Wednesday, 31 May 2017

A Short Perspective on the Risk Profile of Epilepsy in Iran


                                                        mathewsopenaccess.com



Epilepsy is a major neurological disorder with differing particularities in different cultural set-ups [1]. Middle East, for multitude of reasons, is culturally unique and assorted across religious, dietary, social, familial, political aspects. Recently, it has been demonstrated that the median prevalence of lifetime epilepsy had been under-estimated by three fold for this region [2]. Iran, one of the important Middle Eastern countries located in the southwest of Asia and has a population of over 70 million. A meta-analysis conducted for Iran reports an epilepsy prevalence of 5.0/1000; however, a closer look indicates several issues in this work with inappropriate inclusion, and cluster of studies [3]. Despite seeming apprehensions, Iran has a very sophisticated healthcare system with all population covered under insurance and upto 90.0% of medical cost reimbursed [4]. Here we provide a short quick overview of epilepsy risk profile for Iran.

The burden of neurocysticercosis (NCC) in Iran is unknown but is reportedly unexpected [5]. A PubMed search with words ‘neurocysticercosis’ and ‘Iran’ provided only two publications; none of them provide suitable details. Although, The Holy Quran prohibits consumption of pork, its availability and consumption may not necessarily be completely inexistent; although limited, as observed in other Muslim populations [6]. Incidence of tuberculosis in Iran is low (21/100,000) with restricted only to Sistan region of Iran, at the Border with Afghanistan [7]. Malaria, another important risk factor of epilepsy, is at pre-elimination stage in Iran; with epilepsyrelevant falciparum infection (Plasmodium vivax malaria: An unusual presentation) restricted to endemic East and South East regions of the country [8]. Iran similarly has progressed with near elimination of Schistosomiasis with nearly no cases since 2001 [9]. Although Iran is not endemic for paragonimiasis, the burden of toxoplasmosis is particularly high, including children [10,11]. The prevalence of HIV-AIDS in Iran is low, mostly among injected users, even among prison population (2.1%) which traditionally has high HIV prevalence [12]. 

Although pregnancy and birth related factors (hemorrhage, gestational hypertension, prematurity, etc.) are highly important risk factors for epilepsy, more than infections, the burden of these disorders also seem to be low in Iran [13,14]. In this country, in 2010, antenatal care coverage was 94.0% adequate with 97.0% births were attended, equally so in rural populations[15]. However, one of the interesting observations comes from the high frequency of desired cesarean sections that are not medically needed [16]. Similar trends are also noted in other Asian settings such as China; where such trends, like Iran, are to be due to high insurance coverage of the populations [17]. Moreover, although some studies in Iran fail to show the protective role of breast feeding in epilepsy; this does show a major role in more sophisticated surveys performed by the author [18,19]. 

Tuesday, 30 May 2017

Ocular Morbidity among Auto Mechanics at Suame –Magazine Area in the Kumasi Metropolis




An auto mechanic is a worker who repairs and overhauls cars and other automotive vehicles, or their systems and parts. They usually work in service garages or workshops where they are exposed to several occupational hazards such as anticorrosive substances, metal crusts from car parts, high energy radiations, asbestos, paint pigments, and automobile exhaust. The exposure to these hazards may result in ocular and systemic conditions that may ultimately lead to visual impairment and/or death. Visual impairment irrespective of its cause is responsible for a significant number of handicaps in today’s society. The health of workers is important in determining the ability of employees to maintain productivity. Injuries at the workplace and high sickness absences will impact on the well-being of workers. The presence of ocular disorders in industrial workers may result in visual impairment, suffering, reduced productivity, machines and monetary loss. A worker’s eye may be exposed to a variety of dangerous agents depending on the type of industry, which may constitute an occupational hazard. Most of these hazards are avoidable if adequate preventive measures are taken. Although auto-mechanics form a significant portion of the working class in Ghana, there is very little information on eye care documented on this workforce. A cross sectional study by Abu et al. among mechanics in the Cape Coast municipality in Ghana indicated a high prevalence of ocular conditions and a low usage of protective wear. This study therefore seeks to determine the prevalence of ocular conditions and investigate safety practices among auto mechanics in the Suame – Magazine Area within the Kumasi Metropolis.

