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Aug 2023 DOI 10.14302/issn.2692-1537.ijcv-23-4679
Ryu TomikoCorresponding author
Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-Co V-2) has contributed to control of the coronavirus disease 2019 (COVID-19). On the other side, vaccination of SARS-CoV-2 could trigger autoimmune or inflammatory diseases. We present a 50-year-old female with well-controlled optic neuromyelitis with prednisolone (PSL) maintained at a dose of 2.5 mg/day. She ran a fever and liver injury was indicated 5 weeks after a second COVID-19 vaccination (BNT162b2 mRNA/Pfizer ). Liver biopsy showed accumulation of macrophages around the central veins, identified using anti-CD68 antibodies. As the treatment, cyclosporine A improved liver injury. COVID- 19 vaccination may have triggered liver inflammation due to cytokine storm via macrophage activation in the liver.
Apr 2023 DOI 10.14302/issn.2694-1201.jsn-23-4385
Getabalew AytenewCorresponding author
Background Traumatic brain injury in pediatrics is one of the commonest causes of morbidity, disability and mortality worldwide. In low- and middle-income countries Study showed that death of pediatrics from traumatic brain injury was 7.3%. However, there is limited data towards the outcome of traumatic brain injury and its associated factors in Ethiopia. Objective To assess the outcome of traumatic brain injury and associated factors among pediatrics patients in Amhara National Regional State Comprehensive Specialized Hospitals, Ethiopia. Methods An institution based retrospective cross-sectional study was conducted among 423 pediatrics patients from January 1, 2019 to December 30, 2021, and data extraction period was from May 16 to June15, 2022. Systematic random sampling technique was employed to select the study participants. Data were collected from patient charts and registry books by using a data extraction tool. Data were entered into the Epi-info version 7 and analysis was done by SPSS Version 25. Both Bi-variable and multi-variable analyses were employed to identify factors associated with outcome of traumatic brain injury. Result From 423 sampled study participant charts 404 of them had complete information with response rate of 95.5% and included in the final analysis. The overall unfavorable outcome of traumatic brain injury at discharge was found that 12.13% (95% CI: 9.1% - 15.7 %). Sever traumatic brain injury (AOR: 5.11(CI :1.8-14.48), moderate traumatic brain injury (AOR:2.44(CI:1.07-5.58), Hyperglycemia (AOR: 3.01 (CI:1.1-8.04), sign of increased intracranial pressure (AOR:7.4(CI:3.5-15.26), and medical comorbidity (AOR: 2.65(CI:1.19-5.91) were predicted of unfavorable outcome of traumatic brain injury pediatrics patient. Conclusion and recommendations twelve present of traumatic brain injury results unfavorable outcome. Sever and moderate form of traumatic brain injury, hyperglycemia, signs of increased intracranial pressure, and medical comorbidity were factors associated with unfavorable outcome of traumatic brain injury in children. Therefore, it is preferable to improve accesses to acute and post-acute care services to lower the unfavorable outcome of traumatic brain injury in children.
Jun 2022 DOI 10.14302/issn.2471-2140.jaa-21-3911
Izadi MortezaCorresponding author
Ozone CRC BMSU Tehran, Iran
Testicular ischemia-reperfusion injury is an urgent situation which needs a timely and precise diagnosis for prevention of testis damages. Here in we investigated ozone/oxygen therapy in Testicular Ischemia/Reperfusion Injury. For this purpose, animals (rats) were divided to four groups; control, torsion/detortion, torsion/detortion + ozone/oxygen (30 µg/ml) and only ozone/oxygen. Four hours after detorsion, in all groups orchiectomy was done -- for measuring the oxidative stress and mitochondrial toxicity parameters. Also, we preformed analysis of testicular spermatogenesis after 90 days. Our data showed that testicular torsion-detorsion induced significant increase in mitochondrial toxicity and decrease of spermatogenesis, malondialdehyde and GSSG levels were shown. Also, spermatogenesis, a remarkable decrease in malondialdehyde GSSG levels and mitochondrial toxicities were observed when compared with torsion-detorsion group. Obtained results for this research showed that ozone/oxygen therapy enhance antioxidant properties in the spermatogenic cells and protects testes from ischemia-reperfusion injury.
Apr 2021 DOI 10.14302/issn.2470-0436.jos-21-3710
David G. Diciano Jr.Corresponding author
Introduction Large impaled object in the orbital region causes severe visual impact and requires specialized care within the shortest time possible. Objectives In this case report, we discussed the approach and management of a patient that presented with a penetrating orbitocranial injury, from management at the emergency unit, diagnostic imaging, referral to other subspecialty, surgical and medical intervention, and post-operative care. Discussion A 36-year old male had an impaled toilet brush on the supero-nasal aspect of the right orbit, with visual acuity of 6/60 and lacerated upper eyelid. The globe had minimal movement on all gazes, but pupil was reactive to light with no afferent defect. On plain cranial and orbital CT-scan, the foreign body entered the anterior and medial aspects of the right orbit penetrating the right superior orbital wall, right medial lamina papyracea, and the lateral and inferior border of the right frontal sinus with its distal tip at the intracranial region at the right frontal lobe compressing the medial rectus along its tract. Two hours after injury, patient underwent wound exploration, removal of foreign body, repair of eyelid laceration, right craniotomy, frontal contussectomy, duraplasty, and JP-drain insertion under general anesthesia. Intraoperatively, there was note of transected canaliculus and avulsed conjunctiva. The medial rectus was intact and attached. The frontal lobe was contused with embedded fragments of right posterior orbital bone with 3cm opening on the dura. Post-operatively, Fluconazole was added to the medications after culture results of the toilet brush tip tested positive for fungal elements. Patient was discharged after 21 days with visual acuity of 6/6 on both eyes and improved ocular movement. Conclusion These types of injury warrants thorough and systematic history taking and physical examination, acquiring pertinent imaging modalities to better visualize the extent of injury, and execute surgical and medical intervention that is multidisciplinary.
Jan 2021
Ramalingam ManickamCorresponding author
Urology Clinic, Coimbatore
Small extra-peritoneal bladder injury is commonly treated conservatively as it heals spontaneously. However if there is an impinging bony spicule in the rent, the bladder wound does not heal and it is preferable to repair the rent primarily. We present a case of non healing extra-peritoneal bladder injury initially managed conservatively in a trauma center with supra-pubic catheter (SPC). Cystogram was done after 7 weeks showed persistent leakage of contrast. Hence patient was managed by laparoscopic repair of persistent extra-peritoneal bladder rent.
Sep 2020 DOI 10.14302/issn.2694-1201.jsn-20-3554
Getachew Kumara MitikuCorresponding author
Nekemte Referral Hospital, Oromia, Ethiopia.
Background Traumatic brain injury is an expanding major public health problem and the leading cause of death of the young and productive part of the world’s population. Research is mainly done in high-income countries where only a small proportion of the worldwide fatalities occur. Only few studies have examined prognostic factors of traumatic brain injury outcome in developing countries including Ethiopia. This study was aimed at defining the peculiar demographic and other associated factors of traumatic brain injury (TBI) outcome among patients treated for head injury at Nekemte Referral Hospital. Objective The main purpose of this study was to describe the magnitude of TBI outcome and assess factors associated with unfavourable outcome of TBI among patients treated for head injury at the surgical side in Nekemte Referral Hospital from July 8, 2016 to July 7, 2018. Methods A retrospective cross-sectional document review was conducted among TBI patients treated for head injury from July 8, 2016 to July 7, 2018 at Nekemte Referral Hospital. Data were collected using a pre-tested data collection format. Data analysis was done using SPSS version 20. Descriptive statistics were computed and association between the dependent and independent variables were assessed by using logistic regression. Odds ratios with 95% confidence interval were computed. Significant association was declared when the p value was <0.05. Results In this study, out of 378 cases 95 (25.1%) were discharged with unfavourable outcome of which 37(9.8%) were neurologic deficits and 58 were deaths giving overall mortality rate of 15.3%. Patient age>60years (AOR: 15.13; 95%CI: 3.575-64.028), time interval from injury to treatment (AOR: 16.054; 95%CI: 5.832-44.194), low GCS (AOR: 18.224; 95%CI: 4.167, 79.695), conservative management (AOR: 20.774; 95%CI: 6.106-70.681), pupils abnormality (AOR: 9.078; 95%CI: AOR: 2.996-27.509) were associated with unfavourable outcome. Conclusions A quarter of patients treated for TBI at Nekemte Referral Hospital are discharged with unfavourable outcomes. Old age, delayed presentation to the hospital, low GCS, conservative management, and pupillary abnormality increase the odds of unfavourable outcome. Timely management of TBI before patients develop secondary brain injury and use of surgical intervention based on CT scan diagnosis will reduce the occurrence of unfavourable outcome.
Mar 2020 DOI 10.14302/issn.2577-2279.ijha-20-3215
O. Atinuke AnjorinCorresponding author
Department of Anatomy and Cell Biology
Since oxidative stress impairs the cardiovascular function, the hypothesis from the present study is that the treatment of paraquat-exposed adult Wistar rats with methanolic extract of Abelmoschus esculentusseed would reduce paraquat-induced cardiovascular damage. Thirty healthy female Wistar rats weighing 120-150 g were randomly assigned into 6 groups of 5 rats each (Groups A, B, C, D, E and F). Rats in groups A served as control and received normal saline while groups B, C, D, E and F received a single dose of paraquat (7mgkg-1i.p.). Rats in group B was sacrificed 24hours following paraquat administration while daily administration of 100 mg kg-1and 200 mg kg-1 of methanolic extract of Abelmoschus esculentusseed extract were given orally to groups C and D while group E received daily oral dose of Vitamin E at 100mgkg-1 and group F was left untreated. Histological and biochemical preparations of the heart was made and data were expressed as mean± SEM. Significant difference was set at p<0.05. Results showed no significance difference (p<0.05) in nitric oxide activity, Glutathione reductase activity, and troponin I activity across the paraquat-exposed groups when compared with control. Histological studies reveal distortion of normal cardiac histo-architecture in paraquat-exposed group B compared with control rats while Abelmoschus esculentus reversed these changes in other treated groups. The study concluded that paraquat caused significant distortion of the cardiac histo-architecture and methanolic extract of immature Abelmoschus esculentus seed had antioxidant and ameliorative effects similar to Vitamin E on paraquat-induced myocardial injury.
