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Jul 2021 DOI 10.14302/issn.2576-6694.jbbs-21-3819
The present study aimed to evaluate the effect of the Trivedi Effect®- Biofield Energy Treated/Blessed Test formulation/item (TI) composed of minerals (magnesium, zinc, copper, calcium, selenium, and iron), vitamins (ascorbic acid, pyridoxine HCl, alpha tocopherol, cyanocobalamin, and cholecalciferol), Panax ginseng extract, CBD isolates, and β-carotene on elasticity of skin, heart, muscle, and neuronal cells in the H9C2 (rat cardiomyocytes), C2C12 (mouse myoblast cells), HaCaT (human keratinocytes), and SH-SY5Y (human neuroblastoma cells) cell line in DMEM medium. The test formulation constituents were divided into two parts; one section was defined as untreated test formulation (UT), while the other portion of test formulation received Biofield Energy Healing/Blessing Treatment (BT) by a renowned Biofield Energy Healer, Mr. Mahendra Kumar Trivedi. The test items were treated with Biofield Energy Healing/Blessing Treatment and divided as Biofield Energy Treated/Blessed (BT) and untreated (UT) test items. MTT data showed that the test formulation in various concentrations was found as safe and nontoxic in the tested concentrations with viability range from 73% to 307%. Young’s modulus (YM) is a measure of cell stiffness, a decrease in YM value indicates increase elasticity of the cells and vice-versa. YM in H9C2 cells were decreased by 9.6% and 66.1% in the BT-DMEM + UT-TI group at 0.1 and 1 µg/mL respectively, as compared with untreated test group. However, C2C21 cells showed increased YM by 443.9% at 1 µg/mL in the UT-DMEM + BT-TI group, while 869.6% increased YM in the BT-DMEM + UT-TI group at 1 µg/mL as compared with untreated test group. However, 314% increased YM was reported in the BT-DMEM + BT-TI group at 1 µg/mL as compared with the untreated test group. However, the value of YM was significantly decreased in the HaCaT cell line by 247.7% (at 1 µg/mL), 225.8% (at 0.1 µg/mL), and 97.9% (at 1 µg/mL) in the UT-DMEM + BT-TI, BT-DMEM + UT-TI, and BT-DMEM + BT-TI group respectively, as compared with the untreated group. In addition, YM was significantly decreased in the SH-SY5Y cell line by 92.6%, 18.1%, and 26.6% at 1 µg/mL in the UT-DMEM + BT-TI, BT-DMEM + UT-TI, and BT-DMEM + BT-TI group respectively, as compared with the untreated group. Overall, the results showed the significant decreased YM among the SH-SY5Y, HaCaT, and H9C2 cells, while it was increased in the C2C21 cell line. Thus, the mechanical properties of cells such as cellular function, including shape, motility, differentiation, division, and adhesion to its surrounding extracellular matrix were improved. Overall, it can be useful in many disease progressions with improved cellular elasticity and its associated complications/symptoms.
Dec 2018 DOI 10.14302/issn.2328-0182.japst-18-2522
The solid copper(II) soap derived from Neem (Azadirechta Indica)oil and its complex with ligand containing nitrogen, sulphur and oxygen atoms like 2-amino -6-nitro benzothiazole and 2-amino- 6-ethoxy benzothiazole have been synthesized and characterised by elemental analysis, IR spectroscopy and biological studies. From the analytical data, the stoichiometry of the complex has been observed to be 1:1 (metal:ligand). The derived compounds were found active against Staphylococcus aureus,Coagulase-negative staphylococci (CoNs), Acinetobacter baumanii, Pseudomonas aeruginosa and micrococcus bacteria. These findings have high medical, industrial and economic significance as copper (II) soap and copper (II) soap complex could be harnessed in the formulation of medicated soaps.
Sep 2017 DOI 10.14302/issn.2471-2175.jdrt-17-1774
Topical corticosteroids are main therapeutic agents for the treatment of a wide variety of dermatological disorders. Three cases of chronic cutaneous ulceration affecting the skin of the breasts that were caused presumably by previous and continued use of potent topical corticosteroids for the treatment of psoriasis and/or intertrigo lesions were reported here. These three cases were presented to emphasize the potential serious local side effects of topical steroids even progressing to ulceration in breast' skin. These cases highlight the importance of appropriate use of topical corticosteroids, necessity of a strict follow up for adverse effects and the need of warning every patient about possible side effects of topical corticosteroids
Feb 2015 DOI 10.14302/issn.2471-2175.jdrt-14-552
Two pilot studies evaluate fractional Er:YAG laser microporation to enhance topical imiquimod delivery for actinic keratosis and basal cell carcinoma. The approach seeks to increase epidermal penetration while limiting systemic exposure. Early results suggest acceptable tolerability and lesion response, supporting larger controlled trials.
May 2026 DOI 10.14302/issn.2641-4538.jphi-26-6161
Objectives Motor fluctuations and non-motor disorders not manageable by first-line treatments in advanced Parkinson's disease require continuous dopaminergic stimulation strategies such as subcutaneous infusions of apomorphine (APO) or foslevodopa/foscarbidopa (FLD/FCD). A Budget Impact Analysis (BIA) was performed to estimate the cost difference between both treatments assuming equivalent clinical efficacy and safety. Material and methods The efficacy results of pivotal clinical trials at 12 and 52 weeks of treatment and the safety profile of APO vs FLD/FCD were compared, based on latest scientific publications and other available clinical data. A comparative BIA was performed, based on estimated annual drug treatment costs at Spanish published prices. Results The efficacy of APO (16 h/day) and FLD/FCD (24 h/day) in reduction of OFF hours (2.47 vs 2.75, 12 weeks; 3.66 vs 3.50, 52 weeks; respectively) and increase of ON hours without disabling dyskinesias (2.77 vs 2.72, 12 weeks; 3.31 vs 3.80, 52 weeks; respectively) could be considered clinically equivalent, as well as their safety profiles. However, a significant discrepancy is observed in the costs of the aforementioned alternatives. Considering published prices and the average dose reported in the literature, in Spain the annual cost of APO would be €13,980 compared to €55,198 for FLD/FCD. Consequently, the financial resources required for the treatment of FLD/FCD would enable the treatment of approximately three to four patients with APO. The BIA indicated the potential for annual savings in more than €2,500 million, considering a total target population of over 60,000 patients per year. Finally, an univariant sensitivity analysis was performed, considering a scenario in which the hospital acquisition cost of FLD/FCD decreased between 20%-30% (€44,159- €38,638/year). In this scenario, the total annual savings range between €1,875-€1,532 million per year. Conclusions Overall APO is more efficient than FLD/FCD, as it provides similar clinical efficacy at a lower treatment cost. The selection of an appropriate treatment option is to be determined by clinical criteria and patient characteristics, but cost evaluation should be considered to select the most cost-effective therapeutic option.
Feb 2026
Keratinocytes are pivotal in mediating cutaneous inflammation. Identifying anti-inflammatory factors within these cells holds promise for developing novel therapeutic strategies to manage skin inflammation. Transcription factor EB (TFEB) has recently emerged as a key regulator linking cellular energy metabolism to inflammatory processes, primarily through its influence on autophagy and NF-κB signaling. However, whether TFEB activation exerts anti-inflammatory effects in keratinocytes remains unclear. In vitro inflammation model was established in HaCat cells by incubation with proinflammatory mediators LPS and IL-1β. Cell viability and TFEB expression and phosphorylation were measured. The effect of TFEB activation by C1 and adenoviral TFEB overexpression on the expression of proinflammatory genes including COX-2, MCP-1 and IL-6 were detected. Also, IκBα protein level were determined. TFEB phosphorylation is increased while TFEB total protein expression is inhibited by treatment with LPS and IL-1β. Pharmacological activation of TFEB by compound C1 and TFEB overexpression suppressed the expression of COX-2, MCP-1 and TNF-α induced by LPS and IL-1β. TFEB overexpression increased basal IκBα expression and restored IκBα level under LPS treatment. TFEB knockdown reduced TFEB expression and lowered basal expression level of COX-2, MCP-1 and TNF-α. Our findings indicate that TFEB activation can mitigate inflammatory gene expression in keratinocytes triggered by LPS and IL-1β. This implicates TFEB as a significant novel modulator of cutaneous inflammation, highlighting its potential as a therapeutic target. Targeting TFEB could thus be a viable strategy for developing new treatments for chronic inflammatory skin conditions.
Dec 2024 DOI 10.14302/issn.2641-4538.jphi-24-5358
Background Injuries, particularly unintentional ones, are a neglected public health concern and are preventable or avoidable. Children in urban slums are especially vulnerable due to hazardous living conditions, inadequate supervision, and lack of safe sojourns or play areas. Since these injuries result in seeming spontaneous recovery, appropriate care being initiated by the primary care giver is questionable. Objective To assess the burden of unintentional injuries of unintentional injuries in pre-school going children aged 2-6 years in urban slums of Bhubaneswar, Odisha. To compare the knowledge of the 1st level care post-injury among the primary care givers against standardized prescribed care. Methods A cross-sectional descriptive observational study was conducted for over 2 years in urban slums under the Bhubaneswar Municipal Corporation (BMC), the capital city of Odisha. A total of 285 children aged 2-6 years, whose mothers consented to participate, were included in the study. Data regarding the type of injury and its management, as well as, associated socio-demographic factors, were collected using a pre-designed, pre-tested questionnaire. Descriptive statistics was used to derive the burden of unintentional injuries in children. The knowledge of the 1st level of care to be given after the common injuries was assessed among all the primary caregivers to detect the treatment and care gap. Results The majority of primary respondents were mothers aged 21-30 years (82.1%), The frequency of an episode of unintentional injury (occurrence in last 3 months) in the study population was found to be 58%. The most common type of injury reported was skin lacerations or tears, common site being in the upper and lower limbs. Males were more affected as compared to females (54.64 %) The reporting of unintentional injuries among the children was found to have significant association with the occupation of the father. Fathers who were unemployed or working as unskilled labor, their child’s probability of reporting an unintentional injury was found to be high, with p value coming to be statistically significant. Conclusion The study highlights the complex interplay of sociodemographic factors influencing unintentional injuries among children in urban slums and the need to create awareness among the primary caregivers, about the immediate management, so that chronic complications may be averted. It is difficult to avert injury as this age group is agile and nowadays supervision is challenging. Still, the knowledge of management would not just empower the caregiver, but also the growing child, who can attend to their younger siblings or themselves, whenever they get injured next. Further research with larger sample sizes is warranted to validate these findings and develop effective prevention strategies.
Sep 2024 DOI 10.14302/issn.3070-3379.jwc-24-5199
Rwanda is a small Central African country. A land with thousands of hills and mountains. It is a low-income country and one of Africa's fastest-growing economies. It is home to a variety of ecosystems, such as mountainous rainforests, gallery forests, savanna woodlands, wetlands, aquatic forests, and agroecosystems. From rising temperatures to changing rainfall patterns, the hidden dangers of climate change are unmasking themselves in the form of various health risks. Every year, many deaths, bodily injuries, and house collapses, among other repercussions, are documented as detrimental effects of climate change events on public health. This article delves into the intricate relationship between climate change and public health in Rwanda, exploring the adverse effects it has on vulnerable communities. By shedding light on this pressing issue, we can better understand the urgency of taking action to mitigate the impact of climate change on public health as well as potential solutions to the current predicament. The authors researched several literatures to develop their perspectives on the subject and explored potential solutions to protect the well-being of Rwandans in the face of this global crisis.
May 2024 DOI 10.14302/issn.2379-7835.ijn-24-5098
This prospective randomized double-blinded multicentric study aimed to assess the efficacy of a new nutraceutical in controlling itch and skin lesions caused by flea allergy dermatitis (FAD) and compare it with another oral product of proven efficacy. Forty-three dogs, of different age, breed and sex, with FAD were included and divided into two groups: 24 received product A and 19 product B. Both groups received the same antiparasitic treatment. A modified canine atopic lesion index (mCADLI) and pruritus visual analogic scale (pVAS) were recorded at days 0, 30 and 60. pVAS was evaluated both by the examining veterinarian (vpVAS) and the owner (opVAS). Results obtained were compared between the two groups at each time point. In both groups of dogs, a significant decrease of mCADLI, vpVAS and opVAS at day 30 and 60, compared to day 0, was observed. At baseline, the mCADLI scores of Group B were significantly higher than Group A (95% CI: -4.0 to 0.0, p < 0.05), with no differences at D30 and D60 (not significant, p > 0.05). In Group B, significantly lower values of vpVAS were observed at D30 compared to Group A (95% CI: -2.5 to 0.0, p < 0.05), but not at D60 (not significant, p > 0.05). The median values of pVAS in Group B were lower compared to Group A at both D30 (95% CI: -2.5 to 0.4, p < 0.01) and D60 (95% CI: -3.0 to 0.3, p < 0.05). Both nutraceuticals can be useful to control discomfort, skin lesions and pruritus due to flea allergy dermatitis and can be a valuable replacement for antipruritic drugs antihistamines, steroids or Il-31 inhibitors.
May 2024
Waterborne diseases pose a significant global public health threat, particularly in sub-Saharan Africa, where frequent outbreaks occur. These diseases stemming from contaminated drinking water, poor waste management, and insufficient hygiene contribute to high morbidity and mortality in children under 5 years old. A study addressed waterborne diseases in N'Djamena, Chad's 3rd and 9th districts, through decision-making strategies. The research employed various methods, including a household survey using questionnaires, workshops, semi-structured interviews, and focus group discussions. Additionally, documentary research provided essential data for analysing the situation of diseases in the community. Epidemiological data from 2019- 2022 indicated a substantial prevalence of diseases such as diarrhoea, dysentery, skin infections, typhoid, abdominal pain, and malaria, with notable mortality, especially among children. Among surveyed households, 50% believed the consumed water was contaminated, attributing it to faecal matter, while 28% and 22% linked the diseases to inadequate hygiene and unsanitary conditions, respectively. The study advocates for comprehensive strategies, including improving water treatment efficiency, implementing safe waste management, promoting hygiene, and vaccination. Active involvement of all stakeholders, with municipal authorities leading, is crucial for effective implementation and combating waterborne diseases.
Apr 2024 DOI 10.14302/issn.2994-6743.ijstd-24-5006
Objectives This study explores the clinical characteristics, associated infections, and management outcomes of syphilis within a specific population over the years 2018 to 2022. With a focus on the frequency, clinical manifestations, and co-infections of syphilis, the research addresses a critical gap in understanding the nuanced dynamics of this sexually transmitted infection and its impact on public health. Methods The study employs a retrospective analysis of data collected from 2018 to 2022, utilizing three key serological tests (Syphilis AB, RPR/VDRL, and TPHA) to characterize syphilis infections within the population. Clinical manifestations and associated infections, including HIV, HBV, HCV, Chlamydia, Gonorrhea, and HPV, are systematically assessed. Treatment rates and re-infection patterns are also analyzed, providing a comprehensive overview of syphilis epidemiology within the studied timeframe. Results The frequency of syphilis, particularly indicated by the Syphilis AB test, exhibited a marked increase in 2020, reaching 96%, suggesting a heightened frequency within the population. RPR/VDRL test results demonstrated consistent frequency, emphasizing the persistent presence of active syphilis infections. Clinical manifestations, such as chancre, skin rashes, alopecia syphilitica, and lymphadenopathy, displayed dynamic patterns over the study years. Co-infection rates varied, with fluctuations observed in HIV, Chlamydia, Gonorrhea, and HPV, while HBV and HCV showed infrequent but stable frequency. The management of syphilis cases demonstrated commendable treatment rates, but an increase in re-infection rates in 2021 highlights the need for continued vigilance. Conclusion This study provides a comprehensive evaluation of syphilis epidemiology, clinical characteristics, and associated infections within the studied population. The results offer valuable insights into the dynamic nature of syphilis and its co-infections, informing public health initiatives and interventions. The findings contribute to our understanding of the epidemiological landscape and underscore the importance of sustained efforts in both prevention and treatment to curb the transmission of syphilis and its associated infections. The study, however, calls for continued vigilance and research to address the evolving trends and challenges in syphilis management within the specified population.
Apr 2024 DOI 10.14302/issn.2997-2086.jfs-23-4651
This article has been retracted on April 10, 2025. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2997-2086.jfs-25-5857) Myelomeningocele (MMC), a class of spina bifida is a type of neural tube defect. According to the U.S. Centers for Disease Control and Prevention, each year approximately 1,400 babies born in the United States have spina bifida. The disease manifests with the lack of skin and bone covering the caudal part of the spinal cord. The patient developing such a condition often develops lifelong impaired lower limb mobility accompanied by hydrocephalus, and urinary and bowel incontinence. The available interventions include prenatal and postnatal surgery to fuse the dura. Prenatal surgery performed before 26 weeks of gestation reduces the risk of death or the need for ventriculoperitoneal shunting. It also enhanced results on a comprehensive index for mental and motor function. When compared to postnatal surgery, prenatal surgery reduces the manifestation of several secondary outcomes, including the degree of hindbrain herniation seen in the Chiari II malformation. Stem cell therapy for MMC on animal models of chick, ovine, and rodents with reported cases 15/63, 15, and 136, respectively, using human Embryonic Stem Cells (hESCs), Neural Stem Cells (NSCs), Mesenchymal Stem Cells (MSCs) showed significant coverage of MMC defect and slight neurogenesis was also observed. With an understanding of medical literature about in-utero regenerative capacity, it is to be appreciated that placental stem cells surgically seeded within a biocompatible scaffold of the cell patches can play a part in alleviating the spinal cord manifestation associated with MMC. Documented animal studies show that incorporating Placental Mesenchymal Stem Cells in prenatal surgery has reported improved neurogenesis and lower limb mobility. In an ovine myelomeningocele model, the development of in-utero myelomeningocele repair with human Placental Mesenchymal Stem Cells seeded onto an extracellular matrix (PMSC-ECM) enhances motor findings. The clinical trial for the first stem cell therapy on human subjects known as the “CuRe Trial: Cellular Therapy for In Utero Repair of Myelomeningocele.” is expected to be finished by 2030. So far, the cases undergoing treatment have shown significant leg movement and a greater degree of bowel and urinary control. This FDA-approved clinical trial is envisioned to be the future of treating MMC.
Mar 2024 DOI 10.14302/issn.2694-1201.jsn-22-4184
Sarcoidosis is granulomatous autoinflammatory autoimmune remitting relapsing disease affecting every organ in the body, it is the most difficult disease to diagnose in the absence of serum or imaging biomarker. Differential diagnosis is broad which included inflammatory, infective, neurodegenerative and neoplastic, histological biopsy is the only confirmative marker, and even histological confirmation is not robust as infection, malignancy and some drugs can induce granuloma, the most common organs affected are lung, lymph nodes, skin, eyes, liver, and less commonly pituitary gland, bones, brain, peripheral nerves, and heart, causing bilateral hilar lymphadenopathy, granulomatous lymphadenitis.
Feb 2024
Background Junctional epidermolysis bullosa (JEB) is a type of Epidermolysis Bullosa, a group of genetic conditions that cause the skin to be very fragile and to blister easily. It is categorized into: the Herlitz type and the Non-Herlitz type. JEB is inherited in an autosomal recessive pattern. Most common genetic mutations associated are LAMB3, COL17A1, or LAMC2, and LAMA3 genes. Case presentation This study reports a consanguineous couple, carriers for pathogenic variant LAMB3 gene, with an affected child with a homozygous mutation in the LAMB3 gene causing Herlitz type of Junctional epidermolysis Bullosa/ Non-Herlitz type of junctional epidermolysis bullosa. Furthermore, prenatal diagnosis for the Gravida also showed the same pathogenic variant. Conclusion For autosomal recessive genetic conditions, it is advisable to perform a Trio whole-exome sequencing or next-generation sequencing to detect the genes associated with the disease. Depending on the type of variants involved prenatal diagnosis for the next pregnancy and treatment or management (if available) options can be offered/discussed.