We conducted a descriptive cross-sectional study at the Suame – Magazine Area. The selection of this area was based on the fact that it housed most of the auto mechanic garages in the Kumasi metropolis and has the additional advantage of being easily accessible. Five zones were randomly selected out of the twenty six zones in the Suame – Magazine area. Open invitations were sent to all the zones to participate and those who responded were registered for screening at the appointed dates. A total of 175 auto mechanics were registered for the study while 150 auto mechanics turned up at the screening centers (participation rate of 86.0%).

The visual examination was done at the job site of selected auto mechanic workshops. The research participants were guided to fill questionnaires where possible, and where there was difficulty, the questionnaire was read out to them and filled based on their responses. All respondents underwent ophthalmic examination including detailed ocular and medical history, Snellen distant and near visual acuity assessment, external eye examination, and funduscopy.

Monday, 29 May 2017

Caverflo Natural Herbal Coffee: Recall - Presence of Undeclared Active Pharmaceutical Ingredients


                                                         mathrewsopenaccess.com



ISSUE: Caverflo.com is willfully reviewing all heaps of Caverflo Natural Herbal Coffee, 25 grams to the purchaser level. FDA research facility investigation affirmed the nearness of Sildenafil and Tadalafil which are the dynamic fixings in two FDA-endorsed physician recommended drugs utilized for the treatment of erectile brokenness (ED). Caverflo.com has gotten a report of an individual passing after utilization of the espresso. Caverflo Natural Herbal Coffee may likewise contain undeclared drain. 

These undeclared fixings may connect with nitrates found in some physician endorsed medications, for example, nitroglycerin, and may bring down circulatory strain to hazardous levels. Men with diabetes, hypertension, elevated cholesterol, or coronary illness regularly take nitrates. Individuals who have a hypersensitivity or extreme affectability to drain risk genuine or life debilitating unfavorably susceptible response on the off chance that they devour this item. 

Foundation: Caverflo Natural Herbal Coffee is utilized as a male improvement and is bundled in 25 gram dark thwart packs, UPC 9555671709994. Caverflo.com appropriated this item from August 2016 through February 2017. Caverflo Natural Herbal Coffee is devoured as a moment espresso. Caverflo Natural Herbal Coffee was appropriated across the nation to buyers by means of web at Caverflo.com. 

Proposals: Consumers with inquiries in regards to this review can contact Caverflo.com at coffeekingb@yahoo.com. Buyers ought to contact their doctor or social insurance supplier in the event that they have encountered any issues that might be identified with taking or utilizing this medication item. Unfriendly responses or quality issues experienced with the utilization of this item might be accounted for to the FDA's MedWatch Adverse Event Reporting program either on the web, by customary mail or by fax.

Tuesday, 16 May 2017

Influence of Several Excipients on Drug Release of Tablets Containing Resveratrol




For pharmaceutical tablet production, there are lots of commercial excipients available. All these excipients influence the drug release of tablet cores in different ways. In this project the influence of Carbopol 71G®, Carbopol 971P®, Fujicalin®, Neusilin US2®, Neusilin UFL2®, Pemulen TR-1®, Pemulen TR-2®, Sepistab ST 200® and Sepitrap 80® on drug release was investigated. Tablets were compressed with resveratrol as a model drug using an eccentric press. Tablets containing 2 wt.% of resveratrol which was mixed with a certain amount of excipient, in addition to 1 wt.% of talc, 1 wt.% magnesium stearate and Ludipress LCE. These products were compared with tablets without any excipients, but with all the other remaining components of the formulation. Drug release was in vitro investigated in dependence of time, according to European Pharmacopoeia (Ph. Eur. 2.9.3). It appeared that drug release depends on the qualities of the pharmaceutical additives. Tablets with Fujicalin® and Sepistab ST 200® exhibit a rapid release and disintegration time, while the other pharmaceutical additives lead to a delayed release (retardation). Drug release kinetics was described by the mathematical model of Korsmeyer-Peppas.


