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Dec 2024 DOI 10.14302/issn.2474-9273.jbtm-24-5317
Ndje Mireille NdjeCorresponding author
Adolescence in Cameroon, as in many parts of sub-Saharan Africa, is often marked by early childbearing. Studies have shown a national prevalence of adolescent deliveries to be around 14.2% - 14.4%, a higher rate than the average for sub-Saharan Africa This presents a unique challenge for young mothers, who must navigate the complex process of identity reorganization while still navigating their own adolescence with its multiple changes. This article explores the experiences of primiparous (first-time) Cameroonian adolescents as they transition from daughters to mothers. The objective of this article is to understand how identity reorganization takes place among primiparous Cameroonian adolescents who pass without transition from the status of daughter to the status of mother. Drawing on qualitative data from semi-structured interviews, with seven participants chosen on the basis of selection criteria, the article examines the psychological, social, and cultural factors that shape this identity shift. An interview guide with three main themes made it possible to collect verbatim comments from the participants. The thematic analysis highlights the challenges faced by these young mothers, such as navigating social stigma, managing emotional upheaval, and balancing motherhood with their own developmental needs. The findings of this study highlight the complex and multifaceted nature of identity reorganization among primiparous Cameroonian adolescents. The social stigma associated with early childbearing, coupled with the emotional and practical demands of motherhood, can pose significant challenges to these young women. However, a study on a larger sample could reveal the resilience and resourcefulness of some adolescents, who find support within their communities and employ various coping mechanisms to navigate this transition. Finally, the article discusses the implications of these findings for adolescent maternal health interventions and social policy in Cameroon.
Jan 2024 DOI 10.14302/issn.2691-5014.jphn-23-4865
Abdullahi Dahie HassanCorresponding author
Background Breastfeeding is a vital practice for infant health and well-being, with exclusive breastfeeding (EBF) during the first six months being particularly crucial. Despite its benefits, EBF is sub-optimally practiced in many low-to-middle income countries. This study focuses on Somalia, a country with historical political instability and poor health indicators, aiming to identify the prevalence and determinants of exclusive breastfeeding among women with infants under six months attending SOS Mother and Child Hospital in Mogadishu. Methods A hospital-based cross-sectional design was used, and data were collected through a structured questionnaire. The study sample consisted of 345 mothers, selected using a systematic sampling technique. Descriptive, bivariate, and multivariate analyses were conducted to assess breastfeeding practices and determine factors influencing exclusive breastfeeding prevalence. Result The study found that the prevalence of exclusive breastfeeding among the study population in Somalia was 44%, influenced by factors such as maternal education, employment, and utilization of antenatal and postnatal care services. Male infants and younger infants had higher odds of being exclusively breastfed. Conclusion and recommendations The study emphasizes the importance of promoting exclusive breastfeeding as the optimal feeding practice for infants in Somalia, highlighting the need for comprehensive health education during antenatal care visits and postnatal counseling. It recommends the development of supportive policies, such as maternity leave and workplace accommodations, along with community-based initiatives and support groups to facilitate and encourage exclusive breastfeeding practices.
May 2023
Bouguerra FadouaCorresponding author
Background and Aim Breast cancer is the second most common cause of brain metastases after lung cancer. However, the incidence of cerebral metastases from breast cancer has increased during the last years. The purpose of this study is to determine the prognostic value of chemotherapy after whole-brain radiotherapy for patients with brain metastases from breast cancer. Methods We analyzed retrospectively 63 records of patients diagnosed with brain metastases from breast cancer and treated in the radiotherapy department at the Salah Azaiz Institute of oncology over a 5-year period between 2007 and 2011. All patients received whole-brain radiotherapy. Only 4 patients had surgical resection of the metastases before radiotherapy and 36.5% of patients received systemic treatment after irradiation. Results Overall survival was 19% at 1-year and median survival was 4,5 months. Univariate analysis indicated that systemic treatment after irradiation was correlated significantly with longer survival. (p=0,046). Conclusion Determining prognostic factors might help optimize individual treatment for metastatic breast cancer. The results of our study suggest that chemotherapy is more effective on brain metastases after irradiation. This can be explained by the fragilization of the blood-brain barrier by radiation and subsequently a better passage of cytotoxic agents.
Dec 2022 DOI 10.14302/issn.2693-1176.ijgh-22-4218
Oladunni OpeyemiCorresponding author
Adeleke University, Ede, Osun State Nigeria
Growth monitoring activities has been seen as the most effective ways to identify malnutrition and promotes early child development. This has been linked with long term health and social benefits for the child, family and the community. Over the years, the growth monitoring activities have centred round the health workers. Therefore, the study explored task shifting on Mother/ Caregivers capability to undertake growth monitoring roles at the health Facilities in Oyo State Nigeria. Qualitative methods using focused group discussion and Key informant interview guide were used for data collection among 6-8 groups of 10 mothers and 20 health workers providing the service. The data was analysed using inductive coding to generate the themes. The study showed mothers/caregivers low knowledge on growth monitoring and health workers documented some potential challenges encounter during the activities. The mothers/caregivers show low knowledge on growth monitoring. Therefore, mothers/caregivers were willing to take up the role.
Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4281
Nakachwa MariaCorresponding author
School of Post Graduate Studies and Research, Nkumba University, Entebbe 237, Uganda
Uganda still grapples with a high maternal mortality rates of 336 deaths per 100,000. Expectant mothers across the country lack awareness about the availability of antenatal care services; yet attendance of antenatal care services during pregnancy is crucial in protecting the health of women and unborn children. This article describes a protocol for investigating the effectiveness of mobile telephone communication interventions on the utilization of antenatal care services among expectant mothers in the districts of Kyotera and Rakai Districts in Uganda. Under the protocol, 28 health facilities in the districts of Kyotera and Rakai will be selected using simple random sampling and allocated into the intervention and control arms at a ratio of 1:1. A total of 2224 expectant mothers receiving antenatal care from the sampled health facilities will be recruited using systematic sampling. Expectant mothers receiving antenatal care from facilities allocated into the intervention arm will receive mobile telephone voice and text messages reminders for scheduled ANC visits. The mobile telephone messages will further provide maternal health information and availability of ANC services on a fortnightly basis. On the other hand, expectant mothers receiving antenatal care from facilities allocated into the control group will not get any reminders for scheduled ANC visit and maternal health information through the mobile telephone communication platform. Expectant mothers in the control arm will receive standard maternal health care without reminders. Expectant mothers in both groups will provide baseline data, midterm data will be obtained from the ANC registers at 6 moths while end of term data will be collected after an intervention period of 12months. The data collected will include the number of antenatal care visits attended, antenatal care services obtained from the health facilities, sociodemographic factors and mobile telephone usage, ownership and knowledge. The anticipated outcomes are; increased awareness and utilization of ANC services.
Jul 2021 DOI 10.14302/issn.2574-4488.jna-21-3887
N Osnaya-RomeroCorresponding author
Unidad de investigación clínica Instituto Nacional de Pediatría.
Polycystic kidney disease is an inherited disease that can lead to high blood pressure and kidney failure. In Mexico, 4.5% of patients with kidney failure are carriers of this disease; the liver is another of the organs affected by this disease that can manifest as abdominal pain and a mass effect in the abdominal cavity; we present 2 cases of polycystic kidney and liver disease (mother and child), in addition to describing the clinical manifestations, two different stages of the disease are shown, being a hereditary disease it is suggested that once a case is identified, an abdominal ultrasound is performed to first-degree relatives in search of cystic lesions to indicate preventive measures that help us preserve the overall well-being of the patient.
Jul 2021 DOI 10.14302/issn.2835-2165.jfsh-20-3579
Bedada ShumiCorresponding author
Disease Control and Prevention Department, Bale Zone Health Office, Robe, Ethiopia.
Introduction Foodborne diseases are a major public health problem which predominantly affects infants and young children. Appropriate complementary food hygiene practice is very important to reduce the prevalence of foodborne illnesses. However, the information regarding this practice is not available and assessed before. Thus, the study was aimed to assess complementary food hygiene practices among mothers of children aged 6-23 months. Methods A community based cross-sectional study was conducted in Robe town on a samples of 517 mother-child pairs, which were selected by using systematic sampling technique. Data was collected using pre-tested and structured questionnaire, and each variable was described in the frequency and percentage. Bivariable and multivariable logistic regression analyses were used to identify factors associated with complementary food hygiene practice. Odds ratios with 95% confidence interval were used to assess levels of significance. Result The result indicated that 55% of participated mothers scored above the mean score of food hygiene practices. Mothers of children aged 12-23 months had higher odds to practice good food hygiene measures than those of aged 6-11 months (AOR, 1.82 95% CI (1.21, 2.73)). Mothers whose children attended growth monitoring session practice good food hygiene than their counterpart (AOR, 2.74 95% CI (1.49, 5.06)). Mothers having media exposure, and having knowledge on critical times of hand washing had relatively good food hygiene measures (AOR, 0.73 95 CI (1.14, 2.62)). Among food hygiene measures; handwashing with water and soap were low before eating food (17%), before feeding children (21%) and before preparing food (32%) when compared with after visiting the toilet (81%) and touching dirt (68%). Conclusion and Recommendation The study identified that food hygiene practices in the current study were mainly associated with child age, growth monitoring follow-up, maternal awareness about critical times of hand washing, and media exposure. So, improving knowledge of mothers on critical times of handwashing, strengthening growth monitoring follow-up and media promotion are important measures to improve food hygiene practices among mothers of infants and young children.
Aug 2020 DOI 10.14302/issn.2381-862X.jwrh-20-3444
Aboma DanielCorresponding author
Shenen Gibe General Hospital, Msc, IESO
Background In Ethiopia, the levels of maternal and infant morbidity and mortality are among the highest in the world. This is attributed to, among other factors, none use of modern health care services by women. According to the 2011 Ethiopian Demographic Health Survey, more than seven in ten mothers did not receive antenatal care at all. Objectives The objective of this study was to determine level and identify factors influencing maternal antenatal care services utilization among mothers who gave birth in the last twelve months in Gelemso town west Hararghe Oromia, Ethiopia. Methods A community-based cross sectional study design was conducted on 347 study participants in Gelemso town west Hararghe Oromia Ethiopia from July 15, 2017 to August 15, 2017 G.C.A probability to proportional to size sampling technique was used to select the study population in two urban Kebeles. Data were collected using a pre tested structured questionairs. Descriptive results were presented using frequencies, and numerical summary measures. Bivariate analysis was carried out to assess the association between outcome variable and each in dependent variables. Odds ratio with 95% confidence level was estimated to identify factors associated with Antenatal Care (ANC) utilization using multivariable logistic regression. The statistical significance was declared at p- value < 0.05. Result The response rate this study was 98%. The prevalence of antenatal care service utilization was 64.6%. About 146 (42.1%) of the pregnant mother started antenatal care visit during the second trimester of pregnancy and a significant proportion 289(83.3%) had less than the recommended four visits. Educational status (AOR;15.19:CI 95%,6.006,38.417), husband attitude (AOR;1.995:CI 95%,1.016,3.916), marital status(AOR:4.587:CI 95%,1.888,11.146), planned pregnancy (AOR:4.938:CI 95%,2.514,9.702) were major factors associated with antenatal care service utilization. Conclusion Though more than half mother used antenatal care service in the study setting, two in ten of the mothers did not have the minimum number of visits recommended by World Health Organization. Promotion of information, education and communication in the community should be strengthened is to sustain antenatal care service utilization in the community.
Apr 2020 DOI 10.14302/issn.2641-4538.jphi-20-3296
Rezapour BarataliCorresponding author
Department of Public Health, Faculty of Health, Assistant Professor, PhD in Health education and promotion, Urmia University of Medical Sciences, Urmia, Iran
Preventable factors such as infectious diseases (pneumonia, diarrhea, and malaria), malnutrition and neonatal complications are still the leading cause of child mortality worldwide 1 In 2013, it is estimated that 6.3 million babies born worldwide died before the age of 5, and approximately 9.2% of these deaths were due to diarrheal diseases 23 in simple, accessible ways, and effective treatment can reduce diarrhea-related mortality and make hospital admissions unnecessary, and the role of mothers is the most important 4. Since the presentation of Oral Rehydration Therapy (ORT) in 1979, mortality has reduced. Diarrhea has had a steady downward trend 5. If mothers who have children under 5 years of age, used correctly ORS, they could easily resolve the problem of dehydration in acute diarrhea 6. Mothers didn’t use correctly ORS because of their Low literacy and lack of knowledge and wrong attitude about ORT7. Some health care workers provide mothers’ required equipments, regardless of their educational needs, and mothers may not use ORS. In this study, health workers identified mothers' educational needs and subsequently they trained them about using ORS at home in acute diarrhea in children under 5 years of age.
Aug 2019 DOI 10.14302/issn.2379-7835.ijn-19-2876
Oladejo T AdepojuCorresponding author
Department of Human Nutrition, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
Infant and young child feeding (IYCF) practices directly affect the nutritional status of children under two years of age, and ultimately, impact child survival. These practices are influenced by maternal knowledge and attitudes as well as socio-demographic and cultural factors; and an understanding of such factors is important to scaling up IYCF practices. This study was designed to assess the role of religion on knowledge, attitude and infant feeding practices among Christian and Muslim lactating mothers in Ibadan North Local Government Area (LGA), Oyo State. The descriptive cross-sectional study was conducted among 320 lactating mothers in the LGA. Eight focus group discussions were carried out among Christian and Muslim lactating mothers. An adapted pre-tested questionnaire was used to collect information on socio-demographic characteristics and IYCF knowledge, attitude and practices of the respondents. Knowledge on IYCF was assessed on 14-item scale, and the scores categorised as: ˂5.60 poor, 5.60–10.88 fair, and ˃10.88 good knowledge. Attitude was assessed on 13 statements from the IOWA Infant Feeding Attitude scale with lowest and highest obtainable score of 13 and 65 respectively. A score of ˂44 was ranked as poor, and ˃44 points good. Data were analysed using descriptive statistics and one-way ANOVA. Qualitative data was analysed thematically. Mean age of respondents was 30.0±4.9 years, 55.9% were Muslims, and 63.8% had fair knowledge. There was no significant difference in fair knowledge categorisation (63.7%, 63.8%), but there existed slight difference in good (20.7%, 21.3%) and poor (15.6%, 14.9%) knowledge of the Muslim and Christian respondents respectively. Mothers with poor attitude constituted 56.0%. Muslim religion directly supports pre-lacteal feeding and duration of breastfeeding while the other indirectly supports breastfeeding. Religious practices directly and indirectly affect knowledge, attitude and practices of nursing mothers on infant feeding; hence, healthcare Professionals should pay more attention to nutrition education in religious houses using the infant and young child feeding module.
Feb 2018
Oner CagriCorresponding author
Maltepe University, Faculty of Medicine, Department of Medical Biology and Genetics
An inaugural editorial presents the journal's scope spanning chemotherapy research and clinical practice. It invites translational work linking mechanisms, regimens, and real‑world outcomes with an emphasis on safety and effectiveness.
Dec 2017 DOI 10.14302/issn.2641-9181.ijnr-17-1859
Vasei MohammadCorresponding author
Department of Pathology and Cell therapy based research center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Pericentric inversions in chromosome 10 are regarded as both common and rare conditions, based on breakage and rearrangement within each specific segment. We present phenotypic and cytogenetic characterizations of a rare recombinant chromosome 10, namely inv(10)(p11q26), in a 13-month-old flabby girl associated with a maternal pericentric inversion. A review of the literature on the different aspects of this condition is also provided.
Sep 2017 DOI 10.14302/issn.2474-3585.jpmc-17-1739
Tarkang ElvisCorresponding author
Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
Background: The use of Long Lasting Insecticide Nets (LLINs) is seen as a major public health intervention and has shown to have both direct and indirect effects on the dynamics of malaria transmission. This report assessed the methods used by mothers to prevent malaria infection among their children under five years in the Hohoe Municipality. Method: A cross-sectional survey carried out in February 2017 among 418 mothers with children under five. Data were collected in the form of interviews using questionnaires on the usage of LLIN alone, LLIN with other methods (LLIN+) and use of other methods only (OMs). Chi square test and multinomial logistic regression were used to determine the association between dependent and independent variables. Results: Of the 418 mothers, 28.5% used LLIN only, 50.7% used LLIN+ and 20.8% used OMs only to prevent malaria. Mothers aged 30-39 and 40-49 years were 3.87 and 5.55 times more likely to use LLIN only rather than OMs as compared to those aged less than 20 years (AOR=3.87, p=0.019) and (AOR=5.55, p=0.029) respectively. Similarly, mothers aged 30-39 and 40-49 years were 3.08 and 4.02 times more likely to use LLIN+ rather than OMs as compared to those aged less than 20 years (AOR=3.08, p=0.023) and (AOR=4.02, p=0.050) respectively. Mothers who attained a higher level of education were 2.08 times more likely to use LLIN+ rather than OMs as compared to those with no formal education (AOR=2.08, p=0.015). Those who resided in rural areas were 2.00 times more likely to use LLIN only and LLIN+ rather than OMs only as compared to urban dwellers (AOR=2.00, p=0.002) and (AOR=2.00, p=0.013) respectively. Conclusion: More than half of the mothers preferred using LLIN+. One out of 3 mothers used only LLIN while one out of 5 used OMs only to prevent malaria. Age, educational level and place of residence were significantly associated with methods used to prevent malaria. There is the need for targeted education on LLINs in order to improve usage among younger mothers and mothers residing in urban areas. Further investigations to determine reasons for using OMs only and also determine the added value of OMs to LLINs in preventing malaria are recommended.
