The efficacy of complex Decongestive Physiotherapy in patients with Bilateral Primary Lower Extremity Lymphedema and Untreatable multiple health conditions: A Case Report
Published on: 8th September, 2017
OCLC Number/Unique Identifier: 7286355299
Background: Primary lymphedema occurs as a result of genetic abnormalities of the lymph system. Currently, complex decongestive therapy is accepted as the standard treatment of the lymphedema. In this case presentation, we described the management of bilateral primary lower extremity lymphedema and the use of complex decongestive therapy.
Case Report: A 62 years old female patient had stage III primary lymphedema on her left lower extremity and stage II primary lymphedema on her right lower extremity. The patient, who had morbid obesity, also had untreatable sleep apnea, urinary incontinence, umbilical hernia and hypertension controlled by drugs. She had stage 4 gonarthrosis according to Kellgren – Lawrence classification in her both knees. The patient received complex decongestive therapy as an outpatient.
After 27 sessions of complex decongestive therapy, edema reduced in both lower extremities. Before the treatment started, the patient couldn’t go up and down stairs, get out and had difficulty mobility in the home. But after the treatment, the patient could go up and down 16 stairs by holding the railing, get out by two walking sticks and had less difficulty mobility in the home. However, due to gonarthrosis in her knees, her pain did not diminish.
Conclusion: Complex decongestive therapy is effective in the management of bilateral primary lower extremity lymphedema, which progressed with multiple health conditions.
Endometriosis as a risk factor for colorectal cancer
Published on: 12th August, 2020
OCLC Number/Unique Identifier: 8667860684
Endometriosis is a common benign disease in women of reproductive age, it has been associated with an increased risk of various malignancies that is defined by certain histological criteria mainly 80% in ovary and 20% in extragonadal sites such as intestine, rectovaginal septum, abdominal wall, pleura and others; the greatest risk for colorectal cancer is women with adenomyosis or endometriosis; Several genetic alterations have been found in the risk of endometriosis associated with cancer; The symptomatology, imaging and endoscopic characteristics simulate other inflammatory and malignant lesions that make the preoperative diagnosis of extragonadal endometriosis difficult. This is a review of the knowledge about endometriosis and its potential risk of malignancy, particularly with colorectal cancer
Pregnancy and childbirth in women aged 40 and over at befelatanana maternity, Madagascar
Published on: 24th December, 2019
OCLC Number/Unique Identifier: 8501548256
Objective: Pregnancy after age 40 remains a concern as it exposes to particular obstetrical complications. Our study aims to determine the risks of complications related to pregnancy and childbirth of women aged 40 and over.
Study design: We carried out a cross-sectional analytical study of a historical cohort comparing the progress and the outcome of pregnancy in women 40 years of age and over to those aged 20 and 35 who gave birth at the University Hospital of Obstetrics and Gynecology in Befelatanana, from 1st January 2010 to 31 December 2013.
Results: The prevalence of childbirth among 40 years old and over was 0.61%. They were multiparous and large multiparous in 88% of the cases. The analysis showed that parturients aged 40 years and older were at significant risk for caesarean section, with three times the risk of emergency caesarean section. The frequency of this emergency caesarean section increased with parity ((RR = 3.04 [2.15-4.30], p = 10-10). Among their neonates, 23.42% were hypotrophic, 22.86% premature, 12% asphyxiated at birth, 13.14% admitted to neonatal resuscitation and 5.71% died in utero, but without significant difference with the group unexposed. Perinatal death was 7.43% in women aged 40 and over vs. 4% in 20 to 35 year olds ((RR = 1.85 [0,89-3,86]; p 0.052).
Conclusion: We found that pregnancies after 40 years were not exposed to pregnancy-related pathologies or specific fetal complications. The use of an emergency cesarean is, however, frequent.