Aug 2023
DADA2 (deficiency of adenosine deaminase type 2) is an autoinflammatory autosomal recessive disease resulting from biallelic loss of function mutations in ADA2 gene. Clinical presentation and age of onset vary widely even among related patients, and variability of symptoms and severity manifestations include bone marrow failure, autoinflammation, immunodeficiency and vasculitis. Here, we report a case of young male with adult onset DADA2, who presented with fever, lower limbs skin rash, joint pain, and anemia resembling systemic lupus erythematous (SLE). DADA2 has an extremely variable clinical phenotype. It was described into three categories: inflammatory/vascular, immune dysregulation, and hematologic. However, the data is scant in describing autoimmunity phenotype in DADA2 and further studies are required to investigate the clinical correlation and presence of autoantibodies. We recommend genetic testing in cases with lupus-like disease especially if there is consanguinity between parents and family history of vasculitis.
Jul 2023 DOI 10.14302/issn.2575-1212.jvhc-23-4510
Dermatophytosis affect companion animal’s skin and keratin appendages as cats and dogs, resulting in red, scaly, itchy, bald, and raised patches like ring. The three main groups are Microsporum, Trichophyton and Epidermophyton. This study collected samples of skin scrapping and hairs from 130 cats and 70 dogs, using common mycological approach samples were examined. Antifungal agar disc diffusion and broth microdilution assays were utilized on some of the isolates. Three groups of Guinea pigs (6 in each) were then infected with one isolate of M. canis or T. mentagrophytes fungi, another skin scrapping samples of virulent fungi was isolated on the 7th and 14th days, blood samples were collected at 14th day. Reverse transcription-PCR to detect 98 bp protease gene. Resulting in 45% of cats and dogs tested positive for Microsporum and Trichophyton species. Agar disc diffusion revealed that the antifungal medication griseofulvin was the most effective against tested isolates. The best results for MIC test were griseofulvin (0.98 µg/ml) followed by acetic acid (0.28 µg/ml). Differential leukocytic count of Guinea pigs showed that monocyte levels remained unchanged, while neutrophil and lymphocyte levels had increased. The active (isolates from Guinea pigs skin scrapping) and dormant cells (isolates from keratin free media) were distinguished by Reverse Transcriptase-PCR. Collectively, qPCR is a successive and feasible method for the diagnosis for Microsporum and Trichophyton species.
Feb 2023 DOI 10.14302/issn.2641-4538.jphi-23-4452
Interruptions during pharmacological therapy in a hospital ward can be a source of error. We therefore considered two Operating Units of a hospital by asking the following questions: are the nursing staff who administer drug therapy at the set times able to do so with maximum concentration and without interruptions? If yes, how? If not, why and what for? Furthermore, are there organizational and non-organizational improvement strategies so that nurses are less interrupted during therapy and therefore do not cause adverse drug events that could cause harm to the patient? The results that emerged from the data analysis make us reflect considerably on how much interruptions during therapy are to be paid attention to as a problem to which solution proposals can be found.
Nov 2022 DOI 10.14302/issn.2690-4721.ijcm-22-4341
Bacteria of the genus Staphylococcus are pathogenic Gram-positive bacteria responsible for various infections, including skin suppuration, which can be severe or chronic. The objective of this study was to confirm Staphylococci strain’s identification isolated by bacteriological methods from biological products of CHU-B patients, by molecular methods based on the analysis of the gene coding for 16S rRNA. In total, 30 strains of Staphylococci were isolated including 8 (26.66%) community strains, 22 (73.33%) hospital strains. The products of the amplification of gene fragments encoding 16S rRNA from 10 strains of Staphylococci including 6 strains of Staphylococcus aureus (S. aureus) and 4 Coagulase Negative Staphylococci (CNS) were sequenced. The sequences obtained were subjected to bioinformatics analysis to confirm the results of conventional bacteriological methods. Six (6) S. aureus strains, 2 Staphylococcus haemolyticus strains, 1 uncultured bacterium clone nbw618g09c1, and one Staphylococcus sp. have been identified. These results made it possible to confirm the effectiveness of the molecular method and to show the limits of traditional bacteriological methods in the complete identification of bacteria.
Jan 2022 DOI 10.14302/issn.2372-6601.jhor-22-4061
Background Human malignant cell models which reflect the structural and physiological complexity of tumor tissue are of great importance for preclinical research in oncology. Spheroids/tumoroids derived from solid tumors are of great interest as cellular models mimicking the first vascular-free growth phase of a tumor node. The fact of the identity between artificially created tumor multicellular aggregates and the real tumor tissue, however, needs to be specified, described and validated in order to see how closely the spheroids are biologically similar to the malignized tissues in vivo compared to the monolayer cell cultures traditionally used. We present here a comparison study of the characteristics of solid tumor cells of different histogenesis (melanomas, soft tissue sarcomas and bone sarcomas, epithelial tumors) cultured in two dimensions (monolayer culture) and three dimensional space (spheroid), namely: spatial organization, multiplication, metabolic activity. Patients and Methods For the creation of 2 D and 3D cell models the cells isolated from the patient's solid tumor fragments obtained intraoperatively were used. 15 samples of skin melanoma, 20 samples of soft tissue and osteogenic sarcomas (STBS), and 9 samples of epithelial tumors (ET). The tumor cells were all cultivated for at least 10 passages. We used phase contrast, confocal microscopy, and immunohistochemistry to investigate spheroids and monolayer cultures. The supernatants of tumor cells grown in 2D and 3D cultures were studied using ELISA and multiplex analysis for the production of a spectrum of chemokines and cytokines supporting the immunosuppression, invasion and metastasis processes. Results Tumor specimens received were predominantly of metastatic origin (75%). In 100% of cases 2D cultures were received, in 88.6% of cases (39 out of 44) we succeeded in obtaining spheroids. There was no direct correlation between the efficiency of tumoroid formation and the tumor's histogenetic origin and the stage of the cancer process (primary tumor, recurrence, metastasis). The median size of spheroids by 4-5 days of cultivation with a starting concentration of 10000 cells per well was 657.14 μm for melanoma (min 400 - max 1000 μm), 571.42 μm (min 400 - max 700 μm), 507.14 μm (min 300 - max 600 μm) for soft tissue sarcomas, 650.0 μm (min 400 - max 900 μm) for osteogenic sarcomas. Immunochemical analysis of Ki-67, GLUT1, and Ecadherin markers was carried out for tumor tissue samples, single-layer tumor cultures, and tumoroids of every patient. The distribution of the stained groups in the spheroids was distinct from the monolayer cultures and more in accordance with the distribution of such in the tissue tumor, the number of Ki-67+ cells was increasing in the spheroids. We detected no dependence of Ki-67+ and GLUT1+ cell localization grade on spheroid size. We identified E-cadherin in tumor tissue and tumoroids of breast carcinoma and one melanoma culture. Monolayer cultures did not express it. The increase in secretory cell activity of the solid tumor cells from 2D to 3D system was observed when CCL2, CCL3, CXCL1, CXCL16, MIF, IL10, MICA (p<0.01) were investigated. Conclusion The presence of patient-specific cells of solid tumors in a 3D environment causes activation of the proliferative and metabolic processes as compared to monolayer cultures, which makes these models approximate the real world clinical picture. The production of chemokines that can attract to the tumor various types of immune system cells, to include their immature versions, as well as production of cytokines and Immunosuppression factors that, when present in the tumor microenvironment in the high concentrations, contribute to the formation of immune cells having suppressive capacities occurs in the 3D cell system. Three-dimensional model of the initial tumor nodule formation stage thus demonstrates the forming process of tumor cells favorable for them microenvironment. Construction of three-dimensional models - spheroids of tumor cells of differing histogenesis demands individual approach and more thorough investigation.
Sep 2021 DOI 10.14302/issn.2639-3166.jar-21-3955
In the cultivation of vines the risk of hail appears to be increasing with the ongoing climate change. The use of protective plastic nets is spreading, but there is little knowledge on the additional processing costs and on the phenological and qualitative consequences, moreover, as depending on different colors of the nets. Thus, a randomized trial was carried out in Nebbiolo, a wine of great aging, testing three plastic anti-hail nets colored in green, gray and black. Results showed that 24% more-time was necessary for the canopy management practices under the nets. The black nets advanced the ripening process, with a berry weight decrease of about 13%. A significant decrease in the seed number per berry was observed under the black nets (-45%), while a rise (+102%) was observed under the green and gray nets with a parallel increase in the pH of the juice (+13%) and in malic acid (+28%) under the green nets. The berry skin did not show any significant differences in polyphenol and anthocyanin profiles, while the plants that matured in the upper part of the vineyard showed higher level in the berry skin extractable flavan-reactive to vanillin, and total polyphenol. On the other hand, in the seeds grown under green nets an increase in the extractable polyphenol compounds was observed, sign of a delay in seed ripening, with a higher tannin polymerization ratio, preserving the malic acid, and decreasing the acidity of the berry. In conclusion, the use of colored green may be a useful tool against excessive microclimatic warming and / or irradiation. The field internal variability affects much more the ripening dynamics than the nets used. A second aim was to develop a smart NIR SCiOTM model for polyphenols and the results were in line with the favorable expectations, providing R2 predictions of about 0.74 from the skin and 0.81 from the seeds.
