Dr. Takashi Ikeno
National Cancer Center Hospital East, Clinical Research Support Office, Japan.

ISBN 978-93-5547-702-6 (Print)
ISBN 978-93-5547-703-3 (eBook)
DOI: 10.9734/bpi/cpms/v6

This book covers key areas of Medical Science. The contributions by the authors include Resveratrol, breast cancer, Mucinous breast carcinoma, modified radical mastectomy, anthracycline, adjuvant chemotherapy, Diabetes, Type 2 diabetes, insulin, Prostate cancer, radiotherapy, radical prostatectomy, Schizophrenia, psychosocial rehabilitation programme, triangular fibrocartilage, radio-ulnar joint, Molecular imaging, PET-CT, radiotracers, molecular pathways, Carotid space abscess, needle aspiration, respiratory tract, deep neck space infections, Dens invaginatus, Cone beam computed tomography, microdontia, taurodontism, Renal derangement, renal function test, sickle cell anemia, vaso-occlusive crisis,  parkinson’s disease, neuroprotection, anti-inflammatory, antioxidant properties, Cellular signaling, genetic mutations, COVID-19, inflammation, coagulation, Thyroid nodules, thyroid cancer, thyroid FNA, and Otorhinolaryngological symptoms. This book contains various materials suitable for students, researchers and academicians in the field of Medical Science.

Media Promotion:


Interactions of Downregulated Proteins in MCF-7 Cells, Treated with Resveratrol

Raji Sundararajan, Ignacio G. Camarillo

Current Practice in Medical Science Vol. 6, 14 July 2022, Page 1-10

With over 600,000 breast cancer deaths/year, breast cancer, the age-old disease is still an unmet need for many women worldwide. Considering the cost and severe side effects of the commonly administered chemotherapeutic drugs, use of natural compounds, such as resveratrol, available in grapes and many other plants is a viable alternative that is gentle on both the physique and the purse. Towards this, the purpose of this study is to analyze the interactions of the downregulated proteins in MCF-7, the human estrogen receptor positive cell line, when treated with resveratrol, using string interaction diagrams and the corresponding gene ontology functional enrichments and pathways. Results indicate that Resveratrol, with its various anticancer attributes could be a potential anticancer agent and more work needs to be done towards that.

Case Studies on Breast Malignancy with Uncommon Histology: Report of Two Cases

Diptajit Paul, Sheeba Bhardwaj , Rakesh Dhankhar , Vivek Kaushal

Current Practice in Medical Science Vol. 6, 14 July 2022, Page 11-20

Breast carcinomas, the most common cancer in world, is a global burden. Guideline for management of IDC, most common histological type of breast cancer is well established. But, rare histological subtypes management creates headache to physician due to lack of guideline and scarcity of cases. Here, we documented two cases of uncommon breast malignancy: first is mucinous breast carcinoma; treated by radical MRM followed by adjuvant chemotherapy. Patient is having disease free 2-years after treatment completion. Second one is primary breast lymphoma, tried to managed by combination chemotherapy. Partial response was achieved and radiation therapy was offered to the patient. But patient denied and succumbed to death. These two cases demonstrate the need of standard guideline in infrequent subtype of breast malignancy. Our objective of this study was to record response achieved in comparatively uncommon breast tumor with available resources. More case series and prospective studies may improve the treatment outcome in these patients.

Diabetes Mellitus

Ehab Tousson, Manal Elbandrawy

Current Practice in Medical Science Vol. 6, 14 July 2022, Page 21-37

Diabetes mellitus is considered chronic disease characterized by high glucose levels in the blood due to relative or an absolute deficiency of insulin levels in blood circulation. Diabetes, caused by inherited and/or acquired deficiency in pancreatic insulin production (type 1) or by insulin ineffectiveness (type 2), is one of the most chronic disease in the world. T2DM can be caused by a group of biological factors, insulin resistance and insulin deficiency are both linked to hyperlipidemia and hyperglycemia Symptoms often include frequent urination, increased thirst and increased appetite. If left untreated, diabetes can cause many health complications In addition to death, diabetes also leads to many chronic conditions such as nephropathy, neuropathy, and various vascular diseases linked with kidney, retinopathy, heart, brain, and peripheral blood vessels. Insulin is the principal hormone that regulates the uptake of glucose from the blood into most cells of the body.

Demographics in Prostate Cancer Treatment in the U.S.

Christian S. DiBiase , Baoqing Li

Current Practice in Medical Science Vol. 6, 14 July 2022, Page 38-50

Prostate cancer (PCa) is the second leading cause of cancer deaths for men in the United States and the most commonly diagnosed cancer. Though the prevalence of localized PCa among U.S. men is declining, it still causes significant morbidity and mortality. We aimed to study the factors that may impact treatment decisions for patients and physicians. More specifically, we sought to investigate differences in utilization of RP, RT, and AS treatment options to manage localized PCa in the United States for different demographics paying specific attention to the role of population density, and cancer center facility type. Many factors may go into choosing a management option (e.g. availability, accessibility, preference) but the standard of care is not as well delineated as it is for other malignancies.

By revealing these differences in management based on demographics, we hope to increase awareness of the complexity of the treatment decisions in PCa in order to maximize patient outcomes.

A Brief Study about Schizophrenia: Proposing and Defending a Treatment

Wilfried Ver Eecke

Current Practice in Medical Science Vol. 6, 14 July 2022, Page 51-68

This paper provides statistical evidence that in severe mental illness, like schizophrenia, the environmental factors dominate the biological genetic factors. The paper then makes use of Lacan’s theories to explain how schizophrenia can be explained as the absence of a developmental stage in the future schizophrenic. Such patient did have a faze in which the mother/child relationship dominated, and in which two fantasies were developed: i.e., my mother is omnipotent and perfect and I, the child, am everything the mother could want.  The absence of a solid relationship with a third, normally the father, prevented these patients to correct the fantasies developed in their relationship with their mother. The paper refers to Karon to demonstrate that the therapist must start by respecting the delusions of the patient. The paper then analyzes the method of Villemoes which aims at improving the relationship of the patient to language by describing objects in the patient’s environment. Villemoes then helps the patient to describe the objects in the patient’s memory and lets the patient associate the memories of objects with the relationship with people that the patient developed.  This allows the patient to slowly discover who (s)he has become. This is the time when Villemoes starts the process of ending the therapy.

Aim: To Evaluate Functional & Clinical Results of ACS in TFCC Injuries.

Materials and Methods: A) A Study of 28 Cases Done between September 2019 to December 2021.

  1. B) 28 patients with Clinical and Radiological Evidence of TFCC Injuries Secondary to Sporting Activities Were Recruited for This Study.
  2. C) Diagnosis is made clinically, plain radiographs, ultrasound & MRI

Results: 26 Cases Came for Complete Followup.2 Cases Lost Follow-Up After Injection.16 Cases Had Excellent Results, 06 Cases Had Good Results and 04 Had Poor Result At The End Of 6 Weeks. But At The End Of 03 Months, Follow Up With 22 Cases (16+06) Gave us a Total Positive Response And We Labelled Them Under The Excellent Result Category.

04 Cases Who Had Poor Results at the End Of 6 Weeks Were Given One More Shot Of ACS &They Gave Good Response at the End Of 6 Weeks After 2nd ACS Injection.

Conclusion: Through ACS Therapy, We Have Found that Pain Can Be Dramatically Reduced And Healing Stimulated. Treatment Is Fast-Acting While Providing Long-Lasting Relief. Time to Return To Sporting and Gym Activities Also Reduced Compared to Conventional Treatment in Which It Is 3 Months, Where as in this Study We Found Time took to Getting Back to Gym & Sports-Related Activities Is 6weeks. We Are in the Opinion That ACS is a Safe Method to Treat Type 1 TFCC Injuries in Terms of Faster Returning to activities and also in Getting Rid of Pain Along With No Complications.

Contribution of Molecular Imaging in Radiation Oncology

Sheeba Bhardwaj , Diptajit Paul , Vivek Kaushal

Current Practice in Medical Science Vol. 6, 14 July 2022, Page 81-93

Over the past few years, a tremendous progress has been made in the field of oncology pertaining to advanced treatment planning, cancer imaging and treatment techniques. The limitation of conventional imaging in radiation oncology prompted the development of molecular imaging; which allows identifying or describing living biological process at cellular and molecular level and is especially addressed to reveal abnormalities in cells and molecules which cause the cancer. The techniques used include radiotracer imaging like PET scan & SPECT, MRI & MR spectroscopy, optical imaging, ