Dive, food, and exercise effects on blood microparticles in Steller sea lions (Eumetopias jubatus): exploring a biomarker for decompression sickness

Recent studies of stranded marine mammals indicate that exposure to underwater military sonar may induce pathophysiological responses consistent with decompression sickness (DCS). However, DCS has been difficult to diagnose in marine mammals. We investigated whether blood microparticles (MPs, measured as number/μl plasma), which increase in response to decompression stress in terrestrial mammals, are a suitable biomarker for DCS in marine mammals. We obtained blood samples from trained Steller sea lions (Eumetopias jubatus, 4 adult females) wearing time-depth recorders that dove to predetermined depths (either 5 or 50 meters). We hypothesized that MPs would be positively related to decompression stress (depth and duration underwater). We also tested the effect of feeding and exercise in isolation on MPs using the same blood sampling protocol. We found that feeding and exercise had no effect on blood MP levels, but that diving caused MPs to increase. However, blood MP levels did not correlate with diving depth, relative time underwater, and presumed decompression stress, possibly indicating acclimation following repeated exposure to depth.

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Corrigendum

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A computational framework for temporal sharpening of stimulus input in the olfactory system

The olfactory bulb glomerulus is a dense amalgamation of many unique and interconnected cell types. The mechanisms by which these neurons transform incoming information from the sensory periphery have been extensively studied but often with conflicting findings. A recent study by Carey et al. (J Neurophysiol 113: 3112–3129, 2015) details the computational framework for parallel modes of temporal refinement of stimulus input to the olfactory system mediated by local neurons within individual glomeruli.

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A leech model for homeostatic plasticity and motor network recovery after loss of descending inputs

Motor networks below the site of spinal cord injury (SCI) and their reconfiguration after loss of central inputs are poorly understood but remain of great interest in SCI research. Harley et al. (J Neurophysiol 113: 3610–3622, 2015) report a striking locomotor recovery paradigm in the leech Hirudo verbana with features that are functionally analogous to SCI. They propose that this well-established neurophysiological system could potentially be repurposed to provide a complementary model to investigate basic principles of homeostatic compensation relevant to SCI research.

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Model systems for studying cellular mechanisms of SCN1A-related epilepsy

Mutations in SCN1A, the gene encoding voltage-gated sodium channel Na_V1.1, cause a spectrum of epilepsy disorders that range from genetic epilepsy with febrile seizures plus to catastrophic disorders such as Dravet syndrome. To date, more than 1,250 mutations in SCN1A have been linked to epilepsy. Distinct effects of individual SCN1A mutations on neuronal function are likely to contribute to variation in disease severity and response to treatment in patients. Several model systems have been used to explore seizure genesis in SCN1A epilepsies. In this article we review what has been learned about cellular mechanisms and potential new therapies from these model systems, with a particular emphasis on the novel model system of knockin Drosophila and a look toward the future with expanded use of patient-specific induced pluripotent stem cell-derived neurons.

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Impact of Partial Weight-bearing Therapy on Walking Performance in Patients with Peripheral Arterial Disease

2016-04-01T19-45-49Z
Source: International Journal of Therapies and Rehabilitation Research
Mina Farid Henry, Samah Mahmoud Ismail.
Background: Peripheral arterial disease (PAD) is a common circulatory problem. The most common presenting symptom of PAD is intermittent claudication which leads to reduced walking capacitythus representing a disability. Objective: The purpose of this study was to find out the effect of partial body weight treadmill training on walking performanceamongpatients with intermittent claudicationdue to peripheral arterial disease (PAD-IC).Methods: The study was conducted on thirty patients, their age ranged from 45 to 55 years. They were divided randomly into two equal groups in number. The first group (study) performed a training program on the anti-gravity treadmill of moderate intensity (12-14 on the Borg scale for rating of perceived exertion) for 50minutes, 3 sessions per week for 12 weeks in addition to their medical treatment. The second group (control) received their medical treatment only. Ankle brachial pressure index (ABI), walking performance(pain free walking distance (PFWD) and maximum walking distance (MWD) were measured before and after the study for both groups. Results: statistical analysis showeda significant improvement (increase) in ABI, PFWDand MWD by6.06%, 25.32% and 12.7%, respectively in the study group compared to control group. Conclusion: It is recommended for patients with intermittent claudication to participate in partial body weight treadmill training to increase their walking performance.


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Effects of individual and group Sensory- Perceptual Motor Training on Motor Proficiency and Quality of Life in Children with Down Syndrome

2016-04-01T19-45-49Z
Source: International Journal of Therapies and Rehabilitation Research
Gehan Mosaad Abd El-Maksoud, Amira Mahmoud Abd-Elmonem, Soheir Samaan Rezk-Allah.
Background / Aim: Children with Down syndrome (DS) show sensory, motor, cognitive and perceptual impairments that may influence the development and learning of various fundamental and complex actions. Those children experience decreased motor proficiency, reduced social participation and lower life quality. The aim of the present study was to investigate the effects of individual and group sensory perceptual motor (SPM) training on motor proficiency and quality of life in children with DS. Methods: Forty eight children with DS, from both sexes, aged between 8 and 12 years, participated in this study. They were randomly assigned to three groups of equal number. Individual and group SPM training were given to first group (I) and second group (II) respectively. The third group (III) was a control group and received the home programme only. The SPM training was applied for 2 hours, 3 sessions per week for 3 months. Motor proficiency and quality of life were evaluated before and after training for all children using Bruininks - Oseretsky Test of Motor Proficiency-2nd edition and Pediatric Quality of Life Inventory respectively. Findings: This study showed a statistically significant improvement of motor proficiency and quality of life in group I (P =0.000) and group II (P=0.000), however none significant improvement was obtained in group III (P = 0.317 and 0.102 respectively). Moreover, a significant difference was observed between group I and II, but in favor to group II, in motor proficiency (P=0.025) and life quality (P=0.009). Conclusion: SPM training improved motor proficiency and quality of life in children with DS when applied as individual or group treatment.


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Additional Effect of Trunk Stabilization Exercises on Gait and Balance in Chronic Stroke Patients: An Experimental Study

2016-04-01T19-45-49Z
Source: International Journal of Therapies and Rehabilitation Research
Bansari Jitendrasinh Gadhvi, Shraddha Jasmin Diwan, Neeta Jayprakash Vyas.
Background: The trunk being the central key point of the body; proximal stability of the trunk is pre-requisite for distal limb mobility, balance, gait and functional activities which is affected because of impaired trunk muscle strength and motor control.47 Purpose: To determine whether additional Trunk Stabilization Exercises along with conventional therapy program will improve gait and balance in chronic stroke patients. Methods: n=22 subjects with chronic stroke were recruited by convenient sampling method and divided in either Experimental group (n=12) and in Control group (n=10). Trunk control, gait and balance were tested by TIS, 10 MWT, BBS, step length, stride length and cadence. Subjects received 30 minutes of additional trunk stability exercise program 3 times/week for 4 weeks. Results: Results were analysed by SPSS version with level of significance kept at 5%. There was significant improvement in TIS, BBS, 10 MWT and cadence in both the groups with significant improvement of step length and stride length on non-affected limb in comparison to non-significant difference in affected limb. Conclusion: Additional Trunk Stabilization Exercises should be considered not only to improve trunk control but also to improve gait and balance as well.


