Dr. Jorge Paredes Vieyra
Coordinador de Posgrado e Investigación, Facultad de Odontología Tijuana, Licenciaturay Posgrado Responsable de Educacion Abierta, Centro de Educación Abierta (CEA) Universidad Autonoma De Baja California, Campus Tijuana, Mexico.

ISBN 978-93-91215-50-7 (Print)
ISBN 978-93-91215-51-4 (eBook)
DOI: 10.9734/bpi/cdhr/v9

This book covers key areas of disease and health research. The contributions by the authors include Sheehans syndrome, post-partum haemorrhage, hypopituitarism, metabolic disorders, primary hyperoxaluria, AGXT gene, genetic mutations, Alzheimer’s disease, L-carnitine, carnitine supplementation, mediterranean diet, MIND diet, executive function, cognitive flexibilities, autism spectrum disorder, neurobiological development, cognitive habilitation, assessment, and treatment options, acute necrotizing pancreatitis, alloxan, hyperglycaemia, follicular lymphoma, Waldenström macroglobulinemia, T cell lymphoma, small lymphocytic lymphoma, chronic lymphocytic leukemia, simulation based education, bronchoscopy, virtual reality, low fidelity simulation, high fidelity simulation, food contamination of radioactive materials, asbestos/arsenic pollution, north American plate, radioactive materials treatment, rebuild of damaged towns, COVID-19 disease, environmental factors, meteorological factors, dew point, altitudinal factors, global analysis, recurrence of cancer, categories of disease, adjustment, psychosocial factors, gamma ray spectroscopy. This book contains various materials suitable for students, researchers and academicians in the field of disease and health research.


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A Case Report on Sheehan’s Syndrome

Alla Satyanarayana Reddy, Aruna Giri

Challenges in Disease and Health Research Vol. 9, 30 June 2021, Page 1-4

Sheehan's Syndrome refers to hypopituitarism that develops after a severe postpartum haemorrhage (PPH).Sheehan's Syndrome has become a rare entity in developed countries due to good obstetric care. In the Indian context, it is still a rare and serious problem. The severity of the pituitary necrosis determines the timing of presentation, with severe cases presenting immediately and less severe cases presenting years or decades later. At the time of her premature twin pregnancy delivery, a young woman had preeclampsia, antepartum haemorrhage, and postpartum haemorrhage. She presented with secondary amenorrhoea three years later. The diagnosis was confirmed by symptoms such as weakness, hypotension, cold intolerance, loss of sexual hair, breast and vulval atrophy, and loss of libido. ACTH, TSH, FSH, LH, Prolactin, as well as Estradiol, Cortisol, and Sodium levels were all low, confirming the diagnosis. Hormone replacement therapy with Cortisone, Thyroxine, Estrogen and Progesterone improved her general condition. Her menstrual cycles have been restored, her genital organs have been rejuvenated, and her libido has been regained. Less severe forms of Sheehan’s syndrome are insidious in onset, vague in presentation and so are under diagnosed.

Study on Rare Metabolic Disorder (Primary Hyperoxaluria Type 1) among Children: Perspectives to Genotyping and Outcome

Mohamed S. Al Riyami, Badria Al Ghaithi, Nadia Al Hashmi, Naifain Al Kalbani

Challenges in Disease and Health Research Vol. 9, 30 June 2021, Page 5-13

Background: Primary hyperoxaluria belongs to a group of rare metabolic disorders with autosomal recessive inheritance. It results from genetic mutations of the AGXT gene, which is more common due to higher consanguinity rates in the developing countries. Clinical features at presentation are heterogeneous even in children from the same family; this study was conducted to determine the clinical characteristics, type of AGXT mutation, and outcome in children diagnosed with PH1 at a tertiary referral center in Oman.

Method: Retrospective review of children diagnosed with PH1 at a tertiary hospital in Oman from 2000 to 2013.

