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Harrison's Principles of Internal Medicine

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... КН при хроническом алкоголизме могут быть обусловлены плохим питанием и/или дефицитом витаминов группы В [3]. Острые и хронические инфекции, метаболические и эндокринные нарушения (дегидратация, гипераммониемия, гиперкальциемия, гипонатриемия, гипотиреоз, болезни почек, печеночная недостаточность, гипоксемия) также могут негативно влиять на когнитивные функции и должны быть исключены [12,19,20]. ...
... Лабораторные и инструментальные исследования у пациентов с КН должны включать: оценку функции щитовидной железы, уровня витамина В12, развернутый анализ крови, анализ электролитного состава, компьютерную томографию/МРТ, исключение венерических заболеваний, ВИЧ, рентгенограмму грудной клетки, люмбальную пункцию, определение функции печени и почек, концентрации аммония в плазме, тесты на наличие в моче токсических веществ, тяжелых металлов, консультацию психиатра, электроэнцефалограмму [12,19,20]. ...
... У пациентов в возрасте 80 лет и старше с артериальной гипертензией, принимавших АХП, выявлен статистически значимо меньший балл по КШОПС (медиана, Ме 21 [18][19][20][21][22][23] балл) по сравнению с аналогичной группой пациентов, не использовавших такие ЛС (Ме 22,5 [20][21][22][23][24][25][26] балла), p=0,040 [31]. Подобные результаты были получены для бостонского теста называния (Ме 27 [ [11][12][13][14]6] балла; p=0,024) [31]. ...
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Many classes of medications, such as antipsychotics, anticonvulsants, anticholinergics, and other commonly prescribed drugs, can cause cognitive impairment (CI). The negative effect of drugs on cognitive functions is due to the following pathophysiological mechanisms: a reduction in neuronal excitability, an increase in gamma-aminobutyric acid activity, and decreases in enzyme activity, the number of receptors, cerebral perfusion, as well as brain atrophy; moreover, a number of mechanisms have not been fully studied. An important role in the development of drug-induced CI is played by predisposing (senility or childhood, brain damage, chronic diseases, functional disorders, genetic causes, initial cognitive decline, polypragmasia), and precipitating (acute diseases, infections, metabolic disorders, dehydration, acute urinary retention, malnutrition, environmental influences, etc.) factors. The dose of a drug, the duration of its use is of absolute value. There is a need for the differential diagnosis of CI induced by drugs and CI directly related to the diseases, for which these drugs are prescribed. Drug-induced CI should be suspected if an association is established between a decline of cognitive functions and the start of drug intake. The treatment of this CI involves primarily dose withdrawal or reduction and the use of sustained-release dosage forms, if available. In some cases, cognitive training and/or special drug therapy may be required to correct the CI that has occurred. The measures to prevent drug-induced KI include the choice of the lowest-risk drugs, the use of current side-effect rating scales, in particular an anticholinergic burden scale.
... In Iran, according to several cancer center reports, it's the most cancer in Iranian women too. Even in nonindustrialized countries the incidence of breast cancer is increasing now [1,2]. ...
... In this study, we assess the lung function changes during radiotherapy by means of spirometry. Pulmonary function test parameters such as FVC, FEV1 and FEV1 / FVC ratio were included [2]. Numerous studies indicate that pulmonary function changes after the breast radiotherapy. ...
... Based on the planning, V20, V30 and mean lung dose, were extracted. V20 and V30 mean percentage volume of the whole lung irradiated by 20Gy and 30 Gy respectively [2]. Radiation therapy was done with Compact 6Mv linear accelerator machine during a period of 5-7weeks, 5 times a week; range of applied dose was between 50-62 Gy. ...
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Backgrounds: Breast cancer is the most common cancer in women in the United States and the second leading cause of cancer death. In Iran, however, there is no detailed program to record cancer prevalence, according to the reports from several centers; this cancer is the most common type of cancer in Iranian women. Radiotherapy is one of breast cancer treatment modalities, which improves local control followed by an increase in the survival. However, breast radiotherapy would has several complications on the lung. One way to investigate the pulmonary complications is the use of pulmonary function test or spirometry. In this study we evaluate spirometry changes during breast radiotherapy. Methods: To obtain the effect of absorbed dose on the pulmonary function test of patients with breast malignancy, these tests and physical examination were done before and two months after the end of the treatment. Individuals’ information was obtained through a standardized and researcher made questionnaire and the results obtained from all subjects were analyzed. Raw data were entered into SPSS version 17 software. Correlations test, paired t test, 2-Independent-Samples T test, Mann – Whitney U and significance levels were used. Results: age of the patients was between 34-75 years (mean age of 54.60 years). The results showed no significant correlation between the volume of irradiated lung and spirometry parameters, so with increased volume of lung we didn’t find any significant decrease in pulmonary tests (0.05
... Katzman stated that neither hyponatremia nor its correction could explain the patient's clinical deterioration. At that time and for years thereafter, it was thought that rapid correction of hyponatremia was necessary and could only lead to clinical improvement [17]. CPM was eventually confirmed at the autopsy of the patient (R. Laureno, personal communication, June 15, 2020). ...
... They were polite but did not modify their There is extensive myelinolysis (arrows) in the bilateral thalamus. Laureno and Illowsky reproduced experimental myelinolysis in rabbits, where prolonged severe hyponatremia alone did not lead to myelinolysis, but rapid correction of hyponatremia caused neurological disease guidelines [17]. The danger of rapid sodium correction was again shown in rats by endocrinologists in 1991 [27]. ...
Article
Objectives: Central pontine myelinolysis (CPM) is a neurological disorder characterized by damage to the myelin and oligodendrocytes in the pons. This review focuses on the history of CPM and the discovery of its association with the treatment of hyponatremia. Methods: The author reviewed original publications regarding CPM, hyponatremia, and the treatment of hyponatremia. The author interviewed Dr. Robert Laureno who was a pioneer in CPM research with his animal work in dogs. Results: Animal models demonstrated the role of the rapid correction of hyponatremia as causative of pontine and extrapontine myelinolytic lesions. Nevertheless, the importance of the speed of correction was widely denied. There were years of debates and only slow changes in expert guidelines. Conclusion: CPM occurs as a consequence of a rapid rise in serum sodium in individuals with chronic hyponatremia. It is recommended to increase plasma sodium concentration by no more than 8 to 10 mmol/L per 24 h in chronic hyponatremia.
... Sixteen (39%) were smokers Fifteen (30%) of the total study population of fifty (50) were asymptomatic. In the study population the most common symptom, was chest pain occurring in 18(36%) followed closely by palpitations in 11(22%), with dyspnoea in 5(10%) and pedal swelling in 3. Three were in congestive cardiac failure by Framingham's criteria [30] of heart failure with displaced apex beats, raised jugular venous pulsation and heart murmurs. ...
... showing multiple ECG abnormalities. These findings fail to show the benefit attributed to ethanol, it may not be conclusive because of the study size and it did not evaluate the role of antioxidants from wine as most of the study subjects took beer and gin rather than wine However, it did not show any added benefit of alcohol lowering effect on LDL-cholesterol and increase on HDL seen on the Cholesterol arm of this study population 30 .In addition, Alcohol drinkers have longer corrected QT interval. ...