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Is it safe to fully adopt laparoscopic approach for the treatment of appendicitis? Comparison of laparoscopic and open appendectomy in a university hospital

2016-04-01T19-01-47Z
Source: Journal of Contemporary Medicine
Erdinc Yenıdogan, Zeki Ozsoy, Ismail Okan, Huseyin Ayhan Kayaoglu, Servet Tali, Mustafa Sahin.
Objective: Acute appendicitis is one of the most common surgical emergencies. Here we aimed to evaluate the patient, disease characteristics and treatment by comparing open and laparoscopic surgery for appendicitis. Material and Methods: The study was conducted in Gaziosmanpasa University Deparment of General Surgery between january 2011 and january 2012, and laparoscopic approach was exclusively adopted for the treatment of appendicitis. The patient demographics, disease characteristics, pathological findings, morbidity, mortality and length of hospital stay were retrieved from patients file. Results: 156 patients were included into the study. Of these, 73 patients had laparoscopic appendectomy, while 83 had open appendectomy. 98 patients were male and the rest was female. There was no difference between demographic features of patients who were operated by either technique. The mean interval time was 8.73 ± 12.69 and 4.44 ± 8.68 hours for laparoscopic and open surgery cases between admission and operation time with significant difference (p=0.014). Only the rebound was the statistically significantly different physical examination finding between groups (p=0.003). Drains were frequently placed in laparoscopic cases than open ones with significant difference (p=0.006). Moreover, the length of hospital stay was shorter in laparoscopy (1.83±0.83 vs. 2.66±1.69; p


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Urinary tract infections in pregnants who were addmitted University Hospital Obstetric and Gyneacology Outpatient Clinics in Tokat TURKEY: Evalıuation of three years.

2016-04-01T19-01-47Z
Source: Journal of Contemporary Medicine
Asker Zeki ÖZSOY, Mehmet Can NACAR, Bülent ÇAKMAK, Hatice YILMAZ DOĞRU, İlhan Bahri DELİBAŞ, Çiğdem KUNT İŞGÜDER, Selim GÜLÜCÜ.
Amaç: Bu çalışmada, Tokat İlinde Üniversite Hastanesi Kadın Hastalıkları ve Doğum kliniğine başvuran gebelerde idrar yolu enfeksiyonu görülme sıklığının incelenmesi ve idrar kültüründe üreme saptanan mikroorganizmaların tespit edilmesi amaçlanmıştır. Gereç ve Yöntemler: Tokat Gaziosmanpaşa Üniversitesi Kadın Hastalıkları ve Doğum kliniğine Ocak 2012- Haziran 2015 tarihleri arasındaki yaklaşık 3.5 yıllık dönemde başvuran gebelerde idrar yolu enfeksiyonu görülme sıklığı ve üreyen ajan patojenler incelenmiştir. Tam idrar tetkiki hastanemiz biyokimya laboratuarında ve idrar kültürü analizleri hastanemiz mikrobiyoloji laboratuarında değerlendirilmiştir. Elde edilen sonuçların otomasyon sistemi üzerinden retrospektif olarak ulaşılması ile verilerimiz tespit edilmiştir. Bulgular: Hastanemize Ocak 2012 ve Haziran 2015 tarihleri arasında başvuran 2245 gebe hasta çalışmaya dahil edilmiştir. Çalışmaya alınan hastaların (n=2245) yaş ortalaması 28.0±5.63 (min:16, maks:45) olup, %86.5'i (n=1942) 35 yaş altında, %13.5'i (n=303) 35 yaş ve üzerindedir. Hastaların %36.5'inde (n=819) gebelikte idrar yolu enfeksiyonu olduğu saptanmıştır. 35 yaş altındaki hastaların %37.3'ünde (n=725) idrar yolu enfeksiyonu saptanırken, 35 yaş ve üzerindeki hastalarda bu oran %31.0'dir (n=94) (p


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Endoscopic and histologic response to cyclosporine in ulcerative colitis and their impact on disease outcome: A cohort study

Cyclosporine (CsA) is an effective agent for treating patients with acute steroid-refractory ulcerative colitis (UC). The aim was to assess endoscopic and histologic responses to CsA and to determine their predictive value on UC outcome.

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Endoscopic and histologic response to cyclosporine in ulcerative colitis and their impact on disease outcome: A cohort study

Cyclosporine (CsA) is an effective agent for treating patients with acute steroid-refractory ulcerative colitis (UC). The aim was to assess endoscopic and histologic responses to CsA and to determine their predictive value on UC outcome.

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What Would You Do? Excessive ambulance speed during patient transport

Your partner is driving the ambulance too fast for conditions en route to the hospital. Dr. David Tan and Steve Whitehead discuss this scenario. Listen to what they have to say and add your ideas in the comments section about the importance of red lights and sirens transport.

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What Would You Do? Best care for a patient after multiple lift-assist calls

A patient has called for a lift assist twice in the last 24 hours, but refuses transport. Family is unable to stay with the patient and wants her to got to the hospital. Dr. Tan and Steve Whitehead discuss this commonly encountered scenario. Listen to what they have to say and share your thoughts in the comments.

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What Would You Do? Excessive ambulance speed during patient transport

Your partner is driving the ambulance too fast for conditions en route to the hospital. Dr. David Tan and Steve Whitehead discuss this scenario. Listen to what they have to say and add your ideas in the comments section about the importance of red lights and sirens transport.

