https://www.ej-med.org/index.php/ejmed/issue/feed European Journal of Medical and Health Sciences 2021-11-26T06:31:54-05:00 Editor-in-Chief editor@ej-med.org Open Journal Systems European Journal of Medical and Health Sciences https://www.ej-med.org/index.php/ejmed/article/view/1122 Survival in Anaplastic Thyroid Carcinoma: A Population-Based Analysis 1973-2015 2021-10-30T11:02:25-04:00 M. Gore mgoremdphd@gmail.com <div> <p class="Text"><span lang="EN-US">Anaplastic thyroid carcinoma (ATC) is the least common and most aggressive of the thyroid cancers. ATC typically represents less than 5% of all thyroid cancer diagnoses but represents up to 50% of thyroid cancer deaths. The rarity of ATC lends itself to study by population-based studies. Methods. The most recent 1973-2015 Surveillance, Epidemiology, and End Results (SEER) database was queried for patients with a diagnosis of ATC. Data on demographics, overall survival, surgical treatment, and staging were extracted. Kaplan-Meier and log-rank analysis was used to evaluate for univariate survival differences, and logistic regression analysis was used to conduct a multivariate analysis. Results. A total of 1642 patients were identified (1021 female, 621 male). The largest age group was 75-79 years old, with the majority of patients older than 60. Univariate analysis showed that age at diagnosis, AJCC overall stage, T, N, and M stage, and surgical treatment vs. nonsurgical treatment significantly affected overall survival. Conclusions. Anaplastic thyroid carcinoma is a rare and aggressive malignancy. It has a relatively dismal prognosis, but younger age, surgical treatment, and lower stage improve overall survival outcomes.</span></p> </div> 2021-11-30T00:00:00-05:00 Copyright (c) 2021 M. Gore https://www.ej-med.org/index.php/ejmed/article/view/1076 Vaccines for the COVID-19 α Variant: An Econometric Analysis 2021-11-26T06:31:54-05:00 James McIntosh jamesm9@yahoo.com <div><span lang="EN-US">This study examines the success of COVID-19 vaccines in four European countries and Israel for the α variant. These countries respond to the vaccines with varying degrees of success. Countries with successful vaccination programs take about 160 days to get to the minimum number of new cases. Only Italy and Israel came close to eradicating the virus. Vaccines and previous infections have a similar prophylactic effect on new infections. Second doses for the most part add little protection to those who have only one dose. Vaccines become very effective after seven days although there are some added benefits that accrue to individuals in the second week after vaccination. The effect of vaccines on new cases is non-linear and exhibits a decreasing marginal effect. COVID-19 is spread by asymptomatic carriers, a feature of the disease which was discernable at the same time that public health agencies were discouraging the use of masks by the general public and downplaying the importance of social distancing. These were major policy errors and led to many unnecessary deaths.</span></div> 2021-11-22T00:00:00-05:00 Copyright (c) 2021 James McIntosh https://www.ej-med.org/index.php/ejmed/article/view/985 COVID-19 Infection in 8 Big Cities of India: The Dynamics of the Spread and Seropositivity 2021-11-13T02:56:09-05:00 Zameer Shervani shervani.nanotek@gmail.com Deepali Bhardwaj shervani.nanotek@gmail.com Abdullah Sherwani shervani.nanotek@gmail.com Intazam Khan shervani.nanotek@gmail.com Umair Yaqub Qazi shervani.nanotek@gmail.com <p>The seroprevalence in the population of 8 big cities (Ahmedabad, Jaipur, Bangalore, Pune, Coimbatore, Surat, Visakhapatnam, and Nagpur) of India and the dynamics of the COVID-19 spread have been compared. The seropositivity data are of the self-referred residents only. The research is useful to know if the seroprevalence that occurred in the population has decreased the surge in infection in the second wave of the pandemic. The seroprevalence data are for the period July-December 2020 while the monthly new infections have been studied for July 2020-June 2021. For the cities: Visakhapatnam, Nagpur, Surat, Pune, and Coimbatore, the seropositivity of the population reached a plateau and then decreased. A decrease in seroprevalence did not result in higher infection rates. The seropositivity of Jaipur, Ahmedabad, and Bangalore showed a monotonous increase. A relationship between the plateau values of seroprevalence and infection rates could be established. More seroprevalence resulted in lower infection rates in cities (Bangalore, Visakhapatnam, Jaipur) and (Surat, Coimbatore, Pune) in the second wave of COVID-19 pandemic. The investigation of seroprevalence in the population will help in ramping up vaccination to eradicate the pandemic.