Mar 2019 DOI 10.14302/issn.2641-5518.jcci-19-2626
Bertasi GiampietroCorresponding author
University of Padua, Italy
Matrices or tissue scaffolds provide a collagen structure for tissue remodelling while the removal of viable cells aims to minimize or prevent inflammatory or immunogenic response. Allograft collagen scaffold can support the patient’s own cellular ingrowth, ingeneered to minimize an immune response and to yeld a bio-compatible matrix and support incoming cellular growth. The decellyularized dermis retains its growth factors, native collagen scaffold, and elastin, thanks to a LifeNet Health proprietaryprocessin technology.
Nov 2018 DOI 10.14302/issn.2640-6403.jtrr-18-2449
Mohammad F EbtehalCorresponding author
Pharmacology Department, National Organization for Drug Control and Research (NODCAR), Giza, Egypt.
Methotrexate (MTX) is an anti-metabolite in cancer chemotherapy and is associated with various toxicities assigned to inflammation and oxidative stress. The present study was undertaken to corroborate the therapeutic effects of bone marrow mesenchymal stem cells (BM-MSCs) and adipose-derived mesenchymal stem cells (AD-MSCs) in MTX-induced intestinal toxicity in experimental animals as compared with dexamethasone (Dex). Rats were divided into five groups: I-Normal control group, II- MTX (14 mg/kg, as a single dose/week for 2 weeks), III & IV- BM-MSCs & AD-MSCs (2 × 106 cells/rat, 1 week after last dose of MTX), respectively, plus V- Dex (0.5 mg/kg/ for 7 days, 1 week after last dose of MTX). MTX induced marked intestinal elevation of interleukin-6, total oxidant, and nitrite/ nitrate, caspase-3 contents and myeloperoxidase activity, along with the reduction of reduced glutathione content and catalase activity. In conclusion, the positive modulation of MTX toxicity could be attributed to the free radical scavenging, anti-inflammatory and antiapoptotic potential of BM-MSC and AD-MSCs which will possibly make them as remarkable hopeful for the treatment of intestinal injury.
Apr 2017 DOI 10.14302/issn.2474-7785.jarh-17-1483
Dorfman JonCorresponding author
Department of Surgery, University of Massachusetts Memorial Medical Center Worcester, MA
Background: Discharge disposition planning begins at admission and is frequently one of the first questions posed to healthcare providers by patients and families. We hypothesized that pre-injury functional status would predict discharge disposition. Methods: We linked prospective data from the Worcester, MA cohort of the Global Longitudinal Study of Osteoporosis (GLOW) study and the UMassMemorial Level 1 Trauma Center Registry to determine predictors of discharge disposition for female geriatric (over the age of 55) trauma patients using bivariate comparisons and multivariable modeling. Results: 154 women of 5,091 in the Worcester GLOW cohort were evaluated for traumatic injury at UMassMemorial and were discharged alive either to their home (n=30) or to rehabilitation, skilled nursing, or nursing home facilities (n=124). The mean age was 79 years and the majority (99%) was white. There were no statistically significant differences in comorbidities or injury severity score between the groups. All women with femur fractures were discharged to a facility. The most common injury among women discharged home was traumatic brain injury. While univariate analysis revealed differences in pre-injury activity status, only age remained statistically different in a logistic regression model predicting discharge to facility (OR 2.61 per additional 10 years of age, 95% CI 1.62 to 4.19, p<0.0001). Conclusions: The majority of elderly women are not discharged home after injury. Pre-injury activity status was not associated with discharge disposition when accounting for other factors. It appears that physical function, which deteriorates with age, is a proxy for aging in older women at risk for osteoporosis.
Aug 2016 DOI 10.14302/issn.2474-9273.jbtm-16-1151
Xing GuoqiangCorresponding author
Departments of Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814
Oxidative stress mediated neural cell death is thought to be involved in the progression of secondary cell injury following brain trauma. Agents that can block oxidative stress-related injury could be potential therapies for TBI. Resveratrol, a polyphenol found in plants and red wine, is cytoprotective due to its potent antioxidant activities. To further understand how resveratrol could affect oxidative stress-induced injury, we hypothesized that the cytoprotective activities of resveratrol could be dose-dependent. In this study, resveratrol-induced cytoprotection was evaluated in cultured astrocytes. Primary rat astrocytes were cultured in T-75 flasks to a confluence of 80% before being plated onto 96-well plates. After 24 hours of acclimation, astrocytes were treated with various doses of hydrogen peroxide (H2O2) (0.1, 0.25, 0.5 and 1 µM) and resveratrol (25, 50, 75, 100 µM), respectively. Cell viability was determined 24 hours later using Alamar Blue Assay. Treatment of astrocytes with 0.5 mM H2O2, left 65% of astrocytes non-viable whereas treatment of astrocytes with 0.1 mM H2O2 had no effect on astrocytes viability; whereas 1 mM, H2O2 caused total loss of astrocyte viability. Resveratrol treatment at 75 µM and 100 µM has reduced 0.5 mM H2O2-induced cytotoxicity in astrocytes by 50%. Immunostaining with GFAP also confirmed these findings about the cytoprotective effects of resveratrol in astrocytes exposed to H2O2. These results suggest that resveratrol could be a potential neuroprotective agent in TBI due to its antioxidant properties. Further studies are needed to evaluate the long- term effects of resveratrol in animal models of TBI.
Jul 2026 DOI 10.14302/issn.2324-7339.jcrhap-26-6137
Austin Lee J.Corresponding author
Introduction Contemporaneous substance abuse, violence and HIV/AIDS risks (SAVA) result in synergistic negative impacts (syndemic effects). Presence of and risks for syndemic SAVA conditions are common among emergency department (ED) patients, however research on these inter-related processes is limited in sub-Saharan Africa. This study utilizes structural equation modeling to examine the relationships of syndemic SAVA conditions among persons seeking emergency injury care in Nairobi, Kenya. Methods This secondary analysis of a prospective observational study examined SAVA syndemic conditions among non-pregnant, adult ED injury patients able to provide consent at Kenyatta National Hospital. Structural equation modeling using diagonally weighted least squares (DWLS), was used to quantify associations between three latent variables (substance use, HIV risks, violence exposure). HIV risk included partner HIV status, men who have sex with men (MSM), and gay identities; violence exposure covered emotional, physical or sexual violence in the past six months; substance use encompassed positive screening for alcohol use disorder, poly-substance use, injection drug use and injury-related substance use. Model fitness was assessed using the Bentler-Bonett Normalized Fit Index (BB NFI), Goodness of Fit Index (GFI) (>0.9) and standardized root mean square residual (SRMSR) (< 0.05). Covariance between the latent factors was estimated. Results Among 2,368 screened ED patients, 665 were enrolled. Males were 83% of the sample; median age was 30 years (IQR: 24-38). Fit indices using DWLS showed a close fitting model (GFI=0.99, BB NFI=0.95, SRMSR=0.04). The indicator variables had significant loadings on two of the three syndemic factors (substance use and violence exposure, β range 0.10-0.95); in the SEM only MSM status had a significant loading on HIV risk, which was insufficient to confirm the identification of the latent factor. Violence exposure and substance use risk had significant positive covariance (0.30, p<0.001). Discussion and Conclusion This study provides the first available data from ED patients in sub-Saharan Africa on SAVA conditions, showing a co-relationship of violence exposure and substance use but no significant associations with HIV risk. These results can be used to inform programmatic interventions for higher-risk persons addressing synergistic conditions during emergency care.
Jun 2026 DOI 10.14302/issn.2474-7785.jarh-26-6358
Marks RayCorresponding author
Hip fractures, which remain an immense public health concern, have been subject to study and prevention efforts for many decades, but with limited success in averting either incident, second or subsequent hip fractures, commonly attributed to a combination of age related proclivity to fall, low bone and muscle mass. This review examines second hip fracture incidence rates and determinants of this serious functionally debilitating injury as observed over time remains a current 2026 public health concern. It specifically explores if more preventive efforts are currently warranted in this regard, and in what respect, if indeed, more frail older adults are living longer, but may be in excessively poor health, fearful of moving or falling, malnourished, weak with poor balance, or depressed. Based on what is published, it is concluded 1) second hip fracture incidence rates remain considerable, especially among those who are frail with osteoporotic bone disease, poor vision, heart/or cognitive conditions, plus those with muscle deficits of the lower limb, live alone and have a falls history; 2) studies to identify possible mitigation approaches appear promising in this regard, along with more routine efforts to minimize falls risk and bone attrition.
Jun 2026 DOI 10.14302/issn.2694-2283.jsem-26-6247
Quintero GabrielCorresponding author
Background Ankle sprains are among the most common injuries in sports, often characterized by high recurrence rates despite appropriate local treatment. Traditional approaches primarily focus on the injured joint, with limited attention to proximal biomechanical factors that may predispose athletes to injury. Objective To propose a functional, longitudinal kinetic chain model in which sacroiliac joint dysfunction may act as a predisposing factor for ankle sprain/strain injuries in athletes. Methods This paper presents a clinical hypothesis based on biomechanical reasoning and observational findings. The proposed model describes how sacroiliac joint dysfunction, particularly posterior innominate rotation (PI), may lead to pelvic obliquity and functional leg length discrepancy. These changes may induce compensatory femoral external rotation and foot toe-out, altering ground contact mechanics during gait and running. Results (Hypothesis) The altered alignment and loading pattern may increase the vertical impact force and modify the ground reaction vector on the functionally shorter limb, resulting in reduced mechanical stability at the ankle during heel strike or foot contact. Over time, this may increase susceptibility to inversion or eversion injuries, manifesting clinically as recurrent sprain/strain. Conclusion Ankle sprains in athletes may, in some cases, represent the distal expression of a proximal biomechanical imbalance. Incorporating assessment of the sacroiliac joint and the longitudinal kinetic chain into routine clinical evaluation may improve injury risk identification and contribute to more effective prevention strategies. Further research is needed to investigate this proposed relationship.