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The Actual (Un)usefulness of the Bologna System in Medical Education

2016-04-01T15-14-12Z
Source: Medical Archives
Izet Masic, and Edin Begic.
Introduction: Faculty of Medicine, University of Sarajevo has officially started working on 22.11.1944, and is the oldest faculty in the medical field in Bosnia and Herzegovina. At the same time there are two systems of organization of the teaching process, the old system and the Bologna system. Aim: To analyze the implementation of the Bologna system, and making an overview of its justification. Material and methods: Answers from questionnaires from total of 459 students were analyzed (197 who had studied under the old system and 262 who studied under the Bologna system), so total of four generations of the Bologna system. They filled out a questionnaire in which they evaluated the teaching process. Students opinion about quality of medical education was measured by modified Lickert scale. Results: Students of old system are older than students of the Bologna process, whose average age is increasing from generation to generation, given the growing number of students who repeat a year. All students of old system repeated an academic year once or several times (p


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An Aggressive Retroperitoneal Fibromatosis

2016-04-01T15-14-12Z
Source: Medical Archives
Zoran Campara, Aleksandar Spasic, Predrag Aleksic, and Bosko Milev.
Introduction: Aggressive fibromatosis (AF) is a heterogeneous group of mesenchymal tumors that have locally infiltrative growth and a tendency to relapse. The clinical picture is often conditioned by the obstruction of the ureter or small intestine. Diagnosis is based on clinical, radiological and histological parameters. A case report: We report a case of male patient, aged 35 years, with the retroperitoneal fibromatosis. He reported to the physician because of frequent urination with the feeling of pressure and pain. Computed tomography revealed the tumor mass on the front wall of the bladder with diameter of 70mm with signs of infiltration of the musculature of the anterior abdominal wall. Endoscopic transurethral biopsy showed proliferative lesion binders by type of fibromatosis. The tumor was surgically removed in a classical way. The patient feels well and has no recurrence thirty-six months after the operative procedure. Conclusion: The complete tumor resection is the therapeutic choice for the primary tumor as well as for a relapse.


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Belching After Biliary Pancreatitis and Laparoscopic Cholecystectomy

2016-04-01T15-14-12Z
Source: Medical Archives
Mersiha Cerkezovic, Denijal Tulumovic, and Mirnesa Muminovic Umihanic.
Introduction: Belching is often reported symptom. It is rarely an isolated disorder and mainly occurs within various gastroduodenal diseases. Aim: The aim is to show the great breadth of clinical symptoms of postcholecystectomy syndrome which should have a multidisciplinary therapeutic approach taking into account all aspects of patients life. Case report: We report a case of excessive belching within postcholecystectomy syndrome which disturbs the general psycho-physical condition of the patient, with symptoms of depression and anxiety, and social isolation, which significantly reduces the quality of his life.


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Favorable Growth Hormone Treatment Response in a Young Boy with Achondroplasia

2016-04-01T15-14-12Z
Source: Medical Archives
Marina Krstevska-Konstantinova, A. Stamatova, and Zoran Gucev.
Background: Achondroplasia is a skeletal dysplasia, the most common cause of rhizomelic dwarfism. Case presentation: This is a ten year old boy who was first diagnosed prenatally. He had a mutation c1138G>A in the gene FGFR3 in a heterozygotic constellation. His IGF1 and IGFBP3 levels were normal. Two stimulation tests for growth hormone were performed with values within the reference range. His psychomotor development was adequate for his age except for speech difficulty. He started with recombinant hGH (r-hGH) at the age of 3.4 years in a dose of 0.06 mg/kg. His mean Height SDS (HtSDS) was -2.2. Results: The growth increased to 10 cm/year in the first year of therapy (HtSDS -1.1). It decreased during the second year to 4 cm (HtSDS -1.7) and again increased during the third year to 8 cm/year (HtSDS1.3). In the next years the growth was constant (6.5, 2.3, 3.5 cm / year). He is still growing in the 3rd percentile of the growth curve (HtSDS 1.2) under GH treatment. The body disproportion remained the same. Conclusion: The growth response on GH treatment was satisfactory in the first 4 years of treatment, and the boy still continued to grow. The young age at the start of treatment was also of importance. Our other patients with achondroplasia who started treatment older had a poor response to growth hormone.


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Effect of Therapeutic Touch in Patients with Cancer: a Literature Review

2016-04-01T15-14-12Z
Source: Medical Archives
Amir Tabatabaee, Mansoureh Zagheri Tafreshi, Maryam Rassouli, Seyed Amir Aledavood, Hamid Alavi Majd, and Seyed Kazem Farahmand.
Background: The use of complementary and alternative medicine (CAM) techniques has been growing. The National Center for Complementary and Alternative Medicine places therapeutic touch (TT) into the category of bio field energy. This literature review is aimed at critically evaluating the data from clinical trials examining the clinical efficacy of therapeutic touch as a supportive care modality in adult patients with cancer. Methods: Electronic databases (PubMed, Scopus, Scholar Google, and Science Direct) were searched from the year 1990 to 2015 to locate potentially relevant peer-reviewed articles using the key words therapeutic touch, touch therapy, neoplasm, cancer, and CAM. Additionally, relevant journals and references of all the located articles were manually searched for other potentially relevant studies. Results: The number of 334 articles was found on the basis of the key words, of which 17 articles related to the clinical trial were examined in accordance with the objectives of the study. A total of 6 articles were in the final dataset in which several examples of the positive effects of healing touch on pain, nausea, anxiety and fatigue, and life quality and also on biochemical parameters were observed. Conclusion: Based on the results of this study, an affirmation can be made regarding the use of TT, as a non-invasive intervention for improving the health status in patients with cancer. Moreover, therapeutic touch was proved to be a useful strategy for adult patients with cancer.


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Is Prevention of Glaucoma Possible in Bosnia and Herzegovina?

2016-04-01T15-14-12Z
Source: Medical Archives
Svjetlana Terzic, Vahid Jusufovic, Amra Nadarevic Vodencarevic, Mensura Asceric, Adisa Pilavdzic, Meliha Halilbasic, and Amar Terzic.
Introduction: Glaucoma is the second leading cause of blindness in the world and represents a significant social and health problem. Early detection of glaucoma enables early initiation of treatment and may delay disease progression. The aim of this work is to determine whether it is possible to detect glaucoma in early stages. Methods: A public awareness campaign was carried out in University Clinic Center (UCC) in Tuzla, Bosnia and Herzegovina (B&H) during 2012, 2013, 2014 and 2015 Glaucoma Week, with one-day, free of charge screening of individuals. This screening program was composed of getting brief medical history, slit-lamp examination including intraocular pressure and anterior chamber dept evaluation and non-mydriatic fundus exam with evaluation of the cup/disk ration. Results: A total of 682 individuals were screened, 277 were male and 405 were female. The youngest individual was 8 years old and the oldest individual was 84 years old. The mean age was 57.6 years. Intraocular pressure higher then 21,9 mmHg was found in 83 patients. Conclusion: Glaucoma is a disease that affects visual acuity and gradually leads to blindness. It occurs in all age groups in both sexes and in all races. Early detection of disease and proper treatment can prevent permanent loss of vision. Detection and early treatment of glaucoma must become one of the leading public health programs in B&H.