Dec 2020
This article has been retracted on March 01, 2021. VIEW THE RETRACTION NOTICE (https://openaccesspub.org/jsce/article/2243) Background Apis Mellifera L venom (Honeybees) is potent and safe anticancer drug. The present case is Basal Cell Carcinoma (SBCC), recurrent and invasde the skin of head (upper right, in front of the right ear). The patient was 65 years old in time of first intervention and the origin of BCC was primarily seen as abnormal growths and changes in birth mole on right side of head. Materials & Methods Preparation Bee Venom solution: Bee venom powder (crude) of dose 1gm was dissolved in 1000 ml of sterile distilled water then filtered by 0.22 micron syring filter. That final concentration of the stock bee venom become 1 ug /ml (i.e. 1ul=1 ug), and kept at -20◦C. (1mg (dried BV) + 1ml (water) = Final concentration (1ug/1 ul)). Before this novel intervention, allergy test performed by subcutaneous injection of small dose of bee venom (0.1 ml) and wait for at least one hour. The patient was not hypersensitive to honeybees’ venom. First stage of treatment: 1- Syringe of 1ml volume was used for direct local injection of cancer area by 0.3 ml from prepared Honeybees venom (0.1 % conc.). 2- At the same time, subcutaneous injection of 0.5 ml of bee venom solution infiltrated around the affected ear. 3- Topical application of the bee venom ointment 2% (bee venom in Vaseline) inside affected ear to protect the ear drum. This process repeated daily with cleaning of the ear every time by suitable safe and sterile saline solutions. 2nd stage: daily S/C injection in axillary area upper lymph nodes of 0.3 ml / bee venom ‘total doses 0.6 ml BV’ (left & right). 3rd stage: bee venom dissolved in sterile Clove oil was applied on inner ear above the drum. 4th stage: Management of healing process was enhanced by ascorbic acid solution as topical application on dead cancer cells and to help in removal of exudates and debris. Results The complete removal of malignant growths in affected ear achieved after 1 month from first bee venom injections. However; the cancerous areas under the second surgical intervention were treated during the next month. Conclusions Apis Mellifera L venom as anticancer drug is totally different from using direct stings as a method of Apitherapy, that because collection of bee venom lead to evaporating of most allergic substance that present in bees stings, also it can be used per os in people who exhibit different degrees of allergy against the drug safely.
Nov 2020 DOI 10.14302/issn.2577-2279.ijha-20-3591
Objectives Aim of the study was to develop a ‘composite body size score’ (CBSS) using anthropometric traits to estimate body size and to assess the nutritional status of each study individual on the basis of CBSS. Materials and Methods Data on seventeen anthropometric traits were collected from 710 individuals (Male, Female) from fishermen community inhabiting coastal villages of West Bengal, India. For estimating body sizes, Structural Equation Model (SEM) was constructed with Path Analysis (PA). Later, second order Confirmatory Factor Analysis (CFA) was applied on SEM to determine CBSS. It was hypothesized in the models that CBSS is composed with three sets of latent variables viz., linear, circular and skinfold, constructed from anthropometric traits. Applying new derived optimal cut off points of CBSS was used to determine lean, normal and robust body sizes. Individuals with negative values of CBSS were categorised as lean body size,. Positive values of CBSS were categorised into two categories- normal and robust body size. Results On the basis of CBSS, result showed that 50.6%, 48.8% and 0.6% of the individuals were categorised under lean, normal and robust body size respectively. Females showed relatively higher percent of lean body size i.e. under nutrition (73.8%) compared to males (26.2%). Conclusion The hypothesized model estimate more accurate composite body size score, based on anthropometric traits. All the traits are highly significant on the model. The lean body size category can be use in predicting ‘Undernutrition’.
Nov 2020 DOI 10.14302/issn.2328-0182.japst-20-3618
Metronidazole is an antibiotic and useful for the antibacterial and antiprotozoal medication. This study was performed to investigate the impact of the Trivedi Effect®-Biofield Energy Healing Treatment on the structural properties and the isotopic abundance ratio of metronidazole using LC-MS and GC-MS spectroscopy. Metronidazole sample was divided into two parts, one part of metronidazole was considered as control (no Biofield Energy Treatment was provided), while the second part was treated with the Trivedi Effect®-Consciousness Energy Healing Treatment remotely by a renowned Biofield Energy Healer, Alice Branton and termed as a treated sample. The LC-MS spectra of both the samples of metronidazole at the retention time (Rt) 2.61 minutes exhibited the mass of the protonated molecular ion peak at m/z 172 M+H+ (calculated for C6H10N3O3+, 172.07). The LC-MS based isotopic abundance ratio of PM+1/PM (2H/1H or 13C/12C or 15N/214N or 17O/16O) in the treated metronidazole was significantly increased by 8.24% compared with the control sample. Thus,13C, 2H, 15N,and17O contributions from (C6H10N3O3)+ to m/z 173 in the treated sample were significantly increased compared with the control sample. The GC-MS based isotopic abundance ratio of PM+1/PM in the treated metronidazole was significantly increased by 5.92% compared with the control sample. Hence,13C, 2H, 15N, and217O contributions from (C6H9N3O3)+ to m/z 172 in the Biofield Energy Treated sample were significantly increased compared with the control sample. However, the isotopic abundance ratio of PM+2/PM in the treated metronidazole was significantly decreased by 18.2% compared with the control sample. Hence,18O contributions from (C6H9N3O3)+ to m/z 173 in the treated sample were significantly decreased compared with the control sample. The isotopic abundance ratio of PM+1/PM (2H/1H or 13C/12C or 15N/14N or 17O/16O) and PM+2/PM (18O/16O) in the treated metronidazole was significantly altered compared to the control sample. From the results, it can be hypothesized that the changes in isotopic abundance and mass peak intensities could be due to changes in nuclei possibly through the interference of neutrino particles via the Trivedi Effect® - Consciousness Energy Healing Treatment. The new form of treated metronidazole would be better designing novel pharmaceutical formulations that might offer better therapeutic response against bacterial and protozoal infection in the vagina (bacterial vaginosis), stomach (giardiasis, trichomoniasis, pseudomembranous colitis), joints (pelvic inflammatory disease), liver, skin, brain, and respiratory tract, aspiration pneumonia, rosacea, intra-abdominal infections, lung abscess, fungating wounds, periodontitis, amoebiasis, oral infections, etc.
Jun 2020 DOI 10.14302/issn.2577-2279.ijha-20-3445
The passage of the posterior tibial nerve in the tarsal tunnel has a great clinical significance, thus detailed anatomical knowledge is mandatory for safe clinical intervention. This study was to identify the morphological appearance of the tibial nerve and its bifurcation. Sixty lower limbs of formalin embalmed cadavers were randomly selected. Data were collected through the application of standard dissection method of the tarsal tunnel of lower limbs (30 rights and 30 left) of formalin embalmed cadavers. The posterior tibial nerve and its branches were exposed from the distal end of the leg toward plantar surface beyond its bifurcation by resecting the skin and flexor retinaculum. The study triggered several findings: The posterior tibial nerve is flattened shaped in 21 specimens 70% and has a rounded shape in 9 specimens 30%in the right foot. In the left foot it is flattened in 17 specimens 56.7% and rounded shape in 13 specimens 43.3%. Posterior tibial nerve bifurcates into medial and lateral planter nerves inside tarsal tunnel in 20 specimens 66.7% in the right foot and in 21 specimens 70% in the left foot. This study concludes that posterior tibial nerve commonly has flattened shape and divided into medial and lateral planter nerves inside tarsal tunnel.
Mar 2020 DOI 10.14302/issn.2471-2175.jdrt-20-3274
Pharmacodynamic modeling of sunscreens was performed using a new concept of Skin UV Index (SUI) on the exposed skin as a parameter to evaluate the potential effectiveness of sunscreens against sun damage. The SUI predicts the UV heat intensity on the skin surface in terms of the solar UV Index at the time of the study and is calculated by solar UV Index/sunscreen’s SPF. SUI numbers for sunscreen with SPF ranging from 2 to 100 under a solar UV Index of 10 was used for illustration. Based on guidelines from WHO, Australia and New Zealand, sunscreens yielding SUI < 3 are assumed to be effective against sun damage such as sunburn and melanoma. Based on the above assumption, sunscreens with SPF > 4 were found to be effective when sunscreens were evenly applied at 2 mg/cm2. Review of numerous studies suggests that missing applications may represent a major, seemingly unavoidable, SPF-independent factor causing unintended sunburns for sunbathers in the US and other countries with a temperate climate. This might in turn become a major factor for causing exponential increase in melanoma incidence rates observed in the last few decades. For example, in an SPF 30 sunscreen study all 25 participants suffered unintended sunburns after one week of sunbathing. Also, a mean missing application of 20% of the total exposed area and a mean missing of about 50% of the time were reported in two separate studies. Simulations were also performed with under-applications of 50% and 75%. The present simulations may provide a rationale of why routine use of a low SPF 8 sunscreen was reported to be effective against melanoma in a 2018 Australian study. Based on model simulations it is proposed that in the US, SPF 8 sunscreen and SPF 2 to 6 sunscreen may be adequate for routine, unintentional use for sun-sensitive populations and non-sun-sensitive populations, respectively.
Oct 2019 DOI 10.14302/issn.2641-7669.ject-19-3040
Many lay people along with some so called “key opinion leaders” have a common slogan “There's no answer for cancer”. Again, mistake delays proper treatment and make situation worse, more often. Compliance is crucial to obtain optimal health outcomes, such as cure or improvement in QoL. Patients may delay treatment or fail to seek care because of high out-of- pocket expenditures. Despite phenomenal development, conventional therapy falls short in cancer management. There are two major hurdles in anticancer drug development: dose-limiting toxic side effects that reduce either drug effectiveness or the QoL of patients and complicated drug development processes that are costly and time consuming. Cancer patients are increasingly seeking out alternative medicine and might be reluctant to disclose its use to their oncology treatment physicians. But there is limited available information on patterns of utilization and efficacy of alternative medicine for patients with cancer. As adjuvant therapy, many traditional medicines shown efficacy against brain, head and neck, skin, breast, liver, pancreas, kidney, bladder, prostate, colon and blood cancers. The literature reviews non-pharmacological interventions used against cancer, published trials, systematic reviews and meta-analyses.