Jan 2026 DOI 10.14302/issn.2474-7785.jarh-25-5940
Marks RayCorresponding author
Lower limb osteoarthritis, a widespread age related chronic condition is often accompanied by an increased tendency to fall and thereby various degrees of intrinsic and extrinsic injury. Falls, in turn may provoke the disease alone and in turn a high falls risk and cycle of recurrent falls and heightened disability. This report which updates what is known about falls in the context of disabling osteoarthritis argues for a possible future ecological orientation rather than a focal uni dimensional approach to addressing this costly health problem. It examines osteoarthritis falls risk factors, falls injury prevention attempts, and recommendations to advance research and practice using an ecological analytic approach in this regard. Using the PUBMED data base and others, lower limb osteoarthritis linkages and falls interaction studies were sought and examined. The data revealed osteoarthritis can lead to the chances of incurring one or more falls and further health and disability challenges, while falling can provoke the onset of osteoarthritis in its own right. Although many factors appear to be involved, these are rarely viewed through a broad multi dimensional ecological perspective, thus are confusing or overwhelming to apply to the active community dwelling elderly subject.
Nov 2025 DOI 10.14302/issn.2694-2283.jsem-25-5730
A. Heinrich EmilyCorresponding author
Objective The goal of this systematic review is to identify common themes amongst acute spinal cord injuries (SCI) in equestrian athletes. Design A systematic review was performed using PubMed, CINAHL Plus with Full Text (EBSCO), Cochrane Library, and Scopus with pre-determined MESH terms. The initial search returned 354 studies. Following PRISMA guidelines, 13 articles were included. Exclusion criteria included injuries to the horse only, non-English language, cauda equina, and case reports. Data extraction was completed, and common findings were evaluated narratively due to heterogeneity of data. Results Seven manuscripts listed specific horse-related activities that caused SCI, with fall from horse as the highest percentage of injury. Nine articles identified the injury region, with large variations and no clear dominant area of injury. Five articles identified the length of hospital stay with ranges from 1 to 82 days. Four articles looked at the association of professional vs non-professional riders. Only two articles evaluated helmet use at time of injury, with one article showing 81% of those with SCI used helmets, and the other showing only 35.6% utilized this safety measure. Conclusion SCI in equestrian athletes can have a wide presentation, with large variation on location of injury, length of stay, and other factors. However, non-professional riders are at greater risk of SCI and individuals are more likely to sustain injury from a fall from a horse rather than a kick or another modality of injury. Future study can elicit presenting symptoms, types of surgical intervention used, and long-term outcomes and recovery.
Nov 2025 DOI 10.14302/issn.2474-7785.jarh-25-5760
Solís Herrera ArturoCorresponding author
Commotio retinae (CR) is a condition frequently observed in clinical practice, particularly following closed globe trauma (CGT) due to sport, labor, or traffic accident injuries. It is the main cause of unilateral vision loss in male patients aged between. It is characterized by transient gray-white retinal coloration and reduction of visual acuity (VA). Symptoms depend mainly on the location and severity (deep) of the injury, with less complains when only the superficial or peripheral retina is affected. It may be confined to the posterior pole, when it is also called Berlin’s edema, after the first hypothesis of Berlin (1873). There is no specific treatment since the treatment depends on the region of the retina and choroid affected. In this work we report a case of Berlin edema, treated with ǪIAPI 1®, to restore the balance of oxygen, which is generated at the intracellular level.
May 2025 DOI 10.14302/issn.2694-2283.jsem-25-5529
Al-saeed NawafCorresponding author
Background Septic arthritis is a potentially limb or life-threatening joint infection that requires prompt recognition and intervention to reduce morbidity and mortality. While intra-articular joint injections are commonly performed for osteoarthritis and other arthropathies, they carry a rare but significant risk of iatrogenic infection, particularly when performed in the presence of unrecognized joint or periarticular infection. Case Presentation We report a case of a 52-year-old female with a history of traumatic brain injury and chronic right knee pain who developed severe knee swelling, pain, and systemic symptoms following an intra-articular corticosteroid injection performed without ultrasound evaluation/guidance. Post-procedure, she presented with fever, elevated inflammatory markers, and purulent knee effusion. Operative washout revealed a purulent tract extending from the knee joint capsule to the lateral thigh. Cultures from joint aspiration and intraoperative samples grew Streptococcus dysgalactiae. Blood cultures were negative. The patient reported frequent cat scratches to the affected knee and described an unusual sensation of the injection needle tracking laterally during the joint injection. She was treated with surgical drainage and a four-week course of amoxicillin, with full clinical recovery. Discussion This case highlights an unusual presentation of septic arthritis with extra-capsular extension likely due to iatrogenic needle tracking during joint injection. The causative organism, S. dysgalactiae, is an uncommon pathogen in septic arthritis, and the presumed source was contiguous spread from untreated cellulitis, possibly related to cat scratches/bites. The absence of predisposing comorbidities and negative blood cultures further support a local rather than hematogenous source. The case emphasizes the importance of thorough clinical evaluation and consideration of infection prior to joint injections, as well as the potential benefits of ultrasound guidance to minimize procedural complications. Conclusion Careful history, physical examination, and appropriate imaging are essential prior to joint interventions to avoid iatrogenic complications. This case illustrates the rare but serious risk of extra-capsular extension of septic arthritis following intra-articular injection and emphasizes the need for vigilance in identifying underlying infection before proceeding with invasive procedures.
Dec 2024 DOI 10.14302/issn.2641-4538.jphi-24-5358
Kar SonaliCorresponding author
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.2692-1537.ijcv-24-5218
Luna-Rivero CesarCorresponding author
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection often causes coagulation disorders that affect highly vascularized organs, such as the lungs and kidneys. Objective The objective of this study was to report the histopathological findings of variations in the fibrin pattern of pulmonary and renal microthrombi in patients who died from SARS-CoV-2 infection. Methods Minimally invasive autopsies were performed on 40 patients to collect lung (n=40) and kidney (n=16) tissue samples. Histochemical and immunohistochemical staining techniques were used for histopathological analyses. Premortem laboratory data were obtained from the patients' electronic medical records. Results The lung tissue showed a patchy pattern, characterized by areas of both minimal and severe damage. The most significant histopathological finding was the detection of thrombi with fibrin structures organized into discrete star-shaped units, which were more frequently observed in areas with severe lung injury than in those with minimal lung injury (p = 0.012). Star-shaped fibrin structures were also observed in the renal glomerular capillaries. Immunohistochemical staining revealed the presence of platelets and the procoagulant proteins von Willebrand factor (VWF) and Factor VIII within the star-shaped fibrin thrombi. Patients with star-shaped fibrin thrombi had higher levels of the systemic inflammatory indicators C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR). Conclusion Our observations suggest that the inflammatory microenvironment resulting from SARS-CoV-2 infection may contribute to the formation of star-shaped fibrin units in the pulmonary and renal microthrombi.
Jan 2024 DOI 10.14302/issn.2474-7785.jarh-24-4890
Marks RayCorresponding author
Knee joint osteoarthritis, a chronic condition resulting in considerable disability, particularly in later life, not only impacts life quality significantly and severely, but is also strongly associated with the persistence of intractable pain, depression, helplessness, and a high falls injury risk. This narrative overview synthesizes the knowledge base regarding painful knee osteoarthritis and what is known about Tai Chi exercise participation in the context of reducing knee joint disability and its associated risk of one or more injurious falls, as well as pain and depression. To this end, all relevant articles published in the English language on the topic were sought. While most reports rely on Eastern observations, rather than Western medicine studies, collectively, these data reveal that Tai Chi practiced widely in Asia for many centuries may have an enormous positive impact on reducing distress and increasing function and autonomy among older adults living in the community and diagnosed as having knee osteoarthritis. They specifically suggest the increasing numbers of older adults diagnosed as having knee osteoarthritis can safely practice selected Tai Chi exercises with the expectation that consistent applications will enhance mobility, reduce pain and depression, plus instability and possible injurious falls, while reducing fatigue, even if surgery is forthcoming.
Aug 2023 DOI 10.14302/issn.2641-5518.jcci-23-4646
Issa Abdulhamid SayedCorresponding author
Introduction The idea of HLSSM2 is to get the least easy surgical intervention, as arthroscopic surgery begins with examining the shoulder joint, and the location and size of the lesion are determined, then open over the lesion with an open surgical approach that is very limited for surgical repair; not using arthroscopic instruments but conventional surgical instruments in the second step. Figure 1 Figure 1. Methods Clinical experience with this technique consists of 44 cases over a period of thirty-one months, this study was from September 2020 to May 2023. All cases were done as outpatients and under general anesthesia. Results The mean duration of the operation was 35 minutes, and the minimum duration was 25 minutes. There was no major nerve or vascular injury in all cases. This technique is simple, safe, and good cosmetically satisfactory for all patients after full recovery about three months after the procedure, and it is cost-effective. One 43-year-old female patient suffered pain and stiffness during the first six months after surgery and was not very satisfied, she did not stop visiting us till now, she was not happy because of shoulder pain and tenderness. Conclusion It can be used by experienced hand surgeons in shoulder arthroscopy and in Mini Lateral Shoulder Approach (MLSA)3, especially in countries where shoulder arthroscopic release and repair with suture anchors are expensive4 or not available. This technique is not very simple but is available, safe, cosmetically satisfactory, and cost-effective.