Jun 2017 DOI 10.14302/issn.2574-4526.jddd-16-1321
Harrison SanjayCorresponding author
Queen Elizabeth Hospital, Queen Elizabeth Avenue, Gateshead
This review synthesizes key molecular pathways in colorectal carcinogenesis and relates them to differential chemotherapeutic responsiveness. It discusses mismatch repair, chromosomal instability, and serrated pathways, linking biomarkers to therapeutic decision‑making.
Feb 2017 DOI 10.14302/issn.2381-862X.jwrh-15-848
Wittkowski AnjaCorresponding author
University of Manchester, Division of Psychology and Mental Health
Postpartum depression is a common mood disorder following childbirth. Depression occurring at this crucial stage in a child’s life is known to have far reaching and potentially damaging consequences for the mother, the baby and her family. Whilst a number of risk factors have been identified in the literature as contributing to the development of postpartum depression, including a past psychiatric history and lack of social support, some of these are not easily modifiable through psychological interventions. The aim of this longitudinal study was to examine the contribution of specific psychological factors, including maternal beliefs about motherhood and perfectionism and perceived social support, in the development of postpartum depression. Seventy-three pregnant women consented to take part and returned questionnaires during the third trimester of their pregnancy. Of those women, 61 also completed questionnaires 4-6 weeks following the birth of their baby. Significant associations were identified for postpartum depression and the psychological variables of perfectionistic beliefs and social support, whereas many demographic factors were not significantly implicated in the development of depression. Using a multiple hierarchical regression analysis, the study examined whether maternal beliefs about motherhood and beliefs about perfectionism predicted more of the variance in postpartum depression scores than other demographic variables, including a past history of emotional difficulties. As predicted, beliefs about motherhood and perceptions of poor social support from friends and family were significant predictors of postpartum depression, when the influence of antenatal depression scores were accounted for. A past history of emotional difficulties was also retained in the final model, whereas beliefs about perfectionism were not. These findings have implications for clinical services, highlighting the need for refined assessments of expectant mothers’ beliefs about motherhood and their perceptions of their social support during pregnancy and the need for more refined psychological interventions that address these beliefs.
Mar 2016 DOI 10.14302/issn.2374-9431.jbd-16-939
Nusrat-SultanaCorresponding author
Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU)
Objective: To observe association of risk factors with gestational diabetes mellitus (GDM) in a tertiary care hospital of Bangladesh. Materials and Methods: Risk factors of GDM were evaluated in pregnant subjects (n=385; age: 26.4±4.9 yrs; body mass index, BMI: 25.3±4.3 kg/m2; mean ± SD) screened by 75 gram oral glucose tolerance test (OGTT) following WHO 1999 criterion irrespective of gestational age in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU). BMI, maternal age, parity, trimester and family history of diabetes were considered as risk factors. Plasma glucose was measured by glucose-oxidase method on the same day. Results: GDM and normal glucose tolerance (NGT) showed significant difference for age (28.2±4.9 vs. 25.3±4.6 yrs, p<0.001), BMI (26.7±4.4 vs. 24.4±3.9 kg/m2, p˂0.001), family history of DM (55.5% vs. 43.0%, p=0.017) and number of gravida (p=0.048). There was no significant difference of frequencies of GDM among various trimesters (39.4% vs. 42.5% vs. 38.2%; χ2=0.653, p=0.721). OGTT performed before 24 weeks revealed GDM in about 44% (88/202). Multiple regression revealed age (p<0.001), BMI (p=0.007) and family history of DM (p=0.048) as independent predictors for GDM. Conclusion: It is concluded that age of mother, increased BMI, family history of diabetes as well as multigravidae are important predictors for GDM.
Jun 2014 DOI 10.14302/issn.2372-6601.jhor-14-378
Kulma-Kreft MonikaCorresponding author
Department of Radiotherapy and Medical Oncology, Gdynia Cancer Center, Gdynia
Progressive multifocal leukoencephalopathy (PML) is a rare complication associated, inter alia, with rituximab-based lymphoma treatment. PML diagnosis is made easier with the criteria recently published by the American Academy of Neurology. Unambiguous diagnosis of PML can be achieved by demonstration of the histopathological triad comprising:(1) demyelination, (2) bizarre astrocytes and (3) enlarged oligodendroglial nuclei together with detection of viral particles by electron microscopy. However, symptoms of PML may be similar to those observed during lymphoma progression into the central nervous system (CNS). Here we report the case of a patient with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP who developed clinical signs indicating PML. Intravital diagnostic methods failed to yield an unequivocal diagnosis of PML or lymphoma progression in the CNS. However, a post-mortem examination of brain biopsy specimens performed by electron microscopy demonstrated lesions typical for PML and the presence of viral particles. In addition, immunohistochemical assays identified a massive infiltration of lymphoma cells. The case thus suggests either the extremely rare coexistence of two complications: lymphoma CNS infiltration and PML or induction structural CNS lesions by lymphoma infiltration indistinguishable from PML. The presented findings thus highlight the need for a further review of the current diagnostic criteria for PML.
Jul 2013 DOI 10.14302/issn.2326-0793.jpgr-12-160
J. Fu WenjiangCorresponding author
Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan 48824 USA
Maternal-fetal genotype (MFG) incompatibility has been shown to be strongly associated with a number of genetic diseases. Most current methods for the MFG test rely on parents-offspring trio genotype data and do not apply to mother-offspring pair data where paternal genotype is unavailable. In this paper, we developed a two-stage method for testing the allelic effect of given SNP through subgroup analysis of compatible MFG pairs and further tested the MFG incompatibility effect according to different scenarios determined by the allelic effect. Simulation studies demonstrated that this novel two-stage model is powerful in detecting the MFG incompatibility effect. This method can be implemented through publicly available statistical software, such as SAS, R, etc. We demonstrate with a case-control study of small for gestational age neonates that the method identified a SNP in the IGF2R gene with a significant allelic effect (p = 0.037), and a SNP in the IGF1 gene with a significant MFG incompatibility effect (OR = 0.75 and p = 0.033).
Feb 2026 DOI 10.14302/issn.2372-6601.jhor-25-5944
Y. Berezin MikhailCorresponding author
Background Oxaliplatin, a widely used chemotherapeutic agent, is associated with hematologic toxicities such as anemia, leukopenia, and thrombocytopenia. Despite their clinical relevance, the molecular mechanisms underlying lineage-specific bone marrow suppression remain poorly understood. Methods We administered oxaliplatin to mice over eight weeks and performed RNA-sequencing (RNA integrity >8) on bone marrow alongside peripheral blood analysis and cytokine profiling. Transcriptomic data were analyzed to identify differentially expressed genes (DEGs) and enriched pathways. For that, we applied a thematic Gene Ontology (thematicGO) enrichment method that groups GO terms into biologically meaningful categories, such as hematopoietic lineage disruption, cell cycle arrest, and cytokine signaling. Results Oxaliplatin induced broad transcriptional suppression of erythropoiesis and lymphopoiesis, with 3,691 DEGs identified (FDR<0.05, |FC|>1.5). Upregulation of Cdkn1a and downregulation of E2f2 suggest G1/S cell cycle arrest, correlating with repression of key erythroid maturation genes (e.g., Spta1, Slc4a1, Alas2) and hemoglobin subunits (Hba-a1/2, Hbb-bs/t). Despite a ~3000-fold increase in renal Epo expression, bone marrow Epor was reduced, indicating erythropoietin resistance. B and T cell markers were also significantly downregulated, signifying a collapse in adaptive immunity. Notably, neutrophil populations were largely spared. Cytokine analysis in plasma revealed a pro-inflammatory shift with elevated TNF-α and reduced TGF-β, potentially exacerbating hematopoietic dysfunction. Conclusions Oxaliplatin induces a lineage-dependent suppression of hematopoiesis, driven by coordinated cell cycle arrest, metabolic stress, and disrupted cytokine signaling. RNA-seq analysis enabled integration of transcriptomic findings into coherent biological themes. These findings provide mechanistic insights into oxaliplatin’s hematologic toxicity linking bone marrow failure (potentially reversible) via interconnected inflammatory and metabolic pathways and may inform therapeutic strategies to minimize or restore myelosuppression in cancer patients.
Feb 2026
Singhal SunilCorresponding author
Objective The landscape of non-small cell lung cancer (NSCLC) has changed due to liberalized utilization of computed tomography, developments in immunotherapy and targeted treatments, and guidelines encouraging sublobar resections. We analyzed the implications of these advances for surgical procedures over a 16-year period. Methods The National Cancer Database was used to identify NSCLC incident cases from 2004 to 2020. Histology, stage, grade, and treatment were analyzed using descriptive statistics and logistic regression. Results 2,028,553NSCLC patients were identified. Each year was associated with an increase in Stage I for NSCLC (OR1.05, 95%CI 1.05-1.05) and histological subtypes (adenocarcinoma: OR1.03, 95%CI 1.03-1.04; squamous: OR1.02, 95%CI 1.02-1.02; neuroendocrine: OR1.11, 95%CI 1.11-1.12), with no change in adenosquamous histology. A similar increase was observed for well- or moderately-differentiated histology (OR1.04, 95%CI 1.04-1.04). The proportion of patients receiving chemotherapy decreased (OR0.98, 95%CI 0.98-0.98), while more patients were treated with immunotherapy or targeted therapy, including an increase of 14% using immunotherapy or targeted therapy as first-line treatment. There was a decrease in the likelihood of receiving pneumonectomy (OR 0.91, 95%CI 0.91-0.91). Despite guidelines advocating sublobar resections, these procedures only increased by 1.1% per year. Conclusions Over the 16-year study period, there was a significant trend towards diagnosis of Stage I NSCLC. The most pronounced change in treatment patterns has been more patients receiving immunotherapy and less chemotherapy. Despite a promising decrease in pneumonectomies, the frequency of sublobar resections remains stagnant, indicating limited uptage in current practice.
Jan 2026 DOI 10.14302/issn.2574-612X.ijpr-25-5920
Aikaterini ΚoutroukiCorresponding author
The present study examines the effectiveness of Cognitive-Analytic Therapy (CAT) in women diagnosed with breast cancer and Post-Traumatic Stress Disorder (PTSD) on reducing PTSD symptomatology and improving their mental health state (depression, self-esteem, post- traumatic growth, quality of life, therapeutic alliance). Additionally, the investigation includes the determination of the demographic, socio-economic and medical factors’ impact on mental health indicators in women with breast cancer and PTSD. The sample was 188 women with breast cancer and PTSD at the Chemotherapy Unit of ‘Agios Andreas’ General Hospital in Patras. The questionnaire data were analyzed using descriptive and inferential statistical analysis in order to determine any statistically significant correlations between the experimental and the control group and between psychological scales and the demographic and socio-economic factors. The findings confirm the effectiveness of CAT in women with breast cancer and PTSD in reducing PTSD and depressive symptoms, improving self-esteem and quality of life, achieving greater post-traumatic growth, and fostering a better therapeutic relationship with the therapist. The demographic, socio-economic and medical factors examined affected dissimilarly each psychological scale, as statistically significant associations were found with some scales but not with others.
Nov 2025 DOI 10.14302/issn.2379-7835.ijn-24-5360
Alam RashedCorresponding author
Background Malnutrition is a significant public health issue in Bangladesh, particularly impacting women and children. Rajshahi, marked by socio-economic disparities, offers a distinctive context to explore the nutritional status and health outcomes of these vulnerable groups. Objectives This study aims to assess the nutritional status of women and children in Rajshahi and investigate associated health outcomes. Additionally, it seeks to identify socio-economic and cultural factors that influence nutrition. Methods A mixed-methods approach was utilized, incorporating a cross-sectional survey of 460 households and in-depth interviews with mothers and caregivers. Anthropometric measurements were taken to evaluate the nutritional status of women and children, while dietary assessments measured nutrient intake and diversity. Logistic regression analysis was performed to determine the likelihood of malnutrition based on socio-economic characteristics, thereby identifying key risk factors. Results The findings indicate a troubling prevalence of malnutrition, with 36% of children under five classified as stunted and 25% as underweight. The analysis highlights critical factors contributing to chronic undernutrition, including maternal education, employment, and dietary diversity. Notably, mothers aged 27-37 exhibit a lower risk of undernutrition, and urban households with secure food access demonstrate better nutritional outcomes. Discussion Maternal education and employment were positively associated with better nutritional outcomes, as educated and employed mothers had higher chances of maintaining a normal BMI. Regular ANC visits (≥4 visits) were crucial for improved maternal nutrition. Household food security emerged as a significant determinant, with food-secure households showing better maternal nutritional status. Safe water access and adequate dietary diversity were also linked to improved maternal BMI. Additionally, factors such as child birth weight, exclusive breastfeeding, and childhood diarrhea significantly influenced maternal nutrition. Moreover, frequent antenatal care visits and a diverse diet are vital in mitigating undernutrition risks among children. Conclusion This study emphasizes the urgent need for targeted interventions to combat malnutrition in Rajshahi. Recommendations include implementing community-based nutrition education programs and improving access to healthcare services. By addressing the socio-economic and cultural determinants of nutrition, stakeholders can enhance health outcomes for women and children in the region, ultimately contributing to broader public health objectives in Bangladesh.
Jun 2025 DOI 10.14302/issn.2379-7835.ijn-25-5560
Bai YeonCorresponding author
The benefits of exclusive breastfeeding are well-known. Despite the legislative and systemic efforts to promote breastfeeding in South Korea, the nation’s current rate of exclusive breastfeeding (5.2%) during the infant’s first six months is alarming. Under the framework of the theory of planned behavior (TPB), this study elicited the beliefs around exclusive breastfeeding commonly held by low-income women participating in NutriPlus, the community nutrition program. Using a convenient sampling method, online open-ended surveys were conducted with two program clinics in Seoul during spring of 2024. The survey included questions about their demography and beliefs regarding indirect theoretical constructs of the exclusive breastfeeding behavior by listing top three things that came to their mind. A total of 120 NutriPlus clients participated in this survey. Though 53.1% of postpartum women were breastfeeding, only 28.1% were breastfeeding exclusively. Based on most frequently mentioned beliefs, we classified them to behavioral, normative, and control beliefs under TPB. Modal behavioral beliefs were healthy babies (n=87) and mother-baby bonding (n=71) and feeding issues (n=96) and inconvenience resulting from the act of breastfeeding (n=86). Family members seemed to shape both positive (n=122) and negative (n=37) normative beliefs. The presence of support (n=84) mattered to facilitate breastfeeding, while feeding issues (n=98) played as barriers. Promotion efforts need to emphasize breastfeeding knowledge and skill building and include family members and society at large to improve the awareness and transform barriers of breastfeeding to facilitators.
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.
Dec 2024 DOI 10.14302/issn.2379-7835.ijn-24-5352
C. Katusi GodfreyCorresponding author
Introduction Adolescent pregnancy has become a global health concern in recent years, with maintaining dietary diversity being essential to ensure the health of both the mother and fetus. This study aimed to understand the dietary diversity and nutritional status among pregnant adolescents attending antenatal clinic and identify the factors influencing these outcomes. Methodology A hospital based cross-sectional study was done at St Francis Regional Referral Hospital at Ifakara, Tanzania. A total of 131 adolescent pregnant women consented to participate. Data was obtained using questionnaire and 24-hour dietary recall. Results The study revealed that 93.1% (n=122) of adolescent pregnant women met the minimum dietary diversity score based on 24-hour recall period. Similar proportions were observed for age group but vary significantly with the number of children born (p< 0.001), marital status (p = 0.032) and education level (p< 0.001). Additionally, 93.9% (n=123) of adolescent pregnant women had a normal Mid-Upper Arm Circumference (MUAC) and 6.1% (n=8) were undernourished. Similar proportions were observed across age, number of children born, marital status, education status, and occupation. Conclusion Most adolescent pregnant women in this study achieved adequate dietary diversity. However, socio-demographic factors such as age, marital status, and education, as well as challenges like illness and loss of appetite, influenced their dietary diversity and overall nutritional status. Future research should adopt a community-based longitudinal approach to better understand these factors and provide a more comprehensive understanding on the dietary patterns of adolescent pregnant women.