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Introduction: There has been varied views of authors on the benefit of moderate alcohol consumption on the cardiovascular system. Especially on the heart, moderate alcohol consumption is said to be cardio-protective, however, over time arguments have described this view as a myth. Despite the arguments for moderate alcohol consumption, all parties agree that excessive alcohol consumption has a deleterious effect on the cardiovascular system. Electrocardiography has been used to evaluate cardiac abnormalities and is the gold standard in evaluating heart rhythm abnormalities. It has also been used to evaluate cardiac abnormalities in people that consume alcohol. This study set out to evaluate the effect of alcohol on the heart seen on electrocardiography, in a Nigerian population. Method: Forty-seven male subjects who consented to be part of the study had electrocardiography test, after filling a predesigned questionnaire; which provided information on their occupation, social habits, history of alcohol consumption, symptoms and clinical findings. The daily quantity of alcohol consumed was assessed and the study population divided into 3 groups; based on amount of daily alcohol consumption into mild, moderate and excessive drinkers. Results: Forty-seven (47) men consented to be part of the studies, with age range from 19yrs to 91yrs with mean± SD age of 32.85 ± 15.61yrs. Mean± SD BMI of 24.00 ± 3.11kg/m2, mean± SD of systolic blood pressure of 129.33 ± 20.01 mmHg and mean ±SD diastolic blood pressure of 77.30 ± 14.50mmHg, mean ±SD daily value of alcohol consumed was 74.24 ± 43.34g/day, The most common electrocardiographic abnormalities were arrhythmias; sinus tachycardia, sinus bradycardia, heart blocks, conduction delay. Other abnormalities noted were left ventricular hypertrophy (LVH). Left axis deviation, right ventricular hypertrophy (RVH), left and right atrial enlargement. Conclusion: Fifty percent (50%) of those considered by the study to be mild drinkers with daily intake of ≤ 50g/day of alcohol showed abnormalities in their ECGs; which were majorly arrhythmias. Also, fifty percent (50%) of those considered by the study to be moderate drinkers, with daily intake of 50-100g/day had abnormal ECG with 3(13.64%) having multiple ECG abnormalities, whilst Excessive alcohol consumption with daily intake >100g/day was associated with 85% abnormalities on ECG with 4(33.33%) showing multiple ECG abnormalities. This study did not note any significant benefit with mild or moderate alcohol consumption but corroborated the effect of excessive alcohol consumption seen by electrocardiographic findings. Alcohol drinkers have longer corrected QT interval. The impact of alcohol on the heart seen by electrocardiography was dose dependent and showed progressive increase from mild to excessive alcohol consumption. Keywords: Alcohol, ECG, Electrocardiography, Ethanol, QTC.
... Some studies did not mention the technique used in their study. (4,5,11) Few authors mentioned having utilized the bisecting angle technique, (12)(13)(14) while Patel and Wuehrmann (7) reported to have employed the paralleling technique for visualizing NCs. Bisecting angle technique was selected this study for taking the radiographs to bring out the better appearance of nutrient canals which is in concurrence with other authors and convenience in a government setting. ...
... Etiopathogenesis for diabetes was in turn hypothesized by Isselbacher, et al. (13) They stated that the insulin deficiency in diabetes has a mitogenic action on the endothelium, which leads to formation of collateral vessels. The process of atherosclerosis seen in diabetes mellitus too can lead to narrowing of vessel lumen. ...
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Introduction: To evaluate a possible correlation of presence of nutrient canals on radiography in hypertensive and diabetic population as compared to the normal population and whether they can be used as a diagnostic marker for these conditions. Materials and Methods: 360 IOPARSs of the mandibular anterior region were obtained from 120 age and sex-matched subjects without any systemic diseases (Group-I, control group), 120 hypertensive patients (Group-II), 120 diabetic patients (Group III). The radiographs were assessed by two interpreters for the presence or absence of nutrient canals. Statistical Analysis: The data was tabulated and analyzed with Statistical package for the social sciences (SPSS 20.0). χ 2-square test was done and the statistical significance was set at P ≤ 0.05. Results: 225 out of 360 patients showed the presence of nutrient canals whereas 135 patients didn′t have nutrient canals. In Group I (control group), 69 patients showed NCs i.e. 57.5%. In Group II (Hypertensive group) showed NCs in 76 patients (63.3%) while 81 patients (67.5%) showed NCs in Group III. The differences were not statistically significant. Conclusion: Although the results showed a positive correlation between appearance of nutrient canals on the radiograph and the conditions, the difference was not found to be statistically significant. Therefore, it can be concluded that NCs cannot be solely relied upon as a diagnostic marker for the detection of these diseases. However, their role as a possible diagnostic aid in the future cannot be completely ruled out yet.
... Isselbacher et al. postulated the hypothesis explaining the higher prevalence of nutrient canals in diabetic subjects [31]. Insulin deficiency in diabetic subjects may have a mitogenic effect on the endothelial cells, resulting in the development of collateral vessels. ...
... Atherosclerotic alterations may also occur, causing narrowing of the blood vessel lumen. Thus, the development of collateral vessels functions as a redemptive mode leading to a higher occurrence of nutrient canals in diabetic individuals [31]. ...
Article
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Nutrient canals (NCs) are passages containing neurovascular bundles (blood vessels, lymph vessels, and nerves). Best visualized on mandibular anterior intraoral periapical radiographs (IOPAR), their presence is usually associated with underlying pathological such as diabetes mellitus (DM), hypertension (HTN), advanced periodontitis, calcium deficiency, tuberculosis, and disuse atrophy. This study aimed to (a) evaluate NC prevalence in patients with DM, HTN, and chronic periodontitis and (b) correlate the detection of NCs as an important preliminary screening tool for inherent systemic diseases like DM, HTN, and chronic periodontitis and as an investigative clue in age and gender determination. This cross-sectional study was conducted on 200 subjects. Patients with complaints of pain in the mandibular anterior teeth, deep dentinal caries, abrasion, and attrition were subjected to IOPAR of the mandibular anterior teeth region to assess NCs. An increased frequency of NCs in DM (84%), HTN (66%), and periodontitis (52%) with a significant p-value was observed. Most NCs were seen beyond the root apex (72.4%). A notable association between the duration of disease and the presence of NCs in the diabetic and hypertensive cohorts (p-value 0.047 & 0.012, respectively) was observed. However, we could not establish any association between the prevalence of nutrient canals with age and gender. Our study suggested that a higher frequency of NCs on man-dibular anterior IOPAR may be employed as an ancillary screening and investigative support in underlying systemic disorders.
... 26 Atherosclerosis and vascular disease are postprandial phenomena, that is, they arise after eating allergenic and inflammatory foods, 27 associated with hyperglycemia and hypertriglyceridemia, with endothelial dysfunction being the earliest stage of vascular disease, which can be detected through the baroreflex index, hemodynamics 27 and biomarkers already studied in the literature, linked to cardiovascular diseases. 28 In this sense, this study aimed to report the values of the baroreflex and hemodynamic index related to biomarkers that signal obstruction of the blood microcirculation found in the 57-year-old male patient, who died after being affected by COVID-19. ...
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Abstract - Introduction: The slow hemodynamics and the baroreflex index below 90% in Functional Neurometry have been compatible with anemia, subclinical inflammation and/or with endothelial dysfunction. Objective: The objective of this study was to present hemodynamics and the baroreflex index (BI) evaluated by Functional Neurometry and blood biomarkers of a 57-year-old male patient who died when affected by Covid-19. Methods: The evaluations were performed by functional neurometry [Functional Reserve (FR), BI, Hemodynamics and Physiological Response (PR)] and by biomarkers: Blood Count; Serum Ferritin (SF); Transferrin Saturation (TS); B12; Homocysteine; C-reactive protein (CRP); Fibrinogen; 25-hydroxy-vitamin-D3; Apolipoprotein-A1 (Apo-A1); Apolipoprotein-B (Apo-B); Oxalacetic Glutamic Transaminase (OGT); Glutamic-Pyruvic Transaminase (GPT); Gamma GT; Total Cholesterol (TC); Triglycerides (TG); High Density Lipoprotein (HDL) and Low Density Lipoproteins (LDL). Results: 1) The patient presented 7.27% of functional reserve [Expected:>75%]: Adrenal stress and/or hepatic steatosis; 2) BI 60.92% [Expected:>90%]; 3) Hemodynamics 26.07% [Expected:<10%]: This result indicates the possibility of anemia and/or endothelial dysfunction and 4) A PR 33.77º [Expected: 31.5º until 32.5º]: digestive overload; 5) B12 [153]; Homocysteine [16.5]; CRP [1.74]; D3 [21.6]; Gamma GT [67]; TC [200]; TG [611]; CT/HDL 4.76 [Expected: ≤3.3]; TG/HDL 14.4 [Expected: ≤2.5]; APO B/APO A1 0.7957 [Expected: ≤0.5]. Conclusion: This study found subclinical inflammation and endothelial dysfunction. However, as this study is only a case report, it is suggested to conduct a clinical study with several patients with statistical significance.