Nov 2022 DOI 10.14302/issn.2835-513X.ijl-22-4266
O.D AbuCorresponding author
Department of Biochemistry, Faculty of Life Sciences, University of Benin, Benin City, Nigeria
The present study investigated the effect of aqueous and ethanol extracts of Dialiumguineense stem bark on lipid profile and CCl4- induced histological changes in liver of Wistar rats. Adult male Wistar rats (n = 25) weighing 160 – 180 g (mean weight = 170 ± 10 g) were randomly assigned to five groups (5 rats per group): normal control, CCl4 control, silymarin, aqueous extract and ethanol extract groups. With the exception of normal control, the rats were exposed to CCl4 (single oral dose of 1.0 mL/kg body weight, bwt). Silymarin group rats were administered standard hepatoprotective drug, silymarin, at a dose of 100 mg/kg bwt, while those in the two treatment groups received 1000 mg/kg bwt of aqueous or ethanol extract orally for 28 days. Lipid profile parameters were determined in plasma, while rat liver was subjected to histopathological examination. The results showed that the levels of total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C), very-low density lipoprotein cholesterol (VLDL-C), low-density lipoprotein cholesterol (LDL-C) as well as atherogenic index of plasma (AIP) were significantly lower in CCl4 control group than in normal control group, but they were increased by extract treatment (p < 0.05). However, there were no significant differences in atherogenic coefficient (AC) and cardiac risk ratio (CRR) among the groups (p > 0.05). Carbon tetrachloride (CCl4) markedly disrupted the structure of hepatocytes and induced steatosis (intra-hepatocyte fat in-growth and inflammation) which was predominantly microvesicular. However, treatment with aqueous and ethanol extracts of D. guineense stem bark showed marked regeneration of hepatocytes (unremarkable hepatic lobular architecture). The toxic hepatic injury induced by CCl4 was significantly blocked by the plant extracts.
Jun 2022 DOI 10.14302/issn.2328-0182.japst-22-4193
Tariku Belay YilkalCorresponding author
School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
The strategy for safe drug discovery and development has limited clinical success as compared to wasted time and resources annually. This is due to the fact that the results of multiphase preclinical trials are less likely to make an accurate early prediction on the safety of test compounds to progress into the clinic as a valuable therapeutic agent. A lot of time and resources has been wasted in the multistage processes of drug discovery and development that does not work at the end of the procedure every year. During pre-marketing stage, for instance, the number of unsuccessful clinical trials are greater than the successful one because of safety issues. A toxicity study at different stages of preclinical and clinical trials is a routine procedure to investigate the undesirable side effects of test compounds being manifested on the natural processes of living things. It deals with the effect and mechanism of toxicity of test compounds that triggers different biological responses on different organ systems. The biological responses that would be manifested as a result of interaction between the receptors and active molecules of a test compound could be desirable pharmacological effect or undesirable side effect or both responses are manifested simultaneously depending on the selectivity or specificity of the molecule of a test compound for its receptor subtype which makes safe drug discovery and development very challenging. The response efficiency of the body (the net outcome of the body’s biological reaction against the side effect) would determine the potency of a test compound to manifest undesirable pharmacologic effect. In other words, the amount of a drug required to cause a biological harm or injury depends on the magnitude of the body’s biological reaction in which the immune response plays a great pharmacological role by neutralizing and harmonizing xenobiotics with the biological molecules. The dose of a test compound at 100 mg/kg body weight, for instance, could be lethal to some of the study animals while it is still non-lethal to some other study animals depending on the response efficiency of the body. The immune system is well connected to each and every biological systems of the body which allows it to detect undesirable side effects being manifested through immunoglobulins signalling and activation mechanisms. This complex communication network helps to localize the diverse side effects of a test compound being manifested on different organ systems into the immune system which makes a toxicity study relatively simple to monitor. The cellular immune system becomes active following the molecule-receptor interaction and start producing antibodies which is also known as immunoglobulins to protect bodily harm and destruction. Under normal biological circumstances, the amount of immunoglobulins produced by the cellular immune system following exposure to a test compound is proportional to the number of harmful molecules interacted with its receptor subtype. Thus, with the reference to the changes in the immune response against the administered dose, it would be able to deal with the diverse undesirable side effects of a test compound being manifested on treated study animals using computational systemic biology.
Feb 2022
K Al Miraj ACorresponding author
Research Assistant, Department of Vascular Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU)Dhaka, Bangladesh.
Introduction Calcium (Ca2+) plays an important role in the pathogenesis of ischemic cell damage. Intracellular Ca2+ accumulation leads to neuronal damage by triggering the cycle of cytotoxic events, however the relationship of serum Ca levels and the pathways involved in ischemic injury is unclear. Aim of Study To investigate the relationship of serum Ca2+ levels with severity of acute ischaemic stroke, serum calcium (Ca2+) levels were measured within the first 48 hours and were compared with the clinical severity of acute ischaemic stroke. Material and Methods A hospital based cross sectional study was performed among 100 patients of acute ischaemic stroke who fulfilled the inclusion criteria. The Study was done from July 2020 to August 2021 in SPRC & Neurology Hospital Dhaka, Bangladesh And BSMMU Hospital Dhaka, Bangladesh. After hospitalization presenting complaints, physical findings of the patients were recorded. Severity of stroke was measured by NIHSS scale. Serum calcium level of every patient was measured. Calcium level was divided into 3 groups by weighted average. Statistical analysis was carried out by a non-parametric Ruska Wallis test. Results Among the 100 patients 59% were male. Among all patients 57% of patients were found to be smokers (98% male, 2% female). Among all patients 63% patients were found hypertensive and 21% of all patients (24% male, 17% female) were diabetic. Mean cholesterol level was 257.98mg/dl with standard deviation 55.49 which is above the reference range suggesting hypercholesterolemia, Triglyceride was borderline and LDL cholesterol was slightly higher and HDL cholesterol was slightly lower. Calcium level was divided into 3 groups and NIHSS score was calculated for every patient in each group. The median NIHSS score for group1 (calcium level ≤8.8 mg/dl) was 9(2-20), for group 2 (calcium level 8.9-9.6 mg/dl) was 6 (1-17) and for group 3 (calcium level ≥9.7mg/dl) was 4 (1-16). Conclusion Commonest risk factor of ischaemic stroke is hypertension. Other risk factors are smoking, diabetes mellitus and hyperlipidemia, cardiac disease. Higher serum calcium level is associated with less severity of ischaemic stroke.
Jan 2022 DOI 10.14302/issn.2474-7785.jarh-22-4070
Marks RayCorresponding author
Department of Health and Behavior Studies, Columbia University, Teachers College New York, USA.
Background Many older adults, including those who have acquired painful disabling osteoarthritis of one or more joints may be frail rather than obese as is often reported. Those older adults who are frail may acquire osteoarthritis in turn if they encounter excess joint stresses and injury. Aims This report sought to examine what has been published to date on both of these debilitating health states, namely osteoarthritis and frailty. Methods Reviewed were relevant articles published in ACADEMIC SEARCH COMPLETE, PUBMED, WEB OF SCIENCE, SCOPUS and GOOGLE SCHOLAR regardless of time period but that focused on osteoarthritis and frailty related topics. The focus was on ascertaining how these two conditions might interact among community-dwelling older adults and whether more should be done specifically to mitigate any potentially preventable ‘frailty’ induced negative health impact among this group. Results Older adults with osteoarthritis living in the community may suffer from both osteoarthritis and frailty. Those that do are at high risk for disability and injury and should be targeted more effectively. Conclusion Timely and concerted efforts are needed to offset frailty correlates as well as excess osteoarthritis disability among community dwelling older adults.
Jan 2022 DOI 10.14302/issn.2641-5518.jcci-21-3959
EKMEZ MuratCorresponding author
Sultangazi Haseki Training and Research Hospital, Department of Gynecology and Obstetrics, Istanbul, Turkey
COVID-19 epidemic, described as a community health emergency by the World Health Organization, began in December 2019. COVID-19 is a source of deep vein thrombosis (DVT) because of hypercoagulation, blood stasis, and endothelium injury complications. This study reports a 26-year-old pregnant woman with coronavirus hospitalized with a left ovarian vein (LOV) thrombosis at Sultangazi- Haseki Training and Research Hospital in Istanbul. Risk classification for DVT disease is of crucial importance for the forecast of coronavirus.
Dec 2021 DOI 10.14302/issn.2474-7785.jarh-21-4041
Marks RayCorresponding author
Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY 10027, USA.
Background Many older adults are vulnerable to becoming frail. They are also often at risk for falling and serious injuries and poor health outcomes. Aim This exploratory review examines the correlates of frailty, and fear of falling and their association insofar as older adults wellbeing may be jeopardized. Methods and Procedures Articles extracted from major electronic data bases that addressed the current topic of interest were used. Key findings regarding the syndromes of frailty and fear of falling were duly downloaded, analyzed and summarized in narrative form. Results A high proportion of older adults can be expected to exhibit frailty or become frail as they age. Many too are at risk for falls and fear of future falls, regardless of frailty status. A persistent fear of falls may however, heighten frailty risk or manifestations if not duly addressed in a timely manner. Conclusion Prompt comprehensive assessment of at risk older adults, as well as the frail and pre frail older adult, plus those who have fallen may avert serious injury and long term disability plus excess frailty and its deleterious impacts this syndrome has on aging older adults as well as societies.
May 2021 DOI 10.14302/issn.2470-5020.jnrt-21-3843
R. Plasencia AndrésCorresponding author
Department of Neurointerventional Radiology at Clínica Internacional de San Borja, Lima, Peru
Background Perimedullary arteriovenous fistulae, or type IV spinal cord arteriovenous malformations, are very rare and not well-known lesions. This paper aims to present our endovascular experience with these lesions. Methods We report our experience with 4 patients with perimedullary arteriovenous fistulae, subtypes b and c (macrofistulae), exhibiting severe neurological impairment. The patients were treated with endovascular embolization. Results Complete fistula eradication was achieved in all of them. One complication occurred. We discuss the natural history, pathophysiology, clinical presentation, prognosis and embolization techniques, along with the angiographic and clinical outcomes. Conclusion Our experience with endovascular embolization as an upfront treatment allowed us to eradicate these lesions in a safe and effective way, arresting the clinical worsening and reversing partially or completely the neurological injury in most of our cases.