Mar 2024 DOI 10.14302/issn.2997-2108.jcc-23-4838
S. Mardanova KonulCorresponding author
Among the reproductive cancers cervical cancer has special place, because the second most frequent cause of cancer-related death among women worldwide. The studies suggested that the PI3K/mTOR/AKT signaling pathway is associated with certain reproductive tumors. A lot of research is ongoing for understanding this pathway evidence of its role in promoting tumorigenesis and recent progress in the development of therapeutic agents that targeted PI3K/AKT. In this a single-arm study included 34 Azerbaijan population woman with HPV-negative cervical tumors. The core genes of PAM signaling pathway were analyzed using RT-PCR method. Our preliminary results suggested that tumorgenesis of HPV-negative cervical cancer patients approximately 25% associated with dysregulation of PAM signaling pathway reason which are core genes alteration. The overall survival times in the PAM-active and PAM-stable patients were not significantly varies. However, the main factor for overall survival times were treatment strategy: both PAM-active and PAM-stable patients who received radiation therapy alone had a shorter overall survival than patients who received radiation plus chemotherapy. The patients with alteration of ATK1 and mTOR genes in PAM signaling pathway had poor prognosis then patients with PIK3CA and PTEN mutation
Jul 2023 DOI 10.14302/issn.2994-6743.ijstd-23-4641
C. Hughes VirginiaCorresponding author
Syphilis is caused by the bacterium Treponema pallidum and is transmitted from human to human through sexual contact. Congenital syphilis (CS) occurs when the mother transmits the infection to the fetus. Clinical manifestations of CS include anemia, hepatosplenomegaly, blindness, deafness, meningitis, and deformities in bone structure. The number of cases of CS have increased over the past decade in the United States according to the CDC. A study was conducted correlating the number of Medicaid enrollees in 2020, the number of uninsured persons in 2020, and the number of cases of COVID-19 in 2020 to cases of CS in the United States in 2021. A Spearman rank correlation analysis was done using SPSS. Results were statistically significant for all three pairs of variables with positive correlations; Medicaid enrollment and CS cases (r = 0.735, P<.05), uninsured persons with CS cases (r = 0.713, P<.05), COVID-19 cases and CS cases (r = 0.689, P<.05). Reasons for the increase in CS cases are multifactorial, including variations in state laws regarding syphilis screening in the prenatal period, differences in provider processes for persons on Medicaid, persons uninsured, and restrictions to accessing healthcare providers during the COVID-19 pandemic. Future studies should include questionnaires and interviews with women on their experiences during prenatal visits in regards to syphilis screening, particularly women covered by Medicaid, and surveys completed by healthcare providers to gain insight and to identify factors that affect a woman not being tested for syphilis during her pregnancy.
Jun 2023 DOI 10.14302/issn.2379-7835.ijn-23-4587
Bhoite RachanaCorresponding author
Background Cachexia is highly prevalent in cancer patients and is responsible for as much as 20% of all cancer deaths. Nevertheless, there is little emphasis on cachexia in routine clinical practice. This study looks at the efficacy and tolerability of a protein and energy-dense nutritional supplement with immunonutrients on cachexia in cancer patients. Methods This was a three-month, prospective, open-label study of patients undergoing radiotherapy and/or chemotherapy for head and neck or gastrointestinal or lung cancer. Efficacy endpoints were mean change in muscle strength, acute phase proteins (albumin and pre-albumin), C-reactive protein (CRP) levels, weight, Glasgow prognostic score (GPS), and nutritional status at the end of the study period. Results The study population consists of 47 (79.66%) males and 12 (20.34%) females with a mean age of 47.98 ± 12.16 years. The mean change in muscle strength, albumin, pre-albumin, CRP levels, and weight for the overall study population was 0.17 ± 12.09 kg (P=0.9145), -0.05 ± 0.53 g/dl, (P=0.5888), -0.01 ± 0.09 g/dl (P=0.2951), 0.50 ± 37.41 mg/dl (P=0.9258), -0.59 ± 3.70 kg (P=0.2265), respectively. At the end of the study period, there was a significant improvement in the nutritional status concerning total calories, protein, and fat intake. Conclusion Protein and energy-dense nutritional supplement with immunonutrients might help in the improvement of muscle strength, GPS, and dietary intake. The addition of the supplement to the diet regime of patients with cancer cachexia increases their daily consumption of proteins which might translate to multimodal clinical benefits.
Mar 2023 DOI 10.14302/issn.2641-5518.jcci-23-4506
Partanen AnuCorresponding author
Limited data exist on the mechanisms promoting clonal expression of BCR-ABL1 cells in various myeloproliferative disorders. We present a patient whose Janus Kinase (JAK) 2 V617F-negative idiopathic myelofibrosis (IMF) transformed to Philadelphia-positive chronic myeloid leukemia (CML). A 55-year-old man had anemia and splenomegaly. Trephine biopsy showed excess fibrosis without a JAK2 V617F mutation. Diagnosis of high-risk IMF with t(3;12) and del(16q) was made. Five years later a repeated trephine biopsy showed extensive fibrosis and t(9;22) with der(22)t(9;22). BCR-ABL1 fusion gene with typical p210 fusion transcript was found resulting in the diagnosis of CML. A modest treatment response was achieved with tyrosine kinase inhibitor (TKI) therapies, but the disease eventually progressed to a myeloid blast phase. With AML-based chemotherapy plus azacytidine and a second generation TKI the patient survived for years but succumbed 11 years after the initial diagnosis. Clonal evolution may cause atypical disease characteristics or a poor response to targeted therapy in myeloproliferative disorders.
Feb 2023 DOI 10.14302/issn.2576-6694.jbbs-22-4418
Mostafa M. Sabra SherifaCorresponding author
Saudi Arabia is rich in Juniperusprocera Hochst. ex Endl (Cupressaceae) as a medicinal plant. Its known as Arar, its present southwards, KSA. It's used as traditional medicine in the southwestern, KSA. The aim was according to "Saudi Arabian Customs" in using wild-plant extract for treatment and prevention of infectious-pathogens. That was to use Juniperusprocerafrom Ranyah, KSA to eliminate infectious-pathogens that were isolated from patients in the same area. This was the use may reduce the use of chemicals, as well it may be an alternative to chemotherapy. Practice included preparation of wild-plant extract, preparation of infectious-pathogens, interaction to wild-plant extract, and direct total cell count by "Bread Test". Juniperusprocera one crude concentration killed all infectious-pathogens during one day. Lower Juniperusprocera crude extract concentrations eliminated infectious-pathogens within more than one day. The mean number of dead sells / mL of Staphylococcus sp., Streptococcus sp, and Streptococcus pyogenes were (84.9 / mL, 87.0 / mL, and 77.8 / mL). The mean percent of dead cells were (80.0%, 82.0%, and 73.4%). The meannumber of dead sells / mL of Salmonella sp., Shigella sp, and Escherichia coli were (72.6 / mL, 76.1 / mL, and 79.0 / mL). The mean percent of dead cells were (68.5%, 71.8%, and 74.5%). The mean number of Candida albicans dead sells / mL was 69.3 / mL, the mean percent of dead cells was 65.4%. It was concluded that found from the results, the Juniperusprocera extract was preferred "Saudi Arabian Customs" to be used in three quarter and one crude concentration, as the infectious-pathogens eliminating within one day. It was recommended that the Juniperusprocera extract will be used for herbal treatment according to "Saudi Arabian Customs". That will be remark and follow-up through the "Official Herbal Treatment Dept.". That will appropriate the doses will estimate for each patient to eliminate and protect against the infectious-pathogens.
Oct 2022 DOI 10.14302/issn.2641-5518.jcci-22-4323
Y. Fernando GracieuxCorresponding author
Consultant, Section of Medical Oncology-Department of Internal Medicine, University of the Philippines-College of Medicine Philippine General Hospital, Manila
Introduction Primary sarcomas of the breast are <0.1% of all malignant tumours of the breast. To date, there are 13 major breast sarcoma series in English literature. This study adds to these series characterizing primary breast sarcoma among Philippine patients. Methods All breast biopsies from the pathology records of the University of the Philippines-Philippine General Hospital (UP-PGH) were searched for breast sarcoma cases from January 2000 to December 2010. Metaplastic carcinomas and phyllodes tumors were excluded. Results There were 52 patients (45 female, 7 male) ranging in age 25-83 years (median 46 years). Majority had lump, ten cases with pain. No history of previous cancer was given. No history of prior radiation was found. Histopathological diagnoses were spindle cell sarcoma (n=13), fibrosarcoma (n=6), liposarcoma (n=6), MPNST (n=5), stromal sarcoma (n=5), angiosarcoma (n=4), MFH (n=4), leiomyosarcoma (n=3), rhabdomyosarcoma (n=3), chondrosarcoma (n=2), and synovial sarcoma (n=1). Tumors were with grade 1 (n=18), grade 2 (n=8), and grade 3 (n=10). Necrosis was noted in 6 cases. Simple mastectomy was done in 19 cases (37%), MRM in 31 cases (59%), while 2 far advanced had no surgery (3%). None had adjuvant radiotherapy or chemotherapy. The duration of follow-up for 45 patients ranged from 1 – 117 months, excluding those who were lost to follow-up. All 15 deaths were due to progressive disease. Recurrences were observed in 9 patients. The disease-free survival (DFS) and overall survival (OS) was 73%and 75%, respectively. On multivariate analysis, DFS and OS were significantly correlated with size (HR=113.63; p=0.019 and HR=77.36; p=0.037), grade (HR=20.73 ; p=0.003andHR= 39.57; p= 0.004), and having a histology of angiosarcoma (HR=35.20 ; p=0.005and HR= 50.74; p=0.007), respectively. Conclusion Sarcoma remains an important clinical entity among primary breast cancers.
Mar 2022 DOI 10.14302/issn.2471-7061.jcrc-22-4139
Wu JianqingCorresponding author
Healthier World (Independent researcher for cause), P. O. Box 689, Beltsville, MD 20704. USA
We examined special roles of the Central Nervous System (CNS) in an attempt to resolve the puzzle that chronic diseases cannot be cured in medicine. By exploring a skill-learning model, we found that the CNS is able to remember certain information reflecting biochemical and cellular (B&C) processes in the body. From the skill-using ability, we found that the CNS is able to control basic B&C processes that drive and power the skill. From the ability to adjust forces and moving direction of body parts, we infer that the CNS is able to adjust B&C processes that control physical acts. From this controlling capability, we inferred that the CNS must also store certain information on the baseline B&C processes, is able to up-regulate or down-regulate the B&C processes, and make comparisons in performing its regulatory functions. We found that chronic diseases are the results of deviated baseline B&C processes, the CNS plays a role in maintaining deviated baseline B&C processes, and protects the body state of a fully developed disease. The three CNS roles can explain that cancer progresses with increasing malignancy, cancer quickly returns after a surgery, cancer cells repopulate after chemotherapy and radiotherapy, cancer patients develop drug resistance inevitably, immune cells rebound after suppression, etc. We further showed that long-term exercises generally can correct part of the departures in B&C processes and thus help to reverse chronic diseases. Finally, we propose strategies for resetting the CNS’ state memory as an essential condition for curing chronic diseases and cancer.
Feb 2022 DOI 10.14302/issn.2329-9487.jhc-22-4067
O AmaewhuleCorresponding author
Department of Paediatrics, University of Port Harcourt Teaching Hospital. Nigeria.
Introduction Congenital Heart Defects (CHDs) are structural abnormalities of the heart and intra-thoracic great vessels that are present at birth and may be of functional significance. They are the most frequently occurring congenital anomalies and babies born with severe forms of these defects are likely to die in the neonatal period. Objectives The aim of this study was to determine the prevalence of CHDs among neonates delivered in Port Harcourt, Rivers State, Nigeria Methods Using a stratified sampling technique, 530 neonates were selected from three hospitals in Port Harcourt. The biodata of the parents and socio-demographic information were obtained through an interviewer-administered questionnaire to the mothers. Physical examination and echocardiograghy were performed on all the neonates. Results Five hundred and thirty (530) neonates aged 0-7days (5.2±1.8) participated in this study and the male to female ratio was 1.1:1. Forty-three neonates were found to have CHD giving a prevalence of 8.1% 95%CI: 6.0. Thirty-nine were acyanotic and four cyanotic. Congenital Heart Defects were found in 21 (48.8%) males and 22 (51.2%) females. The more common heart defects were isolated Atrial Septal Defect in 16(37.2%), isolated Patent Ductus Arteriosus in 11(25.6%) and isolated Ventricular Septal Defect in 6 (13.9%). The most common cyanotic CHD was Transposition of the Great Arteries in 2 neonates (4.7%). The clinical features identified in neonates with CHD were tachypnoea, dysmorphia, cyanosis, hypoxia and murmur Conclusion The prevalence of CHD is considerably high in Port Harcourt and further studies need to be carried out to ascertain the risk factors.
Jan 2022 DOI 10.14302/issn.2379-7835.ijn-21-4059
Ford KristynCorresponding author
Bachelor of Nutrition and Dietetics, Accredited Practising Dietitian (APD), Department of Nutrition and Dietetics, The Royal Children’s Hospital, Melbourne Australia, Address: 50 Flemington Road, Parkville VIC 3052
Aim There is limited published data describing the characteristics of the paediatric population prescribed semi elemental formulas. This retrospective observational audit aimed to describe the characteristics of the paediatric patients who have been prescribed a hydrolysed whey protein, medium chain triglycerides (MCT) based formula, Peptamen Junior® and the nutritional outcomes. Methods A retrospective observation audit was completed on a cohort of patients that was prescribed a semi elemental formula between 2016 and 2019 from a single tertiary paediatric medical centre. Data variables were collated such as patient characteristics, indications and modalities of administration, duration and tolerance to the formula. Results Data was collated on 375 patients with a median age of 6.2 years. The main underlying medical conditions were haematological/oncology (67%), gastrointestinal disorders (10.7%) and neurological conditions (9.4%). The most common indications for use were chemotherapy related side effects (36.2%), post bone marrow transplant (25.8%) and gastrointestinal symptoms (17.9%). The formula was rarely used as a sole source of nutrition, with 88% patients requiring accompanying forms of nutrition support. The majority of orders prescribed were of standard concentration (80.8%) and tolerance was recorded in 82.8% of patients. Conclusion The semi elemental formula Peptamen Junior® appears to be well tolerated in paediatric patients with a variety of medical conditions that have complex pathologies and may have wider scope of use in a more diverse group of medical conditions than currently indicated.
Nov 2021 DOI 10.14302/issn.2470-0436.jos-21-4016
C. Alabado JibinCorresponding author
Philippines
Malignant transformation of peripheral nerve sheath tumor (MPNST) may develop from a plexiform type of Neurofibromatosis 1 (NF1) or previously irradiated areas. Generally, MPNSTs occur in about 2% to 5% of neurofibromatosis patients. In this paper, we present a 58-year-old male patient with neurofibromatosis who developed MPNST of the eyelids and nasal area. The patient had a history of multiple excision biopsies for facial tumors in 22 years at different institutions, allegedly revealing neurofibromas on histopathological evaluation. A recent consult with the Otorhinolaryngology Service (ORL) prompted an excision biopsy with results consistent with neurofibroma. The mass recurred and enlarged even more rapidly compared to the previously excised tumor. The patient also developed four tumors on the eyelids hence the referral to Ophthalmology Service. The eyelid masses and nasal mass were excised by the Ophthalmology and ORL Services. Histopathology revealed identical MPNST characteristics on all excised tumors. The patient was eventually referred to the Oncology Service to evaluate radio and chemotherapy. A rapid change in the size of a preexisting neurofibroma, infiltration of the adjacent structures, intralesional hemorrhage, and pain usually indicates a possible malignant transformation into MPNST. A high index of suspicion is helpful for clinicians when presented with a case of a recurrent neurofibromatosis, even if the only sign is the rapid growth of the mass since management of MPNST is very different from neurofibromatosis.
Aug 2021 DOI 10.14302/issn.2644-1101.jhp-20-3655
Kayani SumairaCorresponding author
Ph.D. Zhejiang University China
The present study examined the effects emotional intelligence on self-Efficacy of tertiary education students. Two scales Schutte Self-Report Emotional Intelligence Scale 44 and Schwarzer & Jerusalem Self Efficacy Scale 47 were used. The pilot study was conducted to assess the reliability of the instrument and main study was conducted to assess the results on sample of the study. A sample of 50 students (25 males, 25 females) were taken from universities of Islamabad and Rawalpindi. Both questionnaire were administered to the sample. The psychometric properties of pilot study were found satisfactory. In second phase main study was conducted which considered of sample of 200 university students (100 males and 100 females). The psychometric properties of main study were also satisfactory. Scores were analysed using SPSS software. Results of demographic variables such as age, birth order, mother education, father education and number of siblings are positively correlated with both scales and sub scales. The results were significant at (p<0.05) of mean differences with gender, education and family system. This survey consists of three hypotheses, which were accepted.