Physicochemical and microbiological quality of tanker waters in Bengaluru urban for safe water supply
Published on: 11th May, 2020
OCLC Number/Unique Identifier: 8601971117
This study investigated the water quality of tanker waters that was collected from Bengaluru urban areas to assess its suitability for domestic purpose. A total of 50 samples were collected in dry (March 2019) season. All samples were analyzed for various hydrochemical parameters, such as pH, total dissolved solids (TDS), electrical conductivity (EC), turbidity, dissolved oxygen (DO), total hardness (as CaCO3), calcium (CaCO2+), chloride (CaCO−) and nitrate (NO3−). Bacteriological analyses of water samples were analyzed for total coliform count. A very high level of total hardness (186 - 434.6 mg L-1) was determined in 27 water samples tested in this study indicating the necessity of water treatment before used for domestic purpose. Of the 50 samples tested, 7 showed a most probable number (MPN) index of < 23 and 9 showed < 240 and the remaining 34 were unsatisfactory with an MPN index of > 1600 per 100 ml. In some locations, the presence of high MPN index, in particular, rings the bell before using the tanker water in houses and restaurants. Exploration of the mechanisms by which water quality deteriorates during supply chain and potential implication for regulatory policy for monitoring of tanker water while distribution is the need of the hour.
Unilateral pleural effusion as the sole presentation of ovarian hyperstimulation syndrome (OHSS)
Published on: 3rd December, 2020
OCLC Number/Unique Identifier: 8875582680
A 44-year-old G4P2+1 presented to the emergency department on the 10th day following embryo transfer (with two fresh, day 5, blastocysts transferred in a hospital abroad) with the complaints of difficulty breathing, chest discomfort and cough for one day. These symptoms increased on lying on her side and were not related to exertion. She also mentioned having had abdominal discomfort over the preceding few days. On taking a past history, the patient revealed that all her prior pregnancies were the result of IVF treatment and she suffered OHSS with each. Her first pregnancy was a triplet gestation through IVF and complicated by OHSS; followed by her second pregnancy which was an IVF twin gestation also complicated by OHSS with ascites requiring paracentesis. With her third IVF treatment she conceived, had OHSS and miscarried spontaneously. However, these IVF treatments and pregnancies were all managed abroad and no medical records were available.
The clinicopathological correlates of Cystoisosporiasis in immunocompetent, immunocompromised and HIV-infected/AIDS patients, but neglected in SARS-COV-2/COVID-19 patients?
Published on: 20th January, 2021
OCLC Number/Unique Identifier: 8897954051
Cystoisosporiasis (formerly isosporiasis) is caused by Cystoisospora belli (erstwhile named Isospora belli) is encountered globally, particularly in tropical and subtropical regions. Cystoisosporiasis is a human intestinal disease whose etiology is the parasite Cystoisospora belli with infection frequent in immunocompromised subjects, principally HIV-infected and AIDS patients. This coccidium parasite infects the epithelial cells and lining of the villi of the small and large intestines. C. belli is the least frequent of the three intestinal coccidia, viz: Cryptosporidium, microsporidium and C. belli which perturb humans. The clinical presentation of cystoisosporiasis gives a semblance of inflammatory bowel disease and irritable bowel syndrome, as well as other gastrointestinal symptoms, nausea, vomiting and diarhoea found in COVID-19, AIDS and HIV-infected patients. Research has not presented comorbid features of COVID-19 and cystoisosporiasis. The oocytes of C. belli are visualizable microscopically on wet mounts via bright-field, differential interference contrast (DIC) and epifluorescence. Trimethoprin sulfamethoxazole constitute the normal treatment of choice. C. belli,HIV-infected/AIDS and COVID-19 patients have clinicopathological correlates necessary to elucidate comorbidities and mechanisms of the diseases.
Chemical constituents and biological activities of Artocarpus heterophyllus lam (Jackfruit): A review
Published on: 20th January, 2021
OCLC Number/Unique Identifier: 8987258409
Artocarpus (Moraceae) is a deciduous tree with appreciable importance as a source of edible fruit and is widely used in folk medicines. The extracts and metabolites of Artocarpus heterophyllus particularly those from leaves, bark, stem and fruit possess several useful bioactive compounds. This review indents to compile various studies on A. heterophyllus and critically evaluates its ethnomedical and ethnopharmacological properties. Several pharmacological studies from A. heterophyllus have conclusively established their mode of action in anti-inflammatory, antimicrobial, antioxidant and anticancer activities. Based on the available data, it is concluded that Artocarpus as a promising source of useful products and opens up new avenues for novel therapeutics.