Dec 2020 DOI 10.14302/issn.2470-5020.jnrt-20-3629
K QuenumCorresponding author
Neurosurgery Departement of Parakou University Chud/Ba, Republic of Benin
Introduction The extra dural hematoma is a blood collection between the cranial vault and the dura mater. It is a neurosurgical emergency whose statistical data are poorly known in the Republic of Benin. Objective The aims of this study are to assess epidemiology, therapeutic and outcome of traumatic extra dural hematomas for children admitted to the surgical department of CHUD-B/A from 2012 to 2017. Methods This was a cross-sectional, descriptive and retrospective study over a period from January 1st, 2012 to December 31st, 2017. Results One hundred and seventy-eight cases of children aged between 0-15 years were examined for brain traumatic injury. Twenty-seven 27 (15.2%) cases of extra dural hematomas were retained. The most represented age group was between 11-15 years with a frequency of 42.1%. The male sex was more represented (78.9%). Road traffic accidents were the main aetiology (57.9%). 52.6% had a mild head injury, 26.3% had a moderate head injury and 21.1% had a severe head injury. On brain scan the frequently observed location was temporo-parietal (31.6%). Acute anemia was observed in 16 children. Seventeen children were operated on. The operation involved evacuation of extra dural hematoma by cranial bone flap with suspension of the dura mater. There were no deaths. Conclusion The availability of brain CT makes the diagnosis of extra dural hematoma easier. Its management is neurosurgical with a favourable post-operative evolution in all cases in this series.
Nov 2020 DOI 10.14302/issn.2693-1176.ijgh-20-3612
Sah BikashCorresponding author
Associate Professor, Department of Forensic Medicine and Toxicology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Spontaneous rupture of the urinary bladder (SRUB) is a rare clinical condition. Prompt diagnosis is often difficult both clinically and radiologically and necessitates a high index of suspicion as the patients present with non-specific abdominal pain and may not offer a clear history. The depressant effect of alcohol further complicates the diagnosis. We report a case of a young male who was unable to seek medical support and was found dead within 12 hours of the onset of abdominal discomfort following acute alcohol intoxication. At autopsy, rupture of the urinary bladder with blood and blood clots was found in the pelvic cavity with no any corresponding external injury. Spontaneous rupture of the urinary bladder is a rare cause of death in acute alcohol intoxication. In order to further understand this rare condition, the review of related literature has been done.
Aug 2020 DOI 10.14302/issn.2641-7669.ject-20-3529
Wen XianjieCorresponding author
Department of Anesthesiology, the Second People`s Hospital of Foshan City, Foshan, Guangdong Province, China.
Background Local anesthetic neurotoxicity is a common complication in clinical anesthesia, which can cause permanent nerve damage in severe cases. The T-type calcium channel is an important channel for regulating the excitability of neurons. Normally, extracellular calcium ions enter the cell through the T-type calcium channel to change the excitability of neurons. When the intracellular calcium is overloaded, it can cause cell damage. Aims To investigated the roles of T-type calcium channel in the SH-SY5Y cells injury induced by the bupivacaine. Methods The SH-SY5Y cell culture model was used to observe the effect of T-type calcium channel blocker NNC55-0396 on the neurotoxicity of bupivacaine hydrochloride by MTT methold,flow cytometry, Western blotting and other methods. Results The results show that NNC55-0396 can block the T-type calcium channel of SH-SY5Y cells, improve the decrease of cell viability caused by bupivacaine hydrochloride, reduce the level of intracellular calcium ion, reduce the expression of Cleavedcaspase-3, and reduce cell apoptosis. Conclusion The above results indicate that the T-type calcium channel is involved in the SH-SY5Y cell damage caused by bupivacaine hydrochloride, and blocking the T-type calcium channel can reduce the neurotoxicity of bupivacaine hydrochloride.
Aug 2020 DOI 10.14302/issn.2474-7785.jarh-20-3495
Marks RayCorresponding author
Department of Health and Behavior Studies, Teachers College, Columbia University, NY 10027, United States
Hip fractures, which remain highly prevalent among the elderly and produce enormous social and economic costs, have not truly abated in prevalence despite years of research that outlines a multitude of preventable risk factors and intervention programs. This review aimed to examine if sleep disturbances have a bearing on the risk of incurring a hip fracture directly or indirectly, among older adults. The specific aim was to explore and summarize what we know, and how this might inform future research and practice. To this end, PUBMED, Web of Science, Scopus, and Google Scholar data bases were searched to uncover available data representing the topic of sleep in relation to hip fractures among the elderly. Articles of note were scrutinized and summarized in narrative form. Results showed very few studies on the topic prevail, even with no restriction on years examined, and of these, discordant, rather than any solid uniform conclusions prevail. It is concluded there is a need to explore this topic carefully, including both the direct, as well as the indirect impact of sleep that may place an older adult at heightened risk for a fall and hip fracture injury as well as subsequent fractures.
May 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3357
Klepikov IgorCorresponding author
MD, Professor, Retired
This perspective calls for cross‑disciplinary brainstorming on novel COVID‑19 pneumonia phenotypes. It discusses hypotheses on immune dysregulation, microvascular injury, and tailored respiratory strategies.
Nov 2019
Miroslav Budoš MUDr.Corresponding author
Traumatology dep., Bata Hospital Zlín, Chzech Republic.
Modern medicine gives treatment options even in cases, where this has not been possible in the past. We want to present how negative pressure wound therapy (NPWT) helps in limb salvage. The case report brings our insight and experience on how to be successful with NPWT. We present a high-energy injury with an open tibial fracture IIIB according to Gustillo-Anderson classification 11. NPWT is an excellent option to treat extensive soft tissue injury. NPWT is also beneficial in the application of the dermoepidermal graft as we have found. We can confirm that this therapy contributed to a faster healing of soft tissues compared to classical wound healing.
Aug 2019 DOI 10.14302/issn.2470-5020.jnrt-19-2983
Léhleng AGBACorresponding author
Neurology Department, University Hospital Center of Kara, Kara University, PoBox 18 Kara (Togo)
Although it is a vaccine-preventable disease, tetanus is frequently found in sub-Saharan Africa. Because of its rarity, this disease poses two problems for doctors of the 21st century: to make early diagnosis in order to refer patients to appropriate care structures, and to continue to ensure correct prevention of an affection that few current doctors have met. In it generalized form, the diagnosis of tetanus is easy, but when the beginning is localized, tetanus can be change with other diseases leading to a diagnostic wandering and a delay of adequate management. We report a case of tetanus in an 18-year-old male, who was received for neck pain and stiffness of the neck with a positive Kernig sign associated to fever since 48 hours. Initially treated for meningitis, the patient will develop at day 3 of hospitalization, the signs of generalized tetanus which led to evoked the diagnosis of tetanus. This diagnosis was reinforced by the notion of a rusty nail injury to the soles of the right foot 3 weeks before hospitalization and the absence of anti-tetanus vaccination. After using tetanus serum and vaccination with antibiotics (Metronidazole and Penicillin) and Diazepam in association with stripping of the wound under the foot, the patient was improved. This case illustrates that any neurological sign with the first trismus must evoke until proof of the contrary, a tetanus especially in case of association with a wound even if the immunization schedule is up to date.
Aug 2019 DOI 10.14302/issn.2574-4526.jddd-19-2963
J. Demos NicholasCorresponding author
Professor of Surgery, Rutgers Biomedical and Health Sciences, 65 Bergen St, Newark, NJ 07103
Four cases are reported with splanchnic aneurysms of the branches of the main arteries. Three of the cases presented as emergencies. Possible rupture was present in Case 2 and true rupture in Case 4. The etiology of Cases 1 and 2 may have been a floxacin antibiotics, Table 1. This report is the first clinical chronological association of the antibiotics and arterial and aortic pathology. This association was supported by nationwide research by Pasternak, 11. Detailed experimental work done on mice showed connective tissue fragmentation and arterial cell injury. Apparently, the above antibiotic induced mitochondrial DNA damage and dysfunction, 9.
Jul 2019 DOI 10.14302/issn.2694-2283.jsem-19-2938
Hinzpeter C JaimeCorresponding author
Medical Doctor, University of Chile, Clinical Hospital, Santiago Chile.
An anterior cruciate ligament (ACL) injury is an important cause of rest in athletes. In most cases, ACL injuries do not require external contact and they are associated with biomechanical risk factors that increase ACL tension. The increase of the hip flexion angle (HF) is included within these. The ACL requires cooperation of the periarticular musculature of the knee, muscle groups, hip stabilizers and CORE muscles; consequently, fatigue caused by exercise would alter the balance and put this ligament at risk. The objective of the study is to determine the angular behavior for HF before and after a physical load (a standardized training) in children between 11 and 12 years old. A non-randomized clinical study was carried out. The sample consisted of 50 soccer school students born between 11 and 12 years old. The angular behavior of HF was compared before and after performing a training session. The angular behavior was measured through the Drop Jump test (DJ), with data obtained by inertial sensors. After the exercise, there was a significant increase in HF. It was concluded that the angular behavior of HF increases significantly in both extremities after training and that preventive measures must be applied for neuromuscular control of the hip.
Jul 2019 DOI 10.14302/issn.2694-2283.jsem-19-2949
Hinzpeter JaimeCorresponding author
Department of Orthopaedic Surgery, Clinical Hospital, University of Chile, Santos Dumontt # 999, Independencia, Zip Code: 8380456, Santiago, Chile.
Background The Anterior Cruciate Ligament (ACL) injury is uncommon, but constitutes an important percentage of the lesions requiring more than 8 weeks of recovery in sports. Most ACL injuries do not require external contact and are associated with biomechanical risk factors that stress this ligament ACL: like an increase in knee valgus angle (KV) and hip flexion (HF) and a decreased in knee flexion (KF). The ACL requires muscle cooperation to resist the load; however, when there is fatigue, the protective capacity of the musculature would decrease. The objective of the study is to analyze the angular behavior before and after a physical load for HF in children of 14-15 years old. Hypothesis The physical load applied in a single training session is enough to change some biomechanical risk factors of ACL injury. Study Design Experimental study Level of Evidence 2b Methods The sample consisted of 50 students from different soccer schools between 14-15 years old. We analyzed the hip angular behavior of hip flexion before and after a training session. The angles where obtained from inertioal sensor while the students performed a Drop Jump test from a 30 centimeters drawer. Results Statistically significant differences were found in the differences between pre physical load HF / post-load HF (p = 0.00053), right pre physical load HF / right post- load HF (p = 0.0086) and left post- load (p = 0.0248206). Conclusions It was concluded that the angular behavior of HF increases significantly in both post-training limbs, after performing a physical load. Clinical Relevance This study analyzed the importance of using prevention injury programs since early stages, and give importance to the eccentric role of hamstring, gluteus and core exercises.
