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Stem cell therapy offers great hope for patients suffering from diseases for which there is currently no cure. The aim of this study is to investigate the effects of static magnetic field on cellular differentiation and evaluates 18milli Tesla field effect on human umbilical cord-derived mesenchymal stem cells neural differentiation which makes them favorable candidates for some clinical applications. Human cord-derived mesenchymal stem cells were isolated and expanded based on the previously reported experimental conditions and neural differentiation was induced in the presence of magnetic field for the treated samples. Differentiation induction medium was made of a-modified minimum essential medium containing retinoic acid (0.5µM/l) which was replaced with a favorable medium for neural cell growth After exposure made of DMEM F12 (#12660-012) supplemented with Serum-free N2/B27, L-glutamine (2mM), bfGf (20µg/l) and Fetal Bovine serum 5% respectively. All samples were cultured for 3 weeks and were finally observed using light and fluorescence microscopes and examined for gene expression control. Our data showed that static magnetic field exposure causes Sox-2, Nanong, and Oct-4 gene expression decline, conversely hEAG-1 and Nestin genes expression increase after three weeks post-exposure culture time. The effects became dramatic in the presence of retinoic acid suggesting the auxiliary differentiation induction effect of static magnetic field. Stem cell showed that physical inducers just like SMF in moderate intensities along with the chemical ones including retinoic acid can enhance HMSCs neural differentiation to produce neural-like cell lineages.

Objective: The aim is to study the impact of antipsychotics on schizophrenic's metabolic parameters in 6 months. Methods: Blood glucose, lipid profile, liver enzymes weight & waist circumference were assessed for 160 schizophrenia patients; at the beginning and after 6 months of continuous use of antipsychotics. Patients with who used antipsychotics in the past 3 months or have family history of diabetes or obesity were excluded. Results: Except for white blood count and High-Density Lipoproteins (HDL); all the studied parameters showed significant elevation after 6 months of antipsychotic treatment. The relation between the type of antipsychotic and the studied parameters showed that the lipid profile was the only parameter of significance in relation to drug type. Because not only the lipid profile but also other parameters increased after six months we used analysis of covariance [ANCOVA] which showed that the value of any studied parameters at the beginning of the study was significantly determine the values at the end of the study, in addition, the type of drug used in treatment is significantly influences the triglyceride level and interaction of sex, drug used, and the history of drug treatment could significantly determine the serum cholesterol and LDL levels. Conclusion: The study demonstrated elevated metabolic parameters in patients with schizophrenia treated with antipsychotics. The burden of each antipsychotic was explored. More research is needed to confirm our findings which are limited by the short duration of the study, the fewer number of studied antipsychotics and sample size

Background: ASMBS guidelines state that pregnancy is to be discouraged during the first 12-18months post bariatric surgery and until the weight loss stabilizes. There are studies looking at the weight loss outcomes after bariatric surgery in patients who get pregnant after 18 to 24 months. The aim of our study was to evaluate weight loss achieved over two years after bariatric surgery by women who became pregnant within the first post-operative year.

Austin Plastic Surgery: Open Access is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Plastic Surgery.

The journal aims to promote latest information and provide a forum for doctors, researchers, physicians, surgeons and healthcare professionals to find most recent advances in the areas of plastic surgery. Austin Plastic Surgery: Open Access accepts research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of plastic surgery.

Austin Plastic Surgery: Open Access strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.

Substance abuse induces the brain to decrease the production of dopamine and serotonin, a fact that characterizes the chemical dependent. Among the changes caused by frequent use of drugs, there is a change in dietary habits and nutritional status of the user, due to the modification of appetite and food intake or nutrient metabolism. These changes can lead to nutritional deficiencies that can disrupt the brainwaves and their functioning. An example is the omega-3 deficiency that affects neurotransmission resulting in hypo functioning of the mesocortical pathway, system associated with reward and dependence. Based on this, we aimed to perform a nutritional analysis of recovering substance abusers, particularly their consumption of omega-3 containing foods. The sample consisted of 45 male patients from five therapeutic communities in the states of Paraná and Santa Catarina, in the southern region of Brazil. Anthropometric evaluations, general health status assessments and food consumption analyses were performed. According to the body mass index of the individuals evaluated, 51.11% were overweight and 71.11% gained weight after starting treatment. Mean caloric intake was low and was insufficient in most nutrients, including omega-3. In addition, there was a negative correlation between consumption of omega-3 and the duration of addiction. In view of these findings, we suggest that the poor eating habits of the patients could have affected the consumption of omega-3 fatty acids, thereby prolonging addiction. Thus, further studies on supplemental omega-3 therapy may be useful for the process of recovery.