... The worms were authenticated at the Helminthology section of National Animal Disease Diagnostics and Epidemiology Centre (NADDEC), Entebbe, Uganda. The choice of the earthworms was based on their anatomical and physiological resemblance with the gastrointestinal roundworm parasites of human beings 12 . Albendazole tablet (400 mg) manufactured by Beximco pharmaceuticals (Gazipar, Bangladesh) was used as a control drug. ...
... The worms were authenticated at the Helminthology section of National Animal Disease Diagnostics and Epidemiology Centre (NADDEC), Entebbe, Uganda. The choice of the earthworms was based on their anatomical and physiological resemblance with the gastrointestinal roundworm parasites of human beings 12 . Albendazole tablet (400 mg) manufactured by Beximco pharmaceuticals (Gazipar, Bangladesh) was used as a control drug. ...
... Introduction Diabetes Mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia [1]. It is one of the four common non-communicable diseases causing major morbidities and mortalities [2][3][4]. ...
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Background: Diabetes Mellitus recognized as one of the emerging public health problems in developing countries. Self-monitoring needs to be individualized and should assist people with diabetes. This study aimed to assess the predictors of self-management practices among diabetic patients attending hospitals in western Oromia, Ethiopia. Methods: A facility-based cross-sectional study was conducted from November 2017 to February 2018 in hospitals located in western Oromia, Ethiopia. An interview was made with a total of 400 diabetic patients attending the diabetes center and admitted to ward in the study hospitals. The data were entered into Epi Info software version 3.5.4. Data analysis was made using a statistical package for the social sciences (SPSS) version 20. Odds ratio (OR) was used to show the association. The statistical significance was considered at P<0.05, and potential confounding variables were controlled using logistic regression. The analyzed data were presented in texts and tables. Results: From a total of 398 interviewed patients, 129 (32.4%) practiced diabetes self-management. About 63.6% of the study participants' self-management practice was good. Most 103 (79.84%) of those who practiced self-management were presented with one of diabetes mellitus-related complications. Logistic regression analysis results showed that merchants were about six times higher in self-management practice [AOR of 5.945 (1.177-30.027 at 95% CI)] and those having family support in diabetes practiced self-management 2.87 times than others [AOR of 2.835 (1.386-5.801 at 95% CI)]. Conclusions: Compared to the findings of previous studies, diabetes self-management practices of the participants was good. The study participants regular physical activity, food intake, medication adherence, and foot self-examination were moderate. Two variables, being a merchant and having family support were found to be the predictors of self-management practices. Predictors of self-management should be considered to boost self-management practice.
... The causes of opportunistic infections in HIV/AIDS can be protozoan, bacterial, viral, or fungal infections. 3 Mortality from AIDS is often associated with the reactivation of a herpes virus infection. Human herpesvirus-6 (HHV-6) is not usually associated with disease in the immunocompetent, but a major cause of opportunistic infection in HIV-infected individuals. ...
Article
Background: Morbidity and mortality from acquired immunodeficiency syndrome (AIDS) are often associated with the reactivation of a herpes virus infection. Human herpesvirus-6 (HHV-6) is usually common in childhood infections that remain latent and can act as opportunists during immunosuppression to reactivate and cause disease. In human immunodeficiency virus (HIV)-infected patients, the impact of HHV-6 infection can be an up-regulator of HIV replication and accelerate progress towards AIDS. However, studies on HHV-6 infection have never been done in Surabaya, Indonesia. Purpose: To determine the presence of HHV-6 infection among HIV-infected individuals residing in Surabaya, Indonesia. Patients and methods: Plasma and peripheral blood mononuclear cells (PBMCs) were collected from 85 HIV-infected individuals in Universitas Airlangga Hospital, Surabaya, as well as 85 healthy controls. DNA extracted from PBMCs was subjected to PCR to determine HHV-6 infection, while plasma of HIV-infected individuals was used for viral RNA quantification using real-time PCR. Results: HHV-6 infection was detected in 17.6% (15/85) of HIV-infected individuals, and in 3.53% (3/85) of healthy controls. Thus, HHV-6 infection was more likely to be found in HIV-infected individuals than in healthy controls (odds ratio 5.85; 95% confidence interval, 1.6-21). The HHV-6B was the most common subtype identified in both HIV-infected individuals (12/15) and healthy controls (3/3). The HHV-6A and co-infection between HHV-6A and HHV-6B were only found in HIV-infected individuals (2/15 and 1/15, respectively). Viral RNA load of HIV-infected individuals was not correlated to HHV-6 infection. Conclusion: Our results indicate the emergence of HHV-6 infection among HIV-infected individuals residing in Surabaya, Indonesia, and the risk of HHV-6 infection was higher in HIV-infected individuals than in healthy controls.
... The importance of this model became even clearer when it was discovered that blockade of this sympathetic overactivity by beta-blockers prolongs survival in patients with HF. 84 In animal studies, activation of the sympathetic nervous system led to the activation of β-adrenergic receptors on boneforming osteoblasts, resulting in bone loss. 85 Khosla et al. evaluated the role of sympathetic outflow and presented evidence to support the idea that the sympathetic nervous system regulates bone metabolism in humans, primarily via the β1-adrenergic receptor. ...
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There is an increasing interest in osteoporosis and reduced bone mineral density affecting not only post‐menopausal women but also men, particularly with coexisting chronic diseases. Bone status in patients with stable chronic heart failure (HF) has been rarely studied so far. HF and osteoporosis are highly prevalent aging‐related syndromes that exact a huge impact on society. Both disorders are common causes of loss of function and independence, and of prolonged hospitalizations, presenting a heavy burden on the health care system. The most devastating complication of osteoporosis is hip fracture, which is associated with high mortality risk and among those who survive, leads to a loss of function and independence often necessitating admission to long‐term care. Current HF guidelines do not suggest screening methods or patient education in terms of osteoporosis or osteoporotic fracture. This review may serve as a solid base to discuss the need for bone health evaluation in HF patients.
... According to the 2016 Korean National Health and Nutrition Examination Survey, the average prevalence of hypertriglyceridemia is 17.5 % [1]. Hypertriglyceridemia is usually treated using lipid lowering agents, such as fibrate, niacin, bile acid-binding resin, and statins [2,3]. However, these treatments are reported to be accompanied by numerous side effects, such as diarrhea, severe muscle damage, dry skin, and liver dysfunction [4][5][6]. ...
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Angelica gigas Nakai, Korean dang-gui, has long been widely used in traditional treatment methods. There have been a number of studies of the health effects of A. gigas and related compounds, but studies addressing effects on blood triglycerides (TG) are lacking. To investigate the effects of A. gigas Nakai extract (AGNE) on TG in Korean subjects, we carried out a 12-week, randomized, double-blind, placebo-controlled clinical trial. Subjects who met the inclusion criterion (130 mg/dL ≤ fasting blood TG ≤ 200 mg/dL) were recruited for this study. One hundred subjects were assigned to the AGNE group (n = 50) or the placebo group (n = 50), who were given 1 g/day of AGNE (as a gigas Nakai extract 200 mg/d) in capsules and the control group for 12 weeks. Outcomes were efficacy TG, lipid profiles, atherogenic index, and safety parameters were assessed initially for a baseline measurement and after 12 weeks. After 12 weeks of supplementation, TG and very low-density lipoprotein cholesterol (VLDL-C) concentration and TG/HDL-C ratio in the AGNE group were significantly reduced compared to the placebo group (p < 05). No significant changes in any safety parameter were observed. These results suggest that the ingestion of AGNE may improve TG and be useful to manage or prevent hypertriglyceridemia.
... Lighter or darker blood colour is a result of oxygen content and carbon dioxide bound to the haemoglobin molecule: oxyhaemoglobin and carboxyhaemoglobin respectively (cf. [4]). ...
