Open Access Case Report

A Case of Chronic Aortic Dissection with Medial Calcification

Soki Kurumisawa, Shin-Ichi Ohki, Yoshio Misawa

Journal of Advances in Medicine and Medical Research, Page 1-4
DOI: 10.9734/BJMMR/2016/29636

Aims: Cystic medial necrosis is the most common pathological change of dissection. Medial calcification is mainly recognized in peripheral arteries and arterioles, but it can occur in the aorta. We, herein, report a case with chronic aortic dissection associated with medial calcification.

Presentation of Case: A 67-year-old woman presented with chest discomfort. Chest computed tomography showed a dilated ascending aorta associated with chronic aortic dissection, and medial and intimal calcification in the descending aorta. The aortic root and ascending aorta were replaced with a valved conduit. The postoperative course was uneventful. Pathological examination of the resected aorta showed cystic necrosis and calcification in the media.

Discussion and Conclusion: We cannot define that medial calcification was a secondary change after dissection in our case, but we think that the calcification of the media could lead to weakening of medial function, causing arterial or aortic distension and/or dissection.

Open Access Opinion Article

Gaps and Opportunities in Various Aspects and Treatment/Management of Distal Radius Fractures

Gladius Lewis

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/30133

Distal radius fractures (DRFs) are the most common type of fracture presented in hospitals, clinics, orthopaedic centers, and trauma practices all over the world. Thus, there is a very large body of literature on the many aspects of DRFs, particularly, nonsurgical and surgical treatment/management modalities. The present contribution has two focus areas. The first is a summary of many aspects of DRF on which there is controversy or inadequate coverage. As a consequence of this summary, the second focus is detailed expositions on opportunities for future work in nine areas. Results from some of this future work may aid selection of treatment/management modality for a specified patient-fracture pattern combination; for example, detailed cost-utility analyses of candidate modalities. Results from other future studies may translate to improved patient outcomes; for example, further studies on the photodynamic bone stabilization system for intramedullary fixation of fractures.

Open Access Original Research Article

Comparison of Imaging Quality between 2D Synthesised Mammograms Reconstructed from Digital Breast Tomosynthesis and 2D Full-field Digital Mammograms

Johannes Peters, Gudrun Peters, Debra Ardath Meerkotter, Katie Daniels, Jonathan Shulman

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/29709

Objectives: The aim of this study was to evaluate if 2D synthesised mammograms reconstructed from a digital breast tomosynthesis 3D data set are noninferior in imaging quality when compared to 2D full field digital mammograms.

Methods: A random sample of 100 mammograms was selected from a dedicated private breast imaging service in Australia. Selected cases were classified as normal, benign or malignant. Five breast radiologists retrospectively rated the overall imaging quality and lesion quality of 2D synthesised mammograms when compared with 2D full field digital mammograms. Cases with metal artefact were reassessed using metal artefact post processing software.

Results: Overall image quality for all cases before metal reduction post processing was 0.39 (CI 0.32, 0.45) and after post processing 0.40 (CI 0.33, 0.46). Overall lesion quality for all cases before metal reduction post processing was 0.46 (CI 0.28, 0.65) and after post processing 0.58 (CI 0.43, 0.72). Results confirm noninferiority of both overall image quality and overall lesion quality when comparing 2D synthesised mammograms to 2D full field digital mammograms. Metal artefact reduction had an impact on improving ratings for 2D synthesised mammograms.

Conclusions: 2D synthesised mammograms reconstructed from a digital breast tomosynthesis 3D data set are noninferior when compared to 2D full field digital mammograms. This results in reduction of radiation dose and time under compression.

Advances in Knowledge: 2D synthesised mammograms reconstructed from a digital breast tomosynthesis 3D data set can replace 2D full field digital mammograms. Metal artefact reduction software should be used routinely.

Open Access Original Research Article

Protective Role of Walnut Seeds Extract and Vitamin E against Testicular Toxicity Induced by Cyclophosphamide in Male Rats

Aml F. Elgazar

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/29765

Aim: The protective role and antioxidant effect of Walnut seeds extract (WSE) and/or vitamin E (Vit. E), and their combination against testicular damage and oxidative stress induced by anticancer drug cyclophosphamide (CP), were studied on male rats.