In-depth interview was used to gain qualitative data and insight into the personal experiences of a Yemeni woman refugee after death of her mother. The case reported here was manifested by nightmares and periods of unreality associated to problems in concentration and social isolation. Suffering professional harassment while civilian war in Yemen and losing her mother who had dementia. Therefore, she opened up to us about her experiences in Yemen detailing her experiences of trauma as a result of war and we learned about her feelings after her divorce when she discovered the reality that her husband is homosexual. This case study meets both criteria of posttraumatic stress disorder and major depression disorder. with disappearance of sleep disorder and nightmares. In addition to medication, our patient received psychotherapy by psychologist in our institution, and she reported by herself that the combination of both medication and supportive psychotherapy was beneficial for her. Discussion To examine the mental health and cognitive effects of war trauma on war survivors in Yugoslavia, Başoğlu et al found that 33% of survivors suffered from PTSD [1]. De Jong et al attempted to study the impact of trauma in post conflict low-income countries where people have survived multiple traumatic experiences. They found the prevalence rate of assessed PTSD to be 37.4% in Algeria, 28.4% in Cambodia, 15.8% in Ethiopia and 17.8% in Gaza [2]. In this case it is illustrated the co-occurring PTSD and MDD. In previous studies that examined the prevalence and predictors of PTSD or depression in countries that had experienced war atrocities. It's found that the Prevalence of co-occurring PTSD and depression (9%) was higher than that of PTSD (8,8%) or depression alone (5,6%). [3] The most common long-term symptoms of PTSD were related to low mood and cognition. Several studies have shown the co-occurrence of depressive symptoms and PTSD early on after trauma. Furthermore, research has shown that the occurrence of depression during the months that follow a traumatic event is an important mediator of chronicity in PTSD. [4] Previous research studies assert that female sex is a risk factor for PTSD. The reason for this excess risk in women is not clear; however, some have proposed that women are more likely to perceive threatening events as stressful compared with men, and consequently, this may affect their mental health [4]. Treatment of PTSD and comorbid MDD is complex. The recommended medications are antidepressants; current guidelines for the treatment of PTSD recommend the initiation of a selective Case Presentation A Yemeni woman was in 30 presented to our emergency unity via the general physician in the residence hall where she is living. She settled in Morocco about one year ago to continue her studies to achieve the equivalence of her diploma of neuro-physiologist which she obtained in Yemen. After a long struggling with managing dementia in her mother the three last years, she was alone in front of that, her father went and married again, her brother traveled to Malaysia and lost his novella. She had in the same time conflicts with her husband because she discovered he is homosexual which impacted her a lot. The health of her mother became critical and the situation became more delicate with the war ambiance. Our patient had material difficulties to cover the hospitalization needed to her mother, and she was jobless too, she was victim of moral harassment in university where she was teaching neurophysiology. Her mother dead because of bed rest complications. After death of mother, she vended all what she had as goods to start her life in Morocco. In-depth interview was used to gain qualitative data and insight into her personal experiences as a Yemeni woman refugee after death of her mother. The case reported here was manifested by nightmares and periods of unreality associated to problems in concentration and social isolation. Suffering professional harassment while civilian war in Yemen. Therefore, she opened up to us about her experience after her divorce when she discovered the reality that her husband is homosexual. We found Major Depression Disorder's (MDD) criteria associated to Post Traumatic Stress Disorder's criteria. (DSM-5). She experienced sleep disturbance, anhedonia, and concentration difficulties. A psychopharmacological treatment based on Sertraline was started with 50 mg and we increased the posology treatment to 100mg per day beside an anxiolytic treatment based on alprazolam which was effective in 4 weeks of treatment. Our patient starts to feel good

Introduction: TBI results in significant mortality and morbidity worldwide and represents a global health problem with huge economic burden for healthcare systems due to increased demand for health care, social and vocational services. It is complex and variable, requiring integrated multidisciplinary care. Empirical evidence for various rehabilitation interventions commonly trialed in TBI survivors are growing.

Hepatospenic T-cell Lymphoma (HSTL) is rare & an aggressive type of extranodal lymphoma, the disease represent 1-2% of all peripheral T-cell lymphoma [1]. Its incidence might be underestimated, because the disease may mimic other conditions & the diagnosis is sometimes difficult to be established. It has been seen in patients receiving long-term immunosuppressive therapy, following AML or EBV positive lymphoproliferative disorders or during pregnancy. Several cases were reported recently in patients with crohns disease treated with azathioprine & anti-tumor necrosis factor agent infliximab. We present here peculiar scenario of young male adult known case of sickle cell disease patient whose been diagnosed with gammadelta-T-cell lymphoma, after quite long history of unexplained organomegaly & fever.

A 90-year-old woman with the chief complaint of dyspnea was referred to our hospital. Seven years earlier, she had received radiation treatment for a gastric Mucosa-Associated Lymphoid Tissue (MALT) lymphoma. Chest computed tomography revealed right lower lobe atelectasis and narrowing and stenosis of the bronchi. Bronchoscopy was performed; histological and immunohistochemical examination of the bronchial biopsy specimen yielded a diagnosis of MALT lymphoma. Her clinical course and the absence of Helicobacter pylori (H. pylori) suggested that the bronchial lesions were metastases of the previous gastric MALT lymphoma. The spread of gastric MALT lymphoma to endobronchial lesions is rare, and bronchoscopic examination is useful to detect the macroscopic and microscopic characteristics of endobronchial MALT lymphoma.

Context: Despite the seriousness of domestic violence and its consequences, it is largely underestimated, and many female victims cannot receive appropriate assistance. Despite the psychological consequences of domestic violence, women who are victims of such violence are not primarily intended for the psychiatrist. Objective: To study the profile of women who have been victims of domestic violence and to assess their psychopathological impact. Methods: Cross-sectional study carried out for 76 women victims of domestic violence recruited in the ANNAJDA help center in Rabat during a period from March 2017 to May 2017. The instruments used were: a data collection sheet for socio-demographic, clinical and violence characteristics, the PCL-S scale was used to assess Post-Traumatic Stress Disorder (PTSD), the Hospital Anxiety and Depression (HAD) scale was used to assess anxiety and depression and the DSM 5 criteria were used to assess addiction. Results: 76 female victims of domestic violence were included in the study. The average age of the mothers was 34.62 years. 47.3% have a low socioeconomic level. 63.2% of the victims were unemployed. All our victims have been subjected to psychological violence. 68.4% of our sample has a post-traumatic stress condition. 82.9% of victims show definite anxiety. 61.8% of women have a definite depressive disorder. 14.5% a dependence on a substance. There was a significant association between sexual violence and anxiety and drug use, between financial violence and drug use, between physical violence and depression.