... Elevation of aCL in acute Q fever could therefore be associated with vascular lesions, ranging from large vessels causing deep arterial and venous thrombosis to small vessels, causing capillary thrombi and small perivascular hemorrhages as described in C. burnetii meningo-encephalitis [60][61] [62]. The aCL tropism for vascular endothelium is confirmed by the observation of acute Q fever valvular injury [41]. ...
Article
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Introduction: Coxiella burnetii infection is still challenging physicians, mainly because no international coordination has been stated to standardize the therapeutic strategy and improve the clinical outcomes. Areas covered: Based on the recent knowledge on Q fever, we review here the clinical practices from Q fever diagnosis to therapy. We searched Pubmed and Google Scholar to perform the qualitative synthesis. Expert opinion: Four major critical points are highlighted in this review. The first point is that Q fever diagnosis has been reviewed in the light of the new diagnosis tools, including molecular biology, transthoracic echocardiography and 18F-FDG-PET/CT -scan imaging. Q fever diagnosis results from the presence of a microbiological criterion in addition to a lesional criterion. Second, the identification of the anticardiolipin antibodies as a novel biological predictive marker for acute Q fever complications (haemophagocytic syndrome, acute Q fever endocarditis, alithiasic cholecystitis, hepatitis, and meningitis). Third, the observation of a coincidence between Q fever and NHL that has made persistent C. burnetii infection a risk of non-Hodgkin’s lymphoma. Finally, we expose here the close follow-up we proposed from the French National Reference Center for patients with Q fever infection to detect relapse and complications.
... Obesity is a chronic disease that is highly prevalent and that poses a serious risk for the development of diabetes mellitus, hypertension, cardiovascular diseases, musculoskeletal disorders especially osteoarthritis, and certain forms of cancer. [6] It develops gradually and often persists throughout life. ...
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Obesity is a disease of all age group within the people of high socioeconomic status, specifically in of Urban Communities. WHO declared obesity as global epidemic giving rise to new term-Globesity". In 2016, WHO global estimated as about 13% of the world's adult populations (650 million adults & 41 million children) were obese. Obesity is a complex, multi factorial disease which invites several pathological complications like Hypertension, Type 2 Diabetes mellitus, atherosclerosis, infertility, hepatic steatosis/ fatty liver, endocrine abnormalities, obstetric complications, osteoarthritis of weight bearing joints, certain types of Cancers, and possibly immunological impairment as well as it hampers the cosmetic value of the affected person. It has deleterious effects both on body and mind. Obesity i.e. Sthaulya Roga of Ayurveda comes under the heading of Medaroga which results due to dysfunction of Meda dhatvagni (factor responsible for nourishment/ metabolism of Meda dhatu) and is considered as metabolic disorder. Further, its description is available in Ashtaunindita Purusha Adhyaya of Charak Samhita (chapter dedicated to 8 types of undesirable physiques where obese are criticized by society because of inappropriate body size). Rapid increase of prevalence rate of obesity suggest all branches of medicines to understand the etiology and pathogenesis of this disease as per the basic fundamental principles of concerned health Vol 7, Issue 17, 2018. 357 Bishnu et al. World Journal of Pharmaceutical Research sciences and to provide suitable management protocol either by pharmacological or non-pharmacological method to fulfill the global demand. Entire world is expecting a fruitful management protocol and prevention of obesity through Ayurveda and Yoga. Keeping this fact in view, this paper is an effort to understand etiology, pathogenesis and treatment strategy of obesity through Ayurveda and Yoga.
... From 5 to 10 cases per 1,000 persons are seen between the sixth and eighth decades of life. 3 The thoracolumbar trunk (especially T3 to L3) is most commonly affected. HZ may affect cranial nerves, and the trigeminal nerve is then the most frequently affected (18.5%-22% of total cases). ...
Article
Herpes zoster is a common acute viral infection caused by reactivation of Varicella-Zoster virus. Acute pain of herpes zoster lowers the quality of life and interferes with day to day activities. We report a case of herpes zoster in a 68 year old, healthy male patient in which the prodromal symptoms started as toothache. This case highlights the importance of a thorough dental history and examination in patients with toothache.
... The risk factors associated with development of CN are well understood and include the following: age, increased body mass index, 6 duration with diabetes, 7 presence of peripheral neuropathy and loss of protective sensation, 8 and decreased bone mineral density. 9 However, once the diagnosis of CN is established, treatment options are created to maintain or create a plantargrade foot type. ...
Article
Charcot neuroarthropathy is a devastating consequence of diabetes mellitus and peripheral neuropathy. Because of its rarity, the condition is often misdiagnosed or poorly managed. When misadventure occurs, patients with Charcot neuroarthropathy can suffer ulceration, infection, amputation, and death. When patients have Charcot-related foot ulcers, the risks are amplified. Utilizing advanced electronic medical record analysis, a 30-month investigation was undertaken to determine if patients with diabetes mellitus and a concomitant diagnosis of Charcot-related foot ulcer were at greater risk of complications because of location setting of initial treatment for their condition. Charcot foot–related ulcers that are diagnosed in the outpatient setting had established foot specialist care. The outpatient management of the condition lead to a significant reduction in the amount of admissions to a higher acuity setting. However, patient outcomes did not vary once established and dedicated limb salvage efforts were employed. In this large contemporary population managed in a tertiary health system, patients with Charcot-related foot ulcer had negative outcomes when they were initially treated in an inpatient setting and had a significantly greater likelihood of readmission as compared with individuals who had established focused limb salvage care.
... When excess body fat gets accumulated to the extent that it may have a negative effect on health, then it becomes a medical condition, which is termed as obesity. Obesity is a chronic disease that is highly prevalent and that poses a serious risk for the development of diabetes mellitus, hypertension, cardiovascular diseases, musculoskeletal disorders especially osteoarthritis, and certain forms of cancer 1 It develops gradually and often persists throughout life. Like any other chronic condition, such as diabetes or hypertension, obesity worsens when strategies applied for weight reduction are withdrawn. ...
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Sthoulya (Obesity) is a most common nutritional and life style disorder of the present era. Obesity is not only a risk factor for different life threatening conditions but also a serious social, psychological & economic problem. In Ayurveda it has been described under the title of Medoroga. Charak Samhita has considered Sthoulya as a complicated health condition, duly recognizing it as a Nindita (undesirable) condition. In Sthaulya, Jatharagni is found in Tikshna state whereas Medodhatvagni is found in Mandagni state. So person indulges in more food, which produce excessive Meda and vicious cycle go on. This cycle is broken (Samprapti Vighatana) by Kasaya, Katu, Tikta Rasa, Ushna-Virya pradhana drugs and drugs having Lekhaniya and Chedaniya properties. Considering this, in this case of Sthoulya, Triphala Vidangadi Lekhana Basti is given in Kala manner followed by Vidangadi Ghana Vati for 16 days. Trifala Churna, Vidanga, Nagara, Yava, Kalalauha,Yavakshara,Trifala oil,Tila Taila,Madhu,Saindhav are used in Triphala Vidangadi Lekhna Basti. These drugs used in Lekhana Basti are helpful in lowering down the level of Meda by Sroto Shodhana & Kapha Medohara properties, which showed good result in this case of obesity.
... Type 2 DM is a heterogeneous group of the disorder usually characterized by insulin resistance, impaired insulin secretion and increase glucose production. Distinct genetic and metabolic defect in insulin action and secretion give rise to the common phenotype of hyperglycemia in type 2 DM [2,3]. The main complications associated with DM are retinopathy, nephropathy, and micro/macroangiopathy. ...