Results: Total of 18 children were identified. Females composed 61% of the children with median presentation age of 7 months. Severe renal failure was initial presentation in 39% and 22% presented with nephrocalcinosis and/or renal calculi. Family screening diagnosed 39% of patients. Fifty percent of the children underwent hemodialysis. 28% of children underwent organ transplantation. The most common mutation found in Omani children was c.33-34insC mutation in the AGXT gene.

Conclusion: Due to consanguinity, PH1 is a common cause of ESRD in Omani children. Genetic testing is recommended to help in family counseling and helps in decreasing the incidence and disease burden; it also could be utilized for premarital screening. This report is the first from Oman and the gulf region; it highlights the huge disease burden of an autosomal recessive mutation and importance of family screening and genetic counseling.

Dietary Patterns in Alzheimer’s Disease. Preventive Role of L-carnitine and Supplementation with L-Carnitine and Its Derivatives

Alina Kepka, Agnieszka Ochocinska, Malgorzata Borzym-Kluczyk, Ewa Skorupa, Beata Stasiewicz-Jarocka, Sylwia Chojnowska, Napoleon Waszkiewicz

Challenges in Disease and Health Research Vol. 9, 30 June 2021, Page 14-36

The prevention or treatment of neurodegenerative disorders, such as Alzheimer's disease (AD), is a difficult task for modern health care. The purpose of this chapter was to review the literature on the prevention or alleviation of AD by introducing an appropriate carnitine-rich diet, dietary carnitine supplements and the MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet, which contains elements of the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet. L-carnitine (LC) plays a crucial role in the energetic metabolism of the cell. A properly balanced diet contains a substantial amount of LC as well as essential amino acids and microelements taking part in endogenous carnitine synthesis. In healthy people, carnitine biosynthesis is sufficient to prevent the symptoms of carnitine deficiency. In persons with dysfunction of mitochondria, e.g., with AD connected with extensive degeneration of the brain structures, there are often serious disturbances in the functioning of the whole organism. The Mediterranean diet is characterized by a high consumption of fruits and vegetables, cereals, nuts, olive oil, and seeds as the major source of fats, moderate consumption of fish and poultry, low to moderate consumption of dairy products and alcohol, and low intake of red and processed meat. The introduction of food stuffs rich in carnitine and the MIND diet or carnitine supplementation of the AD patients may improve their functioning in everyday life. It should be stressed that correct nutrition is an important element of lifestyle that may be an important factor for healthy, slow, favorable aging and delaying the development of neurodegenerative diseases including dementia and AD.

In the age group of 5 to 13 years school going children there is always a fast growth of Executive Function (EF) parts of the brain. The EF growth gets shunted in the given school environment, where the growing genes of the children and their syllabus plays a major role. During this period, the children are loaded with heavy school curriculum and thus limiting the learning processes and creatively get lost in curriculum based growth. In this paper we propose to strengthen the EF, functioning through a complimentary Yoga frame. This new frame gives us a protocol of yoga techniques to improve, the Attention, Adjustment and Cognitive flexibilities of the mind. Supplementation of yoga along with curriculum inculcates the habit of cognitive aspects of the brain which will make their carriers useful and betterment of the society. Yoga frame for children mediates the link between school curriculum and with EF resulting into better outputs underlying benefits of yoga. The yoga practices will help the individual EF of the child to grow and step into adolescent age.

Autism Spectrum Disorder (ASD) is a complex and dynamic disorder that encompasses a range of unique behaviors and symptoms. ASD can present such variations across social, emotional, cognitive, and verbal domains all with differing levels of impact and severity across the lifespan. While there is not yet a codified method to eliminate ASD, there exists a robust multitude of efficacious and supportive treatment modalities to ameliorate the unique clinical symptomatology. Working to focus and develop the distinctive neurobiological aspects are critical and described.