</p> 2021-11-03T00:00:00-04:00 Copyright (c) 2021 Zameer Shervani, Deepali Bhardwaj, Intazam Khan, Umair Yaqub Qazi https://www.ej-med.org/index.php/ejmed/article/view/1011 Teaching Human Anatomy: A Comparison of In-Person and Online Learning Programs 2021-11-13T02:55:59-05:00 James McKivigan jmckivig@touro.edu Noel Guison nguison@touro.edu Rakhshindah Qureshi rqureshi@touro.edu <div> <p class="Text"><span lang="EN-US"><em>Background:</em> The COVID-19 pandemic created challenges in providing anatomy instruction to allied health professions. Human anatomy laboratory classes often rely on human cadavers as instructional material. At some institutions, the anatomical instructional method shifted to online resources. It was essential to compare online methods to those used in the traditional cadaver-based curriculum to determine efficacy. A technique was devised to compare these two approaches. The working hypothesis was that virtual human anatomy models are equally effective to traditional methods in providing anatomy instruction to allied health students.</span></p> </div> <div> <p class="Text"><span lang="EN-US"><em>Methods:</em> Students enrolled in this study participated in a human anatomy course delivered either in-person or virtually via Aclan’s Anatomy, NetAnatomy, and Anatomy TV. The instructional design was the same except that the in-person learning group participated in a real-time cadaver anatomy lab, while the virtual learning group utilized online models and simulations. Students were assessed using the same three written tests and three laboratory examinations.</span></p> </div> <div> <p class="Text"><span lang="EN-US"><em>Results:</em> Student demographics and evaluation outcomes were presented, and no significant differences concerning sex or educational program between the two student cohorts were identified. Post hoc testing revealed no statistically significant differences between student cohort and test-type. The three-way interaction between test type, test number, and cohort was not significant.</span></p> </div> <div> <p class="Text"><span lang="EN-US"><em>Conclusions:</em> The findings confirmed the hypothesis. There were no statistically significant differences between the test performance of human anatomy students who received online training versus those who participated in in-person classroom instruction. These results suggest that human anatomy can be taught effectively using an online format.</span></p> </div> 2021-11-04T00:00:00-04:00 Copyright (c) 2021 James McKivigan, Noel Guison, Rakhshindah Qureshi https://www.ej-med.org/index.php/ejmed/article/view/954 Distribution of ABO, Rhesus Factor Blood Phenotype and Haemoglobin Genotype among Antenatal Clinic Attendees in Anyigba, North Central Nigeria 2021-11-13T02:55:56-05:00 Simon P. O. Akogu simon.a@ksu.edu.ng Owemidu Idowu Olumorin owemidu.io@ksu.edu.ng Shedrack Egbunu Akor shedrackegbunu@yahoo.com <div> <p class="Text"><span lang="EN-GB"><em>Background:</em> In the practice of obstetrics and gynecology, the ABO and Rhesus factor (Rh) blood type are important. Blood typing for blood transfusion of compatible blood is very common in emergency and routine care. There is a scanty literature on the distribution of ABO and Rhesus blood types in Anyigba, (North central) Nigeria.</span></p> </div> <div> <p class="Text"><span lang="EN-GB"><em>Objective:</em> This study aims to determine the distribution of ABO blood and Rhesus blood group phenotypes and Hemoglobin genotypes among antenatal clinic attendees in a teaching hospital.</span></p> </div> <div> <p class="Text"><span lang="EN-GB"><em>Methods:</em> Antenatal records of attendees (October 2017 to September 2020) at the Kogi State University Teaching Hospital were retrieved and results of antenatal hematological investigations were collected using a structured tool.Bio data, ABO blood group, Rhesus group phenotype and Hemoglobin genotype were collected, inputted and analyzed using SPSS version 20.</span></p> </div> <div> <p class="Text"><span lang="EN-GB"><em>Results:</em> The mean age was 26 +/- 7years, blood group O is most prevalent,561 (53.6%) then A 276 (26.4%), B 189 (18.1%) and AB,21 (2%).1014 (96.4%) were Rhesus D positive, 33 (3.1%) were Rhesus D negative. For hemoglobin genotype, 786 (75.1%) were AA, 258 (24.6%) were AS, AC were 3 (0.3%). </span></p> </div> <div> <p class="Text"><span lang="EN-GB"><em>Conclusion:</em> The distribution of the ABO, the Rhesus (D) blood groups and hemoglobin genotypes are in concurrence with the findings of previous studies; Blood group O is the most prevalent and AB the least prevalent, Rhesus (D) positive in the population is high and the hemoglobin genotype AA is the most prevalent. There is no association between blood group phenotypes studied and the hemoglobin genotypes.</span></p> </div> 2021-11-08T00:00:00-05:00 Copyright (c) 2021 Simon P. O. Akogu, Owemidu Idowu Olumorin, Shedrack Egbunu Akor https://www.ej-med.org/index.php/ejmed/article/view/1105 Role of Growth Factors-Rich Plasma, Gel and Membrane in Dermal Wound Healing and Injured Tissue Restoration and Regeneration 2021-11-13T02:55:52-05:00 Tariq Mehmood Dar drtariqsjg@gmail.com Kashif Ali Samin kashif@kmu.edu.pk <div> <p class="Text"><span lang="EN-US"><em>Background:</em> The socioeconomic burden on society grows as the incidences of chronic age-related degenerative diseases increase which demand extensive wound care as well. To speed up the healing of cutaneous wounds, new wound healing treatments must be researched, trialed &amp; developed. Regeneration therapies are gaining popularity since they are less invasive than other treatments.