Huanglongbing (HLB) is a major disease limiting citrus production worldwide. In this study, a new potential biocontrol agent Bacillus amyloliquefaciens GJ1 against HLB was employed to resistance disease experiment. We utilized isobaric tags for relative and absolute quantification-based quantitative proteomics approach for comparative analysis of protein abundances with Candidatus Liberibacter asiaticus-infected leaves treated and untreated by solution of B. amyloliquefaciens GJ1 (OD 600 nm ≈ 1). The result revealed Differential Abundance Protein (DAP) of 21 expression-increased (FC>1.2, P-value<0.05) and 43 expression-decreased (FC≤0.83, P-value<0.05) and COG classification annotation proteins were elucidated. Among them, the proteins involved in carbohydrate transport and metabolism were analyzed. Bacillus amyloliquefaciens GJ1 treatment brought about decreasing both of the content of the starch and the soluble sugar in leaves was proved, the function of starch degradation caused by B. amyloliquefaciens GJ1 treatment was proven via I 2-KI test in roots. This study highlight one of the reasons in HLB biocontrol in citrus. antibiotic agents [12], inhibiting the LdtR gene by an inhibitor [13] and screening the combination of stock and scion [14]. However, the above mentioned techniques used for solving the problem of HLB present some limitations. Management of HLB to enable the continued economic production of citrus is the largest challenge ever faced by the citrus industry, and new control strategies are urgently needed. Recent advances on host-pathogen interactions, genetics of different varieties, and resistance mechanism are discussed in HLB [15]. Reported that Pathogen-Associated Molecular Patterns (PAMP) activity of flg22 in Las is weaker than those in other well-studied plant pathogenic bacteria [16]. Predecessors thought that host citrus plants have not evolved sufficient immune responses to effectively prevent infection [17]. Given the availability of high-throughput sequencing, transcriptomes and proteomes have been applied to Las-infected plants and treated plants; as a result, numerous characteristic innate immunity elicitors, transcription factors, defense responsive components, and signaling molecules have been discovered [18-22]. However, the resistance metabolism of HLB remains unknown. Bacillus sp. Is a biological control agent that can control diseases to a host animal or plant, thereby preventing the development of disease by a pathogen [23]. Bacillus sp. is widely distributed in nature and harmless to humans and animals. Bacillus belongs mostly to endogenous spores, reproduces rapidly, and can be easily colonized on the surface of plant roots. It can produce a series of metabolites during growth. The antibacterial substances of Bacillus include antimicrobial protein, lipid peptide and polyketone, secretory proteins, enzymes etc. [24] The different genes involved in the metabolite synthesis in B. amyloliquefaciens FZB42 were Abbreviations

Gastric ulcer disease has become a disease predominantly affecting the older population, with the peak incidence occurring between 55 and 65 years of age. It can occur in any part of gastrointestinal tract. Many medications are available for management of gastric ulcer. Prolonged use of these drugs may lead to serious adverse effects. Advanced in the discovery of more effective and safe anti-ulcer agent is due to the introduction of large number of newer experiment methods to evaluate their anti-ulcer activity in different types of gastric ulcers. Several in-vivo-models of gastric damage have been characterized and are primary tools to identify the anti-ulcer property of many new and existing drugs.

Optic disc analysis is an important step for glaucoma diagnosis and management. Clear media is a pre requisite for visualization of optic disc. In circumstances where media opacities hamper clinical assessment, contact B Scan is a useful tool which helps to assess the status of optic nerve head. A prospective, single blinded, cross sectional investigational study was designed. The study included patients posted for surgery in which the optic disc evaluation was not possible due to media opacity. Ultrasonography was performed by a single investigator, unaware of the clinical findings. B scan findings were documented as presence or absence of optic nerve head cupping and later on correlated with clinical findings. The sensitivity of B scan in predicting optic nerve head cupping was found to be 83% (95% CI 0.80-0.90) and specificity of 100% (95% CI 0.97-1). Our data suggests that even by low resolution contact B scanner, we can detect glaucomatous optic disc cupping in patients with cup: disc ratio ≥ 0.8: 1, with high sensitivity and specificity. It is a cost effective method, beneficial in patients with opaque media and can help in taking appropriate intervention and also explain guarded visual prognosis to patients.

Purpose: To evaluate the effect of surgery for dissociated vertical deviation (DVD) alone on concurrent horizontal strabismus.
Design: Retrospective chart review.
Methods: Patients who underwent surgical intervention by a single surgeon for DVD and had concurrent horizontal strabismus from 1998 through 2015 were identified.
Results: 55 patients were included and divided into two groups: (1) Those that underwent surgery for DVD only, and (2) those that underwent concurrent surgery for DVD and horizontal strabismus. 34 patients were included in Group 1 and 21 patients in Group 2. Successful outcome for DVD was defined as resolution or improvement in DVD precluding additional surgery. Successful outcome for the horizontal deviation was defined as resolution of horizontal deviation, well-controlled intermittent exotropia, or constant horizontal deviation <10 prism diopters. Failure was defined as any constant horizontal deviation >10 prism diopters and/or subsequent surgery for horizontal strabismus. 29 of the 34 patients (85.3%) in Group 1 had a successful outcome for DVD compared to 18 of the 21 patients (85.7%) in Group 2 (p=1.00). 22 of the 34 patients (64.7%) in Group 1 had a successful outcome for the horizontal deviation compared to 15 of the 21 patients (71.4%) in Group 2 (p=0.77).