Jul 2021 DOI 10.14302/issn.2641-4538.jphi-21-3897
Pamela NanaCorresponding author
Interstate center in public health in Central Africa (CIESPAC)
Background Water-related diseases are water-related disorders of the body. They are a public health problem as they are responsible for 60% of infant mortality in our developing countries. There are few studies in South Cameroon on the subject. Overall Objective of this work was to study the explanatory behavioral factors of waterborne diseases in children aged 0 to 5 years in the health area of the urban dispensary in Ebolowa in Cameroon in 2020. Methodology This was an analytical cross-sectional study comparing two groups of children (group 1: children affected by waterborne diseases group 2: children unaffected by waterborne diseases) within the health area of the Ebolowa urban area. It lasted 21 months and the study period was from 28 December 2020 to 22 January 2021. We included children aged 0 to 5 years present in households where parents/guardians gave their informed consent. Sampling was probabilistic and cluster sampling. Using the Kelsey formula, we obtained a sample of 420 households and 566 children. Data was collected using a questionnaire and stored in the Excel spreadsheet and analyzed with CDC USA's epi info software 7.2.2.6. The calculation p value was done with Stat Calc at the significance threshold of 0.05. Bold The proportion of waterborne diseases was 97% (549/566) among the children aged 0 to 5 years surveyed. The most common reasons for using the health service for children aged 0-5 years were diarrhea 78.62% (IC75.06-81.80), and malaria 78.09% (74.09-81.30). The median age of children suffering from these pathologies was 36 months (24; 60). The gender ratio (Boys/Girls) was 2.06/1. Conclusion We propose to increase the awareness of mothers/guardians on good practices; also, to increase health promotion in the fight against waterborne diseases.
May 2021 DOI 10.14302/issn.2641-4538.jphi-21-3820
Rutayisire ErigeneCorresponding author
Department of public Health, Mount Kenya University Rwanda Kigali Rwanda
In Rwanda the prevalence of mother-to-child HIV transmission is 1.5%, the prevalence was found to be higher in rural area. The purpose of this study was to determine the Prevalence and Risk Factors of HIV Infection among Children born from HIV Positive Women in Musanze District. The study findings help to decrease the rate of HIV infection among children born from mother HIV positive to zero. This study was conducted in Musanze District, Northern Province in Rwanda. The study targeted 420 HIV positive mothers who delivery in different health facilities located in Musanze district form January 2019 to December 2020 and their children. SPSS version 22 was used for analysis. Of 420 children born from HIV positive mothers 91.7% were aged between 18-24 months, 55.2% were female. The majority of HIV positive mothers 80.2% who participated in the study were married. The prevalence of HIV infection among children born from HIV positive women was 2.9%. Children whose mother had poor adherence to ART were 1.5 times more likely to get HIV at birth compared to those whose mother had good adherence (AOR = 1.5; 95% CI: (1.12-2.21)). Children born from mothers in WHO stage II were more likely to get HIV from their mother (AOR = 1.24; 95% CI: (1.32-2.207)). Children born from HIV positive mother with one ANC visit were 2.5 times more likely to get HIV from their mothers (AOR = 1.56; 95% CI: (2.31-5.17)).
May 2021 DOI 10.14302/issn.2997-1969.ijhs-21-3814
E.E Enwereji,Corresponding author
College of Medicine and Health Sciences, Abia State University, Uturu Abia State.
Introduction Adolescence is a critical stage in human development that is characterized by peer pressure, confusion, exuberance and experimentation, particularly with sexual relationships. This is why attention should be paid to adolescents’ reproductive health issues so as to reduce their exposure to aggressive sexual activities which could expose them to sexually transmitted diseases, unwanted pregnancies and others. This study aimed at reducing the factors and conditions that influence teenage pregnancy among in-school adolescents in Umuahia North LGA of Abia State. Materials and Methods The study used a cross sectional descriptive study. A randomly selected sample of 416 adolescents between the ages of 13-19 years were studied. Structured self-administered questionnaire was used for data collection. Descriptive statistics, using frequencies, percentages and means were utilized for data analysis. Results The study found that 198 (47.6%) of the respondents were sexually active and that 89 (45%) of them had been pregnant. More than half 103 (52%) of the study group indicated that peer pressure influenced their sexual activities. About 46(51.7%) of the adolescents said they were pregnant so as to keep the new born baby with motherless babies homes. Conclusion Therefore, there is need for increased sex education for in-school adolescents so as to highlight the effects of teenage pregnancy on adolescents.
Apr 2021 DOI 10.14302/issn.2372-6601.jhor-21-3801
Qing XinCorresponding author
Department of Pathology, Harbor-UCLA Medical Center, 1000 West Carson Street, Torrance, CA 90502, USA.
Lennert lymphoma (lymphoepitheloid lymphoma) is an extremely rare variant of peripheral T-cell lymphoma, not otherwise specified. Here we report a case of Lennert lymphoma diagnosed in a 57-year-old woman. She had a three-year history of waxing and waning lymphadenopathy with a rapid increase in size in the past four months before presentation. A needle biopsy and a fine needle aspiration were non-diagnostic due to extensive necrosis. The patient underwent a right neck lymph node excisional biopsy which showed the lymph node architecture was effaced by numerous and sometimes confluent clusters of epithelioid histiocytes and infiltration of small lymphocytes. Extensive necrosis was present. Immunohistochemical stains revealed a mixed population of B- and T-cells with the T-cells showing diminished T-cell markers CD3, CD5, and CD7. Flow cytometric analysis detected a small population (7% of total lymphocytes) of CD4-positive T-lymphocytes with loss of CD3, CD5, and CD7 expressions. PCR-based T-cell receptor gene rearrangement studies showed positive results (clonal peaks) in both gamma and beta genes. Stains for microorganisms were negative. The overall findings indicate Lennert lymphoma. To our knowledge, this is the first reported case of Lennert lymphoma with extensive necrosis. The patient is undergoing chemotherapy. The diagnosis of Lennert lymphoma can be challenging, particularly in cases with extensive necrosis. Our case highlights that adequate sampling is important in the investigation of patients with suspected Lennert lymphoma. A careful pathologic examination with ancillary studies including flow cytometry, immunohistochmistry, and cytogenetic and molecular studies leads to the accurate diagnosis.
Mar 2021 DOI 10.14302/issn.2574-4372.jesr-20-3593
Hernández Víctor Manuel VargasCorresponding author
Female Health Clinic, Mexico
Background Women play an important role in the work setting. This leads them to put off their motherhood, sometimes preventing them from getting pregnant. Delaying pregnancy face women with low ovarian response, such as in Premature Ovarian Insufficiency (POI) or Ovarian Aging (OA). There is no current treatment, although there is evidence of improving ovarian function by inyecting mesenchymal stem cells (MSC). Materials and Methods Prospective, observational study of 17 women who attended Pronatal Clinic from 2019 to 2020. Each patient was registered in Assisted Reproductive Treatment (ART) and was enrolled in ovarian treatment with an autologous adipose tissue Mesenchymal Stem Cell (AD-MSCs) protocol. Three groups were assembled: 1) Control: AMH >1.2 ng/mL, without AD-MSCs, 2) POI/OA: female infertility due to POI/OA with AMH <1.2 ng/mL and 3) Amenorrhea: female infertility due to POI/OA with amenorrhea and AMH <1.2 ng/mL. Variables: Age, weight, height, serum AMH, endometrial thickness, follicular size and number on day 2 and 11 of the menstrual cycle, oocyte number, number of blastocysts and pregnancy rate. Results Between month 2 and 5, after AD-MSCs inyection, POI/OA group showed an increase in follicle number (2 to 9) and size (13.5 to 15.5 mm) on day 11 of the menstrual cycle, which resulted in a higher number of MII oocytes (2.6 to 4.2), and an increase in number of blastocysts (0 to 3) and endometrial thickness (8.6 to 9.4). Regarding the Amenorrhea group, a reboot in menstrual cycle was observed, although no further development of blastocyst was found. Conclusion The AD-MSCs inyection directly in the ovary allowed an increase in number of blastocysts and improved pregnancy rates in POI/OA patients.
Feb 2021 DOI 10.14302/issn.2641-4538.jphi-20-3683
Rutayisire ErigeneCorresponding author
Department of public Health, Mount Kenya University Rwanda Kigali Rwanda
Women in Rwanda are still suffering from overweight and obesity and health-related complications. However, little is known about overweight/obesity prevention knowledge and factors associated with overweight/obesity prevention among women. The aim of this study was to determine knowledge and factors associated with overweight and obesity prevention among women attending Kibagabaga Hospital in Rwanda. A quantitative descriptive cross-sectional design was conducted among women aged 20-45 years that was selected randomly. A structured questionnaire was used to collect data from 384 women seeking health care at the hospital during the study period. SPSS version 21 was used for data analysis; descriptive statistics was used to assess women’s knowledge related to overweight/obesity. Logistic regression was used to determine the factors associated with overweight/obesity prevention, the level of significance was set at 5%. Approval to conduct the study was obtained from the University and Hospital. The majority 35.4% of study participants were aged between 30-34 years. Women who live in urban area dominate the study (76.3%), the majority of study participants were married (60.9%). The study revealed that the 22% and 62% of women had higher level and moderate knowledge respectively. In terms of overweight/obesity prevention practices, we found that 67% mothers had adequate practices towards overweight and obesity prevention. The age of 35-39, and unemployment were found to be significantly associated with overweight/obesity prevention practices. Cost-effective health education focusing on women, physical activity and social support to reduce the socio-cultural constraints that promote overweight/obesity are necessary to combat this epidemic.
Oct 2020 DOI 10.14302/issn.2379-7835.ijn-20-3610
Maiti Choudhury SujataCorresponding author
Department of Human Physiology, Vidyasagar University, Midnapore-721102, West Bengal, India
Aim To assess the sanitation and hygienic practices of women and its effects on the nutritional status of the mother and preschool children of the Lodha tribal community in two districts of West Bengal. Methods A cross-sectional study was conducted during November, 2014 - December, 2018 of 941 Lodha mothers and 1043 of their preschool children in Paschim Medinipur and Jhargram districts. All information was collected by using KAP questionnaire following interview and group discussion. Mother nutritional status was assessed based on body mass index (BMI) and mid upper arm circumference (MUAC). A child was classified as underweight, stunting and wasting as weight-for-age, height-for-age and weight-of -height Z-score below -2 standard deviation of WHO standard. Results This study found 35% of the households used safe drinking water. Almost 97.2% of the mother had the low hand wash score and about 67.1% of them had an average WaSH score. Overall, 41.6% and 1.6% mothers were suffered from undernutrition (BMI <18.5 kg/m2) and overweight/obesity (BMI≥25kg/m2). Whereas, 48.9% women were undernourished based on MUAC<22.0cm. Moreover, the overall prevalence of wasting, stunting and underweight of preschool children was 31.9%, 62.1% and 61.3%, respectively. The WaSH score of family was significantly associated with child stunted and underweight. Conclusion There is a good association between poor household WaSH practices with child undernutrition and morbidity. Hence, there is an urgent need to develop the comprehensive knowledge, attitude and practice (KAP) guidelines in their language to educate them about appropriate water storage, retrieval methods, sanitation and hand washing practices.
Aug 2020 DOI 10.14302/issn.2381-862X.jwrh-20-3439
Aboma DanielCorresponding author
Shenen Gibe General Hospital, Msc, IESO
Background Pregnancy and parturition are events of considerable significance in the life cycle of women. Though it is supposed that the quality of care during labor, birth, and postpartum period plays a great role for adverse outcomes of birth, various reports claimed that cesarean delivery carries a higher maternal and fetal morbidity and mortality compared to vaginal delivery. Therefore, this study assessed the Rate, Maternal and Fetal Outcome of Cesarean delivery performed by IESO at Shenen Gibe General Hospital, Jimma south west Ethiopia. Integrated Emergency surgical officer is a health professional qualified and authorized to perform emergency obstetrical-gynecological and emergency general surgical procedures. The training has started in 2010 in 3 universities and 10 affiliated sites with intake of 43 students. The MSc program in integrated emergency surgery is intended to achieve one of the millennium development goals (MDG): reducing the overwhelming maternal mortality ratio and perinatal mortality rate at the local and national level. (1) Methods Hospital based two-year retrospective descriptive cross-sectional study design was employed and data collected from November to December 2019 in shenen Gibe General Hospital ,Jimma south west Ethiopia. A total of 185 mothers who delivered by cesarean delivery from December 2017 to December 2018 and complete data were included in the study. Data were extracted using structured data collection format and cleaned, and entered into Epi data software version 3.1 and exported into SPSS version 26 for further descriptive analysis. Result Among 2115 deliveries in the two years of retrospective data, a total of 186 mothers were delivered by cesarean section, giving cesarean delivery rate 8.8 %. The leading indication for cesarean delivery was fetal distress (24.2%). Among the total cesarean delivery, 22 neonates were died, giving the proportion of neonate mortality rate 16.8%. One mothers were died following cesarean delivery, giving maternal mortality rate following cesarean delivery 12 per 1000 live births. The leading cause for maternal mortality was hemorrhagic shock Conclusion However, cesarean delivery rate in this study was within the WHO recommended range, the health outcome of mothers and neonates’ following cesarean delivery was not acceptable. The neonatal and maternal mortality following cesarean delivery was 16.8% and12 per 1000 live births respectively. The main cause of neonatal death was birth asphyxia.
Jul 2020 DOI 10.14302/issn.2328-0182.japst-20-3472
Abedulla Khan KayamkaniCorresponding author
Department of Clinical Pharmacy & Pharmacology, IbnSina National College for Medical Studies, Jeddah, Kingdom of Saudi Arabia.
Introduction An adequate nutrition pattern is of major importance for one’s health and well-being, especially during pregnancy when a woman undergoes major biological, physical, psychological and social transformations. Macronutrient and micronutrient deficiencies predispose the fetus to preterm birth, neural tube defects, and low birth weight for gestational age. This study was conducted to determine the nutrition awareness of women in childbearing age in order to provide a greater understanding of the life course perspective (LCP) in relation to nutrition behaviors and pregnancy. Methods A cross-sectional study was conducted on based on our conceptualization of nutrition awareness and questionnaire based studies of a face-to-face interview. The participants were women with age group of 17 years to 45 years participate in studies in Jeddah city. Data collection procedures A Semi-structured questionnaires prepared in English language were translated in to Arabic and then translated back to English to check for consistency. The questionnaires were pretested Human ethical committee; the questions assessed respondents’ nutrition knowledge. Results and Discussion Different questions were asked to 175 selected pregnant women to be included in this study assess knowledge of pregnant mothers on nutrition and determinant factors in the study area. Most of the respondents (34.85.2%) were in 19-25 years of age group.69.1 % (n=121) women says they pay attention to the number of soft drinks they drink each day. There would be fascinating to study awareness of specific nutrients and related issues, like consumption folic acid, non-vegetarian diet, minerals and life style such as mental stress and physical exercise.
Jul 2020 DOI 10.14302/issn.2576-6694.jbbs-20-3466
John AkighirCorresponding author
Department of Biochemistry, College of Science, Federal University of Agriculture, Makurdi P.M.B. 2373 (970001) Nigeria
Background and Objective The use of medicinal plants in industrialized societies for extraction and development of many drugs and other chemotherapeutics and traditionally for herbal remedies has increased in recent times. Plant–based medicine is essential in health care services with about 80% global population relying on it because of its cheap source and availability. Jatropha tanjorensis is one such plant used by males and females of childbearing age for treatment of reproductive problems such as infertility. Literature on isolation and characterization of the secondary metabolites in this plant may not be common. Against this backdrop, this research work was carried out to isolate, characterize and determine the effects of J. tanjorensis on the gonadal hormones of male wistar rats. Materials and Methods The secondary metabolites were isolated, characterized, and identified using nuclear magnetic resonance. The experiment was conducted using 25 male wistar rats weighing between 180-200 g randomized into 5 groups, 3 controls and 2 treatment groups of 5 rats each. The treatment groups received 25 mg/kg body weight of phytol and lupeol orally by gastric lavage for 14 days. The animals were anaesthetized and blood samples collected for hormonal assay. Result The experimental data was analyzed using one-way analysis of variance (ANOVA) with Statistical Package for Social Sciences (SPSS) version 17.0, while the post hoc test assessed using Duncan Multiple Range Test at p ≥ 0.05. There was a significant decrease (p ˂ 0.05) in the levels of FSH, LH and TST in the treatment groups when compared to the control groups. The motility and sperm count decrease significantly (p ˂ 0.05) when treatment groups were compared to the control animals. The secondary metabolites, phytol and lupeol present in the leaf extract of Jatropha tanjorensis were responsible for the decrease in some of the gonadal hormones studied.
