Open Access Data Article

Effect of Plasma-leptin on Cardiac Disorders with Type 2 Diabetes-patients

Nabil Al-Aama

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/BJMMR/2017/29482

Background: The net mechanism by which visceral fat concentration is still unclear because of its interference with autonomic dysfunction which could be simply modified by leptin through the dorosomedical hypothulumus. This work studies the potential correlations between visceral fat concentration, cardiac autonomic dysfunction having diabetic disorder (type 2) and leptin.

Methods: The present work includes 90 cases with cardiovascular risk parameters and diabetic patients and 90 (age- and gender-matched) non diabetic. Typical measurements for cardiovascular risk factors have been measured in addition to plasma visceral fat area, heart variability, leptin and soluble leptin receptor standards.

Results: Visceral fat area is highly inversely dependant on the parameters of heart rate variability (p < 0.05 and standard deviations of NN (normal RR) intervals during the 24-hour period r = - 0.239, p =0.003.Similarly, the plasma standard of leptin is also important (p < 0.05) showing reverse dependence with the parameters of heart rate variability standard deviations of NN (normal RR) intervals during the 24-hour period r = -0.238, p = 0.017. In case of non diabetic patients, there are almost zero dependence between leptin and any of heart rate variability parameters.

Conclusions: Patients having visceral obesity and type 2-diabetes are strongly affected with hyper-leptinemia which may lead to cardiac autonomic dysfunction.

Open Access Method Article

Introduction of a Novel Technique for Reduction of Temporomandibular Joint Dislocation

Mohammad Hassan Samandari, Parisa Soltani, Mohammad Moein Kafshdar Goharian, Amirhossein Moaddabi

Journal of Advances in Medicine and Medical Research, Page 1-4
DOI: 10.9734/BJMMR/2017/30583

Aims: Although the conventional method for reduction of acute mandibular dislocation has been a versatile one, it occasionally fails to relocate the condyle within the glenoid fossa.

Application of heavy forces is inevitable in some clinical scenarios which potentially can cause damage to condylar structures. Moreover, the heavy force used in conventional method may be difficult for the patient to tolerate and also it can necessitate the use of adjunctive methods such as medications. The aim of this technical note is to present a novel method for reduction of acute anterior dislocation of mandibular condyle.

Technique: Standing in front of the patient, the clinician should touch the coronoid process of the mandible along the upper vestibule intraorally, slightly rotate the mandible clockwise and apply a mild to moderate backward pressure over the coronoid process. This pressure would bring about the reduction of the condyle.

Conclusion: This maneuver has been applied by the author in 130 cases and it has been successful in all cases of anterior condylar dislocation. It is very effective and simple, comfortable for the patients, does not need any equipment or medications, and eliminates the risk of damage to jaw structures.

Open Access Short Research Article

Diagnosis of Urological Cancer by 1H NMR Based Metabonomics Urinalysis: A Pilot Study

Leslie Clifford Noronha Araújo, Flávia Cristina Morone Pinto, Tássia Brena Barroso Carneiro Costa, Ronaldo Dionísio Silva, Salvador Vilar Correia Lima, Ricardo Oliveira Silva

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2017/30340

Aims: The most prevalent urological malignancies are prostate cancer (PC), bladder cancer (BC) and renal cancer (RC). The diagnosis of each of these diseases is conducted, in most cases, invasively and each procedure may lead to complications. The method of metabonomic spectrometry by nuclear magnetic resonance of hydrogen (1H NMR) provides pathways of diagnostic information that can identify pathologies without invasive procedures. The possibility of using this method for the diagnosis of those cancers by a single sample of urine has not been described yet. 

Study Design: Prospective, observational.

Place and Duration of the Study: Department of Urology and Department Fundamental Chemistry of Universidade Federal de Pernambuco (UFPE), between July of 2015 to February of 2016.

Methodology: A sample of 3 ml of urine was collected from 25 volunteers distributed into 4 groups: A control group (07 volunteers), a PC (08 volunteers), a BC (05 volunteers), and an RC (05 volunteers). All samples underwent 1H MRI to generate spectra.  A multivariate statistics analysis for the development of metabonomic models and comparison analysis groups was performed.