This study aimed to investigate physicochemical, microbiological and sensory properties of white cheese made from different levels of garlic and ginger powder. Cheese samples were processed by adding garlic and ginger powder at 0, 2, 4 and 6% by weight concentration. Standard methods were used in this research to determine the physiochemical, microbiological and sensory properties of all cheese samples. The results of the proximate analysis indicated the highest moisture content in control was 45.10%, and lowest one in 6% garlic was (36.77%). The protein content of cheese processed by using ginger powder were (18.37, 19.25, 19.68%) in 2, 4, 6%, respectively, while in cheese processed by using garlic powder were (15.31, 17.06,17.5%) in 2, 4, 6%, respectively. Statistically, significant differences (p<0.005). The highest fat content in cheese processed by using garlic powder were (25.58, 25.30, 25.18%) in 2, 4, 6%, respectively, while the cheese processed by using ginger powder had the lowest fat content were (24.16, 23.14, 22.1%) in 2, 4, 6%, respectively. The mineral content statistically, affected (p<0.005) by adding ginger and garlic powder. The ash content increased by the increase of the level of garlic and ginger powder, the highest one in cheese with 6% garlic powder was (4.77%). Titratable acidity and pH were significantly affected (p<0.005) by added garlic and ginger powder. The total solids content of cheese sample increased significantly (p<0.005) by increased garlic and ginger powder when the highest one was recorded in cheese sample produced by 6% of garlic powder addition (63.23%). The results obtained from the microbiological analysis of cheese samples showed that the lowest counts of yeast and moulds were observed for cheese samples produced by 6% garlic powder. Coliform and Salmonella count were not detected in processed cheese by different levels of garlic and ginger powder. The sensory evaluation indicated that the panellists accepted all cheese samples concerning the cheese prepared by the addition of garlic powder compared to that prepared by addition of ginger powder. According to the results of this study, it can be recommended that further studies for the assessment of the antioxidant effect of garlic and ginger powder to improve the quality of white cheese.

Open Access Ocular oncology management team needs contributions from various specialties like ophthalmology, medical oncology, radiation oncology, neurosurgery, interventional radiology, otorhinolaryngology and pathology. Advanced imaging techniques have aided in proper diagnosis of difficult intraocular cancer cases especially when the media is opaque and when we need to evaluate the extraocular extension. Radiotherapy, chemotherapy and targeted therapies are gaining priorities in the treatment protocol of ocular malignancies alongside surgical management. In the management of intraocular melanoma episcleral plaque brachytherapy, using small radioactive seeds, are becoming the treatment of choice for most of such cases. Iodine 125 is the most commonly used radioisotope for this purpose along with Cobalt 60, Palladium 103 and Ruthenium 106 [6]. Participating in clinical trial is probably the best option as no systemic therapy (chemotherapy or immunotherapy) has proven to be much effective in the metastatic disease. International Primary CNS Lymphoma Collaborative Group Symposium recommend that unilateral ocular lymphoma should be treated with local therapy in the form of intravitreal methotrexate and rituximab and/or external beam radiation therapy. Whereas bilateral disease and CNS involvement should be treated with systemic and intravitreal chemotherapy. Chemoresistant cases will require whole-brain irradiation and ocular radiotherapy [7]. In India, only few tertiary care centres are efficiently treating most of these cases. Many patients present late due to lack of access to such specialized centres and many do not receive any treatment because of poverty and lack of awareness. Referrences 1. Bakhshi S, Meel R, Radhakrishnan V. Current therapy and recent advances in the management of retinoblastoma. Editorial Ocular malignancy is a rare and highly curable malignancy. India does not have a proper registry for ocular malignancies but according to experts it harbours almost 20% of global ocular cancer cases due to its huge population and the incidence is on the rise. Being a relatively rare cancer and due to complexity involved in its multimodality treatment approach very few centres in India are capable of providing the state of the art care for this disease entity. Common cancers of the eye include retinoblastoma, melanoma, squamous cell carcinoma, lymphoma, or metastatic cancer from other parts of the body (secondary ocular cancer). Secondary ocular cancers are more common than primary ocular cancer. Retinoblastoma is the most common primary ocular cancer in children [1], whereas melanoma is the most common primary ocular cancer in the adult [2]. Tata Memorial Hospital registries from 1984-1993 show that peak incidence of retinoblastoma are in the age group of 0-4 years. The overall incidence of ocular cancer is 0.4% in male and 0.32% in female. The field of ocular oncology is spreading its horizon with new developments and gaining attention worldwide. Many centres have already created dedicated ocular oncology management group and more are coming up with the same idea. As a result, cure rate and overall survival have improved significantly over the years. For example, retinoblastoma was considered a fatal disease earlier but now with multimodality treatment approach (mainly surgery, radiotherapy and chemotherapy) it is one of the most successfully treated pediatric cancer globally [3]. Although according to literature in developing countries about half of all retinoblastoma cases present late (with extra-ocular disease) to a tertiary care referral center [4] necessitating the need for a coordinated approach in the management of ocular malignancies. Similarly, Ocular Surface Squamous Neoplasia (OSSN) is being treated more effectively with topical chemotherapy, which reduces the post-operative recurrence rate and may even obviate the need for surgery in selected cases. Many studies have shown that efficacy of topical Mitomycin-C ranges from 80-100% [5].

The prognosis of Glioblastoma multiforme remains poor. Immunotherapy improved survival in a small fraction of patients. We studied the efficiency of multimodal immunotherapy as part of first line treatment for patients with GBM. Immunogenic Cell Death (ICD) was induced with Newcastle Disease Virus (NDV) and Modulated Electrohyperthermia (mEHT), and Dendritic Cell (DC) vaccinations loaded with autologous tumor proteins were performed. In a retrospective analysis of 60 adults, we detected 15 adults in whom NDV/mEHT were added at days 8/9/10 during Temozolomide Maintenance (TMZm) cycles, multimodal immunotherapy with NDV/mEHT/DC vaccinations were administered after TMZm, and further 3-day NDV/mEHT maintenance immunotherapy treatments were given thereafter. Median age was 60 years. Median Karnofsky was 90. There was no added toxicity due to immunotherapy. Median progression-free survival was 13 months (m). With a median follow up of 17m (ranging 4-30m), median overall survival was not reached, and estimated overall survival at 30m was 58% (95%CI: +27,-42). The detection of Apo10 protein epitope (Apo10) and Transketolase-like 1 (TKTL1) in monocytes, the mRNA expression level for PDL1 on circulating tumor cells, and the Th1/Th2 balance in CD4+ T cells showed a dynamic interaction between tumor cells and immune reactivity. The data suggest that the additional induction of ICD via NDV/ mEHT during TMZm is beneficial in improving overall survival. While TMZm only targets dividing tumor cells, ICD targets dividing and non-dividing tumor cells. DC vaccination induces an antitumoral and anti-viral immune response which is maintained by the 3-day NDV/mEHT maintenance immunotherapy treatments.