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Patients’ Expectations and Perceptions of Service Quality in the Selected Hospitals

2016-04-01T15-14-12Z
Source: Medical Archives
Aliasghar Nadi, Jalil Shojaee, Ghassem Abedi, Hasan Siamian, Ehsan Abedini, and Farideh Rostami.
Background: Hospitals success depends on patients expectations, perceptions, and judgment on the quality of services provided by hospitals. This study was conducted to assess the patients perceptions and expectations from the quality of inpatient health care in Vali-Asr hospital, Ghaemshahr, and Imam Khomeini and Shafa Hospitals, Sari. Materials and Methods: This study is applied regarding the objective of the study. Considering the research methodology, it is a descriptive analytical study. The sample of this study consists of 600 patients with at least 24 hours of being hospitalized in internal, surgery, women, and children sectors of Vali-Asr, Ghaemshahr, Imam Khomeini, and Shafa Hospitals. Using random sampling method, the classifications relevant to the size of each class were selected. The data required was collected through the standard SERVQUAL questionnaire and then it was analyzed using the SPSS software. Results: The overall mean value and standard deviation of expectations were equal to 10.4 and 28, respectively. The mean value for the field of perception was 69.2 and the relevant standard deviation was 26. In terms of patients and hospital visits in concrete cases, the highest priority is related to empathy. The second priority is related to physical appearance, the third priority is related to responsiveness, the fourth priority is related to assurance, and the lowest priority is related to the reliability of the SERVQUAL approach. Examining the gap between patients perceptions and expectations, the widest gap was observed in the Vali-Asr Hospital with the mean and SD (-92.0±39.0) and the lowest gap was observed in Shafa Hospital with the mean value of (-39.9±44.0). According to The KruskalWallis test, the difference observed in these three hospitals were significant. Conclusion: The results showed that patients expectations had not been met in any of the examined dimensions and their consent has not been achieved. It seemed that necessary for managers and relevant authorities to plan and pay special attention to this important issue.


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The Effects of Continued Rehabilitation After Primary Knee Replacement

2016-04-01T15-14-12Z
Source: Medical Archives
Tatjana Nozica Radulovic, Milica Lazovic, Slavica Jandric, Tatjana Bucma, Dragana Dragicevic Cvjetkovic, and Slavko Manojlovic.
Introduction: Tasks of rehabilitation after arthroplasty are to provide painless joint movements, to improve the range of motion, to establish a scheme of walking, to achieve independence in activities of daily living. The aim of the study is to determine the effects of continued rehabilitation on the range of the knee motion and reducing the swelling after total knee replacement. Methods: The study was conducted from 2011 to 2013 and included 140 patients of both sexes, aged 45 to 85 with implanted endoprosthesis based on primary osteoarthritis. They were divided into two groups, experimental, which after early rehabilitation continued ongoing rehabilitation for a period of three weeks, while the control group after completion of early rehabilitation began rehabilitation two months from the surgery for a period of three weeks. The range of motion in the knee joint and the extent of the knee joint in the medium of patella were measured in both groups during the admission and discharge from rehabilitation. In the experimental group, control measurements were carried out three months after surgery. Results: In both groups, there was a significant reduction of the swelling at the discharge in relation to the admission while in the experimental group there was no change on the control of the joint swelling after three months in relation to the release from rehabilitation. In the experimental group, the range of motion of flexion and extension was improved at the discharge in relation to the admission as well as the flexion during the control while the range of motion of extension wasnt significantly changing during the control examination. In the control group, the extension and flexion were significantly improved at the discharge compared to the admission. Comparing both groups, the results showed that there was a significant improvement in flexion movements in the experimental group during rehabilitation in comparison to the control group, while the range of motion of the extension was not significantly different in these two groups. Comparing the range of motion of the experimental group on the control examination and the control group at discharge, it is demonstrated significant improvement in flexion and extension in the experimental group. Conclusion: Results of monitoring the reduction of the swelling and the return of the range of motion confirm the advantage of continuous rehabilitation.


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The Effect of Combination Antiviral Therapy in the Treatment of Hepatitis C on the Occurrence of Depressive Disorder in Patients Treated for Hepatitis C in the Republic of Srpska

2016-04-01T15-14-12Z
Source: Medical Archives
Visnja Banjac, Nera Zivlak-Radulovic, and Mirjana Miskovic.
Background. The current standard treatment of chronic hepatitis C in Bosnia and Herzegovina consists of pegylated interferon alpha in combination with ribavirin. Interferon therapy has many psychiatric side effects, with depressive symptomatology being most prominent. The aim of the study was to establish the frequency and severity of depression in patients with chronic hepatitis C during two months of the aforementioned therapy. Subjects and Methods. The overall sample consisted of 46 subjects, divided into three subgroups, aged 18 to 65. The study population consisted of subjects treated for chronic hepatitis C (n = 15), subjects infected but not treated for chronic hepatitis C (n = 15), and healthy controls (n = 16). The assessment and level of depression were based on the Structural clinical interview (SCID), Montgomery-Asberg Depression Rating Scale and Zung Self-Rating Depression Scale. The assessments were conducted before interferon therapy (on the day 0), after 4 and 8 weeks of therapy. Results. Regarding its frequency, MADRS scoring showed that the number of depressed subjects receiving therapy increased after 8 weeks (46.7%). There was statistical significance between the subgroups after 4 and 8 weeks. Likewise, the ZUNG scale showed that the number of depressed subjects receiving therapy increased after 8 weeks (73.3%). There was statistical significance between the subgroups on the day 0, after 4 and 8 weeks. Conclusions. Depression was significantly more frequent in chronic hepatitis C subjects treated with interferon alpha in combination with ribavirin than in subjects in the group without therapy. Mild depression was most prevalent.


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Foveal Thickness Alterations in Patients with Migraine

2016-04-01T15-14-12Z
Source: Medical Archives
Cem Cankaya, and Mehmet Tecelloglu.
Aim: To investigate the alterations in foveal retinal thickness (FT) values in patients with migraine and to reveal the correlations between FT and clinical characteristics of migraine disease. Methods: This study included sixty-eight eyes of 34 migraine patients [twenty-eight eyes of 14 patients with aura( group 1), and forty eyes of 20 patients without aura (group 2)] and forty eyes of 20 healthy volunteer who served as the control group (group 3). FT values were measured by optical coherence tomography (OCT) in each group. Results: Mean age of patients in group 1, 2, and 3 was 34.0±6.82, 35.2±10.12, and 35.1±6.85 years, respectively (p=0.84). Mean FT was 211.07±7.36, 220.0±12.01, and 221.85±12.27 in groups 1, 2, and 3, respectively. There was statistically significance among the group 1-2 and 1-3 (p=0.002 and p

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Categorization of Ischemic Stroke Patients Compared with National Institutes of Health Stroke Scale

2016-04-01T15-14-12Z
Source: Medical Archives
Mario Marendic, Ana Repic Bulicic, Tonka Borovina, Nikolina Ivica Mise, Rinaldo Romac, Enra Suljic, Marina Titlic, and Marina Milosevic.
Introduction: Scientific guidelines recommend the National Institutes of Health Stroke Scale (NIHSS) for ischemic stroke (IS) assessment. In Clinical Department of Neurology of Split University Hospital Center nurses use the categorization of patients (COP) according to individual needs for health care. Aim: The aim of this study was to demonstrate that there is a positive correlation between the COP and the NIHSS in IS patients. Methods: We analyzed NIHSS scores and COP findings in 325 participants (median age 77 years, min-max: 37-95 years) with acute ISs. Results: There is a statistically significant correlation between the NIHSS score at admission and COP at admission (ρ=0.717; P


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Restless Legs Syndrome in Patients with Hypertension and Diabetes Mellitus

2016-04-01T15-14-12Z
Source: Medical Archives
Adela Sabic, Osman Sinanovic, Dzevad Sabic, Gordan Galic.
Aim: The aim of this study was to analyze frequency of restless legs syndrome (RLS) in patients with hypertension and diabetes mellitus. Patients and Methods: It was analyzed 120 subjects (from Health Center Živinice/Family Medicine Department) through a survey conducted in the period from March to June 2015, of which 30 (8 men/22 women). Subjects were 30 patients with longtime hypertension (HT)(18 men/12 women), 30 patients with diabetes mellitus (DM) type I or II (9 men/21 women), 30 patients with long standing DM type I or II and HT (12 men /18 women), and 30 control subjects (12 men/18 women). RLS were evaluated by questionnaire - International RLS Study Group Criteria. The average age of patients in the group with HT was 58.70 ± 9.07, in the group with DM 48.43 ± 15.37, and in the group of patients with HT and DM 63.90 ± 7.49 years. In the control group mean age was 52.76 ± 14.83 years. Statistical data were analyzed in Excel and SSPS statistical program. Results: RLS was identified in 10 (30%) of those with HT; 7 (21%) in patients with DM, and 10 (30%) in patients with HT+DM. In the control group RLS was verified in 4 (12%) patients. Comparing the results, it was observed significant difference between the HT and the control group (p=0.0012) and HT+ DM and control group (p=0.0012). The frequency of RLS between DM and the control group was not significantly significant (p=0.107). Conclusion: RLS is frequent in patients with hypertension (30%), hypertension+ diabetes mellitus (30%), and patients with DM (21%).


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Anxiety Levels in Patients Undergoing Sedation for Elective Upper Gastrointestinal Endoscopy and Colonoscopy

2016-04-01T15-14-12Z
Source: Medical Archives
Mehmet Sargin, Mehmet Selcuk Uluer, Eyüp Aydogan, Bülent Hanedan, Muhammed İsmail Tepe, Mehmet Ali Eryılmaz, Emre Ebem, and Sadık Özmen.
Background: Anxiety is a common preprocedural problem and during processing especially in interventional medical processes. Aim: Aim of this study was to assess the level of anxiety in patients who will undergo upper gastrointestinal endoscopy and coloscopy. Methods: Five hundred patients scheduled to undergo sedation for elective upper gastrointestinal endoscopy and colonoscopy were studied. Beck Anxiety Inventory (BAI) was administered to each patient before brought to the endoscopy room. Demographic data of patients were collected. Results: BAI scores and anxiety levels were significantly lower in; males compared to females, patients with no comorbidity compared to patients with comorbidity (both P values

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Efficiency of Local Antiseptic Alkosol (Ethanol, Isopropanol-30g and Ortophenilphenol) and Povidone Iodide on the Incidence Of Surgical Site Infection After Inguinal Hernioplasty

2016-04-01T15-14-12Z
Source: Medical Archives
Harun Djozic, Haris Pandza, Sefik Hasukic, Samir Custovic, Berina Pandza, Amina Krupalija, and Edin Beciragic.
Background: The risk of wound infection after elective inguinal hernia repair depends on several factors. One of the most important factors is the preoperative skin preparation. The use of antisepsis is performed to reduce the risk of surgical site infections (SSIs) and to remove causing organisms. This work compares two different agent forms for preoperative skin preparation to prevent SSIs. Objectives: The objective of the study is comparing the effects of two different agents used for preoperative skin preparation and prevention of SSIs. Material and methods: 100 adult patients were divided and randomized into two groups, each containing 50 patients. Both groups included patients that are scheduled for elective Lichtenstein inguinal hernia repair. The first group includes patients whose skin preparations were done with povidone iodine (PI) only. The second group included patients that are treated with two antiseptics; Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol-0.1g) and povidone iodide. Alkosol is applied before the induction of anesthesia. The povidone iodide is applied after Alkosol has evaporated. The presence of bacterial growth in the wound was determined 24 and 48 hours after operation. Swabs were used to take samples, which were then cultivated to check for bacterial growth. The presence of infection was also determined by the following criteria: pain or tenderness, induration, erythema, local warmth of the wound etc. Results: The surgeon or clinician declared that after 24 hours the wound was infected in 20 patients in the control group and in 22 patients after 48 hours. In the Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol-0.1g) and povidone iodide group infection was declared in only 3 patients after 24 hours. Discussion: Compared to the use of providone only, the use of Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol-0.1g) and povidone iodide has many advantages and was associated with lower rates of SSIs following clean surgery. A larger trial is warranted in order to add definitive and more conclusive data to the current evidence base.


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Association of Parental Age and the Type of Down Syndrome on the Territory of Bosnia and Herzegovina

2016-04-01T15-14-12Z
Source: Medical Archives
Mia Sotonica, Mirela Mackic-Djurovic, Sabaheta Hasic, Emina Kiseljakovic, Radivoj Jadric, and Slavka Ibrulj.
Background: Advanced paternal and/or maternal age is a classic risk factor for Down syndrome. The aim of the study was to investigate the frequency of Down syndrome types in children and its association with maternal and paternal age in Bosnia and Herzegovina. Subjects and Methods: The cross sectional, observational study included 127 children, 49 girls and 78 boys, aged 1-180 months suspected to have Down syndrome, admitted to the Centre for Genetics, Faculty of Medicine University of Sarajevo, for cytogenetic analysis and differential diagnosis of Down syndrome during the period from January 2010 to May 2015. Standard method of 72 hours cultivation of peripheral blood lymphocytes has been applied. The accepted level of statistical significance was p


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Relationship Between Chronic Inflammation and the Stage and Histopathological Size of Colorectal Carcinoma

