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Trends in Medical Research

Obesity is a chronic multi-factorial disease associated with serious increases in adiposity, morbidity and mortality rates. Ghrelin, leptin and adiponectin complexly interact to modulate appetite and mediate metabolic processes. The objective was to evaluate the effects of Bioenteric Intragastric Balloon (BIB) versus conservative therapy (diet and physical exercise) on plasma ghrelin, leptin, insulin and adiponectin in obese subjects. A total of 128 adult consecutive morbidly obese individuals were randomized into: BIB group comprised 84 patients treated with Intragastric Balloon and control group comprised 44 obese patients treated with conservative treatment only. In BIB group, insertion of balloon caused a significant reduction in body mass over a 6-months period compared with the control group. After one month, the levels of ghrelin increased significantly then gradually decreased, reaching the starting level three months after the removal of the balloon. Also, leptin level decreased significantly. In the control group, the corresponding of ghrelin and leptin levels remained relatively stable. In BIB group, adiponectin significantly increased as opposed to a transient increase in the control group. Conclusion: intragastric balloons in association with low-calorie diet are effective, safe, reversible, but short-lasting therapeutic endoscopic intervention in obese patients. The treatment with BIB causes significant changes in the levels of appetite-regulatory hormones beside a body mass reduction, changes in carbohydrate and lipid metabolism and improved co-morbidities. 2014/04/27 - 08:00

The correlation between celiac disease (CD) and type 1 diabetes (T1D) mellitus has been known for decades. However, the data assessing celiac disease prevalence in type 1 diabetic patients among Arab population especially in Egypt were scarce. This study assessed celiac disease prevalence and its genotypic profile in Egyptian type 1 diabetic patients and their non diabetic relatives and determined effects of gluten-free diet on diabetes control and anthropometry. A total of 500 outpatients {15-49 years; with type 1 DM (300; F/M: 168/132) and their non diabetic relatives (200; F/M: 91/109)} and another 300 age and sex matched healthy control were randomly enrolled and screened for CD by tissue transglutaminase (TTG) antibodies, HLA genotyping and distal duodenal biopsy. The demographic, clinical, anthropometric data and effects of gluten free diet were assessed. CD prevalence was 10.3, 2 and 0.3% in T1D, relative and control groups, respectively. The majority of CD patients (77.42%) carried the HLA-DQ2 in linkage with HLA-DRB1*03 alone (41.9%) or with other alleles (DRB1*01,*04,*07,*08,*09,*13). Eleven patients (35.48%) carried HLA-DQ8 either alone in three patients or with other alleles (DRB1*03,*07 in five and three patients respectively. Only one patient with positive TTG-IgG and normal histopathology had negative DQ2 and DQ8 but positive DRB1*7 and *11 haplotypes. CD is a frequent but commonly under-diagnosed among Egyptian T1D patients. HLA-DQ2 and DQ8 genotypes (in linkage with HLA-DRB1*3 and HLA-DRB1*4 alleles) responsible for CD development are highly prevalent in Egyptian CD patients with T1D. 2014/04/27 - 08:00

To determine the value of first day serum bilirubin level in prediction of subsequent development of significant hyperbilirubinemia in the newborn population. It was conducted during the period from August 2011-2012. One hundred healthy newborns were enrolled in the study. Serum bilirubin was estimated for all enrolled cases within the first day of life. Babies were followed up clinically for the appearance and progression of jaundice daily up to the fifth day of life. Jaundice was clinically detected in 74 (74%) newborn. The best cut off value of Total Serum Bilirubin (TSB) at the first day in predicting jaundice was 2.7 mg dL-1. The first day TSB of neonates who developed jaundice was significantly higher than those who didn’t develop jaundice (4.1, 2.3 mg dL-1, respectively). Significant hyperbilirubinemia was presented in 9 (9%) of cases. The mean first day TSB level was higher in cases with significant jaundice than that of neonates without significant jaundice (7.4, 3.3 mg dL-1, respectively). The best cut off value of TSB at first day in predicting significant hyperbilirubinemia was 6 with a sensitivity of 100.0% and specificity of 100.0%. Based on results of the present study, first day measurements of total serum bilirubin is a good predictor of significant development of hyperbilirubinemia in the subsequent days. The cutoff point is 6 mg dL-1 in the first day. 2014/04/27 - 08:00

The pathogenesis of type 2 diabetes is a complex phenomenon. Many research works have implicated obesity and dyslipidaemia as possible causes of type 2 diabetes mellitus. The aim of this study was to determine the association between BMI, oxidative stress and skeletal muscle mass in the aetiology of type 2 diabetes. The study was conducted at the Komfo Anokye Teaching Hospital, Kumasi Ghana. The study involved 120 diabetic subjects and 80 non diabetics as control, matching age and sex with the diabetics. Anthropometric parameters measured include height, weight, waist circumference, hip circumference, thigh circumference, plasma glucose was determined by the enzymatic method and plasma creatinine concentration by the Jaffe reaction using creatinine reagent. Urine sugar was estimated using a urine test strip. Malonyldialdehyde level in serum was estimated spectrophotometrically according to the Buege and Aust method. The body mass index was significantly higher in the diabetics than the controls (26.45±6.49 and 22.13±3.30 kg m-2) (p<0.001), respectively. Fasting blood glucose levels were obviously higher in the diabetics than in the non-diabetics (9.925±0.544 and 5.448±0.88 mmol L-1) (p<0.0015). Serum MDA concentration was significantly higher in the diabetics than the controls (0.29±0.03-0.23±0.02 μmol L-1 (p<0.0502) while Serum creatinine of the diabetics was non significantly lower than that of the controls (98.70±53.94-101.9±34.00μmol L-1 (p<0.3677). Overweight, skeletal muscle and oxidative stress may play a significant role in the aetiology of type 2 diabetes or at least aggravate the diabetes. 2014/04/27 - 08:00

This prospective trial conducted on 50 patients who underwent infrainguinal femoropopliteal reconstruction as a definitive treatment of critical chronic lower limb ischemia using either great saphenous vein graft, or polytetrafluoroethylene (PTFE) graft. The clinical outcome of graft patency was assessed in relation to graft infection and risk factors which include: female gender, smoking, the American Society of Anesthesiologists (ASA) grade, diabetes mellitus, hypertension, hyperlipidemia, and obesity. Patients were followed up for a median of 18 months. The outcome of surgery (relieve of rest pain, healing of ischemic ulcers, and patency of the graft) was recorded as well as morbidity and mortality. There were thirty two saphenous vein reconstruction and eighteen PTFE grafts. Thirty days and 3 years mortality were one and 6 respectively. Five cases underwent graft removal and another graft reconstruction. Three patients underwent graft excision but no reconstruction with limb survival in 2 cases and amputation in one case. One patient needed angioplasty. Surgical site infection was diagnosed in 5 patients (10%). The three excised grafts were contaminated with Staphylococcus aureus in two cases and Staphylococcus epidermidis in one case. Enterobacteriaceae was cultured either alone or in combination with Staphylococcus epidermidis in two cases. In one case, the bacterial culture was negative. Females had significantly reduced graft patency rates compared with their male counterparts (p≤0.02) and high ASA grade (III, IV) was predictor of graft failure (p≤0.04). Among the demographic and operative factors which can predict graft failure, the most important are female gender, the presence of critical ischemia at time of primary surgery, the occurrence of a post-operative complication and high ASA grade. A pre-operative history of smoking was not shown to adversely affect long-term graft patency. These data may be of benefit in pre-operative patient selection, patient counseling and ensuring close patient follow-up. 2014/03/28 - 21:44

Myoepithelial cells are highly specialized cells which express cytoskeletal and contractile proteins such as α-smooth muscle actin (α-SMA). This study was performed in order to determine the immunohistochemical and ultra structural features of mammary myoepithelial cells during pregnancy and lactation. Fifteen adult female albino rats assigned into 3 groups; group I (virgin), group II (pregnant) and group III (lactating); were used in this study. Specimens from the mammary gland were obtained and processed for light and electron microscopy. Paraffin sections of the mammary gland were prepared and stained with H and E stain and immunohistochemical stain using anti α-SMA antibody. In the resting mammary gland, the myoepithelial cells (ME) formed a single continuous layer around the mammary ducts. During pregnancy, ME cells were more developed forming multilayered sheaths around the ducts which may protrude to the stroma. Around the acini, myoepithelial cells were branched forming a discontinuous layer around the acinar cells. During lactation, ME cell were stretched, faintly stained, discontinuous and acquired some ultra structural features of smooth muscles. It could be concluded that mammary myoepithelial cells undergo morphological alterations which correlate with the physiological requirements during pregnancy and lactation. 2014/03/28 - 21:44

Lead is considered the most common occupational and environmental toxicants and it has serious potential health hazards to humans. Investigation of toxic effects expressed on the somniferous tubules and possible protective effects produced by vitamin E supplementation. Thirty adult male albino rats weight 100-150 g were included in the study. Rats were equally divided into three groups: Group I: Control group: Included 10 rats. They were subdivided into two subgroups: Subgroup Ia: Negative control group. Subgroup Ib: Positive control group. Group II: the intoxicated group: included 10 rats that received lead acetate orally in a dose of 60 mg kg-1 b.w. dissolved in distilled water by gavage every other day for 6 weeks. Group III: included ten rats that received vitamin E, diluted in soya oil 150 mg kg-1 body weight by gavage every other day for 6 weeks, simultaneously with lead acetate in a similar dose to that of group II. At the end of study period, rats were sacrificed; blood samples were obtained for hormonal and blood lead levels evaluation; while testicular blocks were prepared for both histological and electron microscopy evolution. Lead intoxication was associated with decreased serum testosterone levels when compared to control groups, the effect that inhibited by vitamin E supplementation. Similar results were found for LH and FSH. In addition both histological and ultrastructural findings confirmed deleterious effects of lead toxicity and protective effects of vitamin E on semineferous tubules. Lead (Pb) caused degenerative changes in the seminiferous tubules of mice testis and caused cellular abnormalities in testosterone-producing cells. In addition, vitamin E can reduce the impact of Pb toxicity in the male genital organs. 2014/03/28 - 21:44

To examine the IQ, general cognitive and behavioural outcome at school age
in preterm and full-term children. The present study carried out in Damietta
primary schools. The target population were all children in Damietta primary
schools. The study included 762 children: 206 children who were delivered at
preterm (group B) and 556 children were delivered at full term (group A). All
children were submitted to Binet intelligence test and self-administered questionnaires
were by the parents. For completing the Binet intelligence test each student
was interviewed separately in a quite suitable room by the researcher and two
well-trained psychologists. There was significant increase of behaviour score
(40-60 and >60) in group B (preterm) in comparison to full term group (26.2,
9.7 vs. 13.3, 4.7%, respectively). Similarly, there was significant increase
of enuresis and articulation disorders in preterm group. Finally, there was
significant decline of IQ in preterm in comparison to full term group. Furthermore,
there was significant correlation between IQ from one site and verbal reasoning,
abstract-visual reasoning, quantitative reasoning, short term memory, aggression,
attention problems, somatic problems from the other side in full term group
while in preterm group, this correlation was significant for verbal reasoning,
abstract-visual reasoning, quantitative reasoning, short term and delinquency.
Results of the present study revealed that, preterm had lower total score IQ
and so, preterm are vulnerable to cognitive affection. 2014/03/28 - 21:44

Arteriovenous Fistulae (AVF) for hemodialysis access provide good long-term
solutions for the patient with end stage renal disease. However, complications
are common and require a multimodality approach to maintain their patency and
continued use. In the present study, a prospective analysis was made on 15 patients
who received a brachial artery-external/internal jugular polytetra-fluoro-ethylene
graft for hemodialysis access. The procedure was chosen because of exhaustion
of the veins in the upper extremity owing to previous multiple failures. The
procedure was successful in 12 cases (80.0%), 2 cases (13.3%) needed revision
(they required secondary procedures to maintain graft patency, in the form of
multiple thrombolysis and venous angioplasty) and 1 case (6.7%) failed at 16
months postoperatively (she was 61 old hypertensive female who had previous
5 fistulae and developed thrombosis 12 months after intervention, which was
treated with clot removal and venous angioplasty. She developed second thrombus
at 16 months after intervention catastrophically deteriorated and died before
secondary intervention was carried out. The brachial artery-external/internal
jugular vein graft represented an important alternative procedure used for vascular
access when all upper extremity veins cannot be used. 2014/03/28 - 21:44

Omega-3 fatty acids have a therapeutic role in many inflammatory conditions.
The aim of the study, to investigate the protective effect of omega-3 fatty
acids on 5-fluorouracil-induced small intestinal cytotoxicity. Fluorouracil
(FU) and Omega group rats were given a single intraperitoneal injection of 5-fluorouracil
(150 mg kg-1). Rats of the second group also received oral omega-3
(1 mL animal-1 day-1). Four rats from both FU subgroups
(FU1, FU3, FU6 and FU9) and Omega subgroups (Omega1, Omega3, Omega6, Omega9)
were sacrificed 1, 3, 6, 9 days after 5-fluorouracil injection. Histological,
histomorphometric and statistical studies for small intestine were done. FU1
and FU3 subgroups demonstrated signs of mucositis such as separation of the
epithelium and denudation of the villi. Histological signs of initial recovery
appeared in FU6 and was followed by full recovery in FU9. Preserved structural
integrity and faster recovery were observed in the Omega group. The conclusion
of this study, omega-3 fatty acids ameliorate 5-fluorouracil-induced small intestinal
damage. 2013/07/05 - 12:28

Helicobacter pylori infection and its eradication may influence plasma levels and gastric production of some peptides, which can affect appetite. Ghrelin, an orexigenic hormone, is primarily produced in and secreted from oxyntic mucosa of the stomach. Ghrelin has been demonstrated to play a central role in appetite, food intake and energy homeostasis. As ghrelin production in human is exclusively gastric origin, it is conceivable and not surprising that any injury to the gastric mucosa will affect plasma ghrelin concentrations. To verify this hypothesis, a total of 135 adult consecutive individuals with normal body mass index including 84 H. pylori-infected and 51 H. pylori-negative subjects were included in a randomized controlled trial. Gastric ghrelin mRNA expression levels were measured in endoscopic biopsy specimens in both groups before and after H. pylori eradication. Also, plasma active n-octanoyl ghrelin and obestatin levels and ghrelin/obestatin ratio were measured in both groups before and after H. pylori eradication. The treatment group (44/84) received triple H. pylori eradication therapy for 7 days and followed up for 6 months. In contrast to obestatin, plasma and gastric ghrelin mRNA expression levels were significantly lower in H. pylori-infected subjects. H. pylori eradication significantly reversed these changes. The decrease in plasma ghrelin concentration in H. pylori-positive subjects was accompanied by depletion of ghrelin mRNA expression. These findings suggest that H. pylori induced chronic gastritis impair gastric ghrelin production and consequently the decrease in plasma ghrelin concentration. 2013/07/05 - 12:28

Ossification of the Posterior Longitudinal Ligament (OPLL), is associated with
various degree of neurological deficit. Anterior approach allows direct removal
of ossified posterior longitudinal ligament through corpectomy and allows sufficient
decompression of the spinal cord. The aim of the study is to evaluate the effectiveness
and safety of median cervical corpectomy for management of cervical myelopathy
associated with ossification of the posterior longitudinal ligament. In the
period between May 2009-Aug. 2011, thirty patients were managed by median cervical
corpectomy/corpectomies and bone fusion with anterior plate system fixations;
in Neurosurgery Department Al-Azhar University Hospitals. They were 19 males
and 11 females with the age range from 35-65 years and the mean age was 50 years.
The duration of symptoms ranged from 3-36 months with the mean of 20 months.
The most common complaints were paresthesia or numbness of the hands and the
most common presenting signs were hyperesthesia, gait disturbance, weakness
and hyperreflexia the most common type of OPLL was the mixed type in 16 patients
(53.330). as regard to Magnetic Resonance Image (MRI) classifications of OPLL,
the tear drop was the most common type in 15 patients (50%). Postoperative complications
occurred in 7 patients (23.33%). In this study, the recovery rate by Hirabayashi
formula was ranged from 25-100% with the mean 69.96±16.89%, in mixed
type of OPLL the recovery rate ranged from 25-100% (Mean 65.33±17.38%),
in continuous type it ranged from 42.86-100% (Mean 70.24±18.30%) and
in segmental type it ranged from 71.42-100% (Mean 80.27±10.33%). Anterior
corpectomy with resection of the ossified mass, followed by fusion, is a radical
surgical procedure. It is best indicated for cervical spondylotic myelopathy
with OPLL that extends fewer than three vertebral levels, in patient with no
congenital stenosis or trauma. 2013/06/18 - 06:05

The aim of this study is to evaluate safety and feasibility of endoscopic surgery
for management of nasal Inverted Papilloma (IP). The study estimated tissue
extract Epidermal Growth Factor Receptor (EGFR) and serum Squamous Cell Carcinoma
Antigen (SCCA) levels to determine their applicability for differentiation between
different pathological entities of IP. All patients with IP underwent full history
taking, general and local examination and CT imaging. Endoscopic biopsy was
taken and then endoscopic excision was conducted under general anesthesia. Freshly
excised IP were divided into two parts; the first for pathological examination
and the second part was used for estimation of tissue extract level of EGFR.
Venous blood samples were obtained before and after surgical resection for enzyme-linked
immunosorbent assay (ELISA) estimation of serum SCCA. The study also included
10 healthy volunteers as a control group. The study included 19 IP patients;
9 patients had do novo IP, 6 patients had recurrent IP and 4 had IP with Squamous
Cell Carcinoma (SCC) changes. All surgeries were conducted safely without complications
within a mean operative time of 74.5±13.5 min, mean blood loss of 158.2±27.8
mL and mean postoperative duration of hospital stay of 5.4±1.3 days.
Mean preoperative serum SCCA levels were significantly higher in IP patients
compared to controls and in patients had IP with SCC compared to those had benign
IP with non-significantly higher levels detected in sera of patients had recurrent
IP compared to those had de novo IP. Postoperative serum levels of SCCA were
significantly lower in all patients compared to their respective preoperative
levels and non-significantly higher levels in patients had IP with SCC compared
to those had benign IP. Mean tissue extract levels of EGFR were significantly
higher in tissues of IP with SCC compared to tissues of benign IP with significantly
higher tissue extract levels in recurrent IP compared to tissues of de novo
IP. Functional endoscopic surgery could be considered as safe and effective
line of management of IP. Estimation of EGFR tissue expression level could be
used for differentiation between benign IP and IP with malignant transformation
even in early phases of dysplasia and serum SCCA could be used as a marker for
complete operative excision of IP irrespective of its pathological diagnosis. 2013/06/18 - 06:05

In the present study, some cellular and crystalline components of urine of Sickle Cell Anemia (SCA) were studied. In total 67 samples were investigated. The normal and abnormal cellular components like presence of Red blood cells, White blood cells Epithelial cells, Renal tubules cells, Bacteria, Yeast and Protozoan were observed and counted. Noncellular components/crystals like Tyrosine, Cholesterol, A/T Phosphate, Leucine, B-Granule, Uric Acid, Oxalate and Cystine were counted. It was observed that RBCs, WBCs and Epithelial cells, Renal tubules cells, Bacteria, Yeast and Protozoan were in high number indicating various complications occurring in the body of sickle cell anemic patients. It was observed that RBCs were 13918.18/cumm±SE 4057.90 indicating tremendous hematourea, number of WBC were 224.59±50.002 SE, Sqaumous Epithelial cells were 35.68±10.989 SE, Renal cells were 110.68±74.15 SE. This indicates that SCA patients suffer from kidney damage, hematourea, Urinary Tract Inflammation, Interstitial nephritis, Glomerulonephritis and Pylonephritis. 2013/06/18 - 06:05

Adjuvants are used as a carrier of antigen in modern vaccine therapy. These are heterogeneous compounds which are administered with antigens to elicit better immune response against co-administered antigens by stimulating the immune responses. Ideally, an adjuvant should not be mutagenic, carcinogenic and teratogenic and it should not produce any autoimmune disease. However, many of the adjuvants used in vaccine preparation have one or another side effect. The present paper describes in brief the history, development and recent trends in the adjuvant of vaccine. 2013/06/18 - 06:05

Natural product isolation and extraction is full of many technical hitches. In spite of that plant origin natural products have occupied lead positions as drugs in current pharmacopoeia. In this article, problems in natural product drug development and the possibilities of their improvement through nanoformulations using nanotechnology have been reviewed. Known effects and no side effects have made natural products a powerful therapeutic solution to the organisms. But the delivery of plant origin therapeutic molecules as drugs is problematic due to poor solubility, poor permeability, low bioavailability, instability in biological milieu and extensive first pass metabolism. These limitations of plant origin drugs can be overcome by attaching or encapsulating them with suitable nanomaterials. Nanomaterials can significantly enhance the pharmacokinetics and therapeutic index of plant origin drugs. Targeted delivery and combination therapy can drastically improve the performance of plant origin drugs. 2012/06/22 - 12:07

This study was designed to evaluate the effectiveness, value and safety of biphasic positive airway pressure ventilation in comparison to conventional mode of ventilation (ARDS net low tidal volume strategy) in patient with Acute Respiratory Distress Syndrome (ARDS) and Acute Lung Injury (ALI). This present work was conducted on 32 patients, (22 males and 10 females) with their ages ranging between 20 to 75 years. These patients were admitted to intensive care Department, at Al-Azhar University hospitals from August 2010 to April 2011, they all had documented acute lung injury and ARDS of different etiologies and required invasive mechanical ventilation. The patients were randomized using a concealed allocation approach with sealed envelopes. Patients were randomized to one of two protocol groups consisting of two different ventilatory strategies with identical general ventilatory measures and general care. BiPAP Group (group A): It included sixteen patients in this group who ventilated with BiPAP. Lung Protective Strategy protocol group (Group B): It included sixteen patients in this group who were subjected to Synchronized Intermittent Mandatory Ventilation (SIMV) mode with lung protective strategy protocol. The main results of this study were high statistically significant reduction of the Peak Airway Pressure in BiPAP group. BiPAP group is associated with better results than lung protective strategy group as regard Hypoxic Index. No statistically significant difference between both groups as regard hemodynamic parameters was observed; BiPAP group had shorter duration of ventilation, shorter duration of ICU stay and high statistically significant decrease of the sedation dosage requirement. 2012/06/22 - 12:07

The increased risk of morbidity and mortality in obesity as a result of infections is an emerging health concern which suggests that obesity may affect immune competence. Thus aim of this study was to assess circulating immune cell parameters including T lymphocyte subsets and Natural killer (NK) cells in obese subjects and their relations to metabolic factors. Thirty obese and 20 lean subjects were included in the study. Recorded data involved BMI, Waist Circumference (WC), blood pressure, HOMA-IR, White Blood Cell (WBC) count, Absolute Lymphocyte Count (ALC),CD4 and CD8 T cell count and frequency and natural killer cell frequency (CD56%). CD4, CD8 and CD56 expressions were measured by flow cytometry. Compared with control, obese group had significantly higher CD4%, CD4 count, WBC count and ALC, and significantly lower CD8%, CD8 count and CD56%. In obese subjects, both CD4% and CD4 count had significant positive correlation with BMI (p = 0.005, p<0.001, respectively) and WC (p = 0.014, p = 0.01, respectively). CD4 count had significant positive correlation with systolic blood pressure (p = 0.015), HOMA-IR (p = 0.021) and triglycerides (P=0.02). CD8 count in obese subjects had significant negative correlation with BMI (p = 0.03), WC (p = 0.018), HOMA-IR (p = 0.035) and triglycerides (p = 0.025), while CD56% had significant negative correlation with BMI (p = 0.025), HOMA-IR (p = 0.04) and triglycerides (p = 0.029). Obesity is associated with alterations in circulating immune cells in the form of increased WBC, total lymphocyte and CD4 levels with decreased CD8 and CD56 levels, such alterations are related to obesity measures and metabolic factors, so immune alterations may identify obese at risk of infection and metabolic disease who should be targeted for weight loss strategies. Further studies are needed to determine the role of weight loss in the improvement of immune function in obese individuals. 2012/06/22 - 12:07

Pilonidal sinus is a chronic disease of young age located at the sacrococcygeal region and is found mostly in males. The pathogenesis is generally accepted as the invagination of hair into the skin, followed by foreign body reaction leading to inflammation and abscess formation. The best surgical technique for sacrococcygeal pilonidal sinus is still controversial. The aim of this study was to examine outcome of oblique excision and primary closure of pilonidal sinus on recurrence rate. Between November 2008 and December 2010, 84 patients (69 male, 15 female; average age = 22.4 (12-42 years) were operated on for primary pilonidal sinus. An oblique fusiform-shaped incision was made and the skin with sinus was completely excised. The operation was completed with insertion of subcutaneous suction drain and primary closure of subcutaneous and skin. Patients’ follow up was made at the end of the 4 weeks and 2, 4, 6, 12 and 18 months after surgery. Duration of symptoms ranged from 1 to 73 months (mean 20.02±7.87). Hospital stay duration ranged from 2 to 5 days (mean of 3.21±0.67), drain duration ranged from 3 to 11 days (mean 5.78±1.29). Wound dehiscence developed in 4 patients (4.8%). Healing by secondary intention occurred in 3 patients (3.5%) and recurrence in one patient (1.2%). The technique of oblique excision and primary closure may be considered one of the best operations for pilonidal sinus resulting in a low recurrence rate. 2012/06/22 - 12:07

Most of the drugs are poorly water soluble or lipophilic in nature, that’s why we are facing the problem of poor solubility of drugs, it also affect the bioavailability of drugs. Lipid emulsion (LE) is one of the best methods to improve the solubility of lipophilic drugs. Since 1962 the improvement of lipid emulsions were observed as intralipid iodinated lipid emulsion, Physostigmine salicylate lipid emulsions Amphotericin B lipid emulsion, tcopherol lipid emulsions, Apomorphine, Lipid emulsion as antidote has been occurred. The lipid emulsions are potential carrier for poorly water soluble drugs. The components which are used in lipid emulsions are oils, emulsifiers, buffering agents, antioxidants, chelating agents and preservatives. Oils and emulsifiers play important role in lipid emulsions. 2012/03/10 - 18:33

The present study was designed to investigate the frequency of thyroid dysfunction in Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE) and whether these dysfunctions could be an additional risk factor for the development of cardiovascular diseases. Our study included 132 SLE patients (128 females, 4 males) and 217 RA patients (174 females, 43 males). All patients underwent clinical examination and tests for thyroid function and thyroid autoimmunity (antithyroglobulin or Tg and antiperoxidase or TPO antibodies). One hundred and twenty (90 females, 30 males) from the same geographical area, acted as controls. TPO abs were found in 26 SLE patients (19.7%), 22 RA patients (10.1%) and 7 controls (5.8%) while Tg abs were found in 11 (8.3%) SLE, 13 (6%) RA and 2 controls (1.6%). Abnormal thyroid functions were found in 21 (15.9%) SLE, 18(8.3%) RA patients compared to 5 (4.2%) controls (p<0.05). Of those patients with thyroid dysfunction, 17 SLE, 12 RA and 4 controls were positive for TPO abs. The most common abnormality was clinical hypothyroidism (8.3 SLE, 4.1% RA patients) then subclinical hypothyroidism (5.3 SLE, 1.8% RA patients). Subclinical hyperthyroidism was found in 2 (1.5%) SLE and 4 (1.8%) RA patients. Hypothyroid patients had significantly higher blood pressure, low density lipoprotein, C-reactive protein, lipoprotein (a) anti TPO and anti TG abs than euthyroid patients. In conclusion, SLE and RA patients had higher prevalence of anti-thyroid antibodies and hypothyroidism, compared to our normal population. SLE and RA patients with hypothyroidism are at increased risk for CVD compared to those with normal thyroid function. 2012/03/10 - 18:33