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Background/purpose: Patients with diabetes mellitus have been associated with gingivitis, periodontitis, salivary dysfunction, altered taste, and candidiasis. Diabetes can cause considerable cellular changes. The aims of this study were to assess the oral manifestations in type 2 diabetic patients and to detect cytomorphometric measurements of oral mucosal cells in type 2 diabetic patients and healthy control subjects by using exfoliated cytology smears. Methods: Samples were collected from 50 adults, aged 30-60 years (25 patients with type 2 diabetes mellitus and 25 non-diabetic healthy persons as the control group). Smears were obtained from two sites, normal buccal mucosa and lateral border of the tongue from each subject. The freshly obtained specimens were assessed for cytomorphometric analysis. An eyepiece micrometer was used to take mean values of ND, CyD, and N: C ratio. Comparison of nuclear diameter (ND), cytoplasmic diameter (CyD) and the ratio of two diameters (N: C) among groups was performed by using ANOVA. Results: The results showed that statistically significant increase in ND (p=0.01 for buccal mucosa and 0.007 for tongue) and N:C ratio (p=0.01 for both tongue and buccal mucosa), with a statistically significant decrease in CyD, was found in diabetic patients compared to controls (p=0.001 for both tongue and buccal mucosa). Conclusion: Diabetes produces definite cytomorphometric changes in the oral mucosal cells of patients. The results suggested that nuclear diameter increased while cytoplasmic diameter was decease in type 2 diabetic patients. The most predominant oral manifestations found in type 2 diabetic patients were periodontal disease and oral dryness.
... Erhöhte EPO-Spiegel findet man auch bei aplastischen Anämien, Eisenmangelanämien, hämolytischen Anämien. Sekundäre Polyzythämie wird durch erhöhte Produktion und Freigabe von EPO verursacht, wie zum Beispiel bei Rauchen, Nierensteinen, Lungenfibrosen, die zu Hypoxie führen, Herzleiden, Tumore oder Hämoglobindefizienz(Braunwald 1987).Das Bedürfnis einer objektiven Beurteilung der Sauerstoffschuld, die Kenntnis der zellulären Antwort auf Hypoxie und die Tatsache, dass sowohl für VEGF als auch für EPO standardisierte humane Testkits zur Verfügung stehen, führten zur Formulierung folgender Arbeitshypothesen: ...
Article
Brachycephale Hunde zeigen oft Symptome des Brachycephalensyndromes. Aufgrund einer Fehlentwicklung des Hirn- und Gesichtsschädels verkleinert sich der kraniofaziale Winkel. Die Folge sind enge Nasenlöcher, ein langes Gaumensegel, ein eingeengter Nasopharynx sowie Oedematisierung und Hypertrophie der Schleimhäute, Tonsillen und Larynxtaschen. Die Verengung der oberen Atemwege führt während der Inspiration zu einem erhöhten Unterdruck, der die Kollapstendenz der Weichteile verstärkt. Die Symptome werden durch einen Circulus vitiosus aufrecht erhalten und können sich progressiv verstärken, so dass sie je nach Ausmass der Obstruktion zu Dyspnoe bei Anstrengung, Stressintoleranz und Erstickungstod führen können. Der Körper reagiert auf eine Hypoxie mit verschiedenen Kompensationsmechanismen. Auf molekularer Ebene wird eine Kaskade von Stoffen freigesetzt, die den Sauerstoffgehalt im Blut und im Gewebe aufrecht erhalten sollen. Das Signal bei Hypoxie geht vom Hypoxie induzierbaren Faktor-1 (HIF-1) aus, der die Freisetzung von Transferrin, Endothelin-1, vaskulärem endothelialem Wachstumsfaktor (VEGF) und Erythropoietin (EPO) induziert. VEGF ist ein Faktor mit spezifischer Wirkung auf Endothelzellen und wird benötigt für die normale embryonale Entwicklung von Gefässen, für die Bildung von Kapillaren und das Wachstum von Tumoren. EPO wird bei arteriellem Sauerstoffmangel in den Nieren gebildet und wird zur Erythropoiese benötigt. Das Ziel der Arbeit war die Sauerstoffversorgung bei brachycephalen Hunden unter Belastung objektiv zu beurteilen aufgrund der Quantifizierung von VEGF und EPO im Blutserum. Es wurden acht mesocephale (MC) und acht brachycephale (BC) Hunde während einem kurzen Trab belastet. Vor und nach Belastung wurden Blutproben entnommen, zur Messung der VEGF- und EPO- Serumkonzentrationen. Die VEGF-Basalwerte unterschieden sich weder innerhalb derselben Gruppen noch zwischen den verschieden Gruppen signifikant voneinander. Der Anstieg der VEGF- Werte nach 4 Stunden war bei der BC-Gruppe hochsignifikant. Bei der MC-Gruppe war zu keinem Zeitpunkt ein signifikanter Anstieg zu beobachten. Bei den EPO-Werten waren nur die Basalwerte unterschiedlich zwischen den beiden Gruppen, wobei erstaunlicherweise die Basalwerte der MC- Gruppe signifikant höher lagen als die der BC-Gruppe. Mit der Bestimmung von VEGF vor und 4 Stunden nach kurzzeitiger Belastung konnte ein Ansatz geschaffen werden, mit dem einfach und unter Praxisbedinungen objektiv die Sauerstoffsättigung bei brachycephalen Hunden unter Belastung und der Erfolg operativer Korrekturen beurteilt werden könnte. Im gleichem Sinne könnte der Test auch für Patienten mit anderen chronischen Atemwegserkrankungen eingesetzt werden. Brachycephalic dogs often suffer from the brachycephalic syndrom. A dysplasia of the brain and face skull leads to a too small craniofacial angle. This results in narrow nostrils, a prolonged soft palate, a narrowed nasopharynx, edematous and hypertrophic mucus membranes, tonsilles and everted lateral saccules of the larynx. The narrowing of the upper airways increases the negativ inspiration pressure, which enforces the tendency of the soft tissue to collapse. A circulus vitiosus increases the symptoms progessivly. Depending on the degree of obstruction the dogs show dyspnea during effort, intolerance to stress and heat and death through suffocation. There are different mechanisms of the body to react to hypoxia. On the molecular level a cascade of enzymes regulates the oxygen saturation of blood and tissue. Hypoxia-inducible factor-1 (HIF-1) induces the release from transferrin, endothelin-1, vascular endothelial growth factor and erythropoietin (EPO). VEGF is a factor with specific effect to endothelial cells and is needed for the normal embryonal development of vessels and the growing of capillaries and tumors. EPO is produced in the kidneys as a result of hypoxia and is needed for the erythropoesis. The goal of this study was to estimate the tissue oxygen saturation of brachycephalic dogs objectively with the measurement of blood serum VEGF and EPO. Eight mesaticephalic (MC) and eight brachycephalic (BC) dogs were undergone a short tort. Serum VEGF and EPO levels were measured before and after the physical exercise. Basal VEGF levels did neither differ significantly between the same group nor between the different groups. In the brachycephalic group the increase from the basal level to the 4 hours level was significantly different from the 0 hour level and from the mesaticephalic group. Basal EPO values were higher in the MC group than in the BC group. With the measurement of the VEGF values before and 4 hours after a short physical examination we have an instrument to estimate the oxygen saturation and the success of surgically correction objectively in brachycephalic dogs. The test is practicable and may be also usable for patients with other chronic diseases of the airways.
... It is only within the last fifty years that the importance of the male factor contribution to infertility has been recognized. 1 A male factor is solely responsible in about 20% of infertile couples and contributory in another 30-40%. 2 Male reproductive and sexual function is also dependent on the intact function of the hypothalamic-pituitary-gonadal axis. ...
Article
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Background: The importance of male factor contribution to infertility is well recognised. Semen analysis is an indispensable diagnostic tool in the evaluation of the male partners of infertile couples. Aim and objective of the study was conducted to determine the abnormalities in semen among male partners in infertile couples.Methods: Detailed history, examination and semen analysis was done. Semen samples were analysed for volume, viscosity, sperm concentration, motility, and morphology, according to WHO guidelines.Results: This study, done at a tertiary care center in north eastern India has demonstrated that abnormal semen quality is a major factor contributing to infertility in couples. Total number of participants were 94. Most of the male partners i.e. 65.96%, who came for infertility evaluation were between 30-39 years of age with 56.38% participants having abnormal semen parameters. The most common abnormality found was asthenozoospermia seen in 35.11% of cases followed by oligozoospermia seen in 25.53% of cases. Teratozoospermia and azoospermia were seen in 7.45% and 4.26% of cases respectively.Conclusions: Males contribute towards infertility in couples significantly. Abnormal semen pattern is a common cause. More research is needed to render more valuable and significant results regarding male infertility.