</span></p> </div> <div> <p class="Text"><span lang="EN-US"><em>Method:</em> Published research paper have been reviewed to develop a concept and analyze the role of Platelet-rich plasma (PRP) and Growth factors-rich plasma in speedy wound healing and tissue regeneration. Three patients with diabetic ulcers have been selected and applied Growth factors-rich plasma and membrane treatment on weekly basis and analyzed the results. </span></p> </div> <div> <p class="Text"><span lang="EN-US"><em>Results:</em> Growth factors-rich plasma injection and membrane application on wound have produced remarkable wound healing outcome within 3 to 6 applications with new vascularization and re-epithelialization. </span></p> </div> <div> <p class="Text"><span lang="EN-US"><em>Conclusion:</em> Growth factors-rich plasma and membrane application on wound gained favor as a wound-healing therapy due to its constituents which have remarkable potential to speed up the injured tissue repair and regeneration. The release of cytokines with platelet-derived growth molecules enveloped in alpha-granule, promote &amp; facilitate wound healing.</span></p> </div> 2021-11-08T00:00:00-05:00 Copyright (c) 2021 Tariq Mehmood Dar, Kashif Ali Samin https://www.ej-med.org/index.php/ejmed/article/view/1106 Basic Life Support Awareness in Pakistan: Still in Embryonic Phase 2021-11-13T02:55:46-05:00 Sana Abbas doctor_amcollian@yahoo.com Beenish Abbas beenishabbas1982@gmail.com Ayesha Maqsood amaqsood7@yahoo.com Syeda Rabia docgeelaanee@gmail.com Ramesha Azam ramesha.12@hotmail.com Hina Ishaq bdsgraduate@gmail.com <div> <p class="Text"><span lang="EN-US"><em>Objectives: </em> To gauge/evaluate the knowledge and skill of BLS trained and untrained teaching faculty members at postgraduate tertiary care training institute </span></p> </div> <div> <p class="Text"><span lang="EN-US"><em>Materials and Methods:</em> A prevalidated questionnaire comprising of 44 questions was distributed among teaching faculty of three big tertiary care, post-graduate institutes. The questions were focused on evaluating the knowledge and awareness of the participants. Total number of the participants was 345</span></p> </div> <div> <p class="Text"><span lang="EN-US"><em>Statistical Analysis:</em> Data was entered and analyzed by using SPSS (version 23.0). </span></p> </div> <div> <p class="Text"><span lang="EN-US"><em>Results:</em> The mean knowledge score related to basic life support was 4.57±1.81 out of total 12 points and the mean score for level of awareness regarding BLS was 34.5 %. Moreover, only 28.15% were aware of the current AHA guidelines</span></p> </div> <div> <p class="Text"><span lang="EN-US"><em>Conclusion:</em> The low level of knowledge and awareness regarding BLS in the health care workers depicts that regular BLS hands-on- workshops should be conducted and should be a part of mandatory training.</span></p> </div> 2021-11-10T00:00:00-05:00 Copyright (c) 2021 Sana Abbas, Beenish Abbas, Ayesha Maqsood, Syeda Rabia, Ramesha Azam, Hina Ishaq https://www.ej-med.org/index.php/ejmed/article/view/1114 Improving Medical Handover: An SHO-Led Approach to Implementing A Formalized Handover System 2021-11-21T07:11:26-05:00 Rachel Hallam rachel.hallam3@nhs.net Kurun Kumar kurun.kumar@nhs.net Susan Akintunde rachel.hallam3@nhs.net Opeyemi Akinnawonu o.akinnawonu@nhs.net Saba Mahmood saba.mahmood@nhs.net Rabiu Momoh rabiu.momoh@nhs.net <div> <p class="Text"><span lang="EN-US">Handover is a high-risk exercise. As the number of doctors in hospitals vary between shifts, continuity of care must be secured from many professionals down to a few. Literature has repeatedly shown that handover time is when the greatest number of medical errors occur [1]. Tasks may be inefficiently handover over, mis-represented or forgotten entirely. We have shared perspectives from a quality improvement (QI) project undertaken at the William Harvey Hospital, Kent, United Kingdom towards ensuring safe and smooth handover of medical tasks between shifts at the acute medical department in this hospital.