Jun 2019 DOI 10.14302/issn.2474-3585.jpmc-19-2750
Konadu-Yeboah DominicCorresponding author
Orthopaedic and Trauma Surgeon, Komfo Anokye Teaching Hospital, Kumasi, Ghana, Part-Time Lecturer, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
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.
Nov 2018 DOI 10.14302/issn.2642-3146.jec-18-2416
K.G. Palmer WilliamCorresponding author
Independent Researcher, TRI-LEA-EM, 76 Sideroad 33-34, RR 5, Paisley, ON N0G 2N0, Canada.
Wind turbines are often perceived as benign. This can be attributed to the population majority dwelling in urban locations distant from most wind turbines. Society may understate the risk to individuals living near turbines due to an overstatement of the perceived benefits of turbines, and an understatement of the risk of injury from falling turbine parts, or shed ice. Flaws in risk calculation may be attributed to a less than fully developed safety culture. Indications of this are the lack of a comprehensive industry failure database, and safety limits enabling the industry growth, but not protective of the public. A comprehensive study of wind turbine failures and risks in the Canadian province of Ontario gives data to enable validation of existing failure models. Failure probabilities are calculated, to show risk on personal property, or in public spaces. Repeated failures, and inadequate safety separation show public safety is not currently assured. A method of calculating setbacks from wind turbines to mitigate public risk is shown. Wind turbines with inadequate setbacks can adversely impact public health both directly from physical risk and indirectly by irritation from loss of safe use of property. Physical public safety setbacks are separate from larger setbacks required to prevent irritation from noise and other stressors, particularly when applied to areas of learning, rest and recuperation. The insights provided by this paper can assist the industry to enhance its image and improve its operation, as well as helping regulators set safety guidelines assuring protection of the public.
Oct 2018 DOI 10.14302/issn.2577-2279.ijha-18-2384
A. Hegazy AbdelmonemCorresponding author
Human Anatomy and Embryology department, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt
Background: Oral ingestion of zinc oxide nanoparticles (ZnONPs) may lead to serious liver injury. Vitamin E (VE) is an important antioxidant factor that can reduce such damage. Aim: This study aimed to evaluate the possible changes that could take place in the liver of adult male albino rats after oral ingestion of ZnONPs and elucidate the potential protective role of VE against such damage. Material and Methods: Forty eight male albino rats were divided into four groups of 12 animals each. Group (1) served as control group and received normal saline. Group (2) “VE-treated” received 100 mg/kg/day of VE dissolved in normal saline by oral gavage for 21 days. Group (3) “ZnONPs-treated” received a daily dose of ZnONPs dispersed in the fresh sterilized physiological saline solution 1mg/kg for 5 constitutive days. Group (4) “concomitant ZnONPs and VE-treated” was pretreated with VE 100 mg/kg/day for 14 days followed by the same dose of ZnONPs as in group (3) for 5 days. The extent of hepatic damage was evaluated by histological and immunohistochemical examination of liver samples and serological analysis of liver enzymes. Results: Body weights and liver weights showed very highly significant decrease (P <0.001) in the ZnONPs-treated group. The histological results in ZnONPs-treated group revealed congested dilated central veins and blood sinusoids, loss of normal arrangement of hepatocytes and most of hepatocytes showed marked vacuolated cytoplasm with darkly stained nuclei. Portal area affection was in the form of congested dilated portal veins with bile duct hyperplasia and cellular infiltration. There was an increase in the mount of blue stained collagen fibers around central veins together with strong positive reaction for Caspase 3 in ZnONPs-treated group. Similarly biochemical analysis indicated that the levels of serum aminotransferase (AST &ALT) significantly increased in ZnONPs-treated group when compared with other groups. Rats pretreated with VE showed improvement of the histological findings and biochemical parameters. Conclusion: Ingestion of ZnONPs could be associated with serious liver affection and pretreatment with VE is suggested to induce some improvement of such deleterious changes.
Aug 2018 DOI 10.14302/issn.2474-3585.jpmc-18-2178
N. Rousanoglou ElissavetCorresponding author
Sports Biomechanics Lab, Section of Sport Medicine & Biology of Exercise, School of Physical Education & Sport Science, National & Kapodistrian University of Athens, Greece.
Several studies examine the musculoskeletal pain (MSP) in university students sustaining physical load as part of their compulsory learning. However, only two somewhat outdated cross-sectional studies examine the physical education teacher (PET) students. This study aimed to explore the neck, shoulder and low back MSP prevalence in Greek PET students in a series of academic years. The Nordic Musculoskeletal Questionnaire was used to record the past 12-month neck, shoulder and, low back pain, across three academic years (n = 479). The year association to MSP prevalence was examined with the cross-tabulation analysis (using the column proportion test for the year comparison) and, the gender association to MSP prevalence with the χ2 test (SPSS 22.0, p ≤ 0.05). The year association to MSP prevalence was not significant (p > 0.05). The overall prevalence was 67.6%, with multiple pain at 25.7% and, the low back presenting the highest prevalence (40.9%). Women reported a higher prevalence of neck (36%) and low back (47%) pain (p ≤ 0.05). The majority of pain and time loss duration was 1-7 days. The low back required higher medical attention (19.0%) than the neck (9.2%) and the shoulder (12.9%). The recurrent pain was at 30%, with the previous injury/accident rate at 5.8%, 14.4% and 14.6% for the neck, shoulder and low back. Our PET students present an alarming MSP prevalence. Due to their distinct work demands as PE teachers, entering working life with the healthiest possible musculoskeletal system is of critical importance. Thus, university authorities should consider strategies for the prevention of MSP risk.
Feb 2018 DOI 10.14302/issn.2766-6204.jmpt-17-1913
NF TepeneuCorresponding author
Department of Pediatric and Adolescent Surgery, General Hospital Klagenfurt, Austria
The three most common elbow fractures classically reported in pediatric orthopedic literature are supracondylar (50–70%), lateral condylar (17–34%), and medial epicondylar fractures (10%). The mechanism of injury varies, but the most commonly described mechanism involves a fall on an outstretched hand with varus, valgus or rotational force or a combination thereof. The vectors of force and the degree of chondro-osseous development dictate the type of injury incurred. A review of the literature was conducted to see the most frequent injuries and complications.
Jan 2018 DOI 10.14302/issn.2694-2283.jsem-18-1924
V. Grivas GerasimosCorresponding author
Department of Physical Education and Sport Science University of Thessaly, Greece
An editorial introduces the journal, emphasizing multidisciplinary sports medicine, injury prevention, and performance science.
Dec 2017 DOI 10.14302/issn.2640-6403.jtrr-17-1818
Manuela BesserCorresponding author
University Witten/Herdecke, Centre for Biomedical Education and Research (ZBAF), Dpt. Of Translational Wound Research
If a wound progressively heals or the healing process is impaired is basically influenced by the surrounding milieu. This is reflected by the wound fluid. Its specific composition triggers the migration, proliferation and differentiation of dermal and epidermal cells which so far was not sufficiently examined in 2D cell culture models. The influence of the different wound entities was analyzed on a newly implemented three dimensional in-vitro model, which improved the transferability to the in-vivo situation. The influence of pooled wound fluids from patients suffering from acute or chronic wounds were investigated within a time period of 10 days after wound application. Histological and immunohistochemical analyses were performed addressing the impact of AWF and CWF on regeneration, such as cell proliferation, fibroblast activity and cell migration. AWF slightly stimulated fibroblast migration while CWF inhibited their activation and migration. The CXCR4- immunopositive population was continuously decreased compared to the control and AWF treatment. The expression of FAP was enhanced under AWF and medium. In keratinocytes CWF massively stimulated cell proliferation initiating on day six after injury. The presence of 10% CWF inhibited fibroblast activation and migration and induced the degradation of the collagen matrix. Keratinocytes were stimulated to proliferate, resulting in healing inhibiting hyperplasia. Transferred to human wounds, no effective wound closure would be achieved because of the de-regulation of pro-proliferative and migration-stimulating factors and a degraded extracellular matrix. This newly implemented 3D study model represents a novel appropriate in-vitro system for studying healing mechanisms and potential therapeutic applications.
Dec 2017 DOI 10.14302/issn.2641-7669.ject-17-1789
M.E.Abdel-Salam OmarCorresponding author
Departments of Toxicology and Narcotics
We aimed to study the effect of buspirone, an anxiolytic drug and 5-HT1A agonist on liver injury induced by carbon tetrachloride (CCl4) in rats. Rats were orally treated with CCl4 (2.8 mL/kg in olive oil) along with buspirone at 10, 20 or 30 mg/kg once daily starting with CCl4 and for one week thereafter. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) as well as alkaline phosphatase (ALP) activities were determined in the serum. Markers of oxidative stress: lipid peroxidation (malondialdehyde; MDA), reduced glutathione (GSH), nitric oxide (nitrite/nitrate) levels were measured in the liver. Moreover, paraoxonase 1 activity was determined in the liver and serum. The administration of CCl4 led to significant increases in serum ALT, AST, and ALP activities. Results showed that there were significantly increased hepatic MDA, nitrite and decreased GSH levels. PON1 activity decreased both in the liver and serum, respectively. The immunohistochemical investigations using anti-caspase-3 antibody revealed that CCl4 caused apoptosis to many hepatocytes. DNA studies showed that CCl4 caused hypoploidy in hepatocytes. Rats treated with 20-30 mg/kg buspirone showed significant decrease in serum ALT and AST by 19.5-34.3% and 24.2-31.4%, respectively. Serum ALP decreased by 21.7% after 30 mg/kg buspirone. In the liver, the higher dose of the drug resulted in decreased MDA (by 15.8%), decreased nitric oxide (17.4%) and increased GSH (by 20.1%). Significantly increased serum PON1 activity by 43.9-53.5% was observed after treatment with 20-30 mg/kg buspirone. On histopathologic examination of liver sections, there was mild protective effect for the drug at 30 mg/kg. Sections stained with anti- caspase- 3 confirmed the results obtained from histopathological examination. Moreover, buspirone given at 30 mg/kg resulted in an increase in % of cells containing normal values of DNA. These results indicate that buspirone decreases liver oxidative stress and exerts protective effect against CCl4- toxicity. The study thus indicates more beneficial effects of buspirone as an anxiolytic drug and that the drug could be used safely in patients with liver disease.