The Combination of L-lysine and Alloxan Induces Acute Necrotizing Pancreatitis in Rats: A Recent Study

José D. Méndez, Jianling Xie, Verna Méndez-Valenzuela, José L. Martínez

Challenges in Disease and Health Research Vol. 9, 30 June 2021, Page 51-57

The purpose of this study was to evaluate the L-lysine effect on the pancreas of induced diabetic rats. Adult male Sprague-Dawley rats were divided into four groups (N = 6 rats per group) and researched for 20 days. Group I: Control (saline solution, i.p.). Group II: Rats treated with 10 mM L-lysine. Group III: Rats treated with 120 mg/kg alloxan (diabetic control). Group IV: Rats treated with alloxan plus L-lysine. Blood was drawn from the aorta to determine glucose, triglycerides, and cholesterol levels. Glucose levels in Group III rats increased as predicted. A loss of body weight was also observed (p < 0.001). On day 10 of the experiment, rats in Group IV had higher glucose concentrations than diabetic control rats. The findings show that L-lysine administration to intact animals had an effect on the pancreas. Pancreatic damage was increased in animals that had previously received alloxan injections. It is obvious that a single dose of L-lysine resulted in hyperglycemia. When L-lysine is combined with alloxan, this effect is amplified.

These findings allow us to propose a new model of acute pancreatitis in rats.

Chylothorax Associated with Acute Lymphoblastic Leukemia

Mehmet Can Ugur, Ulku Ergene

Challenges in Disease and Health Research Vol. 9, 30 June 2021, Page 58-62

Chylothorax occurs by accumulation of lymphatic fluid from the ductus thoracicus into the pleural cavity. Chylous fluid typically contains high levels of triglycerides, generally displaying a cloudy and milky appearance. Chylothorax is caused by a trauma or obstruction of ductus thoracicus. Nontraumatic etiologies include malignancies, sarcoidosis, retrosternal goiter, amyloidosis, superior vena cava thrombosis, benign tumors, congenital abnormalities such as lymphangioleiomyomatosis and hemangiomatosis

Here we aimed to present a rare case who presented with shortness of breath due to chylothorax and diagnosed with acute lymphoblastic leukemia. Also, chylothorax cases diagnosed with ALL in the literature are shown in this report.

Advances in Bronchoscopic Simulation Training

Jack A. Kastelik, Shereen Ajab, Mahmoud Loubani

Challenges in Disease and Health Research Vol. 9, 30 June 2021, Page 63-73

Flexible bronchoscopy is an essential skill for clinicians amongst several disciplines including critical care, respiratory medicine and thoracic surgery. Traditionally this skill has been taught using the apprenticeship model which has recognised limitations with regards to patient safety, procedural volume and variability amongst training. Simulation based bronchoscopy training allows for learning in a safe, low stress environment with zero patient harm and provides an opportunity for deliberate repeated practice. Simulation based training has gained increasing acceptance with high quality evidence demonstrating accelerated bronchoscopy skill acquisition, improvements in muscle memory and hand-eye coordination with greater trainee satisfaction. Studies have also supported the transfer of skills from simulation training to clinical practice. Simulation training can be delivered using high fidelity simulators or low fidelity simulation, the latter most commonly involving inanimate models. Low fidelity models lack realism, adaptation and application for specific pathologies, though data demonstrates greater success at bronchoscopy assisted intubation when compared with traditional approaches to training. High fidelity simulators including virtual reality bronchoscopy simulators provide a highly realistic environment with the added advantage of integrated feedback features and assessment through quantitative measurements of objective data. Simulation allows for both standardisation of bronchoscopic training and of assessment of competency using tools such as the Endobronchial Ultrasound-guided Transbronchial Needle Aspiration questionnaire and Bronchoscopy Skills and Tasks Assessment tool. Despite the numerous benefits of simulation based training adoption has been slow and inconsistent, which may be attributed to trainer preferences for traditional training methods, the costs involved with simulation equipment and the time required to introduce simulation based training programmes.