</span></p> </div> 2021-11-14T00:00:00-05:00 Copyright (c) 2021 Rachel Hallam, Kurun Kumar, Susan Akintunde, Opeyemi Akinnawonu, Saba Mahmood, Rabiu Momoh https://www.ej-med.org/index.php/ejmed/article/view/1097 Socio-Cultural and Societal Demands Influencing Pregnancy among HIV Positive Women in Kakamega County, Kenya 2021-11-21T07:11:21-05:00 Isaac Maru maruisaac2015@gmail.com Rose Olayo rolayo@mmust.acke Mary Kipmerewo kipmerewosoi@yahoo.com <div><span lang="EN-US">Globally, the number of women living with HIV who desire pregnancy has been increasing and little is known as what motivates them, with test and treat women accessing ART desiring pregnancy will increase. Kakamega County has been leading in the region on women living with HIV accessing antenatal services. Past literature in the subject matter failed to look at socio-cultural and societal factors influencing pregnancy among HIV positive women in Kakamega County, Kenya; a gap that informed this study. A descriptive cross-sectional research design was employed. The target population were women aged 18-49 years receiving their family planning services in sub-county hospitals in Kakamega County. Key informants were made up of health care workers at comprehensive care clinics. Purposive sampling was used to select 4 sub-county hospitals, systematic random sampling to select 319 known HIV positive women and 4 focus group discussions. Questionnaires focused on group discussions and key informant interviews were used to collect data. Data collected were entered into Statistical Package for Social Sciences version 25.0. Descriptive results were presented in proportionate tables. The results showed that age, education, employment status and parity influenced the desire for pregnancy among HIV positive women in Kakamega County. Society influenced the number of children a woman should have. The community held a negative perception of childless women, especially HIV positive women; the community members did not attach value and pride over the childless HIV positive women. The socio-cultural and societal demand on HIV positive women influenced pregnancy; however, there decreasing association, which meant that the society was 71% less likely to influence the number of children; the spouse was 63% less likely to influence pregnancy. In conclusion, age, education level, marital status parity and employment status, medical cover influenced pregnancy among the known HIV positive women in Kakamega County. Socio-cultural and societal demands were predictors of pregnancy among known HIV positive women in Kakamega County. The community should treat HIV positive women with respect and dignity, thus permitting them to continue their family legacy and sire children. It recommends that there is a need for the county government, department of health services to provide health education to the community on stigma reduction and discrimination meted on these women and negative perception of childlessness women in the society especially known HIV positive women. Further works on the myths and misconception that barrenness is blamed on women leaving men scot-free for the cloud to be the culprits of childlessness in the family. </span></div> 2021-11-16T00:00:00-05:00 Copyright (c) 2021 Rose Olayo, Isaac Maru, Mary Kipmerewo https://www.ej-med.org/index.php/ejmed/article/view/1096 Deciphering Long Covid: Next Emergent Healthcare Dilemma 2021-11-21T07:11:24-05:00 Sana Abbas doctor_amcollian@yahoo.com Beenish Abbas beenishabbas1982@gmail.com Haifsa Rafique haifsa.rafique@gmail.com Aisha Rafique mubasshir85@live.com Saima Zafar saima_i_khan@hotmail.com Ramesha Azam ramesha.12@hotmail.com <p><em>Objective:</em> To determine the prevalence of Long Haul COVID–19 Syndrome among Pakistani Population.</p> <p><em>Methods:</em> This cross-sectional analytical study was conducted after approval from the ethical review committee of the Foundation University College of Dentistry, Islamabad from June 2021 to September 2021. A non-probability consecutive sampling methodology was employed and a total of (168) participants after voluntary consent were enrolled in the study, after explaining the study protocol to the patients. The final Questionnaire is comprised of three sections. Section – I focused on the demographic profile (Age, Gender, Profession) of the participants. Section – II was designed to investigate COVID – 19 disease history, comorbid, coronavirus disease severity along with the number of individuals infected in the family, duration of positive polymerase chain reaction results, and management destination (Hospital or Home). Section – III addressed the frequency of persistent symptoms (Gastrointestinal, Systemic, Cardiovascular, Musculoskeletal, Immunological, Dermatological, Neuropsychiatric, Ophthalmological, Pulmonary, Otorhinolaryngological, Endocrine, Reproductive and Genitourinary systems).</p> <p><em>Results:</em> 168 responders participated in this survey study,48 (28.6%) males while 120 (71.4%) females. About 36 (11.9%) were found to be suffering from comorbidity, 84 (50.0%) suffered from mild disease symptoms, while only 4 (2.4%) experienced the severe disease. The disease was managed at home for a major chunk of responders, 140 (83.3%).132 (78.6%) were found to have suffered from long COVID syndrome with the persistence of symptoms beyond four weeks of infection. The most common symptoms included fatigue (78.8%), fever (60.0%), loss of taste (57.8%), dry cough (45.5%), headache (42.4%), post-exertional malaise (45.5%), shortness of breath (39.4%), insomnia (39.0%), loss of smell (36.4%), loss of appetite (33.3%) and depression (33.3%).Male gender (p=0.009), with existing chronic illnesses (p&lt;0.001), moderate and severe disease (p&lt;0.001), higher age group (p&lt;0.001) and isolated at hospital (p=0.002).</p> <p><em>Conclusion:</em> In conclusion, this study has shown that persistence of COVID disease symptoms (most common symptoms included fatigue, fever, loss of taste, dry cough, headache, post-exertional malaise, shortness of breath, insomnia, loss of smell, loss of appetite, and depression) are common in Pakistani population. Male gender, existing chronic illnesses, moderate and severe disease, higher age group, and isolation at the hospital are the probable risk factors.</p> 2021-11-16T00:00:00-05:00 Copyright (c) 2021 Sana Abbas, Beenish Abbas, Haifsa Rafique, Aisha Rafique, Saima Zafar, Ramesha Azam https://www.ej-med.org/index.php/ejmed/article/view/1117 Optimized QRT-PCR Approach for the Measurable Impact of Adjuvant Cholecalciferol Therapy in Ameliorating Cytokine Gene Expression 2021-11-21T07:11:17-05:00 Javed Akram vc@uhs.edu.pk Akram Tariq akram@soe.ucsc.edu Gibran Ali lonsa25@student.london.ac.uk Fridoon Jawad Ahmed drfridoon@gmail.com Syeda Saba Aslam medicalaffairs@scotmann.com.pk <p>The endemic Vitamin D deficiency in Pakistan and the current COVID-19 epidemic have converged into a double whammy scenario in Pakistan [1]. Nutritional epigenomic studies have highlighted Vitamin D as a master Vitamin influencing various genomic expressions through its active metabolite 1α,25-dihydroxyvitamin D3 [2]. The objective of this study was to evaluate the measurable impact of adjuvant Cholecalciferol therapy in the Cytokine gene expression of COVID-19 patients by quantitative Real-Time Polymerase Chain Reaction analysis. The trial was a randomized control prospective open label interventional trial done on moderate to severe COVID-19 patients with deranged inflammatory and coagulation biomarkers. SunnyD STAT (Vitamin D3 200000 IU) softgels were given at Day 1, Day 3 and Day 5 of the treatment. Optimized quantitative Real-Time Polymerase Chain Reaction analysis showed decreased genetic expressions of Interleukin 6 (IL-6), Interleukin 2RA (IL-2RA) and Tumor Necrosis Factor (TNF-a) in the interventional group against the age and co-morbidities matched controls, providing molecular and genetic level evidence for the purported mechanism of amelioration of Cytokines induced pathogenic inflammation. However, inherent limitations of the design restrict the generalizability of the results and warrants caution for extrapolation. We recommend randomized placebo-controlled trials with larger sampling and genome wide profiling to infer more definite interpretations.</p> 2021-11-16T00:00:00-05:00 Copyright (c) 2021 Javed Akram, Akram Tariq, Gibran Ali, Fridoon Jawad Ahmed, Syeda Saba Aslam https://www.ej-med.org/index.php/ejmed/article/view/1035 Symptom Frequencies and Correlations with Temperature Variations in Suspected Cases of Neuroleptic Malignant Syndrome (NMS) 2021-11-21T07:11:13-05:00 Varadaraj R. Velamoor velamoorraj@gmail.com Stephan C. Mann smann1234@aol.com Michel A. Woodbury michel.woodbury@upr.ed Zack Z. Cernovsky drcernovsky@gmail.com <p><em>Background:</em> The incidence of NMS is rare. Relative frequencies of symptoms that are most valuable in making a diagnosis of NMS can be assessed statistically only if a large sample of suspected NMS cases is available. Similarly, the relationship of such NMS symptoms to temperature (a cardinal symptom of NMS) can be meaningfully evaluated only by studying large samples.</p> <p><em>Method:</em> De-identified archival data on 212 suspected NMS cases were obtained from professionals across the USA and Canada or were extracted from studies published in medical journals. We recorded the symptoms frequencies. The patients’ temperature ranged from 37.20C to 43.00C, with the mean at 39.50 (SD=1.3). All cases were caused by older first-generation antipsychotics (FGAs). We evaluated the frequencies of symptoms reported in these cases. These included symptoms in the realm of mental status, rigidity, and autonomic symptoms. We calculated the frequency of abnormal blood pressure, respiration and heart rate, symptoms such as Dysarthria, Dysphagia, Rigidity, Focal Dystonia, Waxy Flexibility, Myoclonus, Masked Facies, Bradykinesia, Akinesia, Cogwheeling, Stupor, Coma, Obtundation, Mutism, Decrease in Consciousness, Disorientation, Diaphoresis, Sialorrhea, and Seizures. We also calculated their correlations with temperature elevations, the most spectacular symptom of this dangerous syndrome.</p> <p><em>Results:</em> The highest symptom frequencies (those &gt; 10%) were found for Rigidity (91.0% of patients), Autonomic Instability (66.5%), Diaphoresis (45.8%), Mutism (34.4%), Tremor (31.6%), Stupor (20.3%), Confusion (15.6%), Incontinence (15.6%), Sialorrhea (14.6%), Coma (13.2%), and Dysphagia (11.3%). Other symptoms were too rare within the sample of the 212 suspected NMS cases to calculate the statistical significances of their relationships to temperature. The only significant correlations found of temperature were to increased heart rate and to the severe cases of coma.