Tablets are the best known and most frequently used pharmaceutical single unit dosage forms. Today more than 40% of all drugs were consumed in tablet form. Tablets could be economically produced by a machine in large quantities. More advantages are the good acceptance of the patients, the possibility for easy transport and storage. The composition of different mixed substances allows to create formulations which releases the drug at the desired location in gastrointestinal tract (GIT). This means that the right combination of excipients tends to result in a less drug amount, which is necessary to achieve the same effects. As a consequence of this, fewer side effects of drug could be expected. Excipients are characterized with their fields of functions as base material, disintegrant, glidant, and lubricant, binder or granulating agent. Binders are used to enhance cohesion of powder particle and increase plasticity of tablets. Glidants and lubricants are flow aids, which improves tablet pressing process. Disintegrants enhance disintegration of tablets in GIT. Fujicalin® includes calciumhydrogenphosphate and dicalcium phosphate anhydrous (DCPA) (Figure 1c). This fillers could be used for direct compression and to receive hard tablets by using only small low compression force. It is a porous product with a low particle size of 115 ┬Ám, which is able to adsorb liquid oily substances. Fujicalin® doesn’t act as disintegrant

but improves the decay of tablets. Because of the fact that porousity overcomes tablet pressing, water is enabled to penetrate the tablet faster. Sepistab ST 200® is a commercial excipient based on a mixture of native starch and pregelatinized starch, which act as binder, glidant and disintegrant. Sepitrap 80® is an excipient comprised from polysorbate 80 (Figure 1d) which is derived from polyethoxylated sorbitan and oleic acid. In tablets it works as emulsifier to enhance bioavailability for poorly water soluble drugs. Neusilin® is based on a totally synthetic magnesium aluminometasilicate (Figure 1a). Neusilin US2® is granulate, while Neusilin UFL2® is a powder. These porous products increase flowability of powder mixtures and hardness of resulting tablets [10]. Carbopol 71G NF® and Carbopol 971P NF® are a commercial names for the same type of polyacrylic acid (Figure 1e). While Carbopol 71G NF® exhibits a granular physical form, Carbopol 971P NF® is in powder form. It can be used for direct compressing and leads to extended drug release of resulting tablets. Pemulen® is a cross linked copolymer of acrylic acid and a hydrophobic comonomer with high molecular weight (Figure 1f). Table 1 summarizes all described excipients, with its chemical name. 

Monday, 15 May 2017

Hormone Replacement Therapy Tied to Hearing Loss


                                                         mathewsopenaccess.com



Hearing misfortune has been connected to a few components related with menopause,a new review says. One element is your age at menopause. A more seasoned age is attached to a higher danger of hearing inconveniences. What's more, a moment component is the utilization of oral hormone treatment to facilitate a portion of the indications of menopause. The specialists likewise found that the more drawn out a lady utilized hormone treatment, the more noteworthy the chances of hearing issues. 

Hearing misfortune was at that point known to be more typical in ladies after menopause, a period when characteristic hormone levels drop. Along these lines, specialists had associated that the utilization with oral hormone treatment may offer some insurance against menopause-connected hearing misfortune, the analysts said. "The finding from this observational review that ladies who experienced menopause at a later age and utilized oral hormone treatment had more noteworthy hearing misfortune was startling yet ought to prompt all the more testing in a randomized, clinical trial," JoAnn Pinkerton, official chief of the North American Menopause Society (NAMS), said in news discharge from the gathering. 

The present review can just demonstrate a relationship between hearing misfortune and hormone treatment or more seasoned age at menopause. It wasn't intended to demonstrate a circumstances and end results relationship. The discoveries come from an audit of information from about 81,000 ladies in the United States. "Data about the potential impact on hearing is critical to incorporate into an exchange with respect to the dangers and formal of hormone treatment for symptomatic menopausal ladies," she added.Hearing misfortune influences almost 48 million Americans, and that number is required to ascend as the populace ages.