2016-04-01T15-14-12Z
Source: Medical Archives
Ismar Rasic, Svjetlana Radovic, and Goran and Aksamija.
Objectives: The association of inflammatory reactions with almost all types of cancer supports the concept that inflammation is a critical component of tumor progression. The present study aimed to evaluate the relationship of serum markers of chronic inflammation with the stage of and histopathological size of colorectal carcinoma (CRC). Methods: This cross-sectional study included 90 patients of both sexes, mean age 66.2 (range 47-78) years, with clinically and histologically confirmed CRC, who were admitted to the Clinic for abdominal surgery UCCS for surgical treatment of CRC. The patients according to the stage of disease were divided into three groups (stage IIIV). The control group consisted of 30 subjects with no signs of malignancy and acute inflammatory diseases. Staging of CRC was done according to the TNM classification. In each patient, the preoperative blood samples were taken for determination of the parameters of inflammation: the erythrocyte sedimentation rate, white blood cells, C-reactive protein (CRP), fibrinogen and alpha 2 globulins. Results: It was confirmed that increasing markers of inflammation followed increasing stages of colorectal cancer, depth of tumor invasion and the occurrence of metastatic disease. CRP is a biomarker that consistently and significantly increases from the second to the fourth stage of colorectal cancer (7.2 (2.3-14.6) mg/L vs. 21.85 (12.3-41) mg/L vs. 38.6 (21.5-79) mg/L; p


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The Impact of Low-Dose Disease-modifying Anti-rheumatics Drugs (DMARDs) on Bone Mineral Density of Premenopausal Women in Early Rheumatoid Arthritis

2016-04-01T15-14-12Z
Source: Medical Archives
Sylejman Rexhepi, Mjellma Rexhepi, Vjollca Sahatçiu-Meka, Vigan Mahmutaj, and Shkumbin Boshnjaku.
Introduction. Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by symmetrical polyarthritis and multisystemic involvement. Objective. The aim of this study was to assess the impact of low dose of methotrexate on bone mineral density (BMD) in patients with early rheumatoid arthritis (RA). Materials and methods. This paper follows a retrospective study, which involves 60 female patients with early onset RA diagnosed according to the American Rheumatism Association Criteria (ACR/EULAR 2010). The patients were divided into two groups: group I was composed of thirty patients treated with dose of 7.5 mg/weekly methotrexate (MTX), while group II included thirty patients treated with dose of 2 g/daily sulfasalazine (SSZ). The Disease Activity was measured by a combination of Erythrocyte Sedimentation Rate (ESR) and Disease Activity Score (DAS-28). Bone mineral density of the lumbar spine (L24), and femoral neck, was measured by dual energy X-ray absorptiometry (DEXA) (Stratos 800). Laboratory findings included: serum calcium, phosphorus and alkaline phosphatase. Results. In this study, we found no negative effect on BMD in RA patients treated with low dose MTX in comparison to patients treated with SSZ. There was not observed significant difference in BMD of the lumbar spine, femur neck or trochanter, of MTX and SSZ patients in the pretreatment phase, nor after 12 months of treatment. No significant change in the biochemical parameters of the both groups. Conclusion. Based on the results of our study, low dose of methotrexate has no negative effect on BMD in premenopausal RA patients. We believe that these results might provide new insights and that further longitudinal studies with larger groups of premenopausal RA patients are required.


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Time of Occurrence and Duration of Atrial Fibrillation Following Coronary Artery Bypass Grafting

2016-04-01T15-14-12Z
Source: Medical Archives
Sevleta Avdic, Enes Osmanovic, Nedzad Kadric, Emir Mujanovic, Merima Ibisevic, and Azra Avdici.
Introduction: Dilatation of the left atrium and left ventricular diastolic dysfunction (DDLV ) according to recent studies has significance in the occurrence of postoperative atrial fibrillation (AF), stroke and death. Authors of some studies found no relationship between these parameters and atrial fibrillation. Objective: this study is to determine the time of occurrence and duration of atrial fibrillation in patients after surgical revascularization (CABG) due to the presence of left ventricular diastolic dysfunction and left atrium dilatation and identify the most significant predictors of incident AF. Methods: Prospective study included 116 patients undergoing surgical myocardial revascularization followed from admission to discharge. The study was conducted at the Special Hospital Heart Center BH Tuzla for a period of one year (March 2011/2012 g.). For all patients was performed preoperative ultrasound examination, especially parameters of diastolic function of the left ventricle and left atrium volume index (LAVi), as the best parameter sized left atrium, and the postoperative occurrence of certain AF and day occurrence, duration in hours, the number of attacks. To assess whether an event occurred or not was used logistic regression, and the effect of time on the event of interest is analyzed by Cox s regression hazard parallel. Results: 75.9 % of patients had DDLV, and 91.4 % were hypertensives, 12.9 % from the previous stroke (ICV) and 42.2 % diabetics (DM), 14 % with COPD. The average age of patients was 61.41 ± 4.69 years. In both groups was 32.8 % women and 67.2 % men. LAVi preoperative values were significantly higher as DDLV greater degree. In patients with DDLV and higher values LAVi risk of AF is higher, the greater the length of AF and significantly higher number of attacks FA. Early occurrence of atrial fibrillation and its longer duration in function with increasing LAVi a marked increase in the value LAVi have the greatest hazard for the early appearance of atrial fibrillation. As a result of analysis of the most significant predictors of AF are: DDLV and LAVi. Conclusion: Postoperative atrial fibrillation occurs earlier and lasts longer in patients with DDLV and elevated left atrial volume index especially LAV > 36ml/m2. LAVi has the best explanation of the function of hazard occurrence of atrial fibrillation after CABG.


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Effect of Antiviral Therapy on Serum Activity of Angiotensin Converting Enzyme in Patients with Chronic Hepatitis C

2016-04-01T15-14-12Z
Source: Medical Archives
Azra Husic-Selimovic, Amela Sofic, Jasminko Huskic, and Deniz Bulja.
Introduction: Renin-angiotenzin system (RAS) is frequently activated in patients with chronic liver disease. Angiotenzin - II (AT-II), produced by angiotenzin converting enzyme (ACE), has many physiological effects, including an important role in liver fibrogenesis. Combined antiviral therapy with PEG-IFN and ribavirin besides its antiviral effect also leads to a reduction in liver parenchyma fibrosis. Aim of the study: Determining the value of ACE in serum of patients with chronic hepatitis C before and after combined antiviral therapy, as well as the value of ACE activities in sera of the control group. Materials and methods: We studied 50 patients treated at Gastroenterohepatology Department, in the time-period of four years. Value of ACE in serum was determined by Olympus AU 400 device, with application of kit Infinity TN ACE Liquid Stable Reagent. HCV RNA levels in sera were measured by real time PCR. HCV RNA test was performed with modular analysis of AMPLICOR and COBAS AMPLICOR HCV MONITOR test v2.0, which has proved infection and was used for quantification of the viruses and monitoring of the patients response to therapy. Liver histology was evaluated in accordance with the level of necroinflammation activity and stage of fibrosis. Results: Serum activities of ACE in chronic hepatitis C patients is statistically higher than the values in the control group (p=0.02). Antiviral therapy in chronic hepatitis C patients statistically decreases serum activities of ACE (p= 0.02) and indirectly affects fibrogenesis of the liver parenchyma. Correlation between ACE and ALT activity after the therapy was proved (0.3934). Conclusion: Our findings suggest that the activity of ACE in serum is a good indirect parameter of the liver damage, and could be used as an indirect prognostic factor of the level of liver parenchyma damage. Serum activity of ACE can be used as a parameter for non-invasive assessment of intensity of liver damage.