Study Design: Forty five rats were randomized into five equal groups, of nine rats each. Group I was assigned as a negative control and orally received saline solution. The other four groups were given CP orally (dissolved in saline solution) at a daily dose of 5 mg/kg of body weight (b. wt) for six weeks. Group II was used as a positive control and groups III, IV and V were received WSE (400 mg/kg of b. wt), Vitamin E (200 mg/kg b. wt) and their combination in daily doses for six weeks, respectively, four hours after CP administration.

Methods: Initial and final weight of rat, food intake were recorded and weight gain and feed efficiency ratio of rats were calculated and recorded. At the end of experimental, rats were anaesthetized by diethyl ether; testes and accessory sexual organs were dissected out and weighed. Semen was separated and analyzed, serum levels of testosterone, FSH and LH were determined. The right testes were used for estimating testicular antioxidant capacity. The left testes were preserved in 10% formalin solution untills processing for histopathological examination.

Results: Oral administration of WSE, vitamin E and their combination to intoxicated rats caused increases in the weights of testes, seminal vesicles, sperm motility, count and viability. Serum testosterone and levels of FSH and LH were increased. There were significant increases in the activities of testicular antioxidant enzymes, and alleviation of testicular degeneration and necrosis induced by CP. These effects were amplified by combination of WSE with vitamin E.

Conclusion: Combination of Walnut seeds extract with vitamin E exhibited antioxidant activity and protective effect against reproductive toxicity induced by CP in male rats. Therefore, intake of Walnut seeds in food with vitamin E as food supplement may be beneficial for male patients suffering from infertility problems.

Open Access Original Research Article

Obesity in Adolescents: Assessment by DXA Scan and Skinfold Thickness Equations

Wagner L. Ripka, Lucas M. Beraldo, Leandra Ulbricht, Timothy Bungun, Pedro M. Gewehr

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/30131

Aim: This study aimed to compare obesity, estimated percentage of fat in adolescents in Brazil, using Dual-Energy X-Ray Absorptiometry (DXA) with skinfold data that were entered into   mathematical models.

Study Design: This research is a cross-sectional, descriptive study.

Place and Duration of Study: Participants were randomly selected from a pool of 525 students. It was conducted employing a sample with students from elementary and high schools in Curitiba - Paraná – Brazil (December – 2013 to December 2014).

Methodology: Two hundred seventy two adolescents were evaluated (199 males and 73 females), ages 12 to 17.9 years. The percentage of body fat (%BF) has been calculated using five skinfold thickness equations: Slaughter; Boileau, Lohman and Slaughter; Durnin and Rahaman; Parizkova; Deurenberg, Weststrate and Seidell. They have been specifically applied to each gender, and compared to the reference method, DXA.

Results: The results show that despite all equations producing statistically significant correlations, none demonstrated agreement with DXA in a Bland-Altman plot.  Sensitivity analyses showed a range of 37.3 to 77.7 for males and 21.2 to 69.2% for females, The Parizkova equation presented the best results in both genders.

Conclusion: It was concluded that mathematical modeling for skinfold-thickness among Brazilian adolescents for estimate %BF must be improved.

Open Access Original Research Article

Prevalence of Hypertension Stages and the Main Risk Factors in Khartoum Locality, Sudan, 2014

Asma Abdelaal Abdalla, Siham Ahmed Balla, Mohamed Salah Ahmed Mohamed, Hind Mamoun Behairy, Naiema Abdalla Waqialla Fahal, Dina Ahmed Hassan Ibrahim, Maha Ismail Mohamed, Ibtisam Ahmed Ali

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/28539

Background Information: Cardiovascular diseases (CVDs) are number one killer in the world among non-communicable diseases (NCDs). The principal underlying risk factor for CVDs is hypertension (HTN).