... Studi ini mendapatkan bahwa IMT < 18.5 kg/m 2 menurunkan peluang terjadinya konversi sputum sebesar 37,8% (HR 0,622; 95% CI 0,389-0,995). Hasil studi ini sejalan dengan studi yang dilakukan di Amerika Serikat 23 . Studi tersebut menyatakan bahwa individu yang memiliki status gizi yang baik akan mampu mengembangkan respon imunitasnya sehingga proses penyembuhan tuberkulosis dapat berjalan dengan baik, sedangkan pada individu yang status gizinya buruk, mereka lebih berisik o mengalami kegagalan dalam proses penyembuhan. ...
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Lebih dari 50% pasien tuberkulosis memiliki indeks massa tubuh (IMT) yang rendah. Rendahnya IMT dapat memperburuk respon pengobatan dan memperbesar risiko gagal pengobatan. Studi kohort retrospektif ini dilakukan untuk mengetahui hubungan IMT dengan konversi sputum pada pasien tuberkulosis paru BTA positif. Studi dilakukan pada Desember 2013-Januari 2014 di poli paru RSUP Persahabatan dengan jumlah sampel sebanyak 120 pasien (60 pasien dengan IMT < 18,5 kg/m2 dan 60 pasien dengan IMT >18,5 kg/m2). Sampel diambil secara konsekutif. Probabilitas kumulatif gagal konversi pada pasien tuberkulosis paru BTA positif adalah 17% dan 9,2% pasien mengalami gagal konversi. Pasien tuberkulosis paru BTA positif dengan IMT < 18,5 kg/m2 (24,4%) memiliki probabilitas kumulatif gagal konversi yang lebih besar dibanding pasien dengan IMT > 18,5 kg/m2 (9,3%). Pada pasien dengan IMT < 18,5 kg/m2, hazard rate konversi sputum semakin rendah jika peningkatan berat badan yang dialami pasien di akhir tahap intensif < 1 kg dibandingkan dengan pasien yang mengalami peningkatan berat badan > 1 kg. Analisis Regresi Cox menunjukkan bahwa IMT < 18,5 kg/m2 menurunkan peluang terjadinya konversi sebesar 37,8% (HR 0,622; 95% CI 0,389-0,995) setelah dikontrol kategori pengobatan, peningkatan berat badan di akhir tahap intensif, dan hasil sputum di awal pengobatan. Status gizi pasien selama pengobatan perlu ditingkatkan untuk menunjang keberhasilan pengobatan.Kata kunci: Indeks masa tubuh, konversi sputum, RSUP Persahabatan, tuberkulosis paru
... DM is a chronic disease that will be suffered a lifetime. Someone who had a chronic disease always difficult to accept the fact that they have to change their lifestyle [16]. Patients who have received a diagnosis of diabetes can make them into a loss of control [17]. ...
Article
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Diabetes Mellitus as a chronic disease tend to seek appropriate medical treatment to heal the condition. Health-seek searched can be either medical treatment or Complementary and Alternative Medicine. This study explored deeply on the response of diabetes mellituspatients who visited to Indonesian Traditional Medicine Polyclinic on Regional Public Hospital dr. Soetomo Surabaya in using complementary medicine. This study used qualitative study with phenomenological method approach. The focus of this study was diabetes mellitus patients who use complementary medicine. Nine participants were selected based on purposive sampling method with certain criteria. Data collection used was in-depth interview and field note. Data analysis used thematic content analysis. Determining five themes that correspond with the purpose of study and a new theme. Some themes were psychological response after being diagnosed diabetes mellitus, opinion on the diabetes mellitus disease, complementary medicine usage patterns, reasons, the response after the use of complementary medicine, and family support. As a chronic disease, patients need proper treatment and conduct it continuously. Healer shopping was often taken by diabetes mellituspatients. It was required cooperation between patients and health professionals to monitor the behavior in order to achieve the effectiveness of medical treatment.
... Babies that are small for gestational age (under-developed skin) or with breastfeeding difficulties (dehydration) appear at increased risk for salt poisoning from skin salting. 46 Salt as an emetic: Table salt (saline emetic) was once recommended in first-aid manuals (and in early editions of Harrison's Principles of Internal Medicine) 48 to induce vomiting (emesis) after accidental poisoning or drug overdose. 49,50 As such, deaths have occurred in a variety of instances including when: parents used saltwater to induce vomiting in a teen who "may have" taken a pill at a party, 5 parents gave their 4-year old several glasses of salt water after she swallowed bath foam, 7 and in nurses who wished to induce vomiting after patients swallowed cigarette butts, a fellow patient's pills, or overdosed on aspirin. ...
... The high prevalence of depression among diabetic patients is associated with poorer quality of life, impaired self care activities, higher health care costs, a higher risk for the development of diabetes complications and increased mortality rates [12] Despite these known adverse effects and the high prevalence of depression in diabetes and the fact that effective treatments are available, there is a considerable under-detection and subsequent under-treatment of these conditions. Less than half of the depressed patients with diabetes are recognized [13,14]. ...
Article
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The lifetime prevalence of major depression in adults is estimated to be 7 to 12 percent in men and 20 to 25 percent in women [1]. The current estimates of the worldwide prevalence of depression indicate that 350 million people suffer from it and similarly, the worldwide prevalence of diabetes is estimated to be more than 400 million people [2]. Projection rates of diabetes are expected to rise to over 438 million by the year 2030 [3]. Diabetes is one of the most prevalent human diseases worldwide affecting all ages. It is a chronic disease that requires long-term medical attention to limit the development of its complications and to manage them when they occur [4]. Diabetes is a serious metabolic health problem among Arab speaking countries and the prevalence is continuing to increase [5]. International Diabetes Federation (IDF) estimated that around 37 million Arab people have type 2 diabetes mellitus and this is projected to reach 68 in 2035 [6] Unpleasantly, the top six world leading countries; among Arabic speaking, countries were Kuwait, Lebanon, Qatar, Saudi Arabia, Bahrain and United Arab Emirates (UAE) [7]. Diabetes is often comorbid with clinically relevant symptoms of depression [8]; People with diabetes are twice as likely to be depressed as people without chronic diseases [9], Clinical and subclinical expressions of depression ranges between 11% [9] and 40% [10] in patients with diabetes. Despite numerous investigations, the underlying patho-physiologies of the metabolic abnormalities related to the two diseases are poorly understood. A possible explanation could be due to the increases counter-regulatory hormone release involved in glucose homeostasis, alterations in the glucose transport function and increased inflammatory activation triggered by depression [11]. The high prevalence of depression among diabetic patients is associated with poorer quality of life, impaired self care activities, higher health care costs, a higher risk for the development of diabetes complications and increased mortality rates [12] Despite these known adverse effects and the high prevalence of depression in diabetes and the fact that effective treatments are available, there is a considerable under-detection and subsequent under-treatment of these conditions. Less than half of the depressed patients with diabetes are recognized [13,14]. The efficacy of treatment of depression in the presence of serious somatic illness has been examined in a series of studies summarized in a review published in 2010. The review showed that psychotherapeutic interventions (some of which were combined with diabetes education) had a moderate-to-large effect on depressive symptoms and a moderate-to-large effect on glycemic control. Psychopharmacological treatment with selective serotonin reuptake inhibitor (SSRI) medications also had a moderate-to-large effect on depressive disorders with lesser effects on glycemic control [15]. Although most of the studies were small in size, the findings seem to indicate that the treatment of depression by psychotherapy or with medications should be combined with education to achieve diabetes self-care and glucose control [2].
... It is used in congenital adrenal hyperplasia in many old adolescents and adults who are unable to produce ACTH. Usually, it is advised to take at night [18]. In order to promote the growth of the fetus's lungs for those women who are at the risk of delivering prematurely. ...