Sep 2019 DOI 10.14302/issn.2577-2279.ijha-19-3013
The medial calcaneal nerve (MCN) is the first branch of the posterior tibial nerve (PTN) in the porta pedis, enervates the skin of the heel and medial side of the foot. Heel pain is a common condition encountered by physicians, and this may have a significant clinical association with the MCN’s branching pattern. This study was to identify branching pattern variations in the medial calcaneal neurovascular bundle. This study was carried out using 60lower limbs of formalin-embalmed cadavers, using the tarsal tunnel dissection method for 30right and 30 left lower limbs. The medial calcaneal neurovascular bundle course was identified by exposing the PTN and its branches from the distal end of the leg toward the plantar surface beyond its bifurcation and resecting the skin and flexor retinaculum. Many MCN branching pattern variations (specifically concerning origins, numbers, and levels of branching) were observed. In the right foot a single branch was present in 21 specimens (70%), while two branches were observed in nine specimens (30%). In the left foot, a single branch was present in 22 specimens (73.3%) and two branches were present in 8 specimens (26.7%). In this study, two branches originate from lateral planter artery is the most common observation. This study concludes that a single MCN originating from the TN is the most common variant. Two medial calcaneal arteries (MCAs) originating from the LPA is also common.
Aug 2019 DOI 10.14302/issn.2372-6601.jhor-19-2982
Objective Rosenthal's disease (RD) is a rare constitutional hemorrhagic disorder defined by factor XI deficiency. It is clinically characterized by the presence of minimal haemorrhage. We report the first observation of RD in Togo. Observation Mrs. G. A., 45 years old with no particular pathological antecedents, was referred for anemia in a context of chronic epistaxis. It was a spontaneous anterior exteriorization epistaxis often of great abundance, rocking and which evolved episodically. The patient received several transfusions for anemia. The ear-nose-throat examination was normal and a sinus CT scan found only an inflammatory process of the right maxillary sinus. The blood count showed microcytic severe anemia (2,2g/dl). Hemostasis tests showed a prolonged aPTT (57,9 seconds). Clinical examination documented an anemic syndrome with dry skin. Iron deficiency was found. The hemostasis balance confirmed aPTT elongation. Coagulation factors activity showed normal VIII and IX level, but moderate decrease of factor XI (32%). The family survey was not possible (orphan patient). It is recommended the setting under fresh frozen plasma (FFP) in case of a new episode. Follow-up is in progress. Conclusion In the event of any hemorrhagic syndrome, the isolated elongation of the aPTT must lead to a systematic analysis of intrinsic pathway factors
Jun 2019 DOI 10.14302/issn.2690-0904.ijoe-19-2792
In deaths and diseases attributed to tobacco smoke cardiovascular events exceed cancer and respiratory diseases. Second hand smoke promotes the development of arteriosclerosis and can trigger acute changes of endothelial function and blood coagulability. Indoor smoking bans reduced coronary syndrome and myocardial infarction 10-20% within one year and were followed by sustainable decreases of stroke and diabetes. With a smoke-free hospitality industry people recognized tobacco smoke as an air pollutant, smoking in public was denormalized and social acceptance of smoking in front of children and pregnant women decreased also in homes and cars. Combined effects with ambient air pollution are proven for active smoking and suspected for SHS. Contamination with third hand smoke (THS) persists for months in homes and cars, creating secondary pollutants that in some cases are more toxic (e.g. nitrosamines). Remnants found in air, dust, and on surfaces (carpets, wallpapers, upholstery, soft toys) were associated with their metabolites in saliva of children and in urine of nonsmokers residing in homes previously occupied by smokers. In animal experiments effects of THS were found on thrombogenesis, insulin resistance through oxidative stress, on the developing immune system, lipid metabolism and alterations in liver, lung, skin and behavior. Much less is known about health effects for bystanders from the aerosols exhaled during “vaping” of e-cigarettes, but nicotine and other toxins from e-cigarettes are certainly a hazard, which should be prevented by the use of dermal and oral nicotine products, which are safer for nicotine replacement and without risk for bystanders.
Jun 2019 DOI 10.14302/issn.2377-2549.jndc-19-2765
Tetrodotoxin (TTX) is a potent neurotoxin. Its name derives from Tetraodontiformes, an order that includes pufferfish, porcupinefish, ocean sunfish, and triggerfish; several of these species carry the toxin. Although tetrodotoxin was discovered in these fish and found in several other aquatic animals (e.g., in blue–ringed octopuses, rough–skinned newts, and moon snails), it is actually produced by certain infecting or symbiotic bacteria like Pseudoalteromonas, Pseudomonas, and Vibrio as well as other species found in animals. Parameters such as FT–IR and Raman vibrational wavelengths and intensities for single crystal Tetrodotoxin (TTX)are calculated using density functional theory and were compared with empirical results. The investigation about vibrational spectrum of cycle dimers in crystal with carboxyl groups from each molecule of acid was shown that it leads to create Hydrogen bounds for adjacent molecules. The current study aimed to investigate the possibility of simulating the empirical values. Analysis of vibrational spectrum of Tetrodotoxin (TTX) is performed based on theoretical simulation and FT–IR empirical spectrum and Raman empirical spectrum using density functional theory in levels of F/6–31G*, HF/6–31++G**, MP2/6–31G, MP2/6–31++G**, BLYP/6–31G, BLYP/6–31++G**, B3LYP/6–31G and B3LYP6–31–HEG**. Vibration modes of methylene, carboxyl acid and phenyl cycle are separately investigated. The obtained values confirm high accuracy and validity of results obtained from calculations. Molecular structure of Tetrodotoxin (TTX) 1–42.
Jun 2019 DOI 10.14302/issn.2474-3585.jpmc-19-2750
Purpose Foot injuries are common in low- and middle-income countries and continue to increase in incidence due to the surge in the use of motorcycles as means of transport.Yet, there is scanty data on the incidence and outcomes of treatment of open injuries to the foot in the developing world.We aimed to determine the incidence and functional outcomes of open foot injuries that are treated in a teaching hospital in Ghana. Methods We used a structured questionnaire to record the type of open foot injury, the mechanism of injury, any concomitant injuries, the time interval between injury and arrival at the hospital for treatment as well as the type of treatment instituted. Recruited patients were followed up for six months, complications resulting from the injury or its treatment were recorded for each patient. The function of the foot after healing of the injury was measured using a questionnaire-based visual analogue outcome scale of the American Foot and Ankle Society. Regression and chi-square analysis were used to evaluate potential associations. Results Over a four-month period, a total of 81 cases of open injuries to the foot were recorded. Out of this figure, 55 patients (67.9%) were males and 26 (32.1%) were females. It was found, that 66.7% aged between 19 and 49 years, 76.5% of the injuries occurred on the road and 29.7% was motor cycle related. Pedestrians are the most afflicted (61.7%). The treatment outcomes of traumatic amputations, open phalangeal fractures, dorsal skin degloving and lacerations were good. Gustillo-Anderson grade IIIB open fractures with associated plantar skin degloving had the worst outcomes with residual pain on weight bearing, bigger foot, inability to wear previous shoes and inability to tiptoe on the affected foot. Conclusions Open injuries to the foot are common in Ghana and exert a significant health burden, particularly on active young males. Long term disability may occur, even after adequate treatment of open fractures involving the foot.
May 2019 DOI 10.14302/issn.2641-5518.jcci-19-2816
Basal cell carcinoma (BCC) is the most common type of skin cancer, which arises from the basal layer of the epithelium. It is a slow growing tumor and has a low metastatic potential, it accounts for 70–80% of all cutaneous malignancies in the head face and neck region .Defects near nasal tip and ala of the nose are one of the most difficult site to cover in a single stage, bilobed flap is reported to be used very effectively to close the defect in these areas. This article reports a case of basal cell carcinoma involving the ala of the nose which was excised and the reconstruction was done using bilobed flap.
Jan 2019 DOI 10.14302/issn.2691-5014.jphn-18-2456
Vitamin D, the sunshine vitamin, is now recognized not only for its importance in promoting bone health in children and adults, but also for its other health benefits, including reducing the risk of chronic diseases such as autoimmune diseases, common cancer, and cardiovascular diseases. Ultraviolet radiation of the sun with wavelengths of 290-310 nm penetrates into the skin and converts 7-dehydrocholesterol to previtamin D3, which quickly transforms to vitamin D3. Vitamin D (D represents either D2 or D3) made in the skin or ingested through diet is biologically inert and requires two successive hydroxylations first in the liver on carbon 25 to form 25-hydroxyvitamin D 25(OH)D and then in the kidney for a hydroxylation on carbon 1 to form the biologically active form of vitamin D, 1,25-dihydroxyvitamin D (1,25(OH)2D) 121419. The concentration of the produced 25-hydroxy vitamin D in blood circulation is 1,000 times more than 1,25-dihydroxy vitamin D 4, and it is regarded as a standard indicator of vitamin D status in humans 3. 25-hydroxy vitamin D half-life is about 2-3 weeks and it is regulated by calcium (Ca), phosphorus (P), and serum parathyroid hormone (PTH) to some extent. 25-hydroxy vitamin D content also reflects the amount of vitamin D produced in the skin after exposure to sunlight or received through food intake 56. Guidelines for vitamin D insufficiency/deficiency defined by serum 25(OH)D concentrations have been published from many countries and regions all over the world 7891011. Vitamin D deficiency is a pandemic problem. According to global estimations, more than one billion people around the world suffer from vitamin D deficiency. Among Iranian population, the incidence of vitamin D deficiency varies from 2.5 to 98.5% based on geographic area 1213. Various factors may give rise to vitamin D deficiency, including skin pigments, low levels of vitamin D in diet (insufficient fish oil and egg yolk intake), malnutrition, genetic factors, exclusive breast feeding, vitamin D deficiency of mother during pregnancy, prematurity, chronic use of drugs (e.g., anticonvulsants, aluminum-containing anti-acids, rifampcin, isoniazid, antifungal drugs, antiviral drugs, and glucocorticoids), winter and obesity 113. Cultural habits, the need for full body coverage during outdoor activities and the lack of sunlight programs are the risk factors for low vitamin D levels in women 151617. Children enter foster care due to early childhood adverse experiences such as poor prenatal and infant health care, food insecurity, chronic stress, and the effects of abuse and neglect. As a result, they are at higher risk for poor physical, psychological, neuroendocrine and neurocognitive outcomes compared to others. Foster children are at risk for growth and nutritional deficiencies due to their poor nutritional environment prior to placement in foster care. Insufficient caloric intake results in growth deficiencies. Evidence showed that the risk of stunting and underweight is high in this population 18. The risk of developing hypovitaminosis D was significantly higher in children living in foster homes. One reason is that they are at higher risk of child abuse, emotional deprivation and physical neglect than children living with their families. Moreover, these children most likely do not spend much time outdoors and they lack adequate sun exposure. Another reason is that as children grow up in institutional care, they shift from a diet of vitamin D–fortified formula milk to cooked food, which may not be fortified with vitamin D 1. Iranian government has made some efforts to apply efficient interventions to reduce the prevalence of vitamin D deficiency, and the country’s healthcare system should be managed through accurate planning. Yet, in this country, studies on vitamin D deficiency in children living in foster homes are very limited, and given that timely diagnosis and treatment of this deficiency is vital, this research is conducted in Ali Asghar foster home in Mashhad, Iran.
Jan 2019 DOI 10.14302/issn.2471-2175.jdrt-18-2520
Hair is playing an interesting part in human for social and sexual communication. Loss of hair follicle leads to various skin disorders. For this consequence, the present study has investigated the potential of the Biofield Energy Healing (The Trivedi Effect®) Treated test item (William’s Medium E) on the vibrissae hair follicle organ culture cells for the assessment of hair cell growth and development in vitro. The test item was divided into two parts. One part was defined as the untreated test item, where no Biofield Energy Treatment provided, while the other part was defined as the Biofield Energy Treated test item, which received the Biofield Energy Healing Treatment by renowned Biofield Energy Healer, Mahendra Kumar Trivedi. The study parameters like bulb thickness and formation of telogen were assessed using cell-based assay with the help of UTHSCSA Image tool version 3. The experimental results showed that the untreated test item group showed 20.9% and 28.2% increased bulb thickness on day 5 and 7, respectively compared to the day 1, while did not produce telogen follicles upto day 7. Besides, the percentage of telogen follicle was found as 43%, 57%, and 71% on day 3, 5, and 7, respectively of the Biofield Energy Treated test item group compared to the day 1. The overall results demonstrated that the Biofield Energy Treatment has the potential for hair growth promotion as evident via increased the formation of telogen. Therefore, the Biofield Energy Healing (The Trivedi Effect®) Treatment might be useful as a hair growth promoter for various treatment of skin injuries and skin-related disorders like necrotizing fasciitis, actinic keratosis, sebaceous cysts, diaper rash, decubitus ulcer etc.
Dec 2018 DOI 10.14302/issn.2640-6403.jtrr-18-2442
Background: Lyell Syndrome (TEN, Toxic epidermal necrolysis) represents a medical emergency particularly in pediatric patients in whom the massive skin damage can quickly lead to multi-organ dysfunction and death. Prompt restoration of the physiologic mucosal/cutaneous barrier is mandatory. The use of amniotic membranes has been described in the treatment of ophthalmic Lyell Syndrome, but its use has not yet been adopted for the management of larger cutaneous wounds. Study Hypothesis: Here we report the use of amniotic membranes in a pediatric case of severe Lyell Syndrome with complete skin surface, ocular and mucosal involvement with life threating presentation. Methods: A 7-year old female was admitted to our Burn Centre for severe cutaneous/mucosal exfoliation (100% Total body surface area, TBSA) as a result of an adverse reaction to ibuprofen administration. Supportive fluid administration, cardiac-pulmonary assistance and pain management were complemented by serial grafting of amniotic membranes on all affected areas to provide coverage of the exfoliated skin/mucosa. Biopsies were obtained to monitor histological skin changes. Results: The patient showed an excellent response to amniotic membrane treatment, with rapid restoration of mucosal and cutaneous layers in the grafted areas. This resulted in a decreased need for dressing changes, avoidance of additional surgeries and a reduced dependence on supportive therapy. Lower pain levels than usually expected led to a reduced need for narcotic pain medications and allowed for early physical rehabilitation and a short hospital stay. Histology confirmed evidence of topical immune-modulation in treated areas (reduction of inflammatory infiltrate). Conclusion: As we tested in numerously TEN and burn pediatric injuries Amniotic membranes with their regenerative and immune-modulatory effects may represent an life saving treatment even in the worst cases of pediatric Lyell syndrome.
Apr 2018 DOI 10.14302/issn.2640-6403.jtrr-18-2054
Cellulite is a very frequent clinical condition that, despite not being serious, constitutes one of the greatest aesthetic concerns of a large number of women. In recent years, some of the technologies that have allowed the development of devices and key tools in aesthetic medicine treatments have been consolidated. The aim of this article is to test the effectiveness of CoolCell®, a new treatment for cellulite that is administered with Coolifting® technology. We included 24 women who received 8 sessions of Coolifting® CoolCell®, one per week. Thermographic measurements were taken and satisfaction questionnaires were completed. Thermographic analysis showed a statistically significant color variation and self-assessment reports revealed that more around 75% of the subjects witnessed great or spectacular changes on their skin.
Apr 2018 DOI 10.14302/issn.2578-8590.ipj-18-2078
Background: The core interthreshold zone (CIZ) is defined as the range between core temperature (Tc) at the onset of shivering and the Tc at the onset of sweating under consistent mean skin temperatures of 28°C to 30°C. A previous study demonstrated a diurnal change in the CIZ for male subjects and its relationship to the cutaneous sensation threshold zone (CSZ). In the present study, diurnal changes in the CIZ and the CSZ for young Japanese female subjects were investigated using the same experimental protocol from the study of male subjects and the sex differences in these responses were then examined. Methods: The CIZ and the CSZ were measured in 10 female subjects who participated in three experiments in a single day during the morning, afternoon, and evening in the summer of 2014 (single-day experiment), and six female subjects who participated in the same experiments on the morning of day 1, the afternoon of day 2, and the evening of day 3 during the summer of 2016 (multiple-day experiment). Air temperature was controlled at 25°C. Each subject wore a suit perfused with 25°C water at a rate of 600 cc/min, and exercised at 50% of their maximum work rate on an ergometer for 10–15 min until their sweating rate increased. They then remained seated, without exercising, until their oxygen uptake increased. Rectal temperature, skin temperature at seven sites, the forehead-sweating rate, and oxygen uptake were continuously monitored throughout the experiment. Cutaneous warm and cold sensation thresholds were measured at three sites using 1-cm2 and 2-cm2 probes. Results: The results from the single-day experiment demonstrated that the CIZ was proportional to core temperature prior to exercise (Tc-init) whereas the results from the multiple-day experiment demonstrated that the CIZ increased continuously from morning to evening despite almost a constant Tc-init. The CIZ appeared to be proportional to the CSZ measured with the 2-cm2 probe. When compared with the results from the previous study of men, no significant sex difference was observed between the CIZ of 0.25±0.07°C for female subjects and 0.21±0.05°C for male subjects. Conclusion: No significant sex difference or diurnal variation in the CIZ was confirmed. Continuous increase in the CIZ from morning until evening is expected in both men and women under a normal Tc circadian rhythm.
Feb 2018 DOI 10.14302/issn.2470-0436.jos-17-1825
Background: To measure the affected subepidermal nerve sensation with a combination of current perception threshold (CPT) and Semmes-Weinstein monofilament (SWM) testing under pain areas with herpetic ophthalmic neuralgia (HON). Methods: One hundred fifty-five subjects with HON and 30 age-matched volunteers were recruited for the study. Results: The combined SWM and CPT testing yielded significantly abnormal responses at the painful sites for the patients with HON compared to those responses of the normal controls (p< 0.05). The SWM and CPT tests were able to distinguish local hypoesthesia of pain areas when the cut-off values were 0.135g, 53 (5Hz), 66 (250Hz) and 199 (2,000Hz). The ratio of the painful site to the mirror site indicated there were significant differences in the CPT ratio at 250Hz and 2,000Hz among different pain characteristic groups. Post hoc tests showed significant differences in CPT250Hz between itching and lancinating pain (p=0.006), itching and allodynia (p=0.002), and burning pain and allodynia (p=0.042). There were significant differences in CPT2000Hz between deep pain and allodynia (p=0.001) and itching and allodynia (p=0.014). Conclusion: CPT and SWM testing can probably be used as semi-quantitative indicators to represent the neural function at the local skin of pain area with HON.
Dec 2017 DOI 10.14302/issn.2640-6403.jtrr-17-1840
Up till now, chitosan has confirmed its versatile application in skin, cartilage and bone tissue engineering, as well as in drug delivery applications. This study is focused on enzymatic degradation of porous chitosan structures usually designed for mentioned purposes. In vitro degradation was monitored during four weeks of incubation at physiological temperature and in two different media, phosphate buffer saline solution and water. The scaffolds were characterised before and after enzymatic degradation using scanning electron microscopy and infrared spectroscopy with Fourier transformations (FTIR). According to the gravimetric analysis, higher weight loss of chitosan scaffolds was observed in buffered medium with respect to the water. The results implied that the total weight loss obtained in buffer involves physical dissolution of chitosan and lysozyme cleavage of glycoside bond. Importantly, FTIR identification of chitosan scaffolds after enzymatic degradation indicated the absence of lysozyme activity in water, indicating that weight loss is a result of the chitosan dissolution. This finding greatly impacts design of degradation experiments and characterisation of degradation behaviour of chitosan-based materials utilised as implants or drug delivery systems.
Nov 2017 DOI 10.14302/issn.2471-2175.jdrt-17-1760
Metastatic melanoma is a very deadly type of skin cancer with poor prognosis and low 5-year survival rates. Until recently, patients with metastatic melanoma had very few treatment options, which only included dacarbazine and aldesleukin. In 2011, the first checkpoint blocker, ipilimumab was approved for the treatment of unresectable metastatic melanoma but its success was eclipsed by low response rates and high incidence of adverse events. Later in 2014, anti-PD-1 antibodies, nivolumab and pembrolizumab were approved for the treatment of metastatic melanoma. With comparatively high response rates and manageable safety profile, PD-1 blockers were remarkably successful in the treatment of melanoma and also other cancer subtypes such as non-small cell lung cancer and metastatic urothelial carcinoma. This article highlights the success of anti-PD-1 antibodies, discusses the mechanism of PD-1:PD-L1/2 pathway, responses of melanoma patients to PD-1 blockers and the research on improving response rates to PD-1 blockers.