Feb 2020 DOI 10.14302/issn.2641-5518.jcci-20-3217
Ozcelik FatihCorresponding author
University of Health Sciences, Sultan 2. Abdulhamid Han Training and Research Hospital, Department of Medical Biochemistry, Istanbul, Turkey
Small cell carcinoma of the prostate is a rare and highly aggressive subtype of prostate cancers. In this case report, we evaluated a patient applied our outpatient clinic with acute urinary retention, whose pathology reported as pure small cell carcinoma of the prostate. A 73-year-old male patient was admitted to our outpatient clinic with acute urinary retention. Digital rectal examination was normal. The PSA value was 1.81 ng/dl. Prostate size was 101 cc. Open prostatectomy was performed. The pathology of the patient was reported as pure small cell prostate carcinoma. Four cycles of etoposide and cisplatin chemotherapy were administered to the patient. The patient died 13 months later after the first diagnosis. We evaluated the pathological and clinical findings of small cell carcinoma of the prostate.
Feb 2020 DOI 10.14302/issn.2577-2279.ijha-20-3178
Ahmed Abdelrahman NuggedAlla MotazCorresponding author
University of Kassala-Sudan, Faculty of Medicine and Health Sciences, Head Department of Anatomy
Background In recent years great attention has been focused on the structural and histological structures of the placenta and the umbilical cord due to their vital roles in fetal development and neonatal survival. While extensive studies have been documented in this area in the developed world, there is very little published information about the morphological variations that occur in human placenta in Sudan. Therefore, this study was designed to evaluate the structural variations in placental indices and its relation to neonatal outcome. Methods A prospective hospital - based study conducted in Wad Madani Maternity Teaching Hospital Department of Obstetrics and Gynecology between July 2014 and March 2018. Results Mean placental indices for weight, diameter and thickness were 515.51 g, 18.80 cm and 2.43 cm respectively. The mean neonatal indices were 2.95 kg, 33.19 cm and 44.42 cm for weight, head circumference and length respectively. Neonatal weight correlated significantly with placental weight, neonatal length and neonatal head circumference (P < 0.000). On the contrary, neonatal weight had no significant correlation with placental thickness and diameter Conclusion In this study, there was a strong relationship between the placenta and the fetus suggesting that the well-being of the fetus is highly dependent on the placenta since it serves as a link between the mother and the fetus.
Nov 2019 DOI 10.14302/issn.2689-5773.jcdp-19-3061
Bajaj AnubhaCorresponding author
MD. (Pathology) Panjab University, Department of Histopathology, A.B. Diagnostics, A-1, Ring Road , Rajouri Garden, New Delhi, 110027, India.
Novel cancer therapeutics are superior and prevalent in the current scenario although a subset may not be satisfactorily alleviated or undergo disease relapse with the adoption of conventional chemotherapeutic agents. Cancer cells can comfortably elude immune destruction as interaction of cancer cells with native immune cells within tissue microenvironment is a cogent factor in evasion of cancer cells from pertinent immune surveillance. Thus, cancer immunotherapy can be safely contemplated as an efficacious and contemporary treatment modality for managing various malignant disorders.
Aug 2019 DOI 10.14302/issn.2576-6694.jbbs-19-2953
Syed Amber Ilyas NidaCorresponding author
National Center for Proteomics, University of Karachi, Karachi 75270, Pakistan
Breast cancer has high incidence in women from both developed and developing countries. Approximately 2 million women are diagnosed with breast cancer in 2018. In Asia, unfortunately Pakistan leads the highest number of breast cancer patients. Various treatment strategies are present but they are not well developed. There is a great need to develop effective methods for early detection and treatment of the disease. For cancer treatment chemotherapeutic interventions have always been a method of choice. One of the mechanisms involved in cancerous cell proliferation is Mevalonate (MVA) pathway. It is hypothesized that arresting MVA pathway leads to cell death hence cancer cell growth is suppressed. Various inhibitors of MVA pathway have been studied that can suppress cell proliferation. Nitrogen containing bisphosphonates are MVA pathway inhibitor and clinically used for treatment of bone diseases. Their anticancer efficacy is also reported. Current study focuses on alendronate, a nitrogen containing bisphosphonate to examine their anticancer effect on breast cancer cell line. Results of this study may help in addition of new anticancer drug for breast cancer.
Jul 2019 DOI 10.14302/issn.2379-7835.ijn-19-2721
Habulembe Mugode RaiderCorresponding author
National Food and Nutrition Commission, Lusaka, Zambia
Introduction In the past several decades, Zambia has suffered high levels of under nutrition particularly stunting among children below 5 years of age. Although appropriate complementary feeding practices are reported to reduce child deaths by 6%, they have not received the adequate attention from programme officers and caregivers in terms of implementation. Objectives The objective was to investigate issues surrounding the common complementary feeding practices practised by caregivers of children below five years in health facilities and areas where high rates of malnutrition admission come from. Design A cross sectional research using both qualitative and quantitative methods. The study used mostly proportions based mostly on global indicators on complementary feeding. Qualitative data was also analysed according to themes of global complementary feeding indicators Setting The study was conducted in five hospitals, namely Arthur Davison, Solwezi Central, Kabwe and Livingstone General, and University Teaching Hospital. Subjects The target populations were mothers whose children were admitted for malnutrition and those with children 0-59 months living in communities with the highest number of malnourished cases admitted to selected hospitals Results About45.2% (190) of caregivers introduced liquids before six months of age and 7.6% (32) after 6 months attributing child thirst, medication and advice from health worker as the main reasons. Slightly above half (54.2% of 224) of mothers/caregivers used cups to feed their babies. The use of feeding bottles was still common (8.2% of 34). Responsibility to feed the child is mostly left to the mother (86.4%, 362). In addition, children were being feed about 2.67 (SD 0-72) per day. Conclusions Child feeding practices were still poor. This contributes to poor child growth and health. More interventions should be planned to improve child care behaviour.
Jun 2019 DOI 10.14302/issn.2640-690X.jfm-19-2767
Venkateshwari AnanthapurCorresponding author
Institute of Genetics and Hospital for Genetic Diseases, Osmania University, Hyderabad, Telangana, India
Recurrent pregnancy loss is an important reproductive issue with a heterogeneous etiology where two or more consecutive abortions occur before 20 weeks of gestation. Approximately 15% of all clinically recognized pregnancies result in miscarriage with an incidence of 1 in 300 cases. Couples, who experience repeated pregnancy loss before three months of gestation, mostly have fetuses with chromosomal aneuploids. A non-consanguineous couple with a married life of 4 years was referred to the Institute with a clinical history of three first trimester abortions. Karyotype analysis revealed a balanced autosomal translocation between chromosomes 4 and 6 with 46, XX, t (4;6)(q35; q22) karyotype in the female and normal 46, XY in the male partner. Therefore, the siblings and the couple were suggested for extended genetic counseling. Interestingly, similar translocation was seen in her father and three sisters, whereas her mother and elder sister showed a normal chromosomal constitution, indicating the paternal inheritance.
May 2019 DOI 10.14302/issn.2644-0105.jbfb-19-2752
K. Bai YeonCorresponding author
Associate Professor, Department of Nutrition and Food Studies, Montclair State University, Montclair, New Jersey 07043
The proportion of mothers in the workforce has increased over the past 40 years. Examination of factors associated with a working/student mother’s milk expression is needed to provide effective lactation support. The purpose of this study was to examine the role of maternal assets in the relationships between the theory constructs, intention, and behavior of breast milk expression. Using a cross-sectional design framed under the theory of planned behavior, all female personnel associated with a higher education institute in northern New Jersey were invited to participate in the online survey, Milk Expression on Campus. Attitude toward breast milk expression, subjective norm, perceived behavioral control, intention, and behavior of breast milk expression on campus as well as maternal assets such as income, education, living status, and campus role were measured. Maternal assets had no moderation role but showed a significant and meaningful mediation effect on the relationship between perceived behavioral control and the intention to express breast milk on campus, with effect size R2=3.59%, 95% CI (-.1061, -.0047). There was no mediation effect of the asset on the relationship between intention and the behavior of breast milk expression, 95% CI (-.0984, .0232). Future breastfeeding support and promotion may direct its attention to provide systematic social and clinical support to enhance working/student maternal assets, e.g. family education, access to lactation services, or peer-based support programs, thereby helping mothers achieve their breastfeeding goals.
Apr 2019 DOI 10.14302/issn.2643-6655.jcap-19-2737
Köhler-Dauner FranziskaCorresponding author
Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm
Background Mothers with a history of childhood maltreatment (CM) are likely to transmit their own experiences to the next generation. This is highly influenced by the quality of maternal behavior that enables to buffer infant’s hypothalamic-pituitary-adrenal (HPA) axis response to stress. From a transgenerational perspective the research question is, if infant’s cortisol stress response is influenced by maternal CM experiences or rather by the behavioral pathways during the first year of life. Methods 53 mother-child-dyads were measured at 12 months of infant’s age in a laboratory visit assessing the maternal quality of interactive behavior using the Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE) measured during the strange situation procedure (SSP). Maltreatment experiences were assessed using the childhood trauma questionnaire (CTQ). Salivary cortisol of mother and infant were collected prior to and directly, 15 and 30 minutes after the SSP. Results Infants of disruptive mothers showed a significant increase in cortisol (F (3; 147) = 2.897, p= 0.048) after the SSP compared to infants of mothers with sensitive caregiving. Maternal CM did not influence the infant’s cortisol stress response due to the SSP. However maternal cortisol response was altered by trend due to CM (F (1.392; 71.008) = 3.157, p= 0.066). Conclusions Our data indicate that infant’s cortisol stress reactivity is influenced by the quality of maternal behavior and not by the transgenerational transmission of maternal CM experiences per se. These findings implicate that helping mothers to improve their caregiving behavior may help to improve stress-reactivity of their infant.
Apr 2019 DOI 10.14302/issn.2644-0105.jbfb-19-2681
L. Blanco CynthiaCorresponding author
Division of Neonatology, Department of Pediatrics, University of Texas Health Science Center, San Antonio, Texas.
This study compared the effect of container material type on macronutrient changes in human breast milk (HBM) during frozen storage. HBM was collected from breastfeeding mothers and baseline macronutrients were analyzed and recorded. The HBM was aliquoted into milk storage containers of five commonly used materials (low-density polyethylene (LDPE), polypropylene (PP), glass, stainless steel, and silicone). The samples were frozen in a standard freezer (-20°F) for 30, 60, and 180 days prior to thawing and retesting macronutrient values. In the 155 samples analyzed, macronutrient changes among different types of storage materials were insignificant at 30 and 60 days of frozen storage. When comparing macronutrients at baseline to 180 days, there was a significant decrease in protein value over time in LDPE containers as compared to silicone containers (p=0.001). Likewise, there was a significant decrease in total calories from baseline to 180 days in both PP and LDPE containers compared to silicone (p=0.046 and 0.013, respectively). While not significant for short-term storage, HBM has losses of macronutrients (protein) with long-term storage in LDPE and PP plastics. These differences could have major nutritional impact on growth, particularly to infants born prematurely.
Mar 2019 DOI 10.14302/issn.2642-9241.jrd-18-2499
A. S. Sardenberg RodrigoCorresponding author
Chief of Thoracic Surgery, Hospital Paulistano, Americas Serviços Médicos São Paulo, Brazil
Distant metastases generally indicate disseminated disease and the standard treatment for these patients is palliative chemotherapy. Retrospective series showed that selected patients with metastatic lung cancer and a solitary extrathoracic disease could be effectively treated with curative intention by resection of both primary tumor and the single site of metastatic disease. According to current data, adrenalectomy might be considered as an alternative option for patients with isolated adrenal metastases. Significant morbidity and mortality may be happened by these procedures, and a cautious analysis of pros and cons should be discussed with the patient. We present a review of the literature and updated recommendations focusing lung cancer with solitary adrenal metastasis.
Mar 2019 DOI 10.14302/issn.2381-862X.jwrh-19-2617
K Wood NatsukoCorresponding author
Assistant Professor at Washington State University College of Nursing, Spokane, WA, USA.
Objective The purpose of this study was to evaluate the feasibility of a home-based educational skill building program to support exclusive breastfeeding for mothers in the early postpartum period. Specific aims were to: (1) evaluate the effectiveness of the study’s recruitment strategy, comparing the use of an intermediary with a direct approach, (2) examine intervention fidelity, (3) examine program adherence, and (4) assess the acceptability of the intervention to participants. Design and Sample A mixed methods within-group, three-occasion descriptive design, delivered to 14 dyads of breastfeeding mothers and their full-term singleton infants. Intervention The program was implemented during three, 60-90 minute educational training sessions in the home, delivered at 6, 13, and 27 days postpartum. Results Mothers who adhered to the intervention protocol correctly attributed their infant’s crying behavior to factors other than the adequacy of the mother’s milk supply. All participants were recruited through direct approach. The program was delivered as planned with high fidelity, a high retention rate, and with a high rate of acceptability. Conclusions A fully scripted, at-home, nurse-delivered educational skill building program can be delivered with efficiency to breastfeeding mothers with full-term singleton infants; intervention fidelity, retention, and acceptability were high.
Jan 2019 DOI 10.14302/issn.2641-4538.jphi-18-1973
Victoria NthalaCorresponding author
Introduction Adherence to ART is a challenge among pregnant women living with HIV/AIDS. This has an effect on the health of the mother and the unborn child. While studies have been done, it has shown that adherence during pregnancy is a challenge Virological and clinical success depend critically on high adherence to ART because with low adherence. The success of expanded ART coverage in improving health outcomes depends on adherence to treatment. During pregnancy, a compromised Virological response to ART also increases risk of mother-to-child transmission (MTCT) of HIV. This study was carried out to determine factors that influence adherence to antiretroviral therapy among HIV positive pregnant women in Lusaka district of Zambia. Methodology This was a qualitative study which used a case study approach. Data was collected through in-depth interviews. The collected data was analysed using a thematic analytical approach. Results 17 pregnant women living with HIV /AIDS in Lusaka had Challenges with adherence to ART. The study explored factors related to adherence to ART among pregnant women living with HIV/AIDS. ART adherence was found to be low. The findings call for the need to reduce on social stigma. The results confirmed that there is low adherence to ART among pregnant women living with HIV /AIDS in Lusaka. Conclusion Adherence to ART among pregnant women living with HIV/AIDS is a challenge for Zambian pregnant women. Improved levels of adherence to ART is hampered by fear of social stigma, and fear of being blamed by partners if they disclosed their status. Stigmatisation needs to be addressed because nearly all the participants expressed this factor. There is need to address the HIV/AIDS stigma very seriously in order for society to look at HIV/AIDS like any other illness.
Jan 2019 DOI 10.14302/issn.2641-5518.jcci-18-2552
T KaraCorresponding author
Department of Pathology, Mersin University Medical School, Mersin, Turkey
This report presents a case of collision tumors of low-grade B-cell lymphoma and poorly differentiated adenocarcinoma in the caceum of a 63-year-old woman. Lymphoma was diagnosed incidentally after appendectomy for a clinical presentation of acute appendicitis. Imaging follow-up demonstrated mesenteric lymphadenopathy and liver lesions, and all surgically resected regional mesenteric lymph nodes and liver biopsy were found to be infiltrated by both mucosa-associated lymphoid tissue (MALT) lymphoma and adenocarcinoma. Systemic chemotherapy was administered for advanced colonic adenocarcinoma with liver metastases. The occurrence of synchronous lymphoma and adenocarcinoma of the colorectal region is rare, and this is a previously unreported case of a patient that was diagnosed during management of acute appendicitis.
Jan 2019 DOI 10.14302/issn.2641-4538.jphi-18-2545
Ferreira Bento SilvanaCorresponding author
Women´s Hospital “Professor Doutor José Aristodemo Pinotti” – Centro de Atenção Integral à Saúde da Mulher (CAISM), State University of Campinas, Brazil
This is a cross sectional study of a sample of civil servants from the interior of São Paulo state, carried out with the purpose of evaluating the occurrence of unwanted pregnancies, the proportion which were terminated, the reason given for having or not having an abortion and which factors were associated to the decision whether or not to terminate an unwanted pregnancy. Just over one fifth declared to have experienced an unwanted pregnancy and over half of them were aborted. The reasons to abort concentrate on interferance with their life expectancy: “to continue studying or working” “being single”, “too young to get married” and “to become a father or mother”. Also important were fear of parents and rejection by the respondents'partner. Among those who did not terminate the unwanted pregnancy religion acted as a barrier among almost one third and the legal barrier for almost one fourth. Not having a permanent partner, being in use of behavioral or barrier method of contraception and higher education were associated with higher incidence of abortion of the unwanted pregnancy, but in multiple regression, only higher education remain significantly associated. Our results showed that once the unwanted pregnancy occur, more than half of them will be aborted, confirming the need to concentrate the efforts in reducing unwanted pregnancies if we want to prevent abortion.