Oct 2017 DOI 10.14302/issn.2381-862X.jwrh-17-1758
U MazumderCorresponding author
Department of Obstetrics and Gynaecology, Dhaka Medical College, Dhaka , Bangladesh,
Background: The nature of placenta previa can be unpredictable and harsh on the mother and baby. These complications are often unpredictable, unpreventable and often leave the labour ward team in a dilemma. This Obstetricians' nightmare is fortunately a rare complication. The frequency of placenta previa at the time of delivery average 1/200 births i.e. 0.5%. Placenta previa is still an important cause of maternal and fetal death in our country. The risk factors are Advanced Maternal age, Multi parity, Previous Cesarean Section, Multiple gestation, Previous Abortions, Previous intrauterine surgery, placenta previa in previous pregnancy, Smoking. Objective: Identification of risk factors, the feto-maternal outcome and complications of patients having placenta previa with previous caesarean section. Methodology: This cross sectional study was conducted from July 2012 to June 2015 in Obstetrics and Gynaecology department, Dhaka Medical College hospital. 100 patients of placenta previa were included in this study. Non-probability purposive sampling method was used for selection of patients. Results: In this study, Socio-demographic profiles, Identification of risk factors, the feto-maternal outcome and complications of patients having placenta previa were assessed. The frequency of placenta previa associated with previous cesarean section was 61%. In demographic profiles of the patients in this study - with a history of previous caesarean section, 78.7% patients were in the age group 26-35. Multiparity was predominant on scarred uterus group (63.9%). Here, demonstrated that > 2 previous history of caesarean section was associated with 80.3% of placenta previa. Regarding maternal outcome, complications like massive haemorrhage, ureteral injury, bladder injury, wound infection, DIC, maternal and perinatal mortality were more in the scarred patients than in the unscarred patients. In our study, 29.5% of morbid adhesion of placenta observed in scarred uterus. Conclusions: There is significant association of placenta previa with previous cesarean delivery. So, Careful monitoring of high risk pregnancies is of utmost importance. Avoidance of unnecessary caesarean sections and early week’s pregnancy terminations can minimize the Obstetricians' nightmare.
Aug 2017 DOI 10.14302/issn.2471-2140.jaa-17-1541
Yu ZhiCorresponding author
College of Horticulture and Forestry Science, Huazhong Agricultural University, Key Laboratory of Horticultural Plant Biology, Ministry of Education, No. 1 Shizishan Street, Hongshan District, Wuhan City, Hubei Province, China 430070
In the present study, we investigated the chemical compositions, in vitro antioxidant and in vivo hepatoprotective activities of two tea polysaccharides (TPS), which were extracted from two different tea cultivars, Yingshuang (Camellia Senesis, T01) and Yunnan Dayezhong (Camellia Senesis, T09). Compared with T09-TPS, T01-TPS had lower contents of neutral sugar, protein, uronic acid and polyphenol. However, T01-TPS showed stronger scavenging abilities for transient free radicals of hydroxyl radical and superoxide anion radicals and lipid peroxidation inhibition effect, but weaker scavenging ability for stable free radical of DPPH. For hepatoprotective activity in vivo, the results demonstrated that both T01-TPS and T09-TPS could significantly prevent the increase of serum alanine aminotransferase and, aspartate aminotransferase levels, decrease the liver index, reduce the formation of malonydialdehyde and enhance the activities of superoxide dismutase, glutathione peroxidase and peroxidase in carbon tetrachloride-induced liver injury mice. These results suggest that T01-TPS and T09-TPS have potent antioxidant and hepatoprotective activities.
Jul 2017 DOI 10.14302/issn.2471-2140.jaa-17-1630
Aholia Jean- Baptiste AdépoCorresponding author
Laboratoire de Toxicologie et Hygiène Agro-industrielle, UFR Sciences Pharmaceutiques et Biologiques, Université Félix Houphouët-Boigny, BP V 34, Abidjan, Côte d’Ivoire
Introduction: Aflatoxins are cytotoxic andserve as one of the key risk factors of hepatocellular carcinoma. Currently, plants and extract are widely used as potential scavenging substances for the detoxification of mycotoxins. Thus, this study aims to investigate the activity of the crude ethanolic leaves extract from Alchorneacordifolia in aflatoxicosis prevention. Material and Methods: The phytochemical screening was performed through qualitative analysis based on coloring and/or precipitation reactions. Groups of rats were treated daily with a mixture dose of aflatoxin B1 (AFB1) at 150 µg/kg and the crude extract of Alchorneacordifolia at doses of 50, 100, and 300 mg/kg for 21 days. The body weight, biochemical, and histological assessments were determined. Results: The phytochemical screening revealed the presence of polyphenols, flavonoids, sterols and terpenoids, quinoid compounds, tannins catechic and alkaloids. AFB1 treatmentcaused a significant increase of transaminases, urea, and creatinine abundances but reduced the rates of albumin and total proteins. Alchorneacordifolia administration alleviated biochemical parameters and body weight gain compared with the AFB1 group (p<0.05). The histological lesions of organs (liver and kidney) caused by AFB1 were significantly improved after administration of the extract at a dose of 300 mg/kg. Conclusion: This plant plays a beneficial role in AFB1-induced injury and may be used in the treatment of aflatoxicosis.
Jun 2017 DOI 10.14302/issn.2473-1005.jdoi-16-1193
Mugisha Rwenyonyi CharlesCorresponding author
Department of Dentistry, College of Health Sciences, Makerere University, Kampala
The objective of the study was to establish the role of helmet use on severity and pattern of maxillofacial injuries among motorcycle crash victims attending Mulago Hospital. This was descriptive cross sectional case series study using a questionnaire in form of an oral interview, clinical examination and review of medical records of the patients. The pattern of injuries was assessed based on the demarcated regions of the face. The severities of the injuries were scored using the Facial Injury Severity Scale. The data were analysed using SPSS version 17.0. There were 105 participants (male/female: 97/8) aged 15 to 63 years. Most participants (n= 74, 70.5%) were riders and the rest were passengers. There were no female riders. Most participants were from Kampala and surrounding districts. Overall, 35.2% of the participants had helmets: 50% of the riders and 0% of the passengers. About 73% o the participants used Three Quarter Shell helmet design. There was no significant difference in the pattern of injuries between the passengers and non helmeted riders (p=0.076). There was a higher frequency helmeted riders (n = 15, 40.5%) with pan-facial fractures compared to other participants. Non helmeted riders and passengers had significantly more injuries to the lower two thirds of the face compared to the helmeted riders. Passengers had less severe facial injuries compared to riders. We conclude that about a third of the participants who were riders used helmets, being particularly the Three Quarter Shell design. The helmeted riders had more severe maxillofacial injuries and of panfacial category as compared to other participants. The passengers had least severe injuries compared to riders. It is recommended to carry out further studies to elucidate on motorcycle related maxillofacial injuries especially in regard to the quality of helmets and their adequate use.
May 2017 DOI 10.14302/issn.2470-0436.jos-17-1453
Zhang JieCorresponding author
Department of Ophthalmology, Faculty of Medical and Health Sciences, University of Auckland, Private bag 92019, Auckland 1142, New Zealand.
Purpose: High intraocular pressure (IOP) is known to result in retinal ganglion cell (RGC) loss, both with chronically raised intraocular pressure (such as with glaucoma) and with acute raises in pressure (due to injury or acute angle closure). Because IOP is often raised during ocular surgery, the purpose of this study was to evaluate the effect of transient moderate IOP on retinal function, RGC survival and the expression of Connexin 43 (Cx43) and glial fibrillary acidic protein (GFAP), ubiquitously expressed central nervous system (CNS) proteins that are known to be elevated during the retinal inflammatory response to injury. Materials and Methods: Wistar rats were exposed to transient IOP at 40 mmHg for 5 or 30 minutes, and 60 mmHg for 5 minutes (via cannulation of the anterior chamber with a saline reservoir raised to a height corresponding to the desired IOP), mimicking potential IOP rises during surgery such as DSAEK and some laser procedures (LASIK and femtosecond laser cataract surgery). Separate groups of animals had IOP maintained at 10 mmHg for 5 or 30 minutes as cannulation controls, or 120 mmHg for 60 minutes as positive controls. Changes in the optic nerve and retina were assessed immunohistochemically for GFAP and Cx43 expression. Retinal function was assessed using electroretinography (ERG) recorded at baseline and 14 days after the IOP rise and compared with RGC counts. Results: Results showed that there was a differential GFAP labelling pattern observed in the anterior optic nerve in the 40 mmHg 30 minute and 60 mmHg 5 minute groups 4 hours after manipulation. Gap junction protein Cx43 was minimally up-regulated in the retina in the short-term. There was, however, minimal long-term effect on retinal function and no RGC loss. Conclusions: n conclusion, elevations of IOP that are short in duration such as those occurring during surgical procedures, do not cause significant changes long-term in retinal function or RGC survival. Key Messages: Cx43 and GFAP are known to be elevated during the retinal inflammatory response to injury. No previous study has explored the effect of moderate and relatively short increases in IOP on the initial inflammatory response. We observed a mild glial inflammatory response in the anterior optic nerve, but only a minimal up-regulation of Cx43. However, transient and moderate IOP rises did not induce long term disruption to RGC function or number as measured by electrophysiology and RGC counts, respectively. This is applicable to clinical practice, as it means the IOP elevations that occur during some surgical procedures are unlikely to be causing long term damage in retinal function or RGC survival.