Objectives: To identify the prevalence of hypertension, the stages of HTN and the related risk factors such as age, sex, smoking and body mass index (BMI) among the population in Khartoum locality, Sudan, 2014

Methods: A community based cross-sectional study was carried out in Khartoum locality during March- April 2014. A total of 948 adult individual were interviewed using structured questionnaire that was filled by medical officers, house officers and semi-final medical students. Blood pressure (BP) was measured twice with 5-6 minutes in-between. Hypertension was considered as ≥ 140 mmHg and ≥ 90 mmHg for systole and diastole BP respectively. The international classification of BMI was used for underweight, normal, overweight and obesity.

Analysis: Prevalence of HTN and the stages was measured by descriptive statistics. Multiple logistic regressions was used to test relationships of age, sex, smoking and BMI with stages of hypertension, pre-HTN, stage one HTN, stage two HTN, isolated systolic hypertension (ISHTN) and isolated diastolic hypertension (IDHTN).

Results: More than half of the population (51.3%) was in the age group 18-36 years. Males and females account to 44.7% and 55.3% respectively. Overweight and obesity was detected in 59.1% of the study population. Most of the study populations were non-smokers (88.8%). Pre-HTN, HTN (stage one and two), ISHTN and IDHTN were 7.7%, 10.7%, 9.4% and 7.9 respectively.

Smoking contributed to occurrence of pre-HTN by 5.7%. It has no contribution to other stages of HTN. Male sex is the contributing factor for occurrence of pre-HTN, stage one HTN and stage two HTN, Odd Ratios: 4.555, 8.355 and 6.588 respectively. Overweight contributes to all stages of HTN by various degrees. Age is also a contributory factor for stage one HTN, stage two HTN and ISHTN.

Conclusion: Prevalence of different stages of HTN in Khartoum locality was high. Overweight contributes to all stages of HTN. Age and male sex were not contributing to pre-HTN and ISHTN respectively.

Open Access Original Research Article

The Effect of Geothermal Water on Skin Condition and Body Fat

Lolita Rapolienė

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/BJMMR/2016/29892

Balneotherapy for therapeutic purposes has been used since ancient times, and was based on empirical experience carried forward from generation to generation. There is scientific evidence about the positive effects of the thermal water on the skin and on body weight, but studies with the mineral water from a borehole are missing.

Objective: To investigate the effect of high mineralization geothermal water on the skin and body fat.

Methods: The study included 50 women who received geothermal water baths for 15-20 min (34°C, 27,6 g/l mineralization and a pH of 7,24). The participants’ subjective and objective skin state and body fat were assessed after the procedure, as well as 1 and 4 months after the procedure. The statistical software package SPSS 20 was used for the analysis.

Results: There were reductions in the overall number of skin complaints (p=0,001), usage of skincare products (p=0,001), limb volume (p<0,05), skin ridge thickness (p<0,001), and BMI (p=0,015); whereas there was an increase in the moisture content of the skin (p=0,047) after a 15-minute balneotherapy treatment. After 1 month following the treatment, there remained a reduction in the skin ridge (p<0,05), limb volume (p<0,05), itching, networks of veins, cellulite (p=0,046), and usage of skincare products (p=0,001). After 4 months following the treatment, there remained fewer skin complaints (p=0.01), itching and cellulitis (p=0,046); and furthermore, a positive impact on the volume of the limbs was observed (p<0,05), and the skin ridge was significantly lower than before the treatment (p<0,01). After 20 minutes of balneotherapy treatment, there were fewer skin complaints (p=0,003), a decreased BMI (p<0,001) and a lower body fat percentage (p=0,017); as well as greater skin moisture (p<0,05) and skin elasticity (p=0,016).

Conclusions: High mineralization geothermal baths of a duration of 15-20 minutes will improve the skin condition and reduce the amount of fat in the body; the effect lasts up to 4 months after the treatment. As a result, geothermal water treatments should be integrated into the treatment programs for skin diseases and should take a significant place among beauty procedures.

Open Access Original Research Article

Risk Factors of Musculoskeletal Disorders in Dental Students – A Qualitative Study

Cristina Dupim Presoto, Danielle Wajngarten, Patrícia Petromilli Nordi Sasso Garcia

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/30232

Aim: To use a focus group to determine dentistry students' perceptions of risk factors involved in developing musculoskeletal disorders.