Results: These models showed a slight separation between the control group and each of the three groups of patients with oncological diseases. For the elaboration of the definitive models it was necessary to incorporate the volunteers of the BC and RC into one group (BC/RC). The metabonomic method when compared to control group, shown sensitivity of 90.9%, specificity of 100%, 100% PPV and NPV of 85.7% for CB/CR and sensitivity, specificity, PPV and NPV of 100% for the PC.

Conclusion: This pilot study demonstrates that the method is feasible with easy execution, showing simplicity besides being not invasive and allowing the diagnosis of oncological diseases with a single urine collection.

Open Access Short Research Article

Changes in Central Corneal Thickness and Endothelial Cell Count after Lasik

Syed Heena Kubravi, Syed Tariq Qureshi, Shah Nawaz, Arshi Nazir, Khalid Kawoosa

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2017/29973

Purpose: To compare the pre and postoperative endothelial cell counts and central corneal thickness in patients undergoing laser in situ keratomileusis (LASIK) for the treatment of myopia.

Study Design: Prospective study.

Place and Duration: This hospital based study was carried out at the LASIK Centre in the Postgraduate Department of Ophthalmology, Government Medical College, Srinagar for a period of one and a half year (from April 2014 to October 2015).

Materials and Methods: A series of 53 patients (100 eyes) with myopia between -1 and -8.25D and upto -2.75D of myopic astigmatism were included in the study. These patients underwent LASIK using Carl Zeiss Meditec AG’s MEL 80 (Germany) laser. Central corneal thickness and endothelial cell counts were measured before and 1 day, 1 week, 1 month and 3 months after LASIK using non contact specular microscopy. Age and refractive error were also recorded.

Results: The mean age of the patients was 26.9±4.71 years (range 19 to 36 years). The study included 30(56.6%) males and 23(43.4%) females. A total of 100 eyes were operated.47 patients underwent LASIK in both eyes while only one eye was operated in 6 patients. At the end of 3 months, the mean spherical equivalent of refraction was -0.24±0.369 compared to a preoperative mean of -4.81±2.053. The preoperative central corneal thickness ranged from 442 to 590 microns with a mean of 515.7 microns ± 36.4 and endothelial cell count ranged from 2365 to 3578 cells per mmwith a mean of 2874.6 cells per mm2 ± 225.14. At 1 day, 1 week, 1 month and 3 months after LASIK, mean CCT was recorded as 414.5±48.5, 406.7±47.9, 411.3±48.1 and 418.3±48 respectively. No significant correlation was found between age, refractive error and mean CCT. The mean endothelial cell count was recorded as 2867.1±218.14, 2865.6±212.64, 2864.8±207.64 and 2861.3±201.48 at 1 day, 1 week, 1 month and 3 months after LASIK.

Conclusion: There was a significant decrease in central corneal thickness in the immediate postoperative period. It continued to decline till 1 week after the surgery and then increased over time in the late postoperative period. However no significant change was observed in endothelial cell counts in the postoperative period.

Open Access Original Research Article

A Strong Relationship of Physical Activity and Obesity in Adults between 60 and 70 Years from Celaya, Mexico: A Cross Sectional Study

Nicolas Padilla-Raygoza, Lucibel Vasquez-Perez, Georgina Olvera- Villanueva, Silvia del Carmen Delgado-Sandoval, Norma Elvira Moreno-Pérez, María Guadalupe Navarro-Elias

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2017/27512

Purpose: To determine the relationship between calories intake, level of physical activity and overweight/obesity in adults over 60 years in Celaya, Mexico.

Study Design:  It was a cross-sectional study.

Place and Duration of Study: Population: 754 adults between 60 and 70 years old from Day Care Centers for the elderly from Celaya, Guanajuato, México between August 2014 and July 2015.