Purpose: In our previous study, it was reported that the cross-section airway of OSA presented triangle shape, especially in the obese patients. From this finding, we hypothesized that there is structural weakness of airway in the bilateral posterior region. In this short report, to discover the weakness region in the airway, the airway configuration change under the negative pressure loading was observed. Methods: Subject was 33 year-old female, who had no OSA. It was investigated the pressure level of which she was able to keep same the same level stably and constantly for 15 seconds using a pressure gauge. This pressure level was applied during scanning CBCT (S_NP).The airway was scanned via a CBCT with 15 seconds, under following conditions; normal breathing and under S_NP. The airway volumes between the level of the posterior nasal spine and the tip of epiglottis were measured. Results: The airway configuration during normal breathing was elliptical shape. On the other hand, the airway under S_NP presented triangle shape. The airway volumes were 16040mm 3 during normal breathing, and 6567mm 3 under S_NP. The airway volume under S_NP decreased to 41%, compared with normal breathing. Conclusion: In this short report, it could observe the airway configuration under the negative pressure. As a result, the airway may be obstructed from posterolateral direction by fat tissue or negative pressure. This short report provided an importance of research regarding to the structural weakness in the airway.

Background: Traditional bone setters still receive high patronage in developing countries. The study was designed to determine the willingness to patronize traditional bone setters among patients attending the general outpatient department of Federal Teaching Hospital Abakaliki, Nigeria.

The hypothesis is to review the existing evidence on the role of Proximal Fibular Osteotomy (PFO) in unicompartmental medial joint osteoarthritis of knee joint in relatively young patients. The procedure has been described as simple, cheap and effective in treating this condition. Our observations are based on our unpublished experiences with a case series of the management of 30 cases with medial joint narrowing of knee in last one year. These cases are being followed every 3 months to assess the progress. We have been doing this procedure at our institutions under spinal anesthesia and a segment of 1 cm is excised from shaft of fibula through a lateral 4-6 cm long longitudinal incision about 10 com distal to the tip of head of fibula. The check x-ray soon after recovery showed opening of medial joint space and clinically relief from previous arthritic pain. Almost all of our patients had similar effects following PFO. Many patients have dramatic relief of pain and they were able to even squat and climb stairs easily after surgery, while they were unable to do so before. The preliminary results of our cases have encouraged us to continue this procedure and review the available resources. The correction of varus deformity, opening of medial joint space and the pain relief are the main results of PFO in our patients. In our opinion this procedure is simple, cheap and effective in the management of medial joint osteoarthritis of knee in relatively young patients.

Aim: To evaluate the adverse events and tolerability of dienogest administration over an 18-month period for a prevention of recurrent symptoms and lesions after surgery for endometriosis. Methods: Dienogest was administered to 150 patients with endometriosis for over an 18-month period after surgery. The adverse event profile and patient satisfaction regarding dienogest was determined through a questionnaire. We evaluated the adverse events of dienogest, including through laboratory tests, body weight, and bleeding patterns. Post-operation measurements of pain were applied before surgery, postoperatively, before treatment with dienogest, and after dienogest treatment. The body weight was measured during the first visit, and measurements were repeated every six months. Results: The median duration of treatment was 24 months, with the longest follow-up duration being 60 months. Adverse events include headaches, breast discomfort, acne, constipation, hot flushes, weight gain, and mild depression. More than 70% of the patients experienced amenorrhea. However, this was not a reason for discontinuation. The vaginal bleeding pattern associated with dienogest was shown to be tolerable, and only three patients stopped taking it because of heavy menstrual bleeding resulting in anemia. Rather, the major cause of discontinuation was unwanted weight gain. Conclusions: The data indicate that dienogest is well tolerated and has a favorable safety profile for long-term use as a prophylaxis in an effort to post-operatively obviate the recurrence of ovarian endometrioma. Our results suggest that not only atypical vaginal bleeding but also unwanted weight gain should be regarded as significant reactions, however.

Obesity, which is a state of excess of nutrients, chronically activates cellular growth factor and metabolic signalling pathways and stimulates neoplastic transformation. Excess of adiposity has been identified as a risk factor for recurrence, reduced effectiveness and complications of the treatment, development of second primary tumor and mortality. Obesity is associated with the progression of various cancers and it is an important predictor of poor outcome of the disease. Several mechanisms have been proposed to link obesity with cancer. Quantity and quality of surrounding adipose tissue affect biological and secretory nature of adipocytes. Fatty acid metabolism plays significant role in the biology of cancer. Obesity causes alterations in adipose tissue microenvironment along with endocrinal imbalance that favors tumor initiation as well as progression. Tumor-promoting consequences of obesity occur via insulin resistance, dyslipedemia and inflamed adipose tissue that release local and systemic inflammatory mediators, Obesity worsens the progression of the disease affecting clinical course not only in relation to cancer outcome, but also other comorbid conditions. Improvement in the health of adipose tissue to reduce inflammatory state would be a novel therapeutic approach to minimize burden of cancer-related mortality. Hence in future, studies bridging the gap to connect preclinical experimental studies with human observations to evaluate impact of obesity on progression of different cancers are needed.