Feb 2017 DOI 10.14302/issn.2374-9431.jbd-17-1429
Yasmin-AktarCorresponding author
Bangladesh Medical College Hospital (BMCH), Dhaka, Bangladesh
Objectives: To observe pregnancy outcomes in gestational diabetes mellitus (GDM) under treatment. Methods: Pregnant mothers (N=191) diagnosed with GDM (n=91, age: 27.44±4.91yr; body mass index, BMI: 26.88±4.16 kg/m2; mean±SD) on the basis of WHO 2013 criteria were compared with non-GDM (n=100, age: 26.01±4.81yr, BMI: 25.53±3.77 kg/m2, mean±SD) for pregnancy outcome irrespective of gestational age. HbA1c was also measured in all mothers. Gestational hypertension, preeclampsia, premature rupture of membrane (PROM), hydramnios, recurrent urinary tract infection (UTI), recurrent moniliasis, intrauterine growth retardation (IUGR), intra uterine death (IUD), mode of delivery, birth weight, birth injury, neonatal hypoglycemia, hyperbilirubinemia, respiratory distress syndrome (RDS), congenital anomaly were recorded at every trimester. 160 mothers (GDM=75, non-GDM=85) could be followed for outcomes to the end of pregnancy. All the GDM mothers were offered standard treatment throughout pregnancy period. Results: HbA1c was significantly higher in GDM than that in non-GDM (5.42±0.61 vs. 4.98±0.44%, mean±SD; p<0.001).Outcome events in GDM and non-GDM were: gestational hypertension- 3.6% vs. 2.3% (p=0.621), preeclampsia- 2.4% vs. 0% (p=0.150), PROM- 4.9% vs. 0% (p=0.037), hydramnios- none in any group, recurrent UTI- 12.3% vs. 4.7% (p=0.073), recurrent moniliasis- 0.0% vs. 2.3% (p=0.165), caesarian section- 85.3% vs. 72.9% (p=0.056), small for gestational age (SGA)- 26.4% vs. 36.7% (p=0.246), large for gestational age (LGA)- 1.4% vs. 0%, p=0.246, IUGR- 2.3 vs. 2.5% (p=0.952), neonatal hypoglycemia- 2.7% vs. 0.0% (p=0.130), hyperbilirubinemia- 12.0% vs. 11.8% (p=0.963), RDS- 0.0% vs. 2.4% (p=0.181) and birth injury- 0.0% vs. 1.2% (p=0.346), congenital anomaly- 4.0% vs. 1.2% (p=0.254) and abortion- 1.3% vs. 0.0% (p=0.286). Preterm delivery (12.0% vs. 7.1%, p=0.285) and caesarean section (85.3% vs. 72.9%, p=0.056) were more in GDM. Conclusions: Despite treatment, adverse events were relatively higher but non-significant in GDM.
Jul 2016 DOI 10.14302/issn.2474-3585.jpmc-16-1118
Shelli Stephens-StidhamCorresponding author
We used the five dimensions of the RE-AIM model to evaluate a smoke alarm (SA) installation program called Operation Installation (OI), which was implemented in 36 high risk census tracts in Dallas, TX, from 2001-2011. More than 20,000 SAs were installed in 8,134 houses through OI. The RE-AIM model showed that the program had a modest reach into the target population (26.5%), and a relatively high effectiveness (63%) at preventing deaths and injuries in program houses. Adoption and implementation remained high throughout the time period. Individual level maintenance of SAs was high initially (91.8%), but rapidly declined and was only 20% after 10 years. Application of the RE-AIM model to evaluate this long-term SA installation program highlighted areas that warranted improvement, especially for the dimensions of Reach and individual-level Maintenance. The model may be useful for evaluating the impact of other injury prevention programs.
Jul 2016 DOI 10.14302/issn.2473-1005.jdoi-16-1080
Guenka Palma-Dibb ReginaCorresponding author
Department of Restorative Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo. Av. Café, s/nº - CEP: 14040-904 - Monte Alegre. Ribeirão Preto – SP, Brazil.
When a composite resin restoration is photopolymerized, a considerable amount of heat can be produced, potentially causing pulpal injury. Objective: Evaluate the influence of the type of light source and remaining dentin thickness on the temperature increase in the pulp chamber while curing composite resin restorations. Material and Methods: Ninety-six tooth fragments obtained from bovine incisors were divided into groups/subgroups (n=12), according to the light source (LED and halogen light) and remaining dentin thickness (3.5, 3, 2, and 1mm). Class I cavities were prepared and restored with a composite resin. A temperature increase was obtained during photopolymerization of the adhesive and each composite increment. Data were analyzed using ANOVA and Fisher’s Test (α=5%). Results: LED promoted higher temperature increments when compared with the halogen light. Temperature levels were the lowest for 3.5mm-thick and the highest for 1mm-thick remaining dentin. Levels registered during the photopolymerization of each composite increment were superior for LED. Conclusions: Both light sources result in temperature increases above 5.5°C. Additionally, the remaining dentin thickness of 1mm promoted the largest temperature increase.
Feb 2016 DOI 10.14302/issn.2473-1005.jdoi-15-912
M. Ozbek SelcukCorresponding author
Endodontist Dt. Ph.D., Ministry of Health, Oral and Dental Health Hospital, Eskişehir, Turkey.
A healthy 55-year-old man was referred to the Department of Endodontics, Oral and Dental Healthy Hospital, Eskişehir suffering from pain and paraesthesia in the left lower lip and chin.A panoramic radiograph revealed the presence of broken endodontic instrument beyond the apex of the mandibular left third molar. A cone beam computed tomography (CBCT) examination was undertaken, which revealed that the broken instrument was inside the mandibular canal. Damage to the inferior alveolar nerve (IAN) secondary to extrusion of a broken endodontic instrument was diagnosed. Extraction of the tooth was decided and the patient was prescribed with 1 mg/kg/day prednisone 2 times/day, once-daily regimen, and 150 mg/day pregabalin, two doses per day, monitoring the progress with periodic follow-up visits. One month after the incident, the signs and symptoms were gone. The complete resolution of the paraesthesia and the control of pain achieved in the present case suggest that surgical removal of broken endodontic instrument extruded into the mandibular canal with the use of prednisone and pregabalin is a good option in the management of inferior alveolar nerve injury.
Dec 2015 DOI 10.14302/issn.2470-5020.jnrt-15-701
Tong Dao-MingCorresponding author
Department of Neurology, Affiliated Shu Yang People′s Hospital, XuZhou Medical University, Jiangsu, China
This case contrasts reversible cerebral lesions with areas of irreversible necrosis following cardiorespiratory arrest. The authors discuss imaging evolution, mechanisms of hypoxic–ischemic injury, and implications for prognostication and rehabilitation.
May 2015 DOI 10.14302/issn.2379-7835.ijn-14-584
W. Hey DavidCorresponding author
STRIDE California Polytechnic State University, San Luis Obispo, CA 93407
During the past three decades the prevalence of childhood obesity has steadily increased in the United States. Causes of childhood obesity are complex and include numerous individual and environmental factors. The purpose of this study was to determine parent perceptions on the social-ecological barriers (community, school, and family) to physical activity and healthy eating, perceived specific to their children. Self-reported data gathered from a 50-item questionnaire and six focus groups were conducted with parents (n=43) enrolled in the Women, Infants, and Children (WIC) Program. Participants (16 to 67 years old) were predominately female (88.4%), Hispanic (67%), low income, and living in or near Lompoc in Santa Barbara County, CA. The social-ecological model (family, school, and community) was utilized to create focus group questions and provide recommendations as part of the Lompoc Community Health Improvement Project (2006-to-the-present). Popular community barriers for physical activity were: disconnected sidewalks, lack of safe bike routes to school, lack of recreational programming at an affordable cost, and language barriers (lack of marketing physical activity programs in Spanish). Two safety barriers involved parks; fear of injury (dilapidated equipment) and fear of gangs (violence). Common school barriers were: teachers do not lead-by-example, lack of healthy food in school cafeteria, and insufficient time for children to purchase food and eat. Family barriers included: grandparents sabotaging healthy eating environments (e.g., spoiling children), insufficient nutrition knowledge (both children and parents), and economics (not being able to afford healthy food and a recreation/gym membership).
May 2015 DOI 10.14302/issn.2470-5020.jnrt-14-483
Raglio AlfredoCorresponding author
Department of Biomedical and Specialistic Surgical Sciences, Section of Neurological Clinic, University of Ferrara, Via Aldo Moro 8, 44100 Cona, Ferrara, Italy.
In the last years we could find many uses of music in different clinical settings, also in the field of neurology. In this field empirical results, but also scientific studies, showed the efficacy of music interventions on psychological, cognitive and motor aspects. This is consistent with strong effects of music on brain areas. Music can stimulate and modulate/regulate cognitive functions, behaviors, movements and emotions. Music plays an important role also from a psychological point of view, increasing motivation and promoting relationships and communication. Literature has showed how music interventions can improve behavioral, cognitive, motor, psychological, relational and emotional outcomes in different neurological pathologies. Significant results are present in particular in dementia, stroke and Parkinson's disease. We can find also minor results and qualitative research approaches in multiple sclerosis and in other brain injury such as vegetative and minimally conscious state. More rigorous methodologies and criteria of research are needed to support and strengthen the therapeutic value of music.
May 2015 DOI 10.14302/issn.2470-5020.jnrt-14-520
Li Hai-fengCorresponding author
Department of Neurology, Qilu Hospital of Shandong University, Jinan, China
This article has been retracted on November 20, 2015. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2470-5020.jnrt-25-5846) In-stent thrombosis (IST) is a complication of angioplasty and stenting, especially in the vessels with smaller diameter. We present a case of subacute IST after stenting treatment of an isolated higher stenosis of the right middle cerebral artery (MCA). Analysis of clinical features and emergent brain image helped to indicate the pathophysiological mechanism underlining the symptoms of this patient. Emergent Transcranial Doppler (TCD) helped to evaluate the compensatory collateral circulation and provided good supporting evidence in deducing the mechanism of IST. Slightly larger size of the implanted stent that caused dissection or vascular endothelium injury was presumed in this patient. Persistent evidence of inflammatory factors might also contribute to IST in this patient.