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Paramedic PSA about dangers of drunk driving

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Adenosine Tips and Tricks

Adenosine is rarely given in the field, especially to pediatric patients. The reason why has to do with not only the dosing (calculations) but also the logistics of administration.

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What Would You Do? Excessive ambulance speed during patient transport

Your partner is driving the ambulance too fast for conditions en route to the hospital. Dr. David Tan and Steve Whitehead discuss this scenario. Listen to what they have to say and add your ideas in the comments section about the importance of red lights and sirens transport.

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What Would You Do? Best care for a patient after multiple lift-assist calls

A patient has called for a lift assist twice in the last 24 hours, but refuses transport. Family is unable to stay with the patient and wants her to got to the hospital. Dr. Tan and Steve Whitehead discuss this commonly encountered scenario. Listen to what they have to say and share your thoughts in the comments.

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Paramedic PSA about dangers of drunk driving

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Adenosine Tips and Tricks

Adenosine is rarely given in the field, especially to pediatric patients. The reason why has to do with not only the dosing (calculations) but also the logistics of administration.

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What Would You Do? Excessive ambulance speed during patient transport

Your partner is driving the ambulance too fast for conditions en route to the hospital. Dr. David Tan and Steve Whitehead discuss this scenario. Listen to what they have to say and add your ideas in the comments section about the importance of red lights and sirens transport.

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What Would You Do? Best care for a patient after multiple lift-assist calls

A patient has called for a lift assist twice in the last 24 hours, but refuses transport. Family is unable to stay with the patient and wants her to got to the hospital. Dr. Tan and Steve Whitehead discuss this commonly encountered scenario. Listen to what they have to say and share your thoughts in the comments.

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Paramedic PSA about dangers of drunk driving

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Paramedic PSA about dangers of drunk driving

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Adenosine Tips and Tricks

Adenosine is rarely given in the field, especially to pediatric patients. The reason why has to do with not only the dosing (calculations) but also the logistics of administration.

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Adenosine Tips and Tricks

Adenosine is rarely given in the field, especially to pediatric patients. The reason why has to do with not only the dosing (calculations) but also the logistics of administration.

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Ethnopharmacological studies on the uses of Euphorbia hirta in the treatment of dengue in selected indigenous communities in Pangasinan (Philippines)

2016-04-01T13-07-41Z
Source: Journal of Intercultural Ethnopharmacology
Gerard Quinto de Guzman, Aleth Therese Lora Dacanay, Benjel Andaya Andaya, Grecebio Jonathan Duran Alejandro.
Aim: Euphorbia hirta is the most widely used plant in the folkloric treatment of dengue in the Philippines. This study documents the anecdotal uses of E. hirta in the treatment of dengue in 3 indigenous communities in Pangasinan from April to June of 2015. Materials and Methods: The number of use reports pertaining to symptoms of dengue and other diseases were tallied from 82 informants living in Anda Island, Mt. Colisao and Mt. Balungao. The demographics of the informants as well as the corrected major use agreements (cMUAs) and fidelity levels (FLs) of each reported symptom of dengue were calculated. The major dosage forms used during treatment were also tallied. Results: Respondents, dominated by the age group 60-80 and mostly females with at least primary and secondary education, provided information on the use reports of E. hirta. High FL values and cMUA of at least 35% were obtained for cardinal symptoms of dengue-related to bleeding episodes while low cMUAs (i.e. 2-4%) were obtained for symptoms during the recovery phase. High FL values were obtained for symptoms observed during the febrile phase. The most widely used dosage forms are decoctions of the leaves and barks of E. hirta. Conclusion: This study was able to qualify the uses of E. hirta in the treatment of dengue in the 3 communities surveyed.


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Mechanism of vasorelaxation induced by Tridax procumbens extract in rat thoracic aorta

2016-04-01T13-07-41Z
Source: Journal of Intercultural Ethnopharmacology
Hussein Mofomosara Salahdeen, Gbolahan O Idowu, Shakiru A Salami, Babatunde A Murtala, AbdulRasak A Alada.
Background/Aim: Tridax procumbens (Linn) (Asteraceae) is one of the herbs widely distributed in many parts of the world. Its leaves have long been used for the treatment of hypertension in Nigeria. Previous studies have shown that aqueous leaves of Tridax procumbens extract (TPE) lowers blood pressure through endothelium dependent and -independent mechanism in the aortic rings isolated from nomotensive rats. The aim of the present study was to further investigate mechanisms of TPE induced relaxation in aortic artery by assessing its mechanistic interactions with nitric oxide (NO) synthase, cGMP and cAMP. Materials and Methods: The aortic artery isolated from healthy, young adult nomotensive Wistar albino rats (250-300g) were pre-contracted with phenylephrine (10-7M) and KCl (60mM) and were treated with various concentration of aqueous extract of TPE (0.5- 9.0mg/ml). The changes in arterial tension were recorded using Ugo Basile model 7004 coupled to Data capsule acquisition system Model 17400. The interaction between TPE with cAMP and cGMP inhibitors was also evaluated. Results: The results showed that the TPE (0.5- 9.0mg/ml) significantly (p


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Antimalarial activity of fractions of aqueous extract of Acacia nilotica root

2016-04-01T13-07-41Z
Source: Journal of Intercultural Ethnopharmacology
Lukman Adewale Alli, Abdulfatai Ayoade Adesokan, Adeola Oluwakanyinsola Salawu.
Background/Aim: The problem of resistance of malaria parasites to available antimalarial drugs makes the development of new drugs imperative, with natural plant products providing an alternative source for discovering new drugs.To evaluate the antimalarial activity of eluted fractions of Acacia nilotica root extract and determine the phytochemicals responsible for its antimalarial activity. Methods: Crude extract of A. nilotica was eluted with gradients of solvent mixture (hexane, ethyl acetate and methanol) in multiples of 100 ml and each fraction was collected separately. Fifteen fractions were collected and fractions with similar spots and Rf values on thin layer chromatographic (TLC) plates were combined to produce 4 main fractions (F-1, F-2, F-3 and F-4) which were tested separately for anti-malarial activity using the Rane test. Changes in body weight, temperature and packed cell volume (PCV) were also recorded. Results: Fraction F-1 of A. nilotica at 50 and 100 mg/kg b/w produced significant and dose-dependent reduction in parasite count in Plasmodium berghei infected mice compared to the control, and also significantly increased the survival time of the mice compared to the control group. This fraction also ameliorated the malaria-induced anaemia by improving PCV in treated mice. Conclusion: Antimalarial activity of extract of Acacia nilotica root is probably localized in the F-1 fraction of the extract which was found to be rich in alkaloids and phenolics. Further study will provide information on the chemical properties of the active metabolites in this fraction.