Friday, 12 May 2017

Anterior Elbow Dislocation with Radial Neck Fracture- A Variant of the Terrible Triad and a Review of the Literature


                                    http://www.mathewsopenaccess.com/orthopedics-current-issue.html


Terrible triad injuries of the elbow typically present as posterior elbow dislocations with an associated radial head and coronoid fracture. We report an atypical presentation of this injury pattern with an anterior dislocation of the elbow with a radial neck and coronoid tip fracture, as well as a humeral avulsion of the lateral ulnar collateral ligament (LUCL). This patient underwent open reduction and internal fixation of her radial neck fracture and suture anchor fixation of the avulsed LUCL through a lateral approach to the elbow. She has since regained painless and functional range of motion of her elbow. This case highlights the importance of the injury mechanism, fracture pattern and intraoperative stress tests in identifying the crucial injured components of the elbow. Addressing the bony injuries alone without reconstituting the soft tissue restraints of the elbow would invariably lead to persistent instability, arthrosis and poor outcome.

The elbow joint is the second most commonly dislocated joint in adults, after the shoulder. 90% of elbow dislocations are posterior dislocations, most of which are simple posterior dislocations that follow a predictable sequence of soft tissue disruptions that eventually lead to a frank dislocation as described by O’Driscoll. By comparison, anterior dislocations are much less common, and they usually occur in conjunction with an olecranon fracture. An anterior elbow fracture-dislocation in the absence of a proximal ulna fracture is exceedingly rare with scant literature on the pathophysiology of these injuries. We present a rare case of an anterior elbow fracture-dislocation with a radial head fracture and review of the existing literature on anterior elbow fracture-dislocations in the absence of a proximal ulna fracture.

The patient is a 56-year old lady who fell on a flexed right el bow after tripping over a carpet. At the Emergency department, initial radiographs revealed an anterior dislocation of the right elbow with a radial neck fracture.Closed reduction was successfully performed under conscious sedation by extending the elbow and applying a posteriorly directed force on the proximal ulna. She was subsequently followed up in the Orthopedic Specialist Outpatient Clinic and computerized tomography scans revealed a coronoid tip fracture as well as an impacted, anteriorly angulated radial neck fracture. Stress radiograph views done in the clinic revealed an incongruously reduced elbow joint.

Thursday, 11 May 2017

What Harms the Young Heart Also Hurts the Brain Later

                                                             mathewsopenaccess.com



Hypertension, raised cholesterol or a smoking propensity ahead of schedule in life expands your chances for mental decay amid middle age, another review cautions. "While it is outstanding that hypertension, cholesterol and smoking are related with poor intellectual [mental] execution in grown-ups, the impacts of these hazard components from youth on midlife perception were obscure," study lead creator Suvi Rovio said in a news discharge from the American College of Cardiology. 


"These discoveries bolster the requirement for dynamic checking and treatment systems against cardiovascular hazard variables from youth," said Rovio, a senior researcher at the University of Turku, in Finland.For the review, Rovio and partners broke down information from a great many individuals in Finland who were taken after from adolescence to adulthood. The agents found that hypertension and elevated cholesterol in youth, the youngster years and youthful adulthood - and in addition smoking in the teenagers and youthful adulthood - were related with more awful midlife mental execution, particularly memory and learning.When Rovio's group inspected particular hazard variables, it found that grown-ups with the most astounding circulatory strain prior in life were more than eight years more seasoned as far as mental "cognizance" than the individuals who had the least pulse before in life. 

Elevated cholesterol represented just about 7 years' distinction in mental working. What's more, the analysts found a 3.4 years' subjective crevice amongst smokers and non-smokers. The review results were distributed May 1 in the Journal of the American College of Cardiology. As indicated by Dr. Valentin Fuster, diary editorial manager in-boss, "Late proof has shown that hazard elements created in adulthood can affect subjective brokenness in the elderly, on the off chance that they have not been revised." Fuster included that "the discoveries in this paper are essential, since they demonstrate that hazard considers that create at a much more youthful age can have the same unfriendly effect."

Wednesday, 10 May 2017

Cosmetics for Dermal Care from Marine Origin




Atopic dermatitis, skin wrinkling and various other skin related disorders are common problems in now a days. In order to treat these disorders, products especially from marine origin are now a days in fashion. The substances from marine origin including macroalgae, marine collagen, epoxypolysaccharides from cyanobacteria and marine fungi are well known for their therapeutic potential on the skin surface. By the use of modern and advanced method of extraction, number of seaweed and other ingredients are being extracted and used in dermal care products. At present, more than 7000 marine products has been isolated and out of this, 25 % from algae, 33 % from sponges, 18 % from coelenterates (sea whips, sea fans and soft corals), and 24 % from other invertebrate phyla such as ascidians (also called tunicates), opisthobranch molluscs (nudibranchs, sea hares etc), echinoderms (starfish, sea cucumbers etc) and bryozoans (moss animals) are used.

 The important chemical agents isolated from marine source include Bryostatin 1, Didemnin B and Dolastatins etc are getting popularity due to their potent action. Bryostatins are a group of macrolide lactones, first isolated in the 1960s are potent modulators of protein kinase C. In in vitro tests, Bryostatin 1 was able to inhibit cell growth, angiogenesis and caused excitation of cell differentiation and apoptosis. Bryostatin also shows immunomodulatory properties. Therefore, it is in use for dermal care and skin protection from harmful UV-B radiation. Didemnins are cyclic depsipeptide compounds, isolated from a tunicate (sea-squirt) of the genus Trididemnum (family of Didemnidae), that were collected in the Caribbean Sea. It is a strong antiviral agent against both DNA and RNA viruses such as herpes simplex virus type 1, a potent immunosuppressant which exhibits some key role in skin graft. Another important chemical agents from marine sources are Dolastatins. Dolastatins are isolated from from the marine cyanobacterium Symploca sp. The Dolastatins are mitotic inhibitors. They inhibits microtubule assembly by interfering with tubulin formation and thereby disrupt cell division by mitosis and induces apoptosis and Bcl-2 phosphorylation in several malignant cell types. Therefore, Dolastatins are used in dermal care products with anticancer property. 

 Among water algae species, Chlorella Vulgaris and Chlorella Pyrenoidosa are being used as dietary supplement for beautification of skin and for hair care. Chlorella was one of the first green algae, which became a dietary supplement. These green algae are rich in protein, amino acids, vitamins and minerals. When taken in diet, they assist to maintain healthy digestion and healthy skin. Traditionally, algae are known to have effective anti-ageing properties especially when combination of algae extracts are in use. Sea algaes are considered good for the skin because they have chemical compositions, which are similar to human body’s plasma, which enables particularly good penetration of the nutrients. In Asia and some other part of world, apart from algae, another popular product named as marine collagen, derived from fish scales is getting large success in dermal care products. In fact, due to low to optimum molecular weight of fish (marine) collagen, it is up to 1.5 times more easily absorbed than bovine, porcine or chicken collagen. Researchers have suggested that fish (marine) collagen is also the right type of collagen (Type I& II) which is required for the building blocks of our skin. As marine collagen is extracted from fish, it is free from Bovine Spongiform Encephalopathy. 













Tuesday, 9 May 2017

Get Ready for Your 'Capsule Robot' Colon Cancer Check

                                                         mathewsopenaccess.com



Not anticipating your next colonoscopy? Try not to stress - later on, a little case not as much as an inch long may explore your colon to check for tumor chance, researchers report. Analysts at Nashville's Vanderbilt University Medical Center utilized magnets to direct the fastened "case robot" through a pig's colon. "Not exclusively is the case robot ready to effectively move through the GI tract to perform diagnostics, it is additionally ready to perform restorative moves, for example, biopsies of tissue or polyp expulsion, because of the tie - something that other case gadgets can't do," lead specialist Dr. Keith Obstein clarified. 

His group said the polarized container robot is 0.7 inches in length and embedded rectally. It's then guided through the colon by utilizing an outer magnet that is connected to a mechanical arm. The case additionally has a connected tie that is substantially littler in distance across than regular endoscopes utilized for conoloscopies. The scientists effectively tried the case robot many circumstances in the pig's colon. Obstein's group was to show the discoveries Monday at the Digestive Diseases Week meeting, in Chicago. 

"There's probably in the estimation of colonoscopies to keep individuals sound through preventive screening for colon tumor, yet numerous people still maintain a strategic distance from this method, as a result of dread of the test itself, saw inconvenience or the danger of sedation," said Obstein, who's a partner educator of drug at Vanderbilt. "We built up this case robot to make crossing the GI tract substantially simpler, for both the clinician and patient," he clarified in a meeting news discharge. 

Other than being considerably littler than an endoscope, the container approach has different advantages for patients, Obstein said. "Since the outer magnet pulls the case robot with the tie fragment from the front or leader of the case, rather than a doctor driving the colonoscope from behind as in conventional endoscopy, we're ready to maintain a strategic distance from a great part of the physical weight that is set on the patient's colon - perhaps decreasing the requirement for sedation or torment prescription," 

As per the scientists, human trials of the case robot are relied upon to start toward the finish of 2018. Since this examination was exhibited at a medicinal meeting, it ought to likewise be viewed as preparatory until distributed in an associate surveyed diary. Two specialists in gastroenterology said the new innovation may urge more individuals to experience colon tumor screening. "Automated innovation has as of now been demonstrated to indicate stamped change and fulfillment in patients experiencing surgical methods," noted Dr. Jules Garbus. He coordinates colorectal surgery at NYU Winthrop Hospital in Mineola, N.Y. 

As per Garbus, gadgets like the case robot "would cause urge more patients to experience lifesaving colonoscopies." Dr. Arun Swaminath coordinates the provocative illness program at Lenox Hill Hospital in New York City. He said that the thought of a remote-controlled container helped him to remember today's cutting edge planes, where the pilot enables the plane to "fly itself."

Monday, 8 May 2017

Fibronectin as an Immunohistochemical Marker for Postmortem Diagnosis of Myocardial Infarction




Acute myocardial infarction is sometimes a diagnostic dilemma in forensic pathology. Our aim is to evaluate the efficacy of fibronectin by immunohistochemical methods for diagnosis of early myocardial infarction in heart autopsies.Three groups of cases selected from autopsied hearts submitted to the pathology department of legal medicine organization of Iran during years 2004-2007 which included 15 cases of definite myocardial infarction (positive control group), 18 cases of noncardiac death (negative control group) and 26 cases suspicious of myocardial infarction based on clinical presentation just before death, presence of marked stenosis in at least one major coronary artery and exclusion of other causes of death (suspicious group). Fibronectin staining was performed on sections prepared from all of the cases. With our proposed cut off value for fibronectin staining the sensitivity and specificity of this marker are 93.3% and 94.4%, respectively. This marker could also support the occurrence of myocardial infarction in 42% of our suspicious cases.We conclude that in spite of usefulness of this marker for detection of myocardial infarction, the results should be interpreted with caution. 

Diagnosis of acute myocardial infarction is a challenging issue in forensic pathology. In autopsied hearts macroscopic findings of myocardial infarction accompanied by microscopic confirmation are the gold standards for diagnosis. However, the development of these changes requires time and in real practice we rarely are fortunate enough to see the typical cases. In most instances nothing other than significant narrowing of coronary arteries is found in favor of myocardial infarction. Use of an ancillary method is highly advocated in these situations. Application of triphenyltetrazolium chloride to the fresh myocardium, electron microscopy and some immunohistochemical markers including myoglobin, fatty acid binding protein (FABP), troponin, desmin, fibronectin, fibrinogen, C5b-9 and vascular endothelial growth factor (VEGF) are among many different diagnostic methods which have been used to address this diagnostic dilemma. The electron microscopy is not available in every pathology laboratory and requires comprehensive expertise. The triphenyltetrazolium chloride method requires fresh tissue and a great deal of suspicion at the time of autopsy. The immunohistochemical studies are, however, promising alternatives. The aim of the current study is to evaluate the diagnostic power of one of these immunohistochemical markers, the fibronectin, in suspicious cases of myocardial infarction.

The autopsied hearts were fixed in 10% formalin and tissue sections processed routinely. The processed sections were embedded in paraffin block and from which 4 micrometerthick slide sections were prepared and transferred to sialinized microscopic slides. The slide sections incubated for one hour in 60˚C and then deparaffinized in two changes of xylene each for 5 minutes. Then the endogenous peroxidase activity was blocked by incubation for 15 minutes using 3% hydrogen peroxide in methanol. After washing with Tris-buffered saline (TBS), the slides were incubated for 35 minutes by the primary antibody (1/1000 dilution of a proprietary Rabbit anti human fibronectin, monoclonal antibody, Dakocytomation, Denmark). Next the unbound antibody was washed away by floating the slides in three changes of TBS, three minutes each. Finally, the potentially bounded antibodies were developed and detected by LSAB2 System-HRP detection kit (Dakocytomation, Denmark) according to the manufacturer’s instructions.

Friday, 5 May 2017

4 in 10 People Will Suffer Arthritic Hands Over Lifetime

                                                   www.mathewsopenaccess.com


On the off chance that you have hardened, hurting fingers and hands, you're not the only one - another review reports that 40 percent of individuals will be influenced by the agony of joint pain in no less than one hand.The rate found in the new research is "only marginally beneath the rate of osteoarithrtis found in knees and is essentially more noteworthy than that found in hips," noted Dr. Daniel Polatsch. He's co-chief of the New York Hand and Wrist Center at Lenox Hill Hospital in New York City. Joint inflammation "influences hand quality and capacity and causes trouble doing exercises of day by day living," Polatsch said. The review group was driven by Jin Qin, of the Arthritis Program at the U.S. Places for Disease Control and Prevention. The analysts taken a gander at 1999-2010 information on more than 2,200 individuals from North Carolina. All individuals in the review were matured 45 or more established. 

The data gathered included indications the members announced and in addition hand X-beams. Ladies were at higher hazard than men, with about portion of ladies (47 percent) creating hand joint pain. Just about a fourth of men had hand joint inflammation, Qin's group said. Whites were more inclined to the illness than blacks, with rates of 41 percent and 29 percent, separately. Abundance weight was likewise a hazard consider for hand joint inflammation. Lifetime chance among large individuals was 47 percent, contrasted with 36 percent for non-fat individuals, the review found. 

Dr. Steven Carsons is head of rheumatology at NYU Winthrop Hospital in Mineola, N.Y. He said the finding that hand joint pain is more typical in ladies "has been for some time thought to have a hereditary and hormonal premise." The corpulence connection is all the more fascinating, Carsons said. "While corpulence has dependably been thought to be a hazard figure for osteoarthritis of weight-bearing joints, for example, the knee, these information uncover the to some degree astounding relationship of stoutness and lifetime danger of improvement of hand osteoarthritis,"

Wednesday, 3 May 2017

Should the Second Dose of Measles Vaccine be Performed at an Earlier Age?


                            http://mathewsopenaccess.com/pediatrics-current-issue.html


Measles is a highly contagious disease which is a significant cause of mortality and morbidity worldwide. The time between epidemics increased as vaccinations increased and the age for having the disease increased, whereas measles epidemics used to occur every 2-3 years in the prevaccination era. Although there is a reliable and effective vaccination program against measles, children who do not get the vaccine, or who cannot form sufficient level of antibodies with a single vaccine dose, remain susceptible to measles, which, in turn,causes the measles virus to be pandemic. Sensitivity to measles in school-age children is high, and school epidemics have an important role in measles outbreaks. The age at which the administration of measles vaccine is performed is determined according to the age at which children lose maternal antibodies transferred from their mothers. This critical agevaries from society to society. Due to the low rate of vaccination in under developed or developing countries, the antibodies passing from the mother disappear early, and routine measles vaccination is madeat 6 or 9 months of age. Due to the higher vaccination rate in developed countries, the antibodies passing from the mother disappear later, and routine measles vaccination is performed at 12 or 15 months of age. However, in both situationsa second dose of vaccine is necessary. The American Advisory Committee on Immunization Practice [ACIP] and the American Academy of Pediatrics [AAP] declare that 4-6 years of age is the ideal time for the second dose of vaccine, and in most countries a second dose of measles, mumps, and rubella [MMR] vaccine is given at this age.


The significant decrease in mortality and morbidity provided by vaccinations confirms the success and significance of immunization programs. Preventive antibody levels can be measured serologically with various intervals after primary vaccination in order to establish appropriate immunization programs. Due to immigration from neighboring southern countries, an increase in measles cases has recently been identified in Turkey. As measles cases have appearedin children of 4–6 years of age who have not had their second dose of vaccine, it has been suggested that the second measles vaccination be given at the age of 4 years instead of 6-7 years when children are in the first year of primary school. However, to our knowledge, there is no comparative study investigating the effectiveness of vaccinations at this age based on the serologic measurement of preventive antibody levels. In this study our aim, thus, was to measure the measles antibody levels of children who have not yet had the second dose of measles vaccine at 4 to 6 years of age. We have also evaluated the necessity of a second dose of measles vaccine at 4 years of age instead of 6 years of age in a period when the risk for measles is increasing.


Linked Immunosorbent Assay (ELISA) method, and a measles specific kit was used for this method. According to the suggestions of the kit manufacturer, values of ≤10 IU/mL were accepted as non-protective. Statistical analysis of the data was performed using IBM SPSS Statistics 18.0 software. Definitive statistical and Mann-Whitney U tests were used for the evaluation of the mean value of intragroup antibody levels and analysis of anthropometric measurements and demographic data. A probability value less than 0.05 (p<0.05) was accepted as statistically significant.




Tuesday, 2 May 2017

Busiest Docs Get Best Results With Heart Valve Surgery


                                                        www.mathewsopenaccess.com


Patients who have heart valve surgery show signs of improvement results and will probably survive if their specialist does a great deal of the operations, another review. Scientists from Mount Sinai Health System in New York City concentrated New York state information on patients who had a kind of heart operation called mitral valve surgery in the vicinity of 2002 and 2013. 


Harmed mitral valves can be either repaired or supplanted. Mitral valve repair has a few imperative points of interest over valve substitution, including better future and personal satisfaction, as per foundation data with the review. Be that as it may, among heart specialists, there is a lot of changeability over their decision of surgery, the scientists noted. 

In the review, those patients whose specialists accomplished more than 25 of the operations a year will probably get valve repair than substitution, and their repair was more strong than those by specialists who do the methodology less regularly.

Monday, 1 May 2017

Cardiac Light Chain Amyloidosis in a Patient with Heart Failure with Preserved Ejection Fraction


                                                              mathewsopenaccess.com



A 55-year-old man with a history of exertional fatigue presented with dyspnoea since 10 days ago. The electrocardiogram showed low voltage on the limb leads I and aVL, and QS-type waves on the precordial leads V1 to V3. The echocardiography revealed the ejection fraction 59%, left ventricular end-diastolic diameter 36 mm, and interventricular septum 15 mm. 


The serum B-type natriuretic peptide was 1940 pg/ ml and the 24-hour urine protein was 3.69 g. Renal biopsy showed amyloid deposition in glomeruli and mesangial cells (panel A). Both the Congo red staining and potassium permanganate staining were positive (panels B, C). The bone marrow aspiration showed plasma blasts 0.4%, proplasmacytes 6.8% and plasmacytes 17.6%. Flow cytometry showed that there were 24.36% abnormal plasma cells which expressed kappa light chain proteins (panels D, E, F). The patient was diagnosed with systemic light chain amyloidosis with cardiac and renal involvements and given melphalan and prednisone. His recovery was uneventful.


Amyloidosis is a protein-folding disorder with more than organ infiltrated by proteinaceous deposits, and the prognosis of the disease is determined both by the organs involved and the type of amyloid. Cardiac amyloid involvement carries the worst prognosis of any involved organ. Early diagnosis is important for improving the patient’s outcome.