Research
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Dexamethasone sodium phosphate and prednisolone acetate are corticosteroids, both the drugs are available in a veterinary injectable suspension dosage form as DMSP 3.291 mg per ml and PA 7.923 mg per ml. The chromatographic separation was carried out on a reversed-phase C18 column (250mm X 4.6 mm, 5µm) in isocratic mode using acetonitrile: phosphate buffer 0.1% (50:50), at pH 3.0 adjusted with diluted orthophosphoric acid as the mobile phase at a flow rate of 1.0 ml/min. Retention times of DMSP and PA were 2.25 min and 4.50 min respectively. Quantification was carried out with UV detector at 254 nm. The linearity of DMSP and PA was in the range of 10.528µg/ml-23.1616µg/ml and 13.392µg/ml-24.106µg/ml respectively. A simple high-performance chromatography method was developed for the simultaneous determination of dexamethasone sodium phosphate and prednisolone acetate. The developed method is economical in terms of the time taken and the number of solvents consumed for each analysis. The method was validated as per ICH and successfully applied to the simultaneous determination of dexamethasone sodium phosphate and prednisolone acetate in bulk and pharmaceutical dosage forms.
... Etiopathogenesis for diabetes was in turn hypothesized by Isselbacher et al., [10]. They stated that the insulin deficiency in diabetes has a mitogenic action on the endothelium, which leads to formation of collateral vessels. ...
... However, it is believed that the body of Guinea Pigs partially drags along the floor due to their short legs. Urinary tract infection is more common in female Guinea Pigs because of difference in the anatomical structure of urinary tract between male and female [1] . In female Guinea Pigs urethras are shorter than that of males and the urethra of female is close to the anus, so that gastrointestinal bacteria may enter the urethra and may cause urinary tract infection [2,3] . ...
Article
Urinary tract infection is common in female guinea pigs because of their shorter urethras. A female guinea pig, aged 5 months and weighing 600gm was presented to the Teaching Veterinary Clinical complex, Post Graduate Institute of Veterinary and Animal Sciences, Akola with the complaint of haematuria. The case was diagnosed as urinary tract infection on the basis of history, symptoms, clinical examination and USG examination. The case was treated with antibiotics, NSAIDS and supportive treatment. The Guinea Pig showed complete recovery on 5 th day of treatment.
... 26 Atherosclerosis and vascular disease are postprandial phenomena, that is, they arise after eating allergenic and inflammatory foods, 27 associated with hyperglycemia and hypertriglyceridemia, with endothelial dysfunction being the earliest stage of vascular disease, which can be detected through the baroreflex index, hemodynamics 27 and biomarkers already studied in the literature, linked to cardiovascular diseases. 28 In this sense, this study aimed to report the values of the baroreflex and hemodynamic index related to biomarkers that signal obstruction of the blood microcirculation found in the 57-year-old male patient, who died after being affected by COVID-19. ...
Article
Abstract - Introduction: The slow hemodynamics and the baroreflex index below 90% in Functional Neurometry have been compatible with anemia, subclinical inflammation and/or with endothelial dysfunction. Objective: The objective of this study was to present hemodynamics and the baroreflex index (BI) evaluated by Functional Neurometry and blood biomarkers of a 57-year-old male patient who died when affected by Covid-19. Methods: The evaluations were performed by functional neurometry [Functional Reserve (FR), BI, Hemodynamics and Physiological Response (PR)] and by biomarkers: Blood Count; Serum Ferritin (SF); Transferrin Saturation (TS); B12; Homocysteine; C-reactive protein (CRP); Fibrinogen; 25-hydroxy-vitamin-D3; Apolipoprotein-A1 (Apo-A1); Apolipoprotein-B (Apo-B); Oxalacetic Glutamic Transaminase (OGT); Glutamic-Pyruvic Transaminase (GPT); Gamma GT; Total Cholesterol (TC); Triglycerides (TG); High Density Lipoprotein (HDL) and Low Density Lipoproteins (LDL). Results: 1) The patient presented 7.27% of functional reserve [Expected:>75%]: Adrenal stress and/or hepatic steatosis; 2) BI 60.92% [Expected:>90%]; 3) Hemodynamics 26.07% [Expected:<10%]: This result indicates the possibility of anemia and/or endothelial dysfunction and 4) A PR 33.77º [Expected: 31.5º until 32.5º]: digestive overload; 5) B12 [153]; Homocysteine [16.5]; CRP [1.74]; D3 [21.6]; Gamma GT [67]; TC [200]; TG [611]; CT/HDL 4.76 [Expected: ≤3.3]; TG/HDL 14.4 [Expected: ≤2.5]; APO B/APO A1 0.7957 [Expected: ≤0.5]. Conclusion: This study found subclinical inflammation and endothelial dysfunction. However, as this study is only a case report, it is suggested to conduct a clinical study with several patients with statistical significance. Key Words: Baroreflex Index, Hemodynamics, Biomarkers, Covid-19.
... The treatment of diabetes mellitus continuously requires effective self-management and is supported by family members. Braunwald (2005) mentioned that diabetes care diabetes health education and comprehensive self-management of diabetes is very important. Nevertheless, patient compliance is an important factor in self-management of diabetes mellitus. ...
Article
Android Based Diabetic Manager (ABDM) is an application used for diabetic patients to control their diet. This application is an easy way to remind them in consuming foods and giving them alert when its necessary calories have been achieved. This study was conducted in response to technological developments in the Era 4.0 to help people with Type 2 Diabetes Mellitus through diet control that can be done independently. This study was conducted in the city of Magelang aimed to evaluate whether using ABMD was effective to improve patients adherence in their diet and to control their blood glucose levels. This experimental study was using pre test and post test with control group design. By using simple random sampling, 52 people suffering from Type 2 Diabetes Mellitus recruited in this study devided into two groups, ABDM group and control group. The Pearson Chi-Square test result showed that there was significantly different between ABDM group and control group in the status of blood glucose control and patient adherence with p value was 0.048and 0.000 respectively (p value <0.05). This result indicated that H0 was rejected and H1 was accepted, which could be interpreted that Android based Diabetic Managerapplication influenced the status of blood sugar control and improved the patient adherence in managing their diet. Android based Diabetic Managerapplication influenced the status of blood sugar control and improved the patient adherence in managing their diet. Recomendation was made to conduct future study in the wider Diabetes community by adding more complete types of menu list and its variations in the Android based Diabetic Manager.
... Except when the worms were forcefully shaken, paralysis was defined as no movement. The worms perished when they stopped moving [13,14]. ...
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Objective: Investigation of Anthelmintic effect of Neolamarckia Cadamba fruit extracts (Ethanol, Aquaous, Phenyl ether, Chloroform) in Ascariasis. Methods: The experiment was conducted on an adult Indian earthworm, Eiseniafoetida, owing of its morphological and physiological similarities to the human intestine roundworm parasite. Six sets of six earthworms were discharged sequentially into different extracts of N. cadamba fruits at dose levels of 5,10,15,20, and 25 mg/ml, respectively, and 25 mg/ml of albendazole solutions. Albendazole was employed as the standard reference medication. Results: The results showed that Ethanolic extract has the greatest degree of activity. When compared to any other extract or conventional medicine, it produces a paralytic effect sooner and has a shorter time to death (Albendazole). An ethanol extract included alkaloid, saponin, tannins, flavonoids, proteins, and amino acids. As a result, it is possible to infer that the ethenolic fruit extract of Neolomarckia Cadamba showed much more anthelmintic activity against Indian earthworms than the usual treatment (Albendazole). Conclusion: The solvents Ethanol, Chloroform, Phenyl Ether, and Aquaous were used to extract the Neolamarckia Cadamba. The results showed that Ethanolic extract has the greatest degree of activity. When compared to any other extract or conventional medicine, it produces a paralytic effect sooner and has a shorter time to death (Albendazole).
... 15 Haemorrhagic pericardial effusion has been described in pericarditis due to malignancy, tuberculous pericarditis, collagen-vascular diseases, uraemia, trauma, irradiation, postmyocardial infarction syndrome, streptococcal infection and idiopathic pericarditis. 16 The association of haemorrhagic pericardial effusion with viral infections is less known but it has been reported in coxsackie virus. 17 This young man who presented with palpitations and progressive shortness of breath underwent pericardiocentesis due to massive pericardial effusion and signs of cardiac tamponade. ...
Article
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COVID-19 has a broad spectrum of cardiac manifestations, and cardiac tamponade leading to cardiogenic shock is a rare presentation. A 30-year-old man with a history of COVID-19-positive, reverse transcription polymerase chain reaction (RT-PCR) done 1 week ago and who was home-quarantined, came to the emergency department with palpitations, breathlessness and orthopnoea. His ECG showed sinus tachycardia with low-voltage complexes, chest X-ray showed cardiomegaly and left pleural effusion and two-dimensional echocardiography showed large pericardial effusion with features suggestive of cardiac tamponade. He was taken up for emergency pericardiocentesis which showed haemorrhagic pericardial fluid. Intercostal drainage insertion was done for left-sided large pleural effusion. After ruling out all the other causes for haemorrhagic pericardial effusion, the patient was started on colchicine, steroids, ibuprofen and antibiotics to which he responded. Both pericardial and pleural effusions resolved completely on follow-up.
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Based on the classification of human hormones, there is no solid idea in most books. In this view, this article could exemplify a concrete solution, especially for medical and university students. Hormones have many life-saving roles in the human body. With the deficiency of hormones, our body might fall into lots of problems. Data analyses of much information from books, articles, online supplements gave different ideas on total hormones. The result suggested that some hormones were secret from the same glands. Out of 110 hormones (when the same hormone came from different sources), exact different types of hormones were 88. Analyzed hormones consisted of four major groups- amine (4 hormones), eicosanoid (4), steroid (15), and peptide were (65) out of 88 endocrine chemicals. The endocrine and reproductive system (56) jointly secreted most of the hormones, and secondly gastrointestinal tract (26 hormones). Besides the organ system or glands, some are come out from the cell, tissue, tissue system, and placenta. This paper also mentions, phenotypically males and females exhibit many differences, hence hormonal analyses; they are more or less the same. For instance, many sex hormones are also present both in males and females. In the future, it needs to enhance more research on the classification of the hormones in the human body.
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Pompe, Gaucher and Krabbe disease are lysosomal storage disorders (LSDs) which are a group of genetic diseases that causes the accumulation of lipids in tissues and cells. Pompe, Gaucher and Krabbe are characterized by the deficiency of acid α-glucosidase (GAA), β-Glucocerebrosidase (GBA) and galactocerebrosidase (GALC), and treatable if detected in their early stages. Here, we present the fabrication of an electrochemical immunosensor for the multiplexed quantification and simultaneous detection of GAA, GBA and GALC. The sensor was developed by electrodepositing gold nanoparticles (AuNPs) on an array of carbon electrodes, followed by the immobilization of GAA, GBA and GALC specific antibodies via functionalization with cysteamine and glutaraldehyde. The multiplexed immunosensor was able to successfully detect GAA, GBA and GALC at the femtomolar level with respective low detection limits of 0.12 pg/ml, 0.31 pg/ml and 0.18 pg/ml. The immunosensor showed good selectivity, sensitivity and good recovery when spiked in human serum, which confirms its possible applicability in point-of-care testing for the early diagnosis of LSDs.
Article
Corticosteroids represent important therapies for numerous acute conditions and chronic diseases based on their broad anti-inflammatory and immunosuppressant effects. They have been used extensively in managing many oral diseases, due to their excellent anti-inflammatory and Immuno-modulatory effect. This article is present at reviewing the uses of corticosteroids in the treatment of various oral condition. To study more about corticosteroids and other related concepts. It was focus on Physiological effect, Effect of anaesthesia and surgery and Important indication of Steroid in anaesthetic practice. There are strategies that can be used to minimize these risks, but some risks are often unavoidable. Topical use of corticosteroids, including inhalation, can be used to target specific organs for treatment. Corticosteroid therapy can be life-saving in serious and severe medical conditions.
Thesis
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The Turmeric (Curcuma longa) has been analysed for the main phytochemical composition nutrients including mineral, Phenolic compounds, Tannins, Flavonoids, Curcumin‎ in crude plant powder , curcumin‎ in etheric extract and ethanolic extract. The Phytochemical screening of chemical constituents of the plant in different solvents showed that the Turmeric contains : Alkaloids, Flavonoids, Steroids, Carbohydrate, Terpenoids, Tannins, Coumarins, Saponins, Quinones, Proteins and Phenolic compounds .The quantitative contents of phenolic compounds were (±14.5000.70) mg/100gm, Tannins (6.75 ±360.75) mg/100gm, while Flavonoids, Curcumin‎ in crude plant powder, curcumin‎ in etheric and ethanolic extract were [ (0.29±8.873), ) 2.490 (0.098±,)1.150± 0.02) and ‎(24.680±0.13)] % respectively .The moisture, total solid, carbohydrate, crude protein, total fat fibre and ash were found to be equal (6.152±0.27) % , (93.848±0.27) % , (36±8.48) % , (7.737) % , (2.637±0.22) % , (23.280±1.23) % and (8.860±0.03)% respectively .The energy value was (205.881)kcal/100gm with important amount of essential elements (K, Mg, Na, Fe, Ca, Zn, Mn, Cr, Co, Ni and N). The effect of Turmeric powder , Ethereic and Ethanolic extract on the levels of antioxidant parameters , lipid profile and liver function were carried out on experimental female rabbits . The animals were divide into ten groups which include:- -C: As control group treated with H2O2 (0.5)%.to induced oxidative stress. -G1 , G2 , G3: orally treated with (25,50,75) mg/Kg/day of TRP and H2O2 (0.5)%. -G4 , G5 ,G6: orally treated with (2 , 3 , 4) mg/Kg/day of etheric extract and H2O2(0.5)%.. -G7 , G8 ,G9: orally treated with (2 , 3 , 4) mg/Kg/day of ethanolic extract and H2O2(0.5)%.. The results indicated that the levels of GPX , GSH and Albumin were significantly increased in all groups (G1-G9) except G2 in GSH compared to control group (C), while the levels of peroxy nitrate and MDA were significantly decreased in all groups compared to control group (C). The results also indicated that the level of total proteins were significantly increased in all experimental groups except in groups G1,G3 and G6 . Total cholesterol levels were significantly decreased in groups G1 ,G3 ,G4 and G9 in compared to control group. The levels of triglycerides and VLDL were significantly decreased in all experimental groups except groups G3 and G7 ,LDL-C were also significantly decreased in all experimental groups except in G2, In contrast, the levels of HDL-C was significantly increased in all groups except G9 , while in G1 ,G2 and G3 were significantly decreased compared to control group (C). Results of blood glucose showed a significantly decreased in all experimental groups except G1 ,G8 and G9 compared to control group (C). There were also significant decrease in the levels of ALT ,AST and ALP in all groups except group G7 for AST and groups G4 , G6 and G7 for ALP .
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Ethnomedicinal survey documents the traditional uses of Oxalis debilis Kunth leaves in the management of diarrhea and helminthiasis. In our study, the antidiarrheal and anthelmintic activities were evaluated for ethyl acetate and hydro-alcoholic leaf extracts of O. debilis. Both the leaf extracts exhibited antidiarrheal and anthelmintic activities. The hydro-alcoholic extract exhibited better activity profile than that of ethyl acetate extract.Moreover, the anthelmintic activity was found to be more significant in comparison to the antidiarreal activity for the hydro-alcoholic extract. From phytochemical and TLC studies, the pres- ence of phenolic compounds and flavonoids has been demonstrated in the extracts indicating their possible role in the bioactivity of O. debilis leaves. However, the potent antidiarrheal and anthelmintic activities are claimed with the hydro- alcoholic extract of O. debilis leaves. Our present work justifies the ethnomedicinal claims of O. debilis leaves in the treatment of diarrhea and helminthiasis, particularly in the northeastern region of India.
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This book is prepared for Health science students. It provides introduction to clinical medicine, clinical history taking and physical examination. It elaborates approaches to history taking and physical examination of the body systems.
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