Aug 2017 DOI 10.14302/issn.2379-8572.joa-16-1368
We report a case of cholesteatoma associated with unilateral congenital aural atresia (CAA) and microtia, resulting in extracranial complication. A 13-year-old girl presented with right ear purulent discharge from pre and post auricular area with mastoid tenderness. On clinical examination, she had right grade II microtia with pre-auricular skin tag and healed scar tissue in periauricular region. On High Resolution Computerized Tomography (HRCT) scan of temporal bones, there was CAA of right ear with extensive cholesteatoma in middle ear cleft. The cholesteatoma was subsequently removed by radical mastoidectomy with uneventful post-operative period. Cholesteatoma associated with CAA may remain undiagnosed in early childhood resulting in life threatening temporal and intracranial complications.
Aug 2017
Iclaprim is a novel bacterial dihydrofolate reductase inhibitor in Phase 3 clinical development for the treatment of acute bacterial skin and skin structure infections and hospital acquired bacterial pneumonia caused by Gram-positve bacteria. Daptomycin, linezolid and vancomycin are commonly used antibiotic for these indications. With increase selective pressure to these generic antibiotics, outbreaks of bacterial resistance to these antibiotics have been reported. This in vitro study evaluated the activity of iclaprim against methicillin-resistant Staphylococcus aureus (MRSA) isolates, which were also not susceptible to daptomycin, linezolid or vancomycin. Iclaprim had an MIC ≤1 µg/ml to the majority of MRSA isolates that were nonsusceptible to daptomycin (5 of 7 71.4%), linezolid (26 of 26 100%), or vancomycin (19 of 28 66.7%). In time-kill curves analyses, iclaprim demonstrated ≥3 log10 reduction in CFU/mL at 4-8 hours for tested strains and isolates nonsusceptible to linezolid or vancomycin. Together these data support the use of iclaprim in serious infections caused by MRSA nonsusceptible to daptomycin, linezolid or vancomycin.
Jul 2017 DOI 10.14302/issn.2576-9359.jot-17-1597
Cutaneous lymphoma after organ transplantation is rare and its diagnosis may be delayed by both atypical clinical manifestations and failure to consider it in the differential diagnosis. Beside skin-directed therapy for the stage, immunosuppression reduction is also important for disease control. We describe a clinical case of mycosis fungoides after renal transplantation and discuss the therapeutic options.
Oct 2016 DOI 10.14302/issn.2572-5424.jgm-16-1170
Background: Skin is one the most important sites for administration of drugs to obtain desired pharmacological effects either locally or through systemic bioavailability; and this has placed the transdermal route of drug delivery as an attractive and as one of the most innovative areas for conducting drug delivery research. However the stratum corneum in skin creates hurdles and acts as significant barrier for the permeation of drugs through skin. Penetration enhancers play a pivotal role to overcome such barriers and help enhance the permeation of drug through skin. However, penetration enhancement technology is challenging development and needs to be properly and skillfully addressed. Objective: The present investigation aimed to study the penetration enhancing effect of a newly synthesized alcohol derivative of an acyclic monoterpene (Tetrahydrogeraniol-THG). Methodology: The new derivative, 5,9-Dimethyl-1-Decanol (DIMDOL), has been synthesized by a chemical reaction of the THG with Grignard reagent and ethylene oxide. Permeation enhancing effect of the synthesized derivative was explored for better transdermal penetration of the two model drugs viz. tramadol hydrochloride and 5-fluorouracil (5-FU) through the excised rat skin by conducting in-vitro permeation experiments employing Franz diffusion cells apparatus. The standard enhancers Azone and THG were used to compare penetration enhancing effect of the enhancers. Results: It was revealed that DIMDOL could effectively enhance the permeability of both the drugs by 18.60 and 73.19 folds across the skin used with a lag time of 3.35 and 1.20 h, respectively. The newly synthesized derivative was found to significantly increase the partition coefficient and diffusion coefficient values. Conclusion: The results obtained suggest that DIMDOL can more effectively enhance the permeation of these model drugs, expectedly by affecting the stratum corneum and interacting with both lipid-rich layers and keratin-rich layers of the excised rat skin.
Jul 2016 DOI 10.14302/issn.2379-7835.ijn-16-986
Abstract: Several researchers have suggested that a targeted diet for reducing theadipose tissue may interfere with the severity of cellulite. Others emphasize that the diet composition seems to play a more relevant role than the calorie profile for weight loss and cellulite control. Objective: The aim of this study was to evaluate the influence of a controlled diet on body composition and cellulite improvement in adult women. Methods: Thirty two healthy women, aged from 25 to 40 were included. They receivedan orientation for a controlled diet to be followed for 3 months. Assessments were performed at the baseline and the end of the study which included four parameters: 1) Photonumeric cellulite severity scale; 2) Anthropometric measuremets 3) Skin elasticity (Cutometer®) and 4) Collagen density or echogenicity and length of the dermis-hypodermis interface line (ultrasonography - DermaScan®). The data was compared with the Paired T-test, Wilcoxon and Pearson's correlation for statistical analyses. Results: Only 14 completed the study. Although the scores of photonumeric scalereduced, there was no difference in the grade of cellulite severity. There were significant reductions in body measurement. The skin elasticity showed no significant change. On the other hand, the dermal density or echogenicity showed a significant increase in the right and left sides (p = 0.05 and p = 0.005, respectively); however, no difference was observed in the lenght of dermis-hypodermis line. Conclusion: the controlled diet was effective for the reduction of weight and body composition, but despite the increase in dermal collagen density, no clinical effect on cellulite could be detected.
May 2016 DOI 10.14302/issn.2372-6601.jhor-14-401
The hemocyte is a major immunological cell of molluscs. Much of the immunological phenomena associated with molluscan immunology can be attributed to cellular immunity associated with these cells suspended in the hemolymph. These cells are often referred to as amoebocytes or hemocytes. Such cells are of great importance to immune mechanisms associated withBiomphalaria snails. The Biomphalaria snail is the main vector of the important trematode parasite Schistosoma mansoni. This is a waterborne parasite that affects about 200 million people globally and puts countless other millions at risk of infection. Larval stages of the parasite are released from the snail in tainted waters and the larval cercarial stage actively penetrates the skin of humans and other vertebrates. Larvae migrate via the venous system to vital organs associated with the heaptic portal and mesenteric blood vessels. Larvae develop into sexually mature male and female adult worms that live in major venous blood vessels. The worms mate and produce eggs that lodge in major organs such as the spleen, liver, and intestines. Eggs produce extensive granulomas that cause cirrhosis and other pathological conditions in the affected organs.
Mar 2016 DOI 10.14302/issn.2572-5424.jgm-16-1353
The possible interrelation of ethanol and the membrane protein molecules such as TRP ion channels in the whole living organism has not been studied. In the present research we study the influence of ethanol (50%) and agonist of TRPM8 ion channel L-menthol (1% in 50% ethanol) application to abdominal skin on the thermoregulatory response to cooling in rats. We used two types of cooling with the different rates of skin temperature decrease - 0.1 °C/sec for rapid and 0.005°C/s for slow cooling. It was shown, that the effects of ethanol and activation of the cold-sensitive TRPM8 ion channel are mainly directed at different components of thermoregulatory metabolic response to cold. Menthol, as an agonist of the TRPM8 ion channel, besides the constrictor vascular response stimulates predominantly the emergency first phase of metabolic response which appears only at rapid cooling without any effect on the second phase of metabolic response to cooling. Ethanol inhibits the most powerful second phase of metabolic response to cold which is manifested at decreased deep body temperature and is associated with the development of not only non-shivering but also shivering thermogenesis. Effect of ethanol is accompanied by the acceleration of the deep body temperature fall. Ethanol does not prevent the effect of menthol on thermoregulatory blood vessel and emergency phase of metabolic response, and the activation of the cold-sensitive TRPM8 ion channel by menthol has no obvious influence on the effects of ethanol – inhibition being the most powerful thermogenic component of the metabolic response to cold.
Feb 2016 DOI 10.14302/issn.2471-2175.jdrt-15-718
Pernio is an inflammatory disease that is usually characterized by the development of cold-induced erythrocyanotic skin lesions located in acral regions. Diagnosis is difficult if lesions are present in rare locations. A 21-year-old female suffering from fatigue presented with a 4-day history of painful, purple lesions on both thighs. She worked as a cashier, wore tight clothing, and was otherwise healthy except for mild obesity. Dermatological examination revealed tender and painful edematous papules and plaques on the outer aspects of her thighs. The patient was diagnosed with pernio based on her medical history, and clinical and histological findings. Laboratory tests were normal except for her cold agglutinin titer (1:4). Pernio rarely occurs on the thigh, except in people who ride horses. However, it sometimes occurs in non-riders depending on lifestyle and environmental conditions. Therefore, lesions in this region must be confirmed by a thorough medical history and evaluation of clinical and histopathological findings. Cold agglutinins may be associated with this disease.