Study Design: This is a qualitative and observational study with a non-probability sample performed using a focus group.

Methodology: Ten undergraduate students from Araraquara Dental School, UNESP - Univ Estadual Paulista, Brazil participated in the study. An open discussion group was organized. In it, students were asked to respond to or discuss three questions: 1. How would you define risk factor? 2. Do you believe you are exposed to occupational risk factors while working or studying? and 3. Which work or study situations could contribute to musculoskeletal issues? To analyze the data, the discourse of the collective subject (DCS) technique was used within the Qualiquantsoft® software, in which each individual testimony was analyzed in order to obtain collective thought.

Results: Fifty percent (50%) defined risk factor as something that leads to illness or injury, and 90% recognized that they were exposed to factors such as accidents with sharp objects, posture issues, stress, repetitive movements, features of instruments and equipment, a limited operating field, and a lack of training. The work or study situations that may contribute to musculoskeletal issues and which were most frequently cited by the students included treating special needs patients, courses or procedures, stress, and working posture or position.

Conclusion: The students were able to perceive the risk factors that contribute to the development of musculoskeletal disorders during an undergraduate program. The most frequently mentioned risk factors were limited operating field, repetitive movements, manual instruments, non-ergonomic instruments, and lack of training.

Open Access Original Research Article

The WHO FRAX Calculator with and without BMD as an Indicator of Low BMD in Pakistani Women

Madeeha Sadiq, Nuzhat Hassan, Sajid Sattar, Rubina Hussain, Maaz Naqvi

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/30003

Aims: BMD (bone mineral density) testing facilities are still scarce in Pakistan. We evaluated the predictive ability of FRAX with BMD (FRAX+) and FRAX without BMD (FRAX-) in a set of Pakistani females to assess their role in BMD assessment.

Study Design: Cross Sectional.

Place and Duration of Study: Department of Nuclear Medicine, Ziauddin hospital, Clifton Campus, Karachi, Pakistan between March and August 2016.

Methods: We enrolled 200 females above 40 years of age. Average age was 60.7 years (±10.52). Gold standard Dual Energy Xray Absorptiometry (DXA) scans were obtained to assess presence of low BMD. FRAX calculations with and without addition of femoral neck BMD were done. Statistical Package for Social Sciences (SPSS) version 20 was used to plot Receiver Operating Characteristics (ROC) and Area under Curve (AUC) was utilized for evaluation of tool’s diagnostic accuracy.

Results: FRAX+ and FRAX- had comparable predictive power having AUC of 0.784 and 0.799 respectively. The Major Osteoporotic (MO) and hip fracture probabilities for FRAX+ and FRAX- showed significant correlation at the 0.001 level.

Conclusion: FRAX- may be utilized to assess BMD status in the absence of DXA facilities and to assess its need to avoid unnecessary scanning.

Open Access Review Article

It is Time for More Research into Umbilical Cord Stem Cells as a Potential Treatment in Neurological Diseases

Léder Leal Xavier, Carolina Gomes da Silveira Cauduro, Bianca Zanette de Albuquerque, Pedro Marchiori Cacilhas, Fabrizio Loth, Ana Paula Franco Lambert, Pamela Brambilla Bagatini, Karolyn Sassi Ogliari, Régis Gemerasca Mestriner

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/29685

Umbilical cord stem cells (UCSCs) from newborn individuals have been widely used to treat blood and immune disorders. In recent years, many public and private cord blood banks have preserved UCSCs in the hope of using them to cure diseases, especially neurological conditions. Preclinical studies showed UCSCs have considerable regenerative potential and early clinical investigations demonstrated they are safe and effective. Here, we discuss the characteristics and clinical application of UCSCs as a potential treatment for prevalent neurological disorders, based on published studies and ongoing trials registered in Clinicaltrials.gov. Despite the advantages of UCSCs compared to other stem cell sources, few published randomized and controlled clinical studies have investigated their therapeutic potential in neurological disorders, including cerebral palsy and spinal cord injury, with interesting results. Thus, there is an urgent need for more investigation, such as well-designed, phase II and III randomized and controlled clinical trials.