Jan 2019 DOI 10.14302/issn.2691-5014.jphn-18-2456
Mohamadreza AmiriCorresponding author
Vitamin D, the sunshine vitamin, is now recognized not only for its importance in promoting bone health in children and adults, but also for its other health benefits, including reducing the risk of chronic diseases such as autoimmune diseases, common cancer, and cardiovascular diseases. Ultraviolet radiation of the sun with wavelengths of 290-310 nm penetrates into the skin and converts 7-dehydrocholesterol to previtamin D3, which quickly transforms to vitamin D3. Vitamin D (D represents either D2 or D3) made in the skin or ingested through diet is biologically inert and requires two successive hydroxylations first in the liver on carbon 25 to form 25-hydroxyvitamin D 25(OH)D and then in the kidney for a hydroxylation on carbon 1 to form the biologically active form of vitamin D, 1,25-dihydroxyvitamin D (1,25(OH)2D) 121419. The concentration of the produced 25-hydroxy vitamin D in blood circulation is 1,000 times more than 1,25-dihydroxy vitamin D 4, and it is regarded as a standard indicator of vitamin D status in humans 3. 25-hydroxy vitamin D half-life is about 2-3 weeks and it is regulated by calcium (Ca), phosphorus (P), and serum parathyroid hormone (PTH) to some extent. 25-hydroxy vitamin D content also reflects the amount of vitamin D produced in the skin after exposure to sunlight or received through food intake 56. Guidelines for vitamin D insufficiency/deficiency defined by serum 25(OH)D concentrations have been published from many countries and regions all over the world 7891011. Vitamin D deficiency is a pandemic problem. According to global estimations, more than one billion people around the world suffer from vitamin D deficiency. Among Iranian population, the incidence of vitamin D deficiency varies from 2.5 to 98.5% based on geographic area 1213. Various factors may give rise to vitamin D deficiency, including skin pigments, low levels of vitamin D in diet (insufficient fish oil and egg yolk intake), malnutrition, genetic factors, exclusive breast feeding, vitamin D deficiency of mother during pregnancy, prematurity, chronic use of drugs (e.g., anticonvulsants, aluminum-containing anti-acids, rifampcin, isoniazid, antifungal drugs, antiviral drugs, and glucocorticoids), winter and obesity 113. Cultural habits, the need for full body coverage during outdoor activities and the lack of sunlight programs are the risk factors for low vitamin D levels in women 151617. Children enter foster care due to early childhood adverse experiences such as poor prenatal and infant health care, food insecurity, chronic stress, and the effects of abuse and neglect. As a result, they are at higher risk for poor physical, psychological, neuroendocrine and neurocognitive outcomes compared to others. Foster children are at risk for growth and nutritional deficiencies due to their poor nutritional environment prior to placement in foster care. Insufficient caloric intake results in growth deficiencies. Evidence showed that the risk of stunting and underweight is high in this population 18. The risk of developing hypovitaminosis D was significantly higher in children living in foster homes. One reason is that they are at higher risk of child abuse, emotional deprivation and physical neglect than children living with their families. Moreover, these children most likely do not spend much time outdoors and they lack adequate sun exposure. Another reason is that as children grow up in institutional care, they shift from a diet of vitamin D–fortified formula milk to cooked food, which may not be fortified with vitamin D 1. Iranian government has made some efforts to apply efficient interventions to reduce the prevalence of vitamin D deficiency, and the country’s healthcare system should be managed through accurate planning. Yet, in this country, studies on vitamin D deficiency in children living in foster homes are very limited, and given that timely diagnosis and treatment of this deficiency is vital, this research is conducted in Ali Asghar foster home in Mashhad, Iran.
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.
Aug 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2263
FA MagajiCorresponding author
Jos University Teaching Hospital, Jos, Nigeria.
Nigeria is one of the high-burden countries in sub-Saharan Africa for HIV/AIDS and contributes to reproductive health morbidities and mortalities. This study was aimed at determining the prevalence of HIV-discordant rate among pregnant women in Plateau state Nigeria. The study sought to determine the prevalence and trend of HIV sero-discordance among pregnant women in Plateau state, Nigeria. The study was a 5-year descriptive analysis of HIV sero-discordance among pregnant women accessing prenatal care and their partners in Plateau state, Nigeria based on data generated between January 2012 and December 2016. The data was disaggregated by year, HIV concordant negative, HIV concordant positive, and HIV sero-discordant prevalence in the software and analysis were done using excel to obtained the proportions and trend of HIV sero-discordant prevalence among the antenatal population. Out of a total of 7,851 partners of pregnant women studied, 969 (16.3%) were HIV sero-discordant, 5,795 (73.8%) were HIV concordant negative, and 773 (9.9%) were HIV concordant positive. HIV sero-discordant positive males accounted for 12.3% while females were 4.0%. The prevalence of HIV sero-discordance was low with a high proportion of HIV positive male partners in Plateau state with grave public health implications for new HIV infections among partners and eroding the gains made in the Prevention of mother-to-child transmission of HIV.
Aug 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2236
FA MagajiCorresponding author
Jos University Teaching Hospital, Jos, Nigeria.
Nigeria is one of the high-burden countries in sub-Saharan Africa for HIV/AIDS and contributes to reproductive health morbidities and mortalities. This study was aimed at determining the prevalence of HIV-discordant rate among pregnant women in Plateau state Nigeria. The study sought to determine the prevalence and trend of HIV sero-discordance among pregnant women in Plateau state, Nigeria. The study was a 5-year descriptive analysis of HIV sero-discordance among pregnant women accessing prenatal care and their partners in Plateau state, Nigeria based on data generated between January 2012 and December 2016. The data was disaggregated by year, HIV concordant negative, HIV concordant positive, and HIV sero-discordant prevalence in the software and analysis were done using excel to obtained the proportions and trend of HIV sero-discordant prevalence among the antenatal population. Out of a total of 7,851 partners of pregnant women studied, 969 (16.3%) were HIV sero-discordant, 5,795 (73.8%) were HIV concordant negative, and 773 (9.9%) were HIV concordant positive. HIV sero-discordant positive males accounted for 12.3% while females were 4.0%. The prevalence of HIV sero-discordance was low with a high proportion of HIV positive male partners in Plateau state with grave public health implications for new HIV infections among partners and eroding the gains made in the Prevention of mother-to-child transmission of HIV.
Apr 2018 DOI 10.14302/issn.2577-2279.ijha-18-2030
A. Kiryanov N.Corresponding author
Izhevsk State Medical Academy, Russia.
Introduction: The use of non-medicinal facilities for correcting processes in various pathological conditions is one of the most urgent problems of modern medicine. Purpose of the Work: To study the effect of low-intensity infrared laser radiation on reparative bone formation and angiogenesis in bone regeneration which is formed in treatment of fractures under conditions of transosseous osteosynthesis. Material and Methods: A tibia fracture was modeled experimentally in rats in the control and experimental groups. Reposition and fixation of fragments were performed. The fracture zone in the experimental group animals was exposed to the impact of pulsed infrared laser irradiation of low intensity. Animals from the control group underwent the impact simulation. The operated bones were investigated using the methods of X-ray, light and electron microscopy, X-ray electron probe microanalysis. Results: It was established that laser radiation exposure sessions activated fibrillogenesis and angiogenesis, accelerated compacting of newly formed bone tissue and increased its maturity while primary fracture healing occurred. Prolonged capillary dilatation and endothelium-dependent vasodilation, intensive capillarogenesis were noted after sessions of laser therapy in bone regeneration. Endothelial outgrowth was formed in the lumen of the vessels forming capillary buds that propagate along the “mother” vessels (endovascular capillarogenesis). Conclusion: The data obtained revealed a possible mechanism of laser radiation exposure at the level of a whole organism and proved the effectiveness of its application in clinical practice at the early stages of patient rehabilitation under conditions of transosseous osteosynthesis.
Mar 2018 DOI 10.14302/issn.2639-1716.jn-18-1993
W. Kurtis ChildersCorresponding author
Cardiovascular disease and lung cancer are two of the most common causes of death in the United States. The cardioprotective benefits of statin class drugs is predominantly mediated through the inhibition of 3-hydroxy-3-methylglutaryl CoA (HMG-CoA) reductase, decreasing available mevalonate, and thus limiting in vivo cholesterol biosynthesis. Mevalonate and its metabolites have significant roles in cellular membrane synthesis, which is dysregulated during tumorigenesis, and is therefore a potential source for anti-tumor effects of statins. Similarly, dysregulation of cellular signaling is a hallmark of tumorigenesis. In vitro studies of EGFR, RAS, and AKT signaling pathways in cancer cells can all be reformed back to states more indicative of normally functioning cells when treated with statins. Statins have also been shown to exert beneficial properties in the presence of chemotherapeutic medications and radiation therapies by modulating the deleterious effects of reactive oxygen species, decreasing tumor cell resistance, and minimizing damage to surrounding native tissues. There is abundant of in vitro evidence to support the beneficial effects of statins on lung cancer patients. Prospective studies to determine the value of statin therapy on lung cancer prevention could lead to a significant change in lung cancer treatment.
Feb 2018
Zeng JinchengCorresponding author
Dongguan Key Laboratory of Medical Bioactive Molecular Developmental and Translational Research, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan 523808, China
Gastric cancer is one of the most common types of cancer in the world, usually diagnosed at an advanced stage. Despite the advances in specific anticancer agents' development, the survival rates remain modest, even in early stages. HER2 overexpression was identified on 15% - 20% of gastric cancer patients. Trastuzumab-based chemotherapy provides obvious efficacy improving outcomes of HER2 positive gastric cancer patients. We performed a meta-analysis to estimate the efficacy of the addition of trastuzumab over chemotherapy. We identified randomized controlled trials (RCTs) which compare the addition of trastuzumab therapy to chemotherapy alone reporting progression-free survival (PFS), time to progression (TTP), overall survival (OS), and/or response rates as our eligible trials. Night trials including 1101 patients were eligible for analysis. Trastuzumab therapeutic partners were cisplatin (9 RCTs), 5-fluorouracil (8 RCTs), capecitabine (6 RCTs), irinotecan (1 RCTs), docetaxel (1 RCTs), oxaliplatin (1 RCTs), and leucovorin (1 RCTs). The addition of trastuzumab agents improved OS (HR = 0.80; 95% CI = 0.72 - 0.89), PFS (HR = 0.70; 95% CI = 0.59 - 0.83), TTP (HR = 0.69; 95% CI = 0.57 - 0.83), and overall response rate (RR = 1.22; 95% CI = 0.94 - 1.59), DCR (RR = 1.19; 95% CI = 1.10 - 1.28). Our meta-analysis affirmed the efficacy of adding trastuzumab agent to chemotherapy in HER2 positive gastric cancer.
Feb 2018 DOI 10.14302/issn.2641-5518.jcci-17-1880
A D Mettias BassemCorresponding author
ENT Department, Fayoum University, Egypt.
Objective: Presentation of rare case report of primary non-Hodgkin Lymphoma of temporal bone secondary to immunodeficiency after prolonged steroid administration in a diabetic patient. Then review the literature of similar case reports. Method: 49 years old female presented with hearing loss, facial paralysis and otalgia. Biopsy revealed high grade non Hodgkin’s B-lymphoma. She underwent chemotherapy and had remarkable response. Result: Rapidly progressive deafness, facial paralysis and otalgia are common presentations of external canal Non-Hodgkin lymphoma. The disease is common in middle age, females and has a fair response to chemotherapy, good to radiotherapy. Surgery is an alternative method in isolated lesions or recurrent cases. Conclusion: High dose steroid and type II diabetes are potential risks for acquired immunodeficiency. External Auditory canal lymphoma is uncommon sequel. Chemotherapy is very effective in treatment of isolated cases without B symptoms
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.
Oct 2017 DOI 10.14302/issn.2574-4526.jddd-17-1497
Darouichi M.Corresponding author
Medical institute radiology and gynecology ,Genrva,Switzerland.
Volvulus occurring during pregnancy is a rare complication, still potentially lethal nowadays for both the mother and child due to several, early arising complications. We report here a case of small bowel volvulus in a 28 weeks and 4 days, 29 years-old, pregnant woman with a past medical history of appendectomy in her childhood. Patient presented in emergency department with abdominal pain and abnormal hepatic tests. Cholangio-MRI suggested bowel obstruction due to volvulus that was confirmed by gastroscopy (showing the obstruction) and intestinal MRI. Patient was first treated by laparoscopy but, due to a very complicated abdominal status with the presence of several adhesions of the small bowel, surgery was changed to an open laparotomy, which allowed discovery and repositioning of small bowel malrotation and removal of adhesions. Both patient and the foetus were healthy after surgery and the patient was then discharged. In the light of this particularly rare case of small bowel volvulus due to malrotion, we will describe the pathology of bowel obstruction and more particularly volvulus during pregnancy and discuss its diagnosis and treatment.
Sep 2017 DOI 10.14302/issn.2324-7339.jcrhap-17-1694
Coulibaly R BereteCorresponding author
Ophthalmology Department of University Hospital of Treichville
Introduction: Squamous cell carcinomas of the conjunctiva (SCC) are rare neoplasia but have a high rate of increase and a high rate of mortality, especially when they occur in the context of Human Immunodeficiency Virus (HIV) infection. The objective of this study was to establish an epidemiological and clinical profile of SCC in patients living with HIV and to assess its evolutionary characteristics. Patients and Methods: this was a descriptive cross-sectional study carried out over a period of 5 years in the ophthalmology department of the University Hospital of Treichville. The data collected focused on epidemiological, clinical, pathological, therapeutic and evolutionary elements. Twenty tree eyes of 23 patients were examined during this period. Results: The average age of our patients was 45 years with extremes ranging from 31 to 60 years. A female predominance was observed with a sex ratio of 0.92. The average consultation period was 18 months with extremes ranging from 6 to 60 months. Physically, 35% of our eyes (08 eyes) presented a functional loss of the eye. All our patients had a HIV positive status with 16 cases of HIV1 infection, 4 cases of HIV 2 infection and 3 cases of HIV 1 and 2 co-infection. Lymphocyte typing was performed for 15 patients out of the 23 With CD4 cell counts ˂ 200 in 30.43% of cases, between 200 and 500 in 34.78% of cases. All our tumors had had biopsy excision with pathological examination. A postoperative adjuvant topical chemotherapy in 6 cases. The average follow-up period of our patients was 29 months. In all cases, it was invasive differentiated squamous cell carcinoma. Discussion: HIV infection is a risk factor for the occurrence of conjunctival squamous cell carcinoma, but it is also an aggravating factor especially in the case of low CD4 cell count, particularly in sub-Saharan Africa, where the fight against infection, although boosted in these recent years, is far to achieve all objectives Conclusion: HIV seroprevalence is very often associated with opportunistic infections which include carcinogenic processes such as squamous cell carcinomas of the conjunctiva
Sep 2017 DOI 10.14302/issn.2574-4526.jddd-17-1776
Augoulea AretiCorresponding author
Department of Obstetrics and Gynecology, National and Kapodestrian University of Athens, Medical School,, Aretaieio Hospital, 76 Vas. Sofias Ave, GR-11528, Athens, Greece
Objectives: The rate of morbid obesity among women of reproductive age continues to rise worldwide. Surgical treatment remains the most effective mean to face it. Anatomical, physiological and nutritional modifications lead to several challenges for pregnancy after bariatric procedures. In spite of routine supplementation after bariatric surgery, vitamin and mineral deficiency frequently appear in bariatric pregnancies. The aim of this review is to summarize the existing data on the prevalence and management of nutritional deficiencies in pregnancy after bariatric surgery. Methodology: A comprehensive search of Pubmed Database was conducted for English-language studies using a list of key words. Results: The most common post-operative deficiencies in pregnancy include iron, vitamin B12, folate, vitamin D and magnesium deficiency. Less common are selenium, vitamin A, vitamin B6 and vitamin C deficiency. Finally, copper, vitamin K, vitamin B1, vitamin E and albumin deficiencies are considered to be relatively rare. Conclusions: Pregnancy after bariatric surgery has been proven to be safe for both the mother and the fetus. However, there is still the risk of significant nutritional deficiencies with adverse effects on pregnancy and lactation. As a result, a thorough customized nutritional assessment is mandatory for every woman in reproductive age who has undergone a bariatric operation, with strict regular follow-up during pregnancy and lactation.
Aug 2017 DOI 10.14302/issn.2997-2086.jfs-17-1663
Knezevich MichelleCorresponding author
Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.