</p> <p><em>Discussion and Conclusion:</em> Besides the elevated temperature, the most frequently reported symptoms in this sample of suspected NMS caused by FGAs were Rigidity, Autonomic Instability, Diaphoresis, Mutism, and Tremor. Higher temperature was associated with tachycardia as well as profound impairment of consciousness or coma. Reviews and database studies of second generation antipsychotics (SGAs), also referred to as atypical antipsychotics, suggest a lower incidence of NMS and milder severity of symptoms such as hyperthermia and rigidity. It would be of clinical interest to generate similar de-identified files of archival data for suspected cases of NMS in patients treated with SGAs. Furthermore, a similar profile derived from archival data on milder or prodromal NMS cases could enhance our understanding of this syndrome from a spectrum perspective.</p> 2021-11-17T00:00:00-05:00 Copyright (c) 2021 Varadaraj R. Velamoor, Stephan C. Mann, Michel A. Woodbury, Zack Z. Cernovsky https://www.ej-med.org/index.php/ejmed/article/view/1088 Ilex paraguariensisA. St.-Hil. (Yerba Mate) Differently Regulates the Lipid Mobilization and Irisin and Lactate Levels in Sedentary and Chronic Swimming Mice 2021-11-21T07:11:09-05:00 V. L. de Souza vladilopes@hotmail.com E. T. G. Stutz evandro.tgs@gmail.com M. E. de S. F. Pehrson moyses.pehrson@ubm.br G. C. Coelho cenicoelho@gmail.com C. C. Netto claudia.c.netto@unirio.br C. A. B. de Maria carreb@uol.com.br <div> <p class="FigureCaption"><span lang="EN-US">Healthy mice were submitted or not to daily chronic swimming and/or daily yerba mate (YM) infusion intake and had their bloods analyzed after four weeks. We hypothesized that daily intake of YM may act differently on lipid mobilization and, on the creatine, lactate and irisin levels in sedentary mice and those submitted to chronic exercise. The groups were (n=48): YM-non-treated control (NTC), YM-non-treated swimming control (NSC), non-roasted YM (NRY), roasted YM (RY), swimming plus non-roasted YM (SNRY), swimming plus roasted YM (SRY). No significant (P&gt;0.05) difference was observed concerning creatine phosphoskinase (CPK) value. Lactate level decreased significantly (P&lt;0.05) for SNRY and SRY, suggesting accelerated lipid mobilization and glycogen sparing potential. There was significant (P&lt;0.05) body weight loss in all, except for NTC. Higher weight loss in NRY, RY, SNR and SRY indicated greater lipid mobilization. Thiobarbituric acid reactive substances (TBARS) and irisin had significantly (P&lt;0.05) higher values for RY. This is first report that deals with the effect of YM consumption on serum irisin level. Major amounts of caffeic acid derivatives, slightly increased caffeine and less amount of rutin may be responsible by accelerated lipoperoxidation in sedentary healthy mices chronically treated with roasted YM. Chronically consumed YM plus swimming aid in healthy weight loss. Sedentary lifestyle plus roasted YM chronic consumption may cause accelerated lipid mobilization and increased TBARS production via irisin overexpression leading to an increase in lipoperoxidation.</span></p> </div> 2021-11-17T00:00:00-05:00 Copyright (c) 2021 V. L. de Souza, E. T. G. Stutz, M. E. de S. F. Pehrson, G. C. Coelho, C. C. Netto, C. A. B. de Maria https://www.ej-med.org/index.php/ejmed/article/view/1120 Current Review of Delta Variant of SARS-CoV-2 2021-11-26T06:31:52-05:00 Selia Chowdhury chowdhury.selia@gmail.com Mehedi Hasan Bappy chowdhury.selia@gmail.com Samia Chowdhury chowdhury.selia@gmail.com Md. Shahraj Chowdhury chowdhury.selia@gmail.com Nurjahan Shipa Chowdhury chowdhury.selia@gmail.com <p>Mutations <span lang="EN-US">are causing SARS-CoV-2 to alter its genetic structure to improve its potential to elude the immune system, making vaccine buildout against the virus more difficult. Multiple SARS-CoV-2 variants have been found up to this point; based on their impact on public health some are considered variants of concern (VOCs) and some are considered variants of interests. VOCs are linked to superior transmissibility, a decline in neutralization by natural or vaccine induced antibodies, evading capability of detection, and a reduction in the efficacy of vaccines or therapeutics. In this article, a SARS-CoV-2 subtype, known as Delta, has been revised to provide the current state of the art and an appropriate foundation for future research works. The evolution, pathogenesis, current trends of transmission, associated symptoms, suggested prevention and treatments, and vaccine efficacy of Delta variant are reviewed and discussed. </span></p> 2021-11-23T00:00:00-05:00 Copyright (c) 2021 Selia Chowdhury, Mehedi Hasan Bappy, Samia Chowdhury, Md. Shahraj Chowdhury, Nurjahan Shipa Chowdhury https://www.ej-med.org/index.php/ejmed/article/view/1098 Rhabdomyolysis and Obstetric Correlates: Literature Perspectives for the Obstetric Anesthesiologist 2021-11-13T02:55:54-05:00 Rabiu Momoh rabiu.momoh@nhs.net <div> <p class="ReferenceHead"><span lang="EN-US">Rhabdomyolysis complicating the antepartum or peripartum period is not a commonly reported finding and where they occur, it can be life-threatening. The problem with rhabdomyolysis during pregnancy or labour is the potential harmful systemic and local effects it can cause. These includes cardiac arrhythmias, acute kidney injury, clotting problems in severe cases [1]. To the fetus, foetal distress or foetal demise could be the end-result where timely management is not initiated [2].