We investigated the potential susceptibility to liver dysfunction induced by a therapeutic dose of acetaminophen in rats submitted to gestational and lactational protein malnutrition using an animal model. Wistar rats were submitted to gestational and lactational protein malnutrition (control, 25% casein, and protein malnutrition, 7% casein). On the 10 th (P10) or on the 25 th (P25) a therapeutic dose of acetaminophen (15 mg/Kg, i.p.) was administered and rats were decapitated 6 hours after acetaminophen administration. Albumin content, Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) activities were measured in plasma, as well as the Glutathione (GSH) levels and Glutathione S-Transferase (GST) activity in liver. In both age groups, the treatment with acetaminophen decreased albumin levels and increased ALT and AST activities in plasma. It was also observed decreased hepatic GSH levels and increased GST activity just at P10. An acute therapeutic dose of acetaminophen may induce a mild liver dysfunction in protein malnutrition.

Avitaminosis fever is caused by minimal storage or maximal consumption of B vitamins, especially thiamin, riboflavin or niacin inside human body. They were often found after prolonged ultra-heavy labor and hunger. Berberi fever was most important, not rare and fatal, usually associated with random combinations in a great mess of severe signs and symptoms from multiple organs and endocrine glands controlled by autonomic nervous system causing very queer,. complex, complicated clinical manifestations, which made the diagnosis very difficult and confused. It should be diagnosed collectively as autonomic nervous system dysfunction or crisis, briefly as dysautonomia. The dramatic therapeutic effect of parenteral thiamin on dysautonomia remind people that it may be a very powerful physiologic super antibiotic in eliminating microbial infections regardless pathogen and severity as observed. It may be also a powerful anti-tumor agent and had been successfully tried in cyst, lipoma, osteosarcoma, and lyphoma. Ariboflavinosis fever was milder and commonly found in pediatric especially during winter and spring. It often associated with erythematous patches. Pellagra fever was found in two cases.

Objective: To support midwives in coping with the continuous state of change of midwifery practice by studying proactive behavior in midwifery. Design: A cross-sectional study investigated associated antecedents of proactive behavior in a group of Belgian and Dutch midwives. Setting: Midwifery practice in Belgium and the Netherlands. Participants: Belgian and Dutch midwives (n = 139). Intervention: Midwives answered a questionnaire, from September 2017 until December 2017, regarding six personal, seven individual and three contextual antecedents possibly associated to two types of proactive behavior: proactive idea implementation and voice speaking. A proportional odds logistic regression analyses was executed describing the association between these antecedents and the probability to observe proactive behavior. Findings: Of all tested prognostic factors, job autonomy, control appraisal and role breadth self-efficacy, referring to the midwives' commitment to perform tasks that go beyond the expectations, were significantly positively associated with proactive behavior. Conclusions: Midwives having more job autonomy and higher role breadth self-efficacy are positively associated with proactive behavior. Additionally, independent midwives more likely behave proactive. Midwives, more than midwifery students, need a high level of control appraisal in order to show proactive behavior. Midwives tend to lose partly their level of proactive behavior after one working year. Implications for Practice: In the quest to support midwives in turbulent times, this study uncloses additional insights of proactive behavior in midwifery. Anticipating the various significant antecedents, could strengthen the level of proactive behavior of midwives. The awareness for proactive behavior could positively contribute to the work efficiency and coping attitude of midwives and indirectly contribute to the quality of care for mother and child. midwifery students [6]. Two antecedents, being control appraisal and role breadth self-efficacy, were identified as important predictors of proactive behavior. This study aims to confirm and/or supplement recent insights on antecedents of proactive behavior by studying a group (n = 133) of midwives and compare their characteristics and their antecedents on proactive behavior with the results of our earlier study with student-midwives as population. Background Health care practice is characterized by rapid evolutions, the need for cost-effective and accessible health care and constantly changing practices [7,8]. In recent years, the context of midwifery practice presents a growing complexity, due to rapid evolutions, such as centralization of care, medicalization of childbirth as well as an overflow of new insights, innovations and availability of evidence on interventions [7,8,9]. Births also became increasingly complex.

Aim: The current study focused on examining the effect of local cold compression upon pain and movement restriction among patients with knee osteoarthritis.
Background: Knee Osteoarthritis (OA) is one of the most common non-inflammatory rheumatic joint diseases which occurs on synovial bone as a result of imbalance between joint cartilage synthesis and its destruction. And it characterized with damaged joint cartilage, new bone formation on joint cartilage, joint pain and movement restriction. The aim of knee OA treatment is to control pain, movement restriction and other symptoms, to slow disease progression, to increase and to maintain patients’ movement function. Local cold compression, one of the non-pharmacologic methods, produces such effects as eliminating/reducing pain, preventing edema and slowing inflammation process by providing local therapeutic anesthesia. Therefore, importance of cold compression is emphasized among patients with arthritis.

We previously reported that Saskatoon-Berry-Powder (SBP) might have beneficial effects on vascular inflammation and endoplasmic reticulum stress in experimental animals. In a pilot study, we tested various oral doses of SBP and learned that the 5% (w/w) dose seems to have the best effects. This study investigated the impact of dietary intake of SBP at 5% (w/w) on several biochemical factors pertaining to body weight gain, glucose metabolism; lipids, inflammation and organ function over a 4-week study period. The db/db mouse model of type 2 diabetes and their wild-type counterparts (C57BL/6J mice) were used. Body weight, food-intake, whole blood glucose, and plasma total cholesterol levels were significantly higher in the db/db mice as compared with those in C57BL/6J mice. Consumption of SBP did not change the animals' body weight gain rates or food consumption in either animal model over the experimental course. The SBP-treated db/db mice showed approximately 30% reductions in their blood and urine glucose levels as compared to those in non-treated db/db mice over 4 weeks of experiment. Furthermore, the db/db mice show a different inflammatory-marker profile as compared to that in C57BL/6J mice; treatment with SBP was associated with changes in such profiles mainly in db/db mice. It is not clear which component(s) of SBP is responsible for the effects observed in this study. Future studies warrant identification of such functional components of SBP.