Ten Years after the Great Earthquake Hit

Jin-Ichi Sasaki

Challenges in Disease and Health Research Vol. 9, 30 June 2021, Page 74-90

Fukushima, Miyagi, Iwate Prefecture and surrounding area were vigorously shaking by the unexperienced huge earthquake with M 9.1 At 14: 46 on March 11th, 2011. Twenty minutes thereafter the Tsunami with 20-34m high attacked and engulfed the Pacific Coasts and a large number of victims counted over 25,000. As aftermaths; 1) Outbreak of infection as Norovirus, Legionella pneumophila, Clostridium tetani, Rickettsia spp. occurred among the evacuatees in the overtcrowded gymnasiums. 2) High levels of arsenic pollution was there and acconted for 8% (36/129) at 2 sites in the north-east Tohoku regions. 3) The most serious catastrophe due to the Tsunami hitting was the caused of the Nuclear Power Plants explosionin Fukushima that spread radioactive materials. Residents living within 20 km radius from the power plants explosion were forced to evacuate to safety areas. People close to the exploded power plant inhaled, ingested, and drank the polluted materials. Some of the cattle were relocated to the safer places but unmovable livestock and pets starved to death. The biggest Post-Tsunami issue is the treatment of explouded nuclear plants and radioactive debries, and tritium water tc.

Coronavirus Disease-19 - Multi-dimensional Analysis on Incidence Rates- A Global Perspective Study

Hesham Magd., Henry Karyamsetty

Challenges in Disease and Health Research Vol. 9, 30 June 2021, Page 91-111

The world has been impacted severely by COVID-19 pandemic and the spread of the COVID -19 is not under control as confirmed cases are still reported globally. Based on the literature review where it was suggested that the incidence rates of COVID-19 are related to environmental factors existing locally and therefore it is important to examine the diversified environmental and meteorological factors that are contributing to the disease transmission and infection rates that subsequently facilitates better management of future outbreaks and crisis. The current study explores and investigates the significance of population dynamics, dew point and altitudinal factors on incidence rates of COVID -19 across different geographical regions. Data from 129 countries are collected pertaining to the parameters of the study and each parameter is examined to know the degree of association with the confirmed cases. The study results show that the city fraction rate combining with latitude ranges substantially can predict to varying levels the incidence rate of SARS-CoV-2. Additionally, the study suggested also countries having city fraction rate in specific range has affinity to show increase in daily confirmed cases.

Background: The need to prevent cancer lead us to propose three innovative courses of cancer as categories of disease.

Aim: The goals of our research are to investigate the impact of various factors on cancer recurrence adaptation and to assess the quality of life, anxiety as a state, depression as a state, and disease evolution over a three-month period.

Methods and Materials: We met 32 subjects after announcing the recurrence of their cancer during this longitudinal and prospective study, and we saw 21 of them again three months later.        In two times of the study, we made fill out several questionnaires concerning various variables.

Results: Our main findings suggest that the majority of the participants did not have a new cancer recurrence and that the implementation of a fighting strategy is representative of them. Our linear regressions and average comparisons enabled us several relations about to different categories of disease.

Conclusion: Supportive therapies and stress management programmes would be beneficial for cancer patients who have had a recurrence.

The Pollution by Europium-152 in Soil of Kasra and Atash, Iraq

Ali Abid Abojassim, Najlaa Saleh Mahdi, Leith Hani Rasheed

Challenges in Disease and Health Research Vol. 9, 30 June 2021, Page 125-134

This study has been carried out to measure the specific activity of Eu-152 nuclides contaminated in soil samples at Kasra and Atash that it is taken from Al-Tuwaitha site in Baghdad. Ten samples were collected from different the area under study in Baghdad. The measurements have been done using spectral analysis technique for gamma-ray By using scintillation detector system NaI(Tl) gamma spectroscopy with 3"×3". The results show that, specific activity in soil samples under study were ranged from 21.45±0.33 Bq/kg to 96786.84±41.84 Bq/kg with an average 10039.63 Bq/kg. Soil samples are not safe to work in and does constitute a danger or hazard to the citizens.