</span></p> </div> 2021-11-08T00:00:00-05:00 Copyright (c) 2021 Rabiu Momoh https://www.ej-med.org/index.php/ejmed/article/view/1077 Why the Coffee Powder is the Best Topical Wound Dressing? 2021-11-13T02:55:49-05:00 Hendro Sudjono Yuwono hsyabc47@gmail.com <div> <p class="Text"><span lang="EN-US">The coffee powder has inherent capabilities as an antioxidant, anti-inflammatory, and antimicrobial. It is a topical wound dressing for acute and chronic wounds, encouraging results different from the wound dressing known today. It is named the new paradigm of wound management. The study of coffee powder since 2003 as a topical wound dressing has created an understanding condemn to disturb the cells in the wound bed. A thin layer of coffee powder should stay in place to ensure safety, covering superficial wound cells’ growth. The remained thin layer of coffee powder has created minimum detached wound cells. Wound healing provides effectiveness for acute and chronic wounds resulted in low cost, easy to get, acceptable scar, non-traumatic, pleasant scent, and not scary to the patients. The utilization of antioxidant, anti-inflammatory, and antibacterial capacities anticipates the injury of the new growth of epithelial cells at the wound bed. It makes better cell proliferation, proper scar formation and safe naturally. Its simplicity in wound management procedures helps improve public health efforts. Hence, it suggested that the coffee powder has the capabilities of the best topical wound dressing.</span></p> </div> 2021-11-10T00:00:00-05:00 Copyright (c) 2021 Hendro Sudjono Yuwono https://www.ej-med.org/index.php/ejmed/article/view/1070 The Endothelial Barrier Restricts Endocrine Actions to the Luminal Vascular Receptors: Changing the Paradigm: A Didactic Approach 2021-11-21T07:11:34-05:00 Rafael Rubio rrubio@uaslp.mx <p>In 1849, the first list of endocrine hormones was discovered and proposed that the synthesizing gland delivers it to the circulation. The circulatory hormone reaches the target organ, physically unimpeded acts directly on the parenchymal cells. Such a simplistic view persists despite new knowledge of an endothelial wall barrier and implications for every parenchymal cell in the body. This misconception leads to inadequate interpretations of data, wrong diagnosis and therapeutic expectations, erroneous hypotheses, and misleads further research work. The quest of this review is to play down this misconception by pointing out key overlooked findings of the vascular endothelial wall: 1) The selective endothelial barrier physically separates two same-hormone-containing compartments; the endocrine and the interstitial autocrine hormone compartments, 2) the hormone concentrations values in these compartments are independent of each other, 3) in each compartment the hormone acts solely on the receptors of that particular compartment, 4) multiple intravascular endocrine hormones act solely on their corresponding luminal endothelial membrane receptor (LEMR), without directly acting on the parenchymal cells, 5) Agonist-activation of LEMR triggers the release of specific paracrine endothelial agents that in conjunction with autocrine interstitial hormone modulate parenchymal function(s) and perhaps the turnover of the interstitial autocrine hormone, 6) these hormone compartments, functionally interact via paracrine exchange signaling, and the integrated intercourse of all these events result in the final hormonal organ effect. The present challenges to achieving more rationale therapeutic effects are to design agonists or antagonists that exclusively gain access to a target compartment and have high specificity for the receptor of the cells in that compartment.