Methodology: We included a sample of 100 of adults, both genders, who signed the consent form; the calories intake was measure with SNUT survey, physical activity with International Physical Activity Questionnaire and measuring of overweight/obesity with Body Mass Index. Statistical analysis was with Pearson’s r, and lineal regression equation between mean daily calories intake and Body Mass Index and between physical activity (METS/min/week) and Body Mass Index. The variables were categorized and it was calculated Chi squared test, p value, Odds Ratio and it was generated in a logistic multivariable model.

Results: The sample was 100 adults between 60 and 70 years old. There was not a correlation between caloric intake and Body Mass Index in males nor females (P>0.05). There was a good negative correlation between physical activity and body mass index (r=-0.56) and a negative lineal relationship (P<0.05). There was a relationship between physical activity and overweight/obesity (X2= 47.29, df 1 P=.00001) and OR=102.60. There was not a relationship between Mean Daily Caloric Intake and overweight/obesity (X2= 0.84 dg 1 P=.36).

Conclusion: There is a strong negative correlation and lineal relationship between physical activity and Body Mass Index. There is an relationship between physical activity and overweight/obesity in the elderly from Celaya, Mexico.

Open Access Original Research Article

Haptoglobin Phenotype and Soluble Transferrin Receptor among Tuberculosis

Philemond By, H. T. Ahiboh, J. A. Sibli Koffi, F. Koné, H. Touré, M. Traoré, K. S. M. Domoua, F. H. Yapi, D. Monnet

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2017/30095

Introduction: The antioxidant property of haptoglobin (Hp), variable according to the phenotypes, is associated with the pathogenesis of various diseases. Phenotype of haptoglobin is associated with iron metabolism, which is essential for the growth of Mycobacterium tuberculosis. A potential link between Hp phenotype and blood soluble transferrin receptor (sTfR) has not yet been established. This study aimed to determine the association between Hp phenotype and blood sTfR during tuberculosis (TB).

Materials and Methods: With a case-control study involving 70 TB patients and 70 healthy subjects were performed phenotyping of Hp by electrophoresis in polyacrylamide gel and determination of blood sTfR by immunoturbidimetry.

Results: The 3 major phenotypes of Hp were found: Hp1-1, Hp2-1, Hp2-2.  Hp2-2 phenotype was less common among TB patients (17.4% vs 82.6%, p < 0.001). The average rate of TB sTfR was lower than that of healthy subjects (27.5% vs 5.7%, p = 0,014).  In this group, blood sTfR of Hp2 subjects (Hp2-1 and Hp2-2) was lower than those of Hp1 subjects (p = 0.011). However, in healthy subjects, it appeared no association between Hp phenotype and blood sTfR.

Conclusion: the percentage of Hp2-2 was lower in patients with tuberculosis. Furthermore, Hp1-1 phenotype and Hp1 genotype were the most frequent among tuberculosis. In spite of M. tuberculosisinfection, iron-dependent, no association was found between Hp and iron deficiency.

Open Access Original Research Article

Laparoscopic Gastric Plication: Appropriate Option in Times of Crisis?

Abdul Rahman Hammadieh, Mhd Firas Safadi, Osama Shaheen

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2017/30714

Objective: The aim of this study is to investigate the practice of laparoscopic gastric plication (LGP) in Syria with particular emphasis on efficacy and complications, and to explore the concept of bariatric surgery in times of crisis with its related issues and concerns.

Materials and Methods: A prospective cohort study included all patients who underwent LGP between February 2011 and September 2014. The main outcome was the percentage of excess weight loss (%EWL). Secondary outcomes included operative time, hospital stay, postoperative complications, and improvement of related comorbidities.

Results: Of the 129 patients who underwent LGP in the study period, 96 patients were included in the final analysis. The mean body mass index was 39.5 kg/m2 (32–49 kg/m2). No cases of conversion to laparotomy, leak, intraabdominal infection, or mortality were seen. Vomiting was the most common postoperative complaint, which was encountered in 91.6% of patients. Two patients required operation reversal because of protracted vomiting. Mean %EWL was 60%, 65%, 70%, 67%, 66% and 65% at 6, 12, 18, 24, 30 and 36  months respectively. Obesity-related comorbidities were present in 33 patients (34.4%), and they showed considerable improvement or complete resolution in 57-100% of cases. Weight regain was seen in 7 patients (7.3%) after 36 months, three of whom (3.1%) requested reoperation.