Fetal surgery is the newest surgical specialty with a compelling history. The development of fetal surgery began in primates and lambs and, in its most basic form, was first performed in humans in 1965. Since its introduction, the field has expanded and changed dramatically. Several of these changes have involved the ethical aspect of fetal surgery. This field conflicts with the Hippocratic oath mantra of “first do no harm” as one of the patients, the mother, receives no benefit from these procedures. The ethical dilemma resulted in stringent inclusion and exclusion criteria for fetal operations. Initially, fetal surgery was only indicated for life-threatening conditions of the fetus but is now offered in some disease processes to improve quality of life for the child. As the field has matured, it has grown to encompass numerous different types of fetal interventions. Similar to other areas of surgery, the trend has been to migrate from more invasive to less invasive procedures. Currently, some of these therapies are performed entirely percutaneously. Theoretically, this trend would improve outcomes for both the mother and fetus. While this has generally proven true, there are some important exceptions to this rule. Finally, as the field continues to evolve, much research is being performed looking at possible new types of fetal interventions. Some of these procedures, such as fetal stem cell therapy and fetal gene therapy, could change the face of modern medicine.
Jul 2017 DOI 10.14302/issn.2372-6601.jhor-17-1473
R RaacheCorresponding author
Laboratoire des cytokines et NO Synthases (FSB-USTHB), Université des Sciences et de la Technologie Houari Boumediene (USTHB), Alger, Algérie
Objective: This study aimed to evaluate the relation of Lactate dehydrogenase (LDH) levels with stage of the disease and it role in monitoring tumor response to therapy in lymphoma patients. Methods. LDH levels were evaluated on 65 diagnosed Algerian children and compared to healthy control. Results: Our results revealed that LDH levels were significantly higher in untreated children with both hodgkin’s and non hodgkin’s lymphomas compared to control. Moreover, it was observed that the higher is the stage of disease, the more serum LDH level will be. However, there was a significant fall in serum LDH activity by completion of the chemotherapeutic courses. Conclusion: LDH plays an important role in tumor initiation and maintenance. The elevated serum LDH may reflect, release of the enzyme from malignant cells and suggest that they may reflect tumor burden and therefore correlate with disease progression.
Jul 2017 DOI 10.14302/issn.2574-4518.jsdr-16-1413
Harada TetsuoCorresponding author
Laboratory of Environmental Physiology, Graduate School of Integrated Arts and Sciences, Kochi University
Purpose: An intervention program was performed to improve meal habit, sleep habit and academic marks at school. This program was called “Super Meal Educational Program” which was supported by Japanese Ministry of Arts, Sports, Sciences and Education. Effects of the intervention were evaluated by comparing an integrated questionnaire study held both before and after the intervention of a half year. Method: The intervention program consisted of a lecture on sleep health and diurnal rhythms on children by an university professor, a series of lectures and practical classes by elementary school teachers on foods which can be collected nearby, and also practical courses as excursions to learn traditional meals and several foods resources which are products nearby. Integrated questionnaire study and also government official academic achievement test were performed before and after the intervention for 6 months in May to November, 2015. An integrated questionnaire was administrated to elementary school students of grades 1 to 6 (7-12 years old). For the younger students aged 6-9 years old, parents (mostly mothers) answered the questionnaire instead of their children. The participants consisted of 40 to 55 students in each grade from the first to the six one of the elementary school. The rate of answer to the questionnaire was more than 95% and the number of data used for statistic analysis was 295 before and 286 after the intervention. The integrated questionnaire included questions on the diurnal type scale (DTS), sleep habits, meal habits, and other questions on their environments and life-habits. Result: In the histogram on distribution of the diurnal type scale scores (DTS) before intervention, the students which occupied 25% evening-typed significantly shifted to more morning-typed ones after the intervention (p<0.001). There was significantly negative correlation between DTS scores before intervention and the amount of increased change in DTS during the intervention period (r=-390, r<0.001). For all students in the elementary school, there were no significant changes in sleep quality, bedtime in weekdays, wake up time and sleep hours before and after the intervention period. There was negative correlation between sleep hours in weekday before intervention and increased amount in sleep hours before and after that (r=-0.545, p<0.001). The longer the sleep hours were shifted longer during intervention, the better the academic achievement mark of mathematics was after the intervention (students in the second, third and fifth grades: p=0.001). Conclusion: At least for the students who had been originally evening-typed, the intervention on meal habits may be effective for longer sleep hours and improved school achievement and marking for especially mathematics in elementary schools.
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.
Feb 2017 DOI 10.14302/issn.2997-2086.jfs-16-1098
Burjonrappa SathyaprasadCorresponding author
Department of Pediatric Surgery, Winthrop University Hospital, Mineola, NY 11501
We report a twin gestation with one fetus afflicted by a left sided Extra-Lobar Sequestration (ELS) in a morbidly obese mother. The ELS was complicated by a left pleural effusion in the second trimester unresponsive to maternal steroid administration. We discuss the need for repeat shunt placement, in the setting of maternal morbid obesity and twin gestation. Shunt replacement was necessary secondary to dislodgement. Delivery at 34 weeks gestation was followed by successful surgical removal of the ELS. At one year follow up the infant has complete expansion of the left lung with no morbidity.
Nov 2016 DOI 10.14302/issn.2644-0105.jbfb-16-1257
Aumeistere LivaCorresponding author
Institute of Food Safety, Animal Health and Environment BIOR, Riga, Latvia
Background: Breast milk is the ideal food source that contains all components an infant needs. Infants are at risk of receiving possible pollutants and high levels of trans fatty acids through breast milk that may affect their cardiovascular health and cognitive development. Statistics indicate that the proportion of children who are breastfed up to one year of age shows an annual increase in Latvia. Objectives: 1. To review studies conducted among the Latvian population regarding breast milk composition. 2. To evaluate the necessary future studies emphasizing the importance of the trans fatty acid content in a mother’s diet and correspondingly in breast milk and taking into consideration the new changes in Latvian legislation setting the maximum trans fat content in foodstuffs. Conclusions: There is very little research done about the human milk composition in Latvia that could be referable to a general population. It is known that the exposure of breast milk to persistent organic pollutants in Latvia corresponds to the lowest levels detected in the European countries and is not a cause of health disorders. Taking into consideration the adverse effect trans fatty acids have on human’s health regardless of the age, consumption should be as low as possible. Latvia has become the latest European Union country to set the maximum amount of trans fats in foodstuffs, yet there is no information about trans fatty acids content in human milk among women in Latvia. This problem needs to be addressed and set in motion. Therefore, it would be a novel idea to study if the TFA content also declines in milk among Latvian women after the introduction of the new legislation.
Oct 2016 DOI 10.14302/issn.2474-9273.jbtm-16-1173
C. Jellesma FrancineCorresponding author
Research Institute Child Development and Education, University of Amsterdam
Many schoolchildren experience somatic complaints such as headaches, abdominal pain and fatigue. The aim of the current research is to test the full model of previously found associations between negative affect and somatic complaints in parents and children. Participants were 199 children (aged 8-13, 47% boys) and their parents (aged 31-61, mostly mothers (87%). Self-reports of children and parents on worry, anxiety, depression and somatic complaints were used and parents’ reactions to children’s emotions wereassessed. The results of the study show that childhood negative affect and parental somatic complaints are positively associated with childhood somatic complaints. In turn, childhood negative affect is related to children’s worrying and to parents’ responses to children’s emotions. The more anxious or depressed children felt, the more they worried. Maladaptive parental responses (such as reprimands and discomfort) to child emotions were positively related to depression. It was also found that parents who experienced more negative affect, reported more somatic complaints and tended to report more maladaptive responses towards their children’s emotions.
Mar 2016 DOI 10.14302/issn.2577-137X.ji-15-834
Z Kompithra RajeevCorresponding author
Department of Child Health, Christian Medical College, Vellore, Tamil Nadu, 632004, India
The Expanded Program on Immunization (EPI) in India delivers vaccines under its policy, through government hospitals, health centers and outreach clinics. However, the national average full immunization coverage is stagnating at about 70%. The days and times of clinics are not always convenient for mothers working at home or employed outside. Moreover, vaccines not under EPI, but recommended by the Indian Academy of Pediatrics (IAP), are unavailable there, forcing mothers to go to private sector immunization clinics to get them. Recognizing the local need for user-friendly immunization clinic, we designed one in the Department of Child Health. The impetus came from local demand by a civil society organization (Rotary Club of Vellore). Our immunization clinic is open every working day (8.30 am to 4.00 pm) offering both groups of vaccines. Its success is illustrated by the fact that over 7000 children per month receive immunization in this clinic. We describe its design and operation so that this model may be replicated in other urban hospitals with pediatric sections.
Feb 2016 DOI 10.14302/issn.2379-7835.ijn-16-924
Arlappa NimmathotaCorresponding author
Division of Community Studies, National Institute of Nutrition (NIN), Hyderabad, Telangana, India.
Objectives: Vitamin A deficiency (VAD) among the rural pre-school children in India is continues to be a major nutritional problem of public health significance, even after the implementation of national vitamin A prophylaxis programme for more than four decades. The aim of the study was to assess the prevalence of vitamin A deficiency among rural pre-school children of South India. Methodology: A community based cross-section study; adopting multi-stage random sampling procedure was carried out by the National Nutrition Monitoring Bureau (NNMB) among rural pre-school children of four South Indian states viz. Kerala, Tamil Nadu, Andhra Pradesh and Karnataka during 2003-05. A total of 35,480 (Boys: 18,216; Girls: 17,264) rural children of 1-5 year age group was covered for this study. Key Results: The prevalence of Bitot’s spot, an objective ocular sign of VAD among the rural pre-school children of South Indian was 0.6% (95%CI:0.5-0.7). Similarly, the proportion of children with sub-clinical VAD was 59.3%, suggestive of a severe public health problem. In general, the prevalence of VAD was significantly higher (p<0.001) among the children of socio-economically marginalized sections of the communities, labourers, illiterate mothers and those residing in the households with no sanitary latrine. Conclusion: The prevalence of clinical and sub-clinical VAD among the rural pre-school children of south India is suggestive of a public health concern. Therefore, rural communities are encouraged to consume diets rich in pre-formed and pro-vitamin A and administer periodic massive dose vitamin A solution to the children of under five for the prevention and control of VAD.
Feb 2016 DOI 10.14302/issn.2372-6601.jhor-15-822
I.V. ChernikovCorresponding author
Institute of Chemical Biology and Fundamental Medicine SB RAS.
Small interfering RNA (siRNA) based drugs for overcoming multiple drug resistance of hematological malignancies could solve the problem of poor response to the chemotherapy and hight relapse rate. The main factor that significantly limits biomedical application of siRNA is inefficient delivery to target cells and tissues. The attachment of siRNA to molecules, which enter into the cell by natural transport mechanisms, can improve cellular uptake of siRNA. In current study the carrier-free cellular uptake of siRNA containig cholesterol residues conjugated to the 5’-end of the sense strand via oligomethylene linker of various length (here and after Ch-siRNA) was explored. The data demonstrate that cholesterol residue increase the accumulation of siRNA in all tested cell lines and the primary cells. The efficiency of Ch-siRNA accumulation in K562 cells depends greatly on the leangth of the linker connecting cholesterol and siRNA: Ch-siRNAs with linker of 10 - 12 methylene units accumulate the most efficiently in this cells. It was found that Ch-siRNA effectively accumulates in MOLT-3 (acute lymphoblastic leukemia, ALL), HL-60 (acute myelogenous leukemia, AML), K562 (chronic myelogenous leukemia CML) and primary peripheral blood mononuclear cells (PBMC) from patient with non-Hodgkin lymphoma (NHL) or healthy donor resulting in near 100% of transfected cell when used at 1 mM concentration.
Oct 2015
S. Woo JenniferCorresponding author
Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, CHS 13-145, Los Angeles, CA, United States
The mitotic count is the most frequent reason for discordance between pathologists in modified Bloom and Richardson (mBR) scoring. Recently, the phosphohistone H3 (PHH3) immunohistochemical stain has been proposed as a potential surrogate marker for mitotic figures. This study examines the differences between H&E mitotic count, PHH3 mitotic count, and Ki-67 index in invasive breast carcinoma. A retrospective review of invasive breast carcinoma cases from 2013- 2014 was performed. H&E and PHH3 mitotic counts were assigned a mitotic score of 1 to 3 using mBR criteria. Ki-67 index was categorized into a three-grade system: <10% (low), 10 - <20% (intermediate), and >20% (high). A total of 451 cases were evaluated. PHH3 versus H&E mitotic count changed mBR scores in 24% of cases, upgrading in 23% and downgrading in 1%. A total of 431 cases had both Ki-67 and PHH3 available for comparison. Both H&E and PHH3 mitotic scores correlated with Ki-67 in 51% of cases; however, PHH3 had better correlation. We conclude that PHH3 in breast carcinoma allows for a more sensitive and practical approach in the identification of mitotic figures. PHH3 IHC is useful as a confirmatory tool in assessing the final mitotic score for more accurate mBR scoring and grading. In this study, 48 out of 451 (10.6%) of patients had a significant upgrade that may change the patient's treatment plans, including the addition of chemotherapy
Oct 2015 DOI 10.14302/issn.2379-8572.joa-15-691
Abdel Rahman HanyCorresponding author
Departments Of Pediatric Oncology, National Cancer Institute, Cairo University
Background. Nasopharyngeal carcinoma (NPC) is a rare disease in the pediatric age group; it represents 1% of all pediatrics malignancies, however, it is the predominant malignancy arising in the nasopharynx in this age group. Although NPC is a chemo-radiosensitive disease yet, the optimal dose of radiotherapy and optimal timing of chemotherapy is still not standardized. Methods. This is a retrospective study including all the newly diagnosed pediatric NPC who were diagnosed and treated at the Children Cancer Hospital Egypt (CCHE) during the period from July 2007 to December 2012. All imaging studies (e.g., CT or MRI scans) were reviewed by a senior head and neck radiologist for proper staging and assessment of tumor response. Patients were staged according to AJCC staging system. Modified version of the Response Evaluation Criteria in Solid Tumor (RECIST) was used to assess response. Results. Twenty-six patients were diagnosed and received treatment as NPC in CCHE. Median age was 12 years (range 7.8-17 years). There was a male predominance. Eleven patients (42.3%) were stratified as stage 4, and 11 (42.3%) as stage 3. All patients received 3 cycles of neo-adjuvant chemotherapy followed by concurrent chemo-radiotherapy. IMRT was used to deliver radiotherapy in all patients. The overall response rate (CR and PR) to induction therapy was 73%, 19.3% had SD, while 7.7% had PD. By the end of the study, 18 patients (69.2%) were alive in CR, 5 patients (19.2%) had PD, and 3 patients (10%) lost for follow up. The Mean duration of follow up was 35 months, range 5-66 months. The 3 year OS and EFS and rates were 84.6% and 69.3 % respectively. OS for M0 was 91.3% and for M1 33.3% with statistical significance (p =0.032). Conclusion. Neoadjuvant chemotherapy followed by concurrent chemoradiotherapy using IMRT lead to good clinical end results with limited toxicity. Metastatic disease at presentation was identified as the adverse prognostic factor.
Jul 2015 DOI 10.14302/issn.2372-6601.jhor-15-657
Aguayo AlvaroCorresponding author
Division of Medicine, Medical Oncology Department, The American British Cowdray Medical Center, Mexico City
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a known side effect of several oncology drugs, but it is rarely seen secondary to vinblastine with only a few cases reported worldwide. Herein we present a patient with nodular lymphocyte-predominant Hodgkin disease that developed a severe acute hyponatremia seven days after her first cycle of chemotherapy with R-ABVD. After fluid restriction, symptoms and concentration of blood sodium were restored. After a comprehensive review of the literature vinblastine was thought to be the cause and avoided in the second infusion of chemotherapy without recurrence of the SIADH.
Jun 2015 DOI 10.14302/issn.2379-7835.ijn-14-591
Negri RossellaCorresponding author
Department of Translational Medicine, Pediatrics, European Laboratory for Food Induced Diseases, University of Naples Federico II, Italy.
Objectives Taste sensitivity is an important determinant of food choice and differs between children and adults. This difference is probably due to several factors that constitute an individual’s phenotype. The aim of this study was to explore taste perception in relation to the TAS2R38 and CAVI (gustin) genotypes in age classes from infancy to adulthood in a Mediterranean population. Methods In this cross-sectional study we evaluated the TAS2R38 and gustin genotypes and administered a standardized PROP taste test in 705 individuals (435 adults, 270 children); the sample included 224 mother-child dyads. We also explored the acceptance and consumption of bitter and non-bitter vegetables. Results Sensitivity to bitterness was strongly related to the TAS2R38 haplotype, and we observed an intriguing relationship with age. In fact, children were more sensitive than adults with the same TAS2R38 haplotype also within mother-child dyads. The mother-child tasting differences decreased with age and became minimal when children reached adolescence. Variations in the gustin gene did not contribute significantly to the overall taste phenotype, but helped to differentiate among non-tasters. Conclusions The genetic profile of the bitter-taste receptor TAS2R38 explains most of the variance in bitter taste perception, but the related phenotype is also strongly influenced by age, also in mother-child dyads that share the same genotype. This finding is likely to have a significant impact on the complex feeding relationship between mother and child.
May 2015 DOI 10.14302/issn.2471-7061.jcrc-14-574
B. Irby RosalynCorresponding author
Department of Medicine Penn State Hershey Cancer Institute, Penn State College of Medicine, Hershey, PA 17033. &Denotes equal contribution
Colon cancer has a five-year survival of 64.7%, and about 50,000 people are expected to die from colon cancer this year. Patients with metastatic colorectal cancer have a significantly worse prognosis, a 12.9% five-year survival. This emphasizes the need for strategies to inhibit the growth and metastases of colorectal cancer. Prostate apoptosis response protein 4 (Par-4) is a pro-apoptotic protein that has been shown to mediate apoptosis in response to stimuli, such as chemotherapeutics and radiation. Recombinant Par-4 protein has been shown to reduce the occurrence of Lewis lung carcinoma metastases in-vivo; however, the mechanism by which Par-4 can inhibit metastasis has not been elucidated. In this study, human colon cancer cell lines - SW480 and SW620 - were transfected with Par-4 plasmid or anti-Par-4 shRNA, and the effect on metastasis was examined. Par-4 overexpression inhibited cell migration and invasion, while Par-4 knockdown promoted it. Moreover, the morphology of SW620 cells was altered when Par-4 levels were increased. The change was characteristic of a mesenchymal-to-epithelial transition (MET) in these cells. MET can be induced by upregulation of E-cadherin expression, and RT-PCR and Western blot analyses showed that E-cadherin mRNA and protein levels, respectively, were increased in the Par-4 overexpressing cells concomitant with a decrease in vimentin. The results of this study demonstrate the potential of Par-4 in colon cancer therapy, not only in primary tumors but also in metastatic cells.
May 2015 DOI 10.14302/issn.2470-0436.jos-14-527
Sanjay SrinivasanCorresponding author
Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore
A 66 year old Chinese male with a medical history of hypertension, diabetes mellitus and hepatitis B carrier was diagnosed with hepatocellular carcinoma in 2009. He underwent treatment with selective internal radiation spheres and sorafenib, and multiple cycles of chemotherapeutic agents such as bevacizumab, erlotinib, OXAFI ( intravenous oxaliplatin and doxorubicin given on days 1, 8 and 15 in a 28-day cycle, a daily continuous infusion of fluorouracil and subcutaneous interferon alfa-2b 5 million units administered thrice weekly), thalidomide, capecitabine, and rapamycin over the course of four years. Along the course of treatment, he developed pulmonary embolism and was initially started on anti-coagulation. Two months later, he developed hemoptysis and the anti-coagulants were stopped. During his routine ophthalmology visit for diabetic eye evaluation, he complained of blurring of vision of his left eye for the past four to five weeks. He was found to have central retinal vein occlusion (CRVO) of the left eye, associated with macular edema. Visual acuity was 6/15 for the right eye and 6/60 for the left eye. Eyelids, conjunctiva, cornea, anterior chamber, pupils, lens and ocular motility were normal. Humphrey visual field testing showed a superior arcuate and basal defect. This is the first reported case of CRVO in hepatocellular carcinoma. The etiology of CRVO is multifactorial, withhepatic malignancy, previous major surgery, multiple cycles of chemotherapy and cessation of anticoagulant therapyas possible aetiological factors. His background medical problems of diabetes and hypertension are further contributors.
May 2015 DOI 10.14302/issn.2574-4496.jtc-13-347
Emilio MevioCorresponding author
Primary thyroid leiomyosarcoma, is extremely rare, with only 19 cases reported in the literature to date. Onset of the tumor, which usually develops in only one lobe of the thyroid, is sudden and the tumor spreads rapidly to surrounding tissues. Preoperative differential diagnosis is extremely difficult. The long-term prognosis for the patient is extremely poor and unrelated to treatment. Indeed, thyroidectomy and neck dissection followed by adjuvant chemotherapy and/or radiation therapy have not been shown to affect rate of recurrence and long-term survival. The authors describe the case of a patient with leiomyosarcoma of the thyroid gland and review the relevant literature, considering the differential diagnoses and alternative treatment strategies.
May 2015 DOI 10.14302/issn.2644-0105.jbfb-14-547
Di Luigi GianlucaCorresponding author
University of L’Aquila; Department of Life, Health and Environmental Sciences. Gynecology & Obstetrics. Ospedale Civile “San Salvatore”. L’Aquila, Italy.
Background: Scientific research is constantly expanding our knowledge of nutritional needs in pregnancy and lactation. In June 2014 the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) issued draft-revised advice encouraging pregnant women, those who might become pregnant, breastfeeding mothers and young children to eat more fish, a total of least 8 ounces per week and to eat a variety of fish lower in mercury in particular anchovies, butterfish, catfish, clam, haddock (Atlantic), herring, mullet, oyster, perch (ocean), sardine, shad, trout (freshwater). However, the presence of radionuclides released from the damaged Fukushima Daiichi nuclear power plant in Pacific biota has aroused worldwide attention and concern. Objective and Methods: Evaluating all the scientific literature available after the Fukushima nuclear disaster, the aim of this review is to demonstrate the safety of seafood products and the use of omega-3 supplements potentially derived from contaminated radioactive fish. Results and Conclusions: There are no reasons to fear the amount of radiation in Japanese fish. The dose received from seafood consumption can be estimated to result in two additional fatal cancer cases per 10,000,000 similarly exposed people. The safest way to get omega-3 fatty acids during pregnancy is by taking a high-quality fish oil supplement, approved by a governing body that provides proof of quality such as the Council for Responsible Nutrition, the European Pharmocopeia Standard or the Norwegian Medicinal Standard and by the Food and Drug Administration or the Environmental Protection Agency 12. Pregnant and breastfeeding women do not need to cut fish out of their diet completely, and it may be safely eaten up to three times per week safely 3.
May 2015 DOI 10.14302/issn.2372-6601.jhor-14-493
Prunier1 ECorresponding author
In autologous hematopoietic stem cell transplantation patients for whom granulocyte-colony stimulating factor fails to mobilize a sufficient number of peripheral blood stem cells, plerixafor proposes an option for successful rescue mobilization. This paper evaluates the efficacy of plerixafor to mobilize peripheral blood stem cells (PBSCs) in patients who failed previous mobilization with G-CSF alone, by retrospectively analysing the PBSC results from lymphoma and myeloma (MM) patients between 2006 and 2011. Patients were classified according to the CD34+ cells/kg yield collected by apheresis: < 2 x 106 CD34+ cells/kg was considered collection failure, whereas ≥ 5 x 106 CD34+ cells/kg was considered good mobilization. 797 patients underwent one or more apheresis. The first mobilization success rate was 82%; 140 patients proved to be poor mobilizers. Suboptimal first mobilization was significantly associated with age >50 years (p=0.005) and the absence of chemotherapy in prior PBSCs stimulation (p=0.04). 149 rescue protocols were used in the 140 poor mobilizers, and 71 patients received plerixafor. In univariate analysis the remobilization rate without plerixafor was 42% and increased to 65% when plerixafor was added. In multivariate analysis, plerixafor administration reduced the PBSC remobilization failure risk by a half (OR=0.47). The median value of CD34+ cells/kg in transplants increased from 1.43 (range, 014.03) without plerixafor to 3.85 (range, 0–18.25; p=1 x 10-4) with plerixafor. There were more good mobilizers after plerixafor use (35% with plerixafor versus 15% without plerixafor; p=0.005). Plerixafor efficacy was similar for lymphoma (60% remobilization) and MM (80%; p=0.12). These data show that plerixafor was effective in poor mobilizers and that it synergized with G-CSF to improve the quantity of collected PBSCs. Plerixafor also increased transplant feasibility by 23%. While the clinical results of this study are promising, economic data were not taken into account and there is a need for real work concerning the cost-effectiveness of this treatment. We propose a subsequent study in which the economic efficacy of plerixafor’s use is evaluated based on the financial aspects of the treatments received by the cohort evaluated in this paper.
Feb 2015 DOI 10.14302/issn.2381-862X.jwrh-14-532
Elie NKWABONGCorresponding author
Department of Obstetrics & Gynecology; University Teaching Hospital/ Faculty of Medicine and Biomedical Sciences, Yaoundé (Cameroon).
Objective: To identify risk factors for ≥4500 g macrosomic babies given that maternal and neonatal complications of macrosomia increase with birth weight. Design: Cross sectional analytical study. Setting: The Yaoundé University Teaching Hospital and Central Maternity, Cameroon from October 1st, 2012 to June 30th, 2013. Population: 42 women who delivered ≥4500 g babies and 126 women who delivered babies of 4000 to <4500 g were recruited. Methods: Data were analysed using SPSS 18.0. Analyses included the student t-test and the Fisher exact test. The level of significance was P<0.05. Main outcome measures: Fetal sex and birth weight, gestational age at delivery, maternal age at delivery, parity, mother's pre-gestational body mass index (BMI), weight gain during pregnancy, father's BMI and past history of ≥4000 g macrosomia. Results: Main risk factors for ≥4500 g macrosomic babies were maternal weight gain of ≥16 kg (OR 4.2, 95%CI 2.0-8.9), maternal age ≥30 (OR 3.8, 95%CI 1.8-8.2), post term (OR 2.3, 95%CI 0.9-5.6), past history of ≥4000 g macrosomia (OR 1.9, 95%CI 0.9-4.1) and male sex (OR 1.3, 95%CI 0.6-2.8). Conclusion: To reduce the risk of ≥4500 g macrosomic babies, women at risk should make efforts to gain less than 16 kg bodyweight during pregnancies. Moreover, post term pregnancies should be avoided.
Jan 2015 DOI 10.14302/issn.2372-6601.jhor-14-377
Zaidah A WCorresponding author
Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia,Kubang Kerian, Malaysia.
Background Abnormalities of plasma von Willebrand Factor (vWF) system has been described in solid tumors but more information is required to understand the pathophysiological process in haematological malignancies. Objectives This study was carried out to investigate the changes in vWF-related parameters including ADAMTS13 protein level in aggressive haematological malignancies and to identify the prevalence of anti-ADAMTS13 antibody as well as its correlations with vWF-related parameters. Patients/Methods Patient newly diagnosed or having relapse acute leukaemias or aggresive non-Hodgkin lymphomas were recruited into this study. Exclusion criterias include; pregnancy, patient already commenced chemotherapy, sepsis or has background congenital bleeding disorders. Blood specimen was subjected to; blood counts, ADAMTS13 protein, ADAMTS13 antibody detection, vWF:Ag, vWF activity, factor VIII level (FVIII) and vWF: CBA (collagen binding assays) Results and Conclusion A total of 60 subjects with median age at 42.5 (IQR: 23.25-57.5) were included. There were 34(56.7%) lymphomas and 26(43%) acute leukaemias. FVIII, vWF:Ag, wVF activity and vWF:CBA level were elevated whereas ADAMTS13 protein was reduced in majority of patients. Those with lymphomas showed significantly higher levels of FVIII, vWF:Ag, vWF:activity and vWF:CBA compared to the leukaemias. 38(63.3%) of patients showed presence of ADAMTS 13 autoantibody. There was however no correlation between ADAMTS13 protein and vWF-related parameters or with ADAMTS13 autoantibodies. There was a high prevalence of ADAMTS 13 autoantibodies in this cohort despite the absence of thrombotic thrombocytopenic purpura (TTP). The more pronounced changes in vWF-related parameters among aggressive lymphomas compared to acute leukaemias are in tandem with the marginally higher rates of venous thromboembolism in the former.
Nov 2014 DOI 10.14302/issn.2379-8572.joa-14-429
Ver Halen JonCorresponding author
Background: We reviewed the 2005-2011 ACS-NSQIP database to evaluate factors associated with adverse events (AE) after total laryngectomy (TL). Methods: All total laryngectomies performed from 2006 to 2011 were identified for analysis. The cohort was characterized with respect to preoperative and demographic characteristics, complications, reoperation, and mortality. Results: 493 cases were identified. Complications of any category occurred in 189 cases (38.3%). Factors that were found to confer significant risk for medical complications were increased age (dds Ratio (OR) 1.03), prior PCI (OR 2.84), disseminated cancer (OR 2.47), chronic steroid/immunosuppresion use (OR 2.87), unintended weight loss > 10% over 6 months prior to surgery (OR 2.02), increasing work RVU total (OR 1.02), and increased anesthesia Z-score (OR 1.31). Only increased anesthesia Z-score (OR 1.27) was found to be a statistically significant risk factor for surgical complications. Chronic steroid/immunosuppression use (OR 3.16) and increased anesthesia Z-score (OR 1.29) were both found to be statistically significant risk factors of reoperation within 30 days. Conclusions: NSQIP is the only dataset that correctly discerns between minimally invasive and wide excision in laryngectomy. The use of the NSQIP dataset may be imperfect, as pertinent details of chemotherapy and radiation, and procedure-specific complications, including fistula formation, are not tracked. In spite of this, our findings suggest avenues for improvement in the care of TL patients, and suggest directions for a laryngectomy-specific outcomes database.
Sep 2014 DOI 10.14302/issn.2372-6601.jhor-14-499
L. Edwards ChristopherCorresponding author
Department of Psychiatry, Division of Medical Psychology, Duke University Medical Center.
Medical advances in obstetrics and hematology have encouraged researchers to investigate the reproductive risk in women with Sickle Cell Disease (SCD) attempting motherhood. However, few hematological studies have been completed focused specifically on the reproductive mental health of Black women with SCD. Historically women with SCD have been guided away from childbirth under the premise that they were not emotionally or physically capable of managing children. One question that remains unclear, from the limited research available in this area, is whether the presence of children serves to influence mood and pain in Black women with SCD. The current study examined the effects of the presence of children on self-reported pain and depressive symptoms and the relationship between pain and psychological functioning in African American women with SCD. Self-reported rates of depression, pain intensity, and pain severity were evaluated in 70 African American females with SCD. Results of Analysis of Covariance (ANCOVA) did not find differences in reported mood or pain between women with and without children. The current study serves as an initial observation upon which replication of the current findings and future prospective studies can be conducted. The study may ultimately mature into an area of research that guides reproductive decision-making for women with SCD and their doctors.
Jun 2013 DOI 10.14302/issn.2324-7339.jcrhap-12-74
Madiba SphiweCorresponding author
School of Public Health, Faculty of Health Sciences, University of Limpopo, Medunsa Campus, South Africa
HIV infected children who started antiretroviral therapy (ART) in public health facilities in South Africa have survived to older age and disclosure has become an essential part of their care. Available data on HIV disclosure to children were collected much earlier in the provision of ART in South Africa. The aim of the study was to (a) determine the characteristics of caregivers of pediatric HIV patients in Gauteng, South Africa, (b) estimate the prevalence and timing of HIV disclosure among these patients, and (c) assess the factors associated with disclosure status. A cross-sectional study was conducted among 286 caregivers of paediatric ART children aged 4–17 in two centres in Gauteng, South Africa. Bivariate and multivariate logistic regression analyses were carried out. The highest proportion of care givers were biological mothers (n=140, 49.3%). The mean age of the children was 8.5 years, (range 4-17 years). More than a third (n=99, 34%) were disclosed their HIV status, and the mean age at disclosure was 9.3 years, (SD = 2.7). Child’s age older than 10 years (OR =1.63; 95% CI: 1.44–1.85), having a nonbiological caregiver (OR=1.75; 95% CI: 1.06-2.89), caregiver educational level (OR =0.64; 95% CI: 0.47–0.87), and caregiver’s age older than 60 years (OR=1.02; 95% CI: 1.01-1.04), were significantly associated with HIV disclosure to infected children. The relatively higher prevalence of disclosure is attributed to increasing access to paediatric ART. Training healthcare providers to support caregivers in disclosure will increase the rate of disclosure to HIV infected children receiving ART in public health facilities.
A. S. Sardenberg RodrigoCorresponding author
Chief of Thoracic Surgery, Hospital Paulistano, Americas Serviços Médicos São Paulo, Brazil
Distant metastases generally indicate disseminated disease and the standard treatment for these patients is palliative chemotherapy. Retrospective series showed that selected patients with metastatic lung cancer and a solitary extrathoracic disease could be effectively treated with curative intention by resection of both primary tumor and the single site of metastatic disease. According to current data, adrenalectomy might be considered as an alternative option for patients with isolated adrenal metastases. Significant morbidity and mortality may be happened by these procedures, and a cautious analysis of pros and cons should be discussed with the patient. We present a review of the literature and updated recommendations focusing lung cancer with solitary adrenal metastasis.