Explicating the presentations of Acanthamoeba keratitis with special concern in the COVID-19 pandemic ambient
Published on: 18th March, 2021
OCLC Number/Unique Identifier: 8987259294
This article presents an overview of information regarding Acanthamoeba keratitis per epidemiology, host-pathogen interactions, clinical manifestations, risk factors, environmental implications, diagnosis, treatment and management as well as COVID-19 characteristics which may be taken into cognizance for suspected infected patients, researchers and ophthalmologic practitioners. Acanthamoeba spp. is pathogenetically ubiquitous in nature. Acanthamoeba keratitis is considerably an ocular-threatening and debilitating keratitis that exhibits contumacious characteristics which hinder or impede treatment or management. At inception, Acanthamoeba generally depicts atypical clinical features which are frequently misdiagnosed as other microbial keratitis. Fundamentally, it constitutes a rare corneal infection of which the aetiologic agent is the protozoon Acanthamoeba spp. in contact lens wearers, presenting features of severe ophthalmic distress, blurred vision, blepharospasm, ocular excoriation, extraneous entity sensation and photophobia culminating in aberrant visual functionality. These are perspicuously due to retarded prompt and adequate treatment and management. Personal and environmental hygiene, especially on the hands, face and ocular areas as advised for the COVID-19 protocol could prevent contamination and dissemination of Acanthamoeba keratitis infection. The differentiating relatedness of Acanthamoeba keratitis, COVID-19 ophthalmologic infections and other ocular problems may not have been clearly elucidated.
Psychoanalysis of the doctrine of acute pneumonia
Published on: 29th April, 2021
OCLC Number/Unique Identifier: 9028067876
It is difficult to predict how the founder of psychoanalysis, Sigmund Freud, would react to an attempt to link his theory and the method of treating mental disorders based on it [1], with such a purely physical disease as acute pneumonia (AP). It is unlikely that such an innovation could cause full approval and support. However, in this context, we are not talking about psychoanalysis as a therapeutic method for AP. In this case, only the diagnostic features of this technique are of interest
Cystic Micronodular Thymoma. Report of a Case
Published on: 20th January, 2017
OCLC Number/Unique Identifier: 7286426157
Micronodular thymoma is a rare subtype of thymoma with less than 20 cases published in the English literature. These tumours have been reported with thymoma or thymic cyst. The authors describe a new case of micronodular thymoma in a 68-year-old-patient which is well documented and particular by its cystic degeneration which hasn’t been described yet. Micronodular thymoma is a rare variant of thymoma with a challenging diagnosis. Clinicians must be aware of this entity in order not to confuse it with a thymic cyst.
Recurrent Peripheral Ameloblastoma of the Mandible: A Case Report
Published on: 30th January, 2017
OCLC Number/Unique Identifier: 7286357027
Ameloblastoma is the second most common odontogenic tumor being back only for the odontoma. An unusual case of recurrent peripheral ameloblastoma in the mandible from the site of previous occurrence, reducing oropharyngeal space due compression by lesion. Panoramic radiography not showed presence of lesion, except one step in left side of mandible angle. Multislice CT scans revealed presence of hypoattenuated image, well-defined, histopathological exam suggesting Ameloblastoma Follicular.
Aortic dissection complicating carotid dissection and myocardial infarction
Published on: 18th March, 2021
OCLC Number/Unique Identifier: 8982641722
A 58-year-old hypertensive man presented to our insti-tution with acute chest pain and dizziness. Electrocardiogram revealed inferior wall myocardial infarction with suspected right ventricular involvement (Figure 1A). Computed tomographic aortography (CTA) depicted ascending aortic dissection (AAD) with involvement of bilateral carotid, subclavian, and right common iliac arteries (Figure 1B). Replacements of aortic valve and ascending aorta with CABG (Ao-RSVG1-LAD and Ao-RSVG2-RCA) were conducted.