</p> 2021-11-13T00:00:00-05:00 Copyright (c) 2021 Rafael Rubio https://www.ej-med.org/index.php/ejmed/article/view/1099 COVID-19 Induced Cardiovascular Complications and Recent Therapeutic Advances 2021-11-21T07:11:32-05:00 Selia Chowdhury chowdhury.selia@gmail.com Mehedi Hasan Bappy chowdhury.selia@gmail.com Samia Chowdhury chowdhury.selia@gmail.com Md. Shahraj Chowdhury chowdhury.selia@gmail.com Nurjahan Shipa Chowdhury chowdhury.selia@gmail.com <p>A global pandemic instigated by SARS-CoV-2 virus has been going strongly for almost two years. There have been almost 240 million cases with almost 5 million fatalities all over the world so far. COVID has affected almost every aspect of people’s lives halting the world in immeasurable ways. Although COVID-19 is mostly affecting the respiratory system, it is also responsible for a significant amount of cardiovascular system involvement. On one hand, it deteriorates any pre-existing cardiovascular condition, on another hand, it triggers other inflammation-facilitated acute events. They comprise of inflammatory heart disease, severe pericardial effusion, ventricular arrhythmias, endothelial dysfunction, pulmonary hypertension, heart failure, and many more. In this article, we summarize the features, management, and treatment of several important COVID-19 induced cardiovascular complications. Recent advances in the treatment of these diseases along with the justification and concerns of specific therapeutic measures are also discussed.</p> 2021-11-13T00:00:00-05:00 Copyright (c) 2021 Selia Chowdhury, Mehedi Hasan Bappy, Samia Chowdhury, Md. Shahraj Chowdhury, Nurjahan Shipa Chowdhury https://www.ej-med.org/index.php/ejmed/article/view/1055 The Diagnosis of Unilateral Diaphragmatic Paralysis Using M-mode: A Case Report from Palestine 2021-11-13T02:56:01-05:00 Mohammed Khatib m_taisir1993@yahoo.com Muayad Salman muyad.salman@iah.ps Sami Smerat sami_sm2006@yahoo.com Marah Abu Muhsen marahabumuhsen@iah.ps <p><em>Background:</em> Diaphragmatic paralysis is one the causes of dyspnoea and difficulty in breathing. There are many causes of diaphragmatic paralysis, especially trauma and iatrogenic injury of phrenic nerve. Usually, diaphragmatic paralysis diagnosis depends on fluoroscopic examination of diaphragmatic displacement during sharp sniffs. However, due to disadvantages of fluoroscopic examination, the trend for less radiation examination by using ultrasound is increasing especially using M-mode for detection of diaphragmatic motion during respiration.</p> <p><em>Case:</em> A new-born baby boy with uneventful pregnancy and normal delivery with good general condition, developed severe respiratory distress at 3rd day of life and was diagnosed to have bilateral pneumothorax. Bilateral chest tubes were inserted with improvement of his condition. The baby then started to develop desaturation with serial chest x-rays done and showed elevated left hemi-diaphragm. Suspicion toward left hemi-diaphragm paralysis increased and due to his general condition, fluoroscopic examination was difficult. So that, Ultrasound with M-mode was used with diagnosis of the patient with left hemi-diaphragmatic paralysis.</p> <p><em>Conclusion:</em> Ultrasound and the using of M-mode in detection of diaphragmatic motion is one of the most important and applicable diagnostic procedure for diagnosis of diaphragmatic weakness and paralysis.</p> 2021-11-03T00:00:00-04:00 Copyright (c) 2021 Mohammed Khatib, Muayad Salman, Sami Smerat, Marah Abu Muhsen https://www.ej-med.org/index.php/ejmed/article/view/1049 An Unusual Case of Uterovesical Polyp in a Patient Following Repeated Caesarean Section 2021-11-21T07:11:37-05:00 Okwudili C. Amu amuokwy@yahoo.com Emmanuel A. Affusim primusal@gmail.com Ugochukwu U. Nnadozie ugodozie1@gmail.com Balantine U. Eze buneze@rocketmail.com <p>NE is a 36yr old petty trader who has had four previous caesarean sections. She went for her routine abdominal ultrasonography at 36weeks of her fifth pregnancy and an incidental posterior bladder polypoid mass was found with a normal singleton fetus. Patient declined cystoscopy but accepted exploration of bladder at same time with a caesarean section. At Surgery, a polyp was found arising from the lower uterine segment traversing the thin posterior bladder wall into the bladder. The polyp was carefully dissected out and separated from bladder. Bladder and uterus were repaired, and patient had uneventful recovery. </p> 2021-11-13T00:00:00-05:00 Copyright (c) 2021 Okwudili C. Amu, Emmanuel A. Affusim, Ugochukwu U. Nnadozie, Balantine U. Eze https://www.ej-med.org/index.php/ejmed/article/view/1112 Dislocation After Bipolar Hemiarthroplasty in Elderly Patient: A Case Report 2021-11-21T07:11:29-05:00 Cokorda Gde Oka Dharmayuda dharmayudadr@gmail.com Febyan febyanmd@gmail.com <div> <p class="Text"><span lang="EN-US">Total hip arthroplasty and hemiarthroplasty are two primary treatment choices for elderly patients with fractures or dislocations of the pelvic bone, as well as in fractures of the femoral neck. Dislocation of bipolar hemiarthroplasty is a rare postsurgical complication, but it can be a problem that requires acute management and is quite challenging to revise. We presented a case of an elderly patient with dislocation of hip bipolar hemiarthroplasty on the right side. The patient underwent a revision of total hip arthroplasty and had a satisfactory outcome. Mobilization began within two days after surgery. One-year follow-up revealed no occurrence of long-term complications.</span></p> </div> 2021-11-13T00:00:00-05:00 Copyright (c) 2021 Cokorda Gde Oka Dharmayuda, Febyan