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A brief qualitative survey on the utilization of Yoga research resources by Yoga teachers

2016-04-01T13-07-41Z
Source: Journal of Intercultural Ethnopharmacology
Ananda Balayogi Bhavanani.
Introduction: Yoga has become popular worldwide with increasing research done on its therapeutic potential. However, it remains to be determined whether such findings actually percolate down into teaching and practice of Yoga teachers/therapists. Materials and Methods: The aim of this survey was to document awareness of Yoga research findings in the Yoga community and find out how these were utilized. It was undertaken with a select group of 34 international Yoga teachers and therapists utilizing email and social media between August and December 2015. Majority of responders had well-established reputation in Yoga and were from diverse lineages with 30 of them having more than 5 years of experience in the field. A set of eight questions were sent to them related to essentiality of Yoga research, how they updated themselves on research findings and whether such studies influenced their teaching and practice. Responses were compiled and appropriate statistics determined for quantitative aspects while feedback, comments and suggestions were noted in detail. Results and Discussion: About 89% agreed that it was essential to be up-to-date on Yoga research but only 70% updated themselves regularly with average papers read fully per year being


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Systemic acupuncture in patients with faecal incontinence

Complementary Therapies in Clinical Practice

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Survey of Hepatitis B surface Antigen (HBsAg) prevalence and its risk factors among pregnant women at Bishoftu Hospital, Oromia Regional State, Ethiopia

International Journal of Infectious Diseases

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Novel 3D magnetic resonance elastography for the noninvasive diagnosis of advanced fibrosis in NAFLD: A prospective study

The American Journal of Gastroenterology

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Inhibition of E-selectin expression on the surface of endothelial cells inhibits hepatocellular carcinoma growth by preventing tumor angiogenesis

Cancer Chemotherapy and Pharmacology

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Assessment of sit-to-stand movement in nonspecific low back pain: a comparison study for psychometric properties of field-based and laboratory-based methods.

One of the most difficult tasks associated with the management of nonspecific low back pain (LBP) is its clinical assessment. Objective functional methods have been developed for assessment. However, few studies have used daily activities such as sit-to-stand (STS). The aim was to compare the psychometric properties of two commonly used STS assessment methods. A test-retest reliability study design was used. Participants with nonspecific LBP performed the 30-s chair stand test (30CST) and the STS test in Balance Master, which measures weight transfer, rising index and centre of gravity sway velocity. The same tests were reperformed after 48-72 h. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change and coefficient of variation were calculated to compare the reliability. The correlations between the tests, the Oswestry Disability Index and pain intensity were examined for validation. The 30CST had very high intrarater reliability (ICC=0.94). The variables of STS test in Balance Master had moderate intrarater reliability (ICC=0.62-0.69). There were significant correlations between the 30CST, Oswestry Disability Index and pain intensity at activity (P

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African Americans have better outcomes for five common gastrointestinal diagnoses in hospitals with more racially diverse patients

The American Journal of Gastroenterology

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Patients with prolonged effect of succinylcholine or mivacurium had novel mutations in the butyrylcholinesterase gene.

Introduction: Mutations in the butyrylcholinesterase enzyme (BChE) can result in prolonged duration of action of the neuromuscular blocking agents, succinylcholine and mivacurium, as BChE hydrolyses these drugs. Hereditary low BChE activity can cause extensively prolonged apnoea during general anaesthesia when these drugs are used. The aim of this study was to describe novel mutations in the butyrylcholinesterase gene (BCHE) in patients who have experienced prolonged duration of action of mivacurium or succinylcholine. Methods: The Danish Cholinesterase Research Unit registers patients with prolonged duration of action to succinylcholine and mivacurium. Patients were studied if they had equivocal phenotypes on the basis of BChE activity, biochemical inhibitor reactions and with pedigree if possible. Complete nucleotide sequencing was performed to describe the genotype and pedigree was used to separate the alleles. Multiple sequence alignment of BChE was performed for comparison with other species. Results: Genotyping indicated seven novel mutations in the BCHE (I373T, G467S, W518R, L184S, V421A, M462I and R577H). Conclusion: We have found seven new variants of the BCHE, which seem to reduce the activity of BChE in patients undergoing anaesthesia involving succinylcholine or mivacurium. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Filamentation of Metabolic Enzymes in Saccharomyces cerevisiae

Publication date: Available online 1 April 2016
Source:Journal of Genetics and Genomics
Author(s): Qing-Ji Shen, Hakimi Kassim, Yong Huang, Hui Li, Jing Zhang, Guang Li, Peng-Ye Wang, Jun Yan, Fangfu Ye, Ji-Long Liu
Compartmentation via filamentation has recently emerged as a novel mechanism for metabolic regulation. In order to identify filament-forming metabolic enzymes systematically, we performed a genome-wide screening of all strains available from an open reading frame-GFP collection in Saccharomyces cerevisiae. We discovered 9 novel filament-forming proteins and also confirmed those identified previously. Out of the 4159 strains, we found 23 proteins, mostly metabolic enzymes, that are capable of forming filaments in vivo. In silico protein-protein interaction analysis suggests that these filament-forming proteins can be clustered into several groups, including translational initiation machinery, glucose and nitrogen metabolic pathways. Using glutamine-utilising enzymes as examples, we found that the culture conditions affect the occurrence and length of the metabolic filaments. Furthermore, we found that two CTP synthases (Ura7p and Ura8p) and two asparagine synthetases (Asn1p and Asn2p) form filaments both in the cytoplasm and in the nucleus. Live imaging analyses suggest that metabolic filaments undergo sub-diffusion. Taken together, our genome-wide screening identifies additional filament-forming proteins in Saccharomyces cerevisiae and suggests that filamentation of metabolic enzymes is more general than currently appreciated.



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