Effect of pre-treatments and drying methods on Moisture percentage of dried Tomato Slices
Published on: 14th August, 2017
OCLC Number/Unique Identifier: 7286355298
A study was undertaken the effect of pretreatments and drying methods on quality parameters of tomato slices with respect to storage using two factors as treatments i.e. 5 pre-treatment levels (P1-Peeled by hot water dip blanching, P2-Peeled by hot brine dip blanching, P3-Unpeeled by hot water blanching, P4-Unpeeled by hot brine blanching, P5-Control- No peeled and no blanched) and 2 drying methods i.e. (D1-Tray drying, D2-Sun drying) with completely randomized design of factorial concept with three repetitions at Post Graduate Laboratory of Horticulture Department, College of Agriculture, Junagadh Agricultural University, Junagadh. The quality was evaluated on the basis of physicochemical (i.e. drying time (h) and moisture content (%) at 1, 20, 40, 60 and 80th day of storage. Result of study depicts that the pretreatment P2 i.e. peeling of tomato by hot brine dip blanching followed by tray drying (D2) recorded minimum (14.50 h) drying time and the minimum changes in moisture content (4.00%-6.54%) observed in treatment P1 at 1st to 80th day of storage, respectively.
Evaluation of Clupeids and Danish fish meal based diets on the growth of African catfish, Clarias gariepinus fingerlings
Published on: 4th December, 2018
OCLC Number/Unique Identifier: 8255863994
Two experimental feeding trials were conducted concurrently to study the growth response of African catfish Clarias gariepinus fingerlings to graded levels (0, 5, 10, 15 or 20%) of clupeids in Danish fish meal (DFM) based diets. Chemical analysis of the DFM and clupeids fish meal (CFM) was carried out. Completely randomized design with triplicated groups of fingerlings were used for both trials in an indoor and out-door concrete tanks for six and twelve weeks respectively. The study aimed at achieving a cost effective fish meal from local aquatic resources (clupeids fish) highly prolific and abundant in Nigeria water bodies to replace foreign fish meal in West Africa Region. A project supported by West African Agricultural Productivity Project (WAAPP) in NIFFR, Nigeria.
The results of proximate, amino acid profile, mineral and fatty acid composition analysis of CFM indicated values which are very close to those of the DFM. The proximate analysis revealed CFM to contain 70.6% crude protein while DFM contains 72%. There were no significant difference between the treatments with respect to final weight, feed consumed, feed conversion ratio, digestibility and survival (P>0.05) although there was significant difference in specific growth rate (P<0.05) with the highest value obtained in the diets with both fish meal at ratio 1:1. There were no significant difference in haematological parameters (P>0.05). However the lymphocytes were high in all the groups which might not be particularly due to the treatments. The high proliferation of the body defence cells by the fish could be a mechanism of survival in the aqua-medium which is likely to be high in microbial load due to waste materials. Feed Cost/Kg for DFM was N260.16 while for CFM was N227.16. The results of chemical analysis and feeding trials indicated positive replacement of the DFM with CFM in fish feeds without negative effect on growth performance
Environmental Risk factors associated with Breast Cancer in Gaza Strip
Published on: 14th January, 2019
OCLC Number/Unique Identifier: 7991636172
The study aimed to identify possible environmental risk factors for breast cancer among women in Gaza Strip and conducted in 2010. A case- control study design was used with face to face interviews by structured questionnaire with breast cancer patient women as well as healthy women. Statistical Package of Social Science (SPSS) was used to analyze the collected data. The study population was 288 women, 144 were women with breast cancer (cases) and 144 were healthy women (controls) with response rate 100% for cases as well as controls. The study was carried out in the two main hospitals in Gaza Strip (El-Shifa and European Gaza) and on cases who had a regular follow up in each hospital, while controls have been chosen from women who had no history of breast cancer by mammogram or by self-examination. In this study the main statistically significant risk factors were; marital status, educational status, physical trauma on breast, medication for infertility treatment, eating red meat 500g or more weekly, eating canned food, eating chicken skin, eating raw and cooked vegetables, using oils with saturated fats in cooking, living in or beside a farm, dealing with crops with naked hands, working in a farm during pesticides application or during 24 hours of pesticides application, cleaning pesticides’ equipment, living with people working in a farm or a agricultural field, and application of pesticides personally. In contrary, no statistically significant differences were found between cases and controls in relation to area of residency, exposure to X-ray in the past, having radiation therapy, getting contraceptive pills, using hair dyes, using anti-deodorant underarm, using facial cosmetics, using hair removal ointment, washing vegetables and fruits, buying and transporting pesticides, and wearing protective tools during pesticides mixing and application.