Conclusions: LGP is a feasible and safe operation for the treatment of morbid obesity, and it is comparable to other restrictive bariatric operations with fewer rates of serious complications. It is an appropriate technique in times of crisis due to low cost and ease of follow-up.

Open Access Original Research Article

Microbial Profile of Paediatric Ear Infections in a Tertiary Hospital in the Niger Delta Region of Nigeria

Kemebradikumo Pondei, Oliemen Peterside, Ebi Totyen

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2017/30087

Background: Ear infections are common in childhood. The diagnosis and management of these infections in children is often difficult due to absence or non-implementation of clinical guidelines in developing countries like Nigeria. Empiric treatment is very common.

Methods: In order to determine the microbial agents responsible for ear infections in the paediatric population, the records of children sent for ear infection investigations over a twenty-eight month period were analysed.

Results: Positive cultures were obtained from 60.8% of the patients. The incidence was greatest in the zero to twelve months and one year to three years age groups. There was a male preponderance of subjects with ear infections. Only 47 (23.6%) of the subjects had full ear examinations by the Otorhinolaryngologist, with 17 (8.5%) of these having perforations of the tympanic membrane. Gram negative organisms accounted for 60.5% of all isolates. Staphylococcus aureus and Pseudomonas aeruginosa were the most frequently isolated organisms, accounting for 32.5% and 30.2% of all isolates respectively. Candida albicanswas isolated from six subjects and Serratia marcescens from one patient’s specimen. Staphylococcus aureus, Pseudomonas aeruginosa and Proteus species exhibited multi-drug resistance In vitro, being resistant to three or more classes of antibiotics. Generally, most of the isolates were susceptible In vitro to the quinolones, but resistant to the cephalosporins and nitrofurans. Most of the subjects did not return for follow-up treatment, with only 3 subjects continually being seen by the ENT specialists.

Conclusion: Ear infections are common in children, but differentiating the types of ear infections is not usually done due to treatment guidelines being vague and not well developed. There is a need for collaborative multi-disciplinary approach in the management of childhood ear infections.

Open Access Original Research Article

Evaluation of Dental Caries in Preterm Born Children with Enamel Defects

Rajesh Kumar, Abi M. Thomas

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/BJMMR/2017/28094

Introduction: Predisposition of preterm born children to systemic illness and metabolic disorders leads to defects in hard tissue calcification. One such defect may manifest as hypoplasia of enamel. Imposed on this is frequent sugar exposure due to chronic medication, lowered immunocompetence that accounts for lower serum IgG, IgM and IgA antibodies further predisposes to these children to dental caries. This study is done to evaluate the dental caries in preterm born children with enamel defects.

Materials and Methods: A total of 200 children in age group of 2-8 years were taken, out of those group 1 comprised of preterm born children and group 2 comprised of children born full term. Intraoral examination was done to check for enamel hypoplasia and dental caries and was assessed using DDE (developmental defects of enamel) index for enamel hypoplasia and DMFS (Decayed missing filled) index, defs (decayed extracted filled surfaces) index for dental caries respectively.

Results: The results showed that enamel hypoplasia can be the major contributing factor to develop dental caries.

Conclusion: Early recognition and intervention to treat enamel hypoplasia in preterm children should be a prime consideration so as to prevent development of dental caries. Education of both health care professionals and parents regarding overall dental health is of utmost importance.

Open Access Review Article

A Review of the Degenerative Intervertebral Disc Disease

Tomaz Velnar, Gorazd Bunc, Uros Maver, Lidija Gradisnik

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2017/22925

Degenerative disc disorders represent an important cause of morbidity in everyday clinical practice. Numerous factors may initiate degenerative processes, which most commonly affect the nucleus pulposus and ultimately influence the biomechanics of the spine. Mechanisms of degeneration and associated factors are briefly described.