282.

Conclusion: The difference in cement dosage used in VP and that used in BKP is not significant.

Open Access Original Research Article

General Psychological Profile in Malaysia University Students Who Practise Archery

Suthahar Ariaratnam, Adlina Suleiman, Ambigga Devi Krishnapillai, Nurul Atiqah Amran

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/28956

Aims: To determine the psychological profile of archers among undergraduate students from public universities.

Study Design: Descriptive, cross-sectional multi-centre study.

Setting: Archers in four Malaysian public Universities.

Participants: A total of 150 archers active in this sport were recruited (male, n=72; female, n=78).

Main Outcome Measures: The validated Depression, Anxiety and Stress 21 questionnaire (DASS 21) and sociodemographic characteristics were administered.

Results: Of the total 150 patients surveyed, depression, anxiety and stress were found in 48 (32%), 90 (60%) and 6 (4%), respectively. ANOVA revealed that gender, caregiver, parents’ education level, parents’ occupation and type of dwelling were significantly associated with depression as well as number of siblings, caregiver, parents’ education level, parents’ occupation and type of dwelling were significantly associated with anxiety whilst number of siblings, caregiver, parents’ education level, parents’ occupation and type of dwelling were significantly associated with stress.

Conclusions: Depression, anxiety, stress and sociodemographic variables were essential correlates of anxiety and depression among archers. Incorporating psychological profile assessment among sporting activity like archery may improve health outcomes.

Open Access Original Research Article

Improvement in Cardiovascular Risk Markers with Glimepiride in Non Obese Subjects with Pre Diabetes: Similar to Obese Cohort Treated with Metformin

Reshma Esmail, Udaya Manohar Kabadi

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/29466

Background: We recently documented better efficacy of glimepiride in non obese subjects for delaying progression from Pre diabetes to type 2 diabetes as compared to metformin in obese subjects over duration of 5-9 years (mean, 7.2±0.2). Moreover, no deaths or adverse cardiovascular events occurred in either group and this finding may be attributed to beneficial changes in lipids and cardiovascular surrogate markers. However, the effects of interventions on lipids and cardiovascular surrogate markers were not reported.

Objective: Therefore, Cardiovascular risk factors including Lipid fractions, e.g. serum Total cholesterol (TC), Triglyceride (TG), Low density Lipoprotein cholesterol (LDLC), High Density Lipoprotein Cholesterol (HDLC) and  other markers, e.g. Homocysteine (HomC), highly sensitive C-Reactive Protein (CRP), Fibrinogen (FIBR) and Plasminogen Activator Inhibitor1 (PAI1) were assessed prior to intervention and at interval of 6 months’ in subjects with Pre diabetes; lean treated with glimepiride and obese administered metformin.

Subjects and Methods: 18 non obese subjects, 10 men and 8 women ages 27-78 years and 20 obese subjects, 10 men and 10 women with ages 32-81 years with Pre diabetes (fasting plasma glucose, 100 – 125 mg/dl and/or HbA1c, 5.7-6.4%) participated in the study. The study period was 5-9 years (mean, 7.2 ± 0.2). Non obese subjects received glimepiride and obese subjects were administered metformin. Subjects were counseled with lifestyle intervention (appropriate diet and exercise) at each visit during the study. Comparisons were conducted between lipids and CV markers at entry, at six months and at the last visit of the study for individual group as well as between groups for levels at baseline and at the end of the study period.

Results: In glimepiride group, marked improvements occurred in all parameters following treatment (Post Rx) at 6 months  and were sustained till the end of the study HbA1C (%): 6.2 ± 0.2, 5.5± 0.1*, 5.7 ± 0.1*; TC (mg/dl): 212± 15, 174 ± 13*,178 ± 14*; TG (mg/dl): 202± 32, 162± 28*, 178± 14*; LDLC: 130± 12, 105± 10*, 109± 9*; Non HDLC(mg/dl): 181 ± 24, 130 ± 14*,109± 9*; HomC (μ Mol/l): 18± 3, 11± 2*, 12 ± 2*; CRP(Units): 13 ± 3, 6 ± 2*,5 ± 2*; FIBR (mg/dl): 403 ± 41, 296 ± 32*, 289± 28*; PAI1 (ng/ml): 18 ± 4, 13 ± 3*, 12 ± 4*; Post Rx vs. Pre Rx, p<0.05 for all values]. HDLC was not significantly altered. Similar changes were also noted in obese subjects treated with metformin. No significant differences were also noted between 2 groups at the entry, 6 months or the end of study.

Conclusion: In subjects with Pre diabetes, glimepiride is as effective in improving lipid profiles and cardiovascular surrogate markers in nonobese when compared with metformin in obese subjects thus explaining similar cardiovascular outcomes in both groups.

Open Access Original Research Article

Classic Genotypes of the ACE Gene do Not Interfere in Blood Pressure Responses to Reactivity Test in Male Adolescents

José Fernando Vila Nova de Moraes, Orlando Laitano, Marcelo Magalhães Sales, Sérgio Rodrigues Moreira, Sérgio Rodrigues Moreira, Ferdinando Oliveira Carvalho, Vinicius Carolino de Souza, Otávio de Toledo Nóbrega, Carmen Silvia Grubert Campbell

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/29554

Background: The Angiotensin Converting Enzyme (ACE) is responsible for converting Angiotensin I into Angiotensin II, which has vasoconstrictive properties. Polymorphisms in the ACE gene have been associated to higher levels of Angiotensin II and, therefore, higher blood pressure values.

Aims: To verify if classic genotypes of the ACE gene could interfere in blood pressure reactivity responses to a reactivity test.

Study Design: Cross-sectional study aiming to associate genotypes of the ACE gene with blood pressure reactivity responses.

Place and Duration of Study: Male adolescents from the city of Petrolina, Pernambuco, Brazil participated in the study from February to October of the year 2013.

Methods: One hundred and sixty (160) male adolescents, aged 14 to 20 years, students from three high schools from the city of Petrolina, Pernambuco, Brazil, participated in the study. The participants underwent measurements of body mass, height, waist circumference and skinfold thickness. Body mass index and waist-to-height ratio were calculated. DNA was extracted from blood samples in order to determine the genotypes of the rs4646994 of the ACE gene. Blood pressure was measured at rest, during the application of a reactivity test (Cold Pressor Test), and 1 min after the test. One-Way ANOVA was used to verify the differences between the genotypes of the ACE gene and the anthropometric and blood pressure variables. Odds ratio was calculated in order to attest if the D allele carriers presented higher chances of having increased resting blood pressure values and of being hyper-reactive to the Cold Pressor Test.

Results: No statistically significant differences were found between genotypes when comparing anthropometric and blood pressure values at rest as well as responses to the reactivity test.

Conclusion: Classic genotypes of the ACE gene do not seem to interfere in blood pressure responses to a reactivity test in male adolescents.

Open Access Review Article

The Use of Magnification and Work Posture in Dentistry – A Literature Review

D. Wajngarten, P. P. N. S. Garcia

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/29885

Background: Loupes represent a type of magnification and their use can promote higher quality on dental treatment. Besides those advantages magnification can be beneficial for musculoskeletal health maintenance on dental professionals.

Aim: This study intends to review the literature in order to verify what has been studied regarding the influence of magnification on work posture of dentists.

Methods: 41 manuscripts were collected and only complete articles available in English, addressing magnification loupes in general Dentistry, were included (n=28).

Conclusion: Magnification contributes to the maintenance of ergonomic work posture in dentistry, once these lenses bring the operatory field closer to professional.