A rare case of giant ovarian serous cystadenoma presenting as psuedo-meigs syndrome
Published on: 18th January, 2021
OCLC Number/Unique Identifier: 8897949620
Meigs’ syndrome is a rare condition characterized by the presence of a benign fibroma of the ovary, ascites and pleural effusion. Other benign cysts of the ovary (such as struma ovarii, mucinous cystadenoma, serous cystadenoma and teratomas), leiomyoma of the uterus, and secondary metastatic tumours to ovary if associated with hydro thorax and ascites are referred to as ‘Pseudo-Meigs” syndrome. It very uncommon and diagnosis is made difficult by symptoms that usually mimic disseminated malignancy or tuberculosis. The gold standard treatment is laparotomy and, by definition of the syndrome, after tumor removal, the symptoms resolves and the patients become asymptomatic. We presented an 18 years old girl with giant ovarian serous cystadenoma with associated pseudo-meigs syndrome, successfully managed in a low resources setting.
Menstruating primary umbilicus cutaneous endometriosis: A case report and review of literature
Published on: 5th May, 2021
OCLC Number/Unique Identifier: 9041187527
Primary umbilical cutaneous endometriosis is a rare umbilical endometrioma that affects women who are within the reproductive age group. It may be associated with infertility and severe dysmenorrhea and can be difficult to diagnosed in an asymptomatic patient.
We report a case of a 38-year-old nulliparous with seven years history of infertility and severe dysmenorrhea. Her hormonal profile assay and hysterosalpingogram results were normal while her husband semen analysis was also within normal range. She complained of monthly bleeding from a painful rubbery multilobate cutaneous nodule on the umbilicus of one year duration. She was diagnosed of cutaneous endometriosis. The diagnosis was confirmed histologically and she had surgical excision with good outcome.
Vulvar lipoma: A rare tumour
Published on: 5th May, 2021
OCLC Number/Unique Identifier: 9030351429
A 26 year nulliparous woman presented to the OPD with complaint of painless swelling in the vulva for the last 1.5 years which gradually increased in size causing difficulty in walking.
Enhancing adipose stem cell chondrogenesis: A study on the roles of dexamethasone, transforming growth factor β3 and ascorbate supplements and their combination
Published on: 31st July, 2017
OCLC Number/Unique Identifier: 7317597470
Varied exogenous chondrogenic factors (CFs) are implicated in promoting differentiation of stem cells along a chondrocyte lineage in the field of regenerative tissue engineering for articular cartilage repair. The effects of dexamethasone, transforming growth factor β3 (TGF-β3), ascorbate, and their combinations, on mRNA expression in micromass-cultured human adipose derived stem cells (hADSCs) were investigated as a function of time. Indices include chondrogenic, hypertrophic, angiogenic, fibrogenic and osteogenic markers along with mechanical properties, assessed by atomic force microscopy. Early in the culture, i.e., at day three, no significant differences in mRNA expression of SOX9, aggrecan, lubricin, Col XI, Col X, vascular endothelial growth factor, Col I, and alkaline phosphatase were observed among samples treated with different CFs. However, significant differences in mRNA expression levels of pre-mentioned markers among samples treated with each CF exist when samples were supplied with the CFs for more than three days. A new indexing scheme summing expression of chondrogenic and subtracting non-chondrogenic angiogenic, fibrogenic and osteogenic marker levels shows dexamethasone is the overall leading CF among the factors and their combinations. Based on this scheme, we have projected not only the possible signaling pathways which might be affected by addition of CFs but also hypothetical indexes that may occur upon temporal variation of growth factor regimens.
Impact of alloimmunization on transfusion-dependent patients
Published on: 16th November, 2017
OCLC Number/Unique Identifier: 7286352883
Red blood cell (RBC) alloimmunization can be a life-threatening complication for patients with thalassemia major and sickle cell disease (SCD) who must receive chronic therapeutic transfusions. Chronic transfusions can lead to erythrocyte alloimmunization, patients continue to develop alloantibodies due to the transference of the immunogenic antigens on the donor RBCs. Many complications are possible. Difficulty in finding compatible match units for the patients can cause transfusion delays delayed, or present alternative risks to the patients from delayed hemolytic transfusion reactions. This review discusses the possible mechanisms, risk factors associated with alloimmunization formation and the hemolytic transfusion reactions and also describe the guideline for transfusion management of these patients, including opportunities and emerging approaches for minimizing this life-threatening complication.
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