Feb 2016 DOI 10.14302/issn.2574-4488.jna-15-712
Background Dapagliflozin; the new oral hypoglycemic agent; is a sodium-glucose cotransporter-2 (SGLT2) inhibitor that acts by inhibiting glucose reabsorption in the proximal tubule of the nephron. Main reported side effects are osmotic diuresis, dehydration, urinary tract and genital infections. Here, we report a case of acute bilateral hydronephrosis after the introduction of dapagliflozin. Case Presentation A 52 year old nurse lady, with 15 year history of type2 diabetes mellitus (T2 DM) complicated by type4-renal tubular acidosis, hypertension, proteinuria, and hyperlipidemia. Patient had two episodes of UTI’s in 2011 required full urologic work up, were successfully treated with simple courses of oral antibiotics. CT pyelography done in 2011 was normal. Dapagliflozin was added to her therapeutic regimen in March 2015. Results Within 48 hours after starting dapagliflozin, she reported increased urine output. Ten days later; she developed severe bilateral loin and lower back pain, followed by suprapubic pain, dysuria and fever. Urine analysis and cultures confirmed E. coli urosepsis. Renal US revealed echogenic kidneys with 12 mm bilateral hydronephrosis, normal ureters and urinary bladder. Discontinuation of dapagliflozin in April 2015 resulted in resolution of symptoms. Repeat CT of the abdomen in July 2015 revealed no hydro nephrosis. Conclusions This is the first case report of reversible bilateral hydronephrosis after the use of dapagliflozin. The cause of hydronephrosis, could be explained by over-diuresis and/or by the unmasking of underlying subclinical obstruction in both uretero-pelvic junctions (UPJ).
Dec 2015 DOI 10.14302/issn.2379-8572.joa-15-807
Upper and lower airway disease is a common condition. Its prevalence is increasing in different areas of the world, but, at present, non-allergic rhinitis is underestimated. The aim of this study was to investigate FeNO (fractional exhaled nitric oxide) and nasal cytology in allergic and non-allergic patients, in order to reach a correct diagnosis. This study was performed on 120 children with rhinitis and/or asthma, evaluated by an allergist and an otolaryngologist. Skin prick-test and nasal cytology were tested in all patients; FeNO only in the asthmatic ones. The proportion of positive results in nasal cytology was higher in non-allergic than in allergic children: 22 out of 23 patients, vs 91 out of 97 patients. A significant correlation was found between FeNO levels and increase in nasal eosinophil counts. There is compelling evidence of a close relationship between upper and lower airway in asthma and rhinitis. The presence of rhinitis should always be investigated in children with asthma; therefore, FeNO and nasal cytology have clinical benefit both in allergic and non-allergic children. Our finding also supports the use of nasal cytology to evaluate non-allergic rhinitis (NAR).
Dec 2015 DOI 10.14302/issn.2471-2175.jdrt-15-858
Background: Lavender has been used for centuries, but its exposure has become part of the everyday life in our days. It is used in the alternative medicine, and as a flavouring component in soaps, cosmetics and in food products (chocolate, ice-cream, spices). The increasing number of exposures resulted the appearance of hypersensitivity- reactions. Objectives: A survey on the prevalence of lavender hypersensitivity was conducted by the Contact Dermatitis Work-Group of the Hungarian Dermatological Society in a multicentre, prospective study. Patients and Methods: 1509 consecutivedermatological patients of 7 dermatological centres were involved in this study. Results were based on the analyses of age distribution and characteristic clinical signs of the patients, on symptoms-localization, and on relevance of positive skin lavender oil test results as well as other associated contact hypersensitivities. Results: We detected 8 patients with lavender hypersensitivity (0.53%). Typical localisations of skin symptoms were face, eyelids and hands. Associated hypersensitivity to fragrance and balsam components were not detected. Conclusion: The lavender hypersensitivity of our patients couldn’t be detected by fragrance screening allergens.The use of lavender oil in cosmetics and foods is very popular. The different types of contacts may result further increase of the sensitivity rate worldwide.
Nov 2015 DOI 10.14302/issn.2471-2175.jdrt-15-698
Bullous pemphigoid (BP) is one of the most common autoimmune blistering diseases. Here, we report an old woman presented with a 2-month history of bullous lesions located just over the skin of the right thigh and buttock where the orthopedics operation was performed using artificial hip made of titanium alloy and a twenty days history of similar lesions involving the rest of the body gradually.
May 2015 DOI 10.14302/issn.2379-7835.ijn-14-603
Epigenetic mechanisms based on DNA methylation, histone modifications and RNA interference have recently showed important association to the development of a wide variety of diseases such as cancer, cardiovascular, metabolic, skin, autoimmune diseases and neurologic disorders. In the context of preventive aspects, the importance of nutrition on epigenetic function has been revealed. Therefore, drastic changes in dietary modifications may contribute to reduced disease risk. For instance, dietary intervention has been showed to affect DNA methylation in Alzheimer’s disease patients. Moreover, maternal high-fat diet can regulate gene expression through promoter histone modifications. Most importantly, RNA interference and particularly micro-RNA mediated regulation of gene expression has been linked to disease development. Remarkably, dietary intake has been demonstrated to significantly affect various miRNAs and their regulation on gene function. In this review, the relationship between epigenetics and disease and development of drugs based on epigenetic targets is presented as well as the influence of dietary intake on epigenetic mechanisms and its effect on disease prevention and therapy will be discussed.
May 2014 DOI 10.14302/issn.2374-9431.jbd-13-283
Continuous-time glucose monitoring (CGM) effectively improves glucose control, as oppose to infrequent glucose measurements (i.e. using Lancet Meters), by providing frequent blood glucose concentration (BGC) to better associate this variation with changes in behavior. Currently, the most widely used CGM devices rely on a sensor that is inserted invasively under the skin. Because of the invasive nature and also the replacement cost of sensors, the primary users of current CGM devices are insulin dependent people (type 1 and some type 2 diabetics). Most non-insulin dependent diabetics use only lancet glucose measurements. The ultimate goal of this research is the development of CGM technology that overcomes these limitations (i.e. invasive sensors and their cost) in an effort to increase CGM applications among non-insulin dependent people. To meet this objective, this preliminary work has developed a methodology to mathematically infer BGC from measurements of non-invasive input variables which can be thought of as a “virtual” or “soft” sensor approach. In this work virtual sensors are developed and evaluated on 20 subjects using four BGC measurements per day and eight input variables representing meals, activity, stress, and clock time. Up to four weeks of data are collected for each subject. One evaluation consists of 3 days of training and up to 25 days of testing data. The second one consists of one week of training, one week of validation, and 2 weeks of testing data. The third one consists two weeks of training, one week of validation and one week of testing data. Model acceptability is determined on an individual basis based on the fitted correlation to CGM testing data. For 3 day, 1 week, and 2 weeks training studies, 35%, 55% and 65% of the subjects, respectively, met the Acceptability Criteria that we established based on the concept of usefulness.
Nov 2013 DOI 10.14302/issn.2324-7339.jcrhap-13-266
Objective: Toanalyze the socio-economic pattern amongst HIV patients in eastern and north-eastern India as measured by different parameters such as educational status, wealth, marital status, sexual behaviour. Methods: This study involved 650 HIV seropositive individuals enrolled in a HIV Apex Clinic in a tertiary care hospital in Kolkata, India during 2006 to 2011. Socio-demographic data were obtained while keeping the names of HIV seropositive individual’s names confidential. HIV testing was done according to the guidelines of NACO, India. Diagnoses of different common opportunistic infections were also done. Results: Out of the 650 individuals, 53% reported to have presenting symptoms of low grade fever, 21% had weight loss, general weakness and malaise. 13% reported to have frequent skin rashes, 13% ported to severe seizures and lack of coordination. 41.07 % of them had an income ranging from Rs1000 - 1500 per month. These individuals mainly were daily workers, labourers who work in per day income basis. 44.13% (89 out of 202) of the females were married at a young age, 65 (32.17%) were widowed whose husbands succumbed to HIV. Assessment of the educational qualifications reveals that those individuals affected reveals that 65% of the males received education till standard VIII, 25% received elementary education till standard IV. Conclusion: The study highlights the sectors of the socio-economic class who need more attention to tackle the HIV burden. The analysis of the socio-economic status reveals the low income and lack of education are main contributing factors towards the spread of this disease in this region.
Jun 2013 DOI 10.14302/issn.2324-7339.jcrhap-12-174
Background: In India, Human immunodeficiency (HIV) infected patients with highly active antiretroviral therapy (HAART) are at higher risk of developing adverse drug reactions (ADRs). Objectives: The aim of this study was to characterize the pattern of use of HAART, occurrence, incidence, severity and causality of ADRs to HAART in Indian HIV positive patients. Methods: This was a prospective observational study conducted between August 2009 and May 2012. Enrolled HIV positive patients were intensively monitored for ADRs with fixed dose antiretroviral therapy as per National AIDS Control organization (NACO).World Health Organization (WHO) definition of ADR was adopted to detect ADRs to HAART and classified based on WHO adverse reaction terminologies. Naranjo’s scale was used for causality assessment of ADRs. Preventability was assessed using Thornton and Schuman criteria and severity was assessed using the modified Hart wig and Siegel scale. Pattern of ADRs was assessed with patient demographics, ADRs characteristics, and pattern of drug and reaction characteristics. P-value <0.05 was considered as statistically significant. Results: A total of 426 ADRs to HAART were evaluated from 1982 HIV positive patients during the study period. The overall incidence of ADRs to HAART was 21.4%. Significant difference was seen in the incidence of ADRs in the age group of 41-60 years (p <0.001), CD4+T-cell counts of 350-500 cells/µl (p <0.001), females (p <0.001). Three fatal ADRs of with cutaneous drug eruptions of Steven Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) was 1.1%. Anemia (31.7%) accounted for majority of the reports followed by vomiting (15.5%), skin rash (12.9%) and peripheral neuropathy (10.7%). The suspected drug was withdrawn for the management of the ADRs in majority (27.9%) of the reports. Higher incidence rate of ADRs was noted with lamivudine (3TC) + nevirapine (NVP) + stavudine (D4T) (22.9%). In, naranjo's causality assessment, majority of the ADR reports were rated as possible (69%). Symptomatic treatment for ADRs was given in 91.8% of the reports and 86.4% of the reports the patient recovered from the suspected adverse reaction at the time of evaluation. Conclusion: In India, occurrence of ADRs to HAART in HIV infected patients was found to be higher with zidovudine induced anemia (31.7%). The higher percentage of ADRs to HAART was seen with female patients, age 41-60 years; CD4+ T-cell counts 350-500 cells/µl. Physician must focus for monitoring all lab investigations for early detection and prevention of adverse effects associated with HAART.