Cardio Vascular Disease (CVD) is the number one killer and leading cause of disability among women in most of the developed countries. Several epidemiological studies indicate that women during the fertile age have a lower risk of cardiac events and the female hormone estrogen provides this natural protection. Usually, the protection fades after menopause and this risk increases gradually in the five to ten years after the female hormone estrogen begins to dwindle. Hence, postmenopausal women leaving with untreated risk factors make them vulnerable to develop myocardial infarction, heart failure and sudden cardiac death. In addition, several recently published articles have shown the effect of stress on cardiovascular system and in pathogenesis of myocardial infarction and myocardial ischemia. Moreover, the effect of stress on estrogen level has also been supported by some recently published articles. For these reasons, in this review the possible links among stress, estrogen and CVD in women have been described. 2012/01/05 - 03:45

Pain is one of the most common presenting complaints in patients diagnosed with advanced head and neck cancers occurring in about thirds of the patients at the time when they are first diagnosed in the initial stages of the disease process. Among these, about half of the patients die within five years from the day of diagnosis while the ones who survive are left with significant morbidity. Cancer-associated pain is one of the most common situations difficult to manage in a significant number of head and neck cancer affected patients. Despite all the advances in the understanding, diagnosis and the treatment modalities available for the treatment of cancer associated pain, a significant fraction of patients are left to bear considerable pain owing to the lack of an exact criteria for the evaluation of pain, reluctance of the health care providers regarding the use of opioids and the reservation of advanced treatment modalities for the management of pain only in its advanced or terminal stages. The aim of this paper is to highlight the varying aetiologies and patho-physiologies of the head and neck cancer associated pain and more than that the need for an effective pain management protocol to be followed in the management of the variable expressions of this type of pain in patients who are left to suffer agony of pain despite the availability of voluminous literature regarding the understanding of cancer associated pain. 2012/01/05 - 03:45

This study assessed the level of awareness and knowledge of HIV Counselling and Testing (HCT) among adults of reproductive age in Osun State with the aim of providing a background for a study on HCT uptake. Three Local Government Areas (LGAs), namely Atakumosa West, Olorunda and Ayedaade were randomly selected for the study which employed both quantitative and qualitative methodologies. The quantitative survey employed an analytical cross-sectional design using an interviewer-administered, semi-structured questionnaire to elicit information from 720 male and female respondents of reproductive age group. The qualitative aspect consisted of twelve Focus Group Discussions in all, four conducted in each of the LGAs. The data were analysed using descriptive and inferential statistics and the results of both the qualitative and quantitative methods were triangulated. The results showed that 84.0% of the respondents were aware of HCT. Thirty seven percent had correct understanding, 88.4% knew where it could be accessed while 89.6% knew that HCT was beneficial. The knowledge of HIV status and access to early treatment were the most important benefits reported. Sixty-one percent of the respondents had fair knowledge of HCT. The study concluded that adults of reproductive age in Osun State had fair knowledge of HCT. 2012/01/05 - 03:45

The study examined the utilization of antenatal care centres in Ibadan, Oyo State. The aim of the study was to evaluate the utilization of antenatal care centers among child-bearing women in Ibadan North Local Government Area, Oyo State, Nigeria. Data for the study were obtained through the administration of two hundred and thirty-one copies of questionnaire to child bearing women. Data obtained was analyzed using tables, simple percentages and multiple regression analysis. Result indicated that 6.3% of the utilization of ANC by childbearing women was explained by age, cultural preference, income, education, religion, marital status and occupation. The strength of contribution of each of these selected factors showed that mother’s education had the greatest contribution (0.227) to the utilization of ANC, followed by cultural preference (0.131), income (0.092), marital status (0.083) and mother’s occupation (0.070). The ANOVA result further revealed that age, culture, income, education, religion, marital status and occupation significantly influenced the utilization of ANC by child-bearing women (F = 2.141, p<0.05). The study therefore, revealed that though the utilization of ANC centres was low but the combination of socioeconomic and demographic variables significantly influenced their utilization by child-bearing women. Based on the findings of the study, it was recommended that government and other sponsoring agencies should provide antenatal care free or subsidize the charges in order to guarantee easier access to ANC by childbearing women. 2012/01/05 - 03:45