Open Access and SPECT/CT imaging can be carried out by using SPECT/CT apparatus. Detailed information on bone metastasis site and non-bone metastasis accumulation site and irradiation dose evaluation was possibly obtained with radiation dosimetry (Figure 3). Absorbed dose can be calculated by using OLONDA/EXM ver.1.1 (HERMES) [9-11]. The accumulation of normal tissue was found to be low in Short Communication Prostate cancer at stage IV spreads to bone frequently, which occurs in up to 90% [1]. Bone metastasis is a substantial source of morbidity since it is related to bone pain and skeletal-related events [1]. 223 Ra selectively targets bone metastases with alpha particle [2-3]. 223 Ra was approved for the treatment of metastatic castration-resistent prostate cancer patients (CRPC) [2]. 223 Ra also releases gamma rays accompanying alpha or beta rays. However, the therapeutic effect and its radiation dose assessment have not yet been adequately studied. The side effects and therapeutic effects of 223 Ra radiation therapy by using radiation dosimetry for patients with castration-resistant prostate cancer needs to be evaluated [4-7]. Firstly we performed the investigation of phantom study using four types of collimators including low-energy general purpose, extendent low energy general purpose, middle energy general purpose and high energy general purpose type (Figure 1). We observed that middle energy general purpose image was more efficient than a dedicated alpha detector which showed remarkably decreasing counting rates. We therefore constructed procedures and standards for handling 223 Ra in clinical practice. Bone scintigraphy can detect bone metastasis accurately. Bone scintigraphy was performed before and after the therapy in all subjects with CRPC, as well as the measurement of prostate specific antigen (PSA). Bone scan index and other indices by boneNAVI software version 1.0.1 of EXNI or FUJIfilm RI farma were calculated [8]. BoneNAVI is a first update of the Japanese version. This software, using artificial intelligence, has a high sensitivity for diagnosing bone metastasis. Our preliminary findings obtained in our institution was that bone scan index was useful in monitoring the patients regarding pre-and post-treatment and it can be a future prognostic indicator for 223 Ra treatment when alpha treatment can be monitored with bone scan index of boneNAVI (Figure 2). Figure 1: Phantom study to determine sensitivity of each collimator. A: Low-energy general purpose (LEHR); B: Middle energy general purpose (MEGP), C: Extendent low energy general purpose (ELEGP); D: High energy general purpose (HEGP) type. Figure 2: Bone scintigraphy of a patients with prostate cancer. Bone scan index with artificial network analysis showed severity of the disease. Bone Scan Index (BSI) before Ra-223 treatment was 2.00. BSI decreased after the treatment (2.41). Hot Spot before Ra-223 treatment was 29, and changed to 25.

Concentration is a card game that can be used for the rehabilitation and examination of individuals with an impaired cognitive function; however, there are few psychological reports on its use. In this study, we used functional magnetic resonance imaging to psycho physiologically investigate the localization of brain activity in 12 healthy males during a game of Concentration. Both a Control task, in which a card was selected in order, and a Concentration task were performed, and the results of each task were compared. During the Concentration task, both sides of the entire cerebrum and the cerebellum were activated. Upon comparison of the trials, the left pallidum, left caudate nucleus, and left thalamus were activated during the Concentration task more significantly than during the Control task. These results suggest that Concentration is related to the memory function including the visuospatial working memory, inhibition process, reward process and the learning effect. is expected in the future. Concentration is a card game that can be played either alone or with multiple players. In the game of Concentration, a player selects two cards from a group of cards turned upside down on the table; the player looks at the two cards and places them back on the table facedown, attempting to memorize the placement of the cards. During subsequent turns, each player turns over two cards, attempting to match each new card with a card that has been seen previously. When a player matches two cards, that player wins the cards. The player learns the position of each unmatched card placed during each turn of play. When two cards do not match, the cards are replaced on the table. From a psycho physiological viewpoint, players initially recognize and memorize the visuospatial information (number and spatial position) contained in each card they select. While maintaining such memory, they newly select a card, and recognize the visuospatial information contained in it. When the new card matches the old one, players restart this process. If it does not, it is necessary for them to continue selecting other cards, while maintaining the visuospatial information contained in the unmatched card. In other words, in Concentration, it is thought that not only simple memory work but also working memory is used. Working memory refers to the system or systems that are assumed to be necessary in order to remember something while performing complex tasks such as reasoning, comprehension, and learning. Baddeley [9,10] proposed that this system is a multi-component system comprising an attentional system, the 'central executive', aided by three subsidiary slave systems, the "phonological loop", "visuospatial sketchpad"

Development of fungal CNS (Central Nervous System) infections is primarily determined by the immune status of the host. They are more frequently encountered in immuno-compromised individuals like recipients of organ transplants, patients on chemotherapy, and human immunodeficiency virus infections. Early diagnosis and prompt initiation of appropriate therapy are crucial in preventing an often fatal outcome.

In this short review, we will discuss some practical points to consider when using palmitoylethanolamide (PEA) as an analgesic and anti-inflammatory compound. Since the emergence of PEA in a number of food supplements, it is important to be aware of practical issues related to what dose to use, how long to use it and what formulation to choose. As PEA resets a nuclear receptor, and down regulates over-active inflammatory pathways by doing so, it is recommended to use PEA for at least 2 months before deciding how to proceed. The standard daily recommended dose is 1200 mg and the author most often prescribes a fixed combination between PEA and low dosed vitamins B in order to achieve synergistic effects.

Previous studies indicate shrimp Heat shock protein Hsc70 play key roles in White spot syndrome virus infection, but its regulatory mechanism remains unclear. In the present study, we identified Hsc70 was a direct target gene of miR-9a in shrimp, overexpression of miR-9a in shrimp primary cells was sufficient to inhibit the mRNA and protein expression of Hsc70 and miR-9a could directly target the coding region of Hsc70, further investigation indicated that the apoptosis- inducing effect of miR-9a in shrimp primary cells was mediated by reducing the production of Hsc70. These findings revealed the possible regulation mechanism of Hsc70 in shrimp and provided novel evidences that miRNAs mayalso target CDS ofmRNAsto play their post-transcriptional regulatory effects.

The present investigation was undertaken to isolate and assess the microbial degradation of phenol by bioaugmentation of Pseudomonas mendocina isolated from activated sludge of Common Effluent Treatment Plant (CETP) based at Ankleshwar (Gujarat, India). The strain was isolated and designated as Pseudomonas cepacia ETL 2413 after examined for colony morphology, gram stain characteristics and various biochemical tests. Pseudomonas cepacia ETL 2413 was found to be highly effectual for the removal of phenol which was used as sole carbon and energy source. From an initial concentration of 200mg/L, it degraded to 76.43 ± 1.23 mg/L. In turn the effect of temperature (25 to 500C), pH (5.5 - 10.5) and glucose concentration (0, 0.25 and 0.5%) on the rate of phenol degradation was investigated. Observations revealed that the rate of phenol biodegradation was affected by pH, temperature of incubation and glucose concentration. The optimal conditions for phenol removal were found to be pH of 7.5 (82.63% removal), temperature 300C (78.69% removal) and 0.25% supplemented glucose level (98.28% removal). The significance of the study is the utilization of native bacterial strains isolated from the waste water itself having potential for environmental bioremediation in the activated sludge process of a CETP Plant.

Fractal analysis is an objective approach that in pathology we have one of the most important fields of application. Here we review and present fractal methodologies at histological level that have been successfully applied to characterize pathological features and able to perform differential diagnosis and prognosis in cancer.

An 18 year old male patient diagnosed as Acute Lymphoblastic Leukemia (ALL) two years back was treated by the MCP 841 protocol. The patient attained remission and was being on the maintenance phase of the protocol. The patient while being investigated for diminution of vision was diagnosed as isolated CNS relapse in the form of bilateral optic nerve leukemic infiltration. The patient was treated with chemotherapy systemic and intra-thecal along with radiotherapy. The treatment resulted in regaining of vision in one eye while the other stayed refractory to the treatment.

A calibrated and validated finite difference numerical model was used to estimate the spatial and temporal distribution of the Meteoric Groundwater Discharge (MGWD) and Submarine Groundwater Discharge (SGD) into a coasted estuary known as the Indian River Lagoon (IRL) at two transects. Specifically, this paper describes the methodology used to determine: a) the quantity of MGWD originating from the mainland and the barrier island, b) the spatial distribution of the SGD into the IRL, c) the groundwater salinity and hydraulic head distribution below the IRL, and d) the regional flow directions of the MGWD and the Oceanic Groundwater Discharge (OGWD) in a vertical plane below the transects. It was found that a brackish transition zone, in which groundwater salinity varies from freshwater salinity to lagoon water salinity, exists in the surficial aquifer, below the IRL, at both the Palm Bay and Titusville transects. The daily SGD flow into the IRL for each month ranged from 1.77 to 2.10 m3/d, and from 0.37 to 0.42 m3/d, per meter of lagoon shoreline, at the Palm Bay and Titusville transects, respectively. These numbers are close to the 0.45 m3/d per meter of lagoon shoreline MGWD, through a 22 m outflow face, estimated by at the Eau Gallie transect. The mainland produced 98% of the MGWD at the Palm Bay transect and 86% of the MGWD at the Titusville transect. The estimated annual MGWD were 9.0 % and 1.6 % of the annual rainfall at the Palm Bay and Titusville transects. These numbers are reasonable given the impervious character of the watersheds that discharge into the IRL at these transects. The MGWD can occur at distances of several kilometers from the groundwater divide and up to a kilometer away from the IRL shoreline, and can affect the brackish water salt concentration below the IRL. Also, it is possible that, below the lagoon, zones of meteoric ground water may occur below the brackish water at depths of 20 to 30 m as in the case of the Palm Bay transect. The MGWD appears to be the primary source of SGD into the IRL at the study transects, as no ocean water enters the lagoon, and there is virtually no tidal influence at any of the transects which implies that the reversed estuarine water discharge (REWD) is also negligible.

Malakoplakia is a rare histiocytic inflammatory disorder that predominantly affects the urinary tract and rarely the female genital tract. The pathogenesis is hypothesized to be a result of defective bacterial degradation within dysfunctional phagolysosomes, resulting in formation of the pathognomonic Michaelis-Gutmann bodies. Immunocompromised patients are more commonly affected. We present a case of malakoplakia of the vulva and left mainstem bronchus in a 67-year-old postmenopausal immunosuppressed female following bilateral lung transplantation. Multiple painful nodular lesions were present on the labia, which did not respond to multiple courses of antibiotic therapy. Histologic examination revealed a diffuse histiocytic infiltrate with associated lymphocytes, neutrophils, and pathognomonic Michaelis-Gutmann bodies. The patient also complained of progressive cough and was found to have concomitant bronchial malakoplakia, diagnosed after endobronchial biopsy of a nodule at the anastomotic site. Both areas were cultured and grew Escherichia coli, the organism most frequently implicated in malakoplakia. After surgical excision, the vulvar lesions did not recur. Malakoplakia is a diagnostic entity that the pathologist should consider in the differential diagnosis when encountered with histiocytic inflammation in the female genital tract. This entity can mimic gynecologic malignancies and can frequently persist and recur if not treated appropriately. In the gynecologic tract, it is a rare occurrence. We present an unusual case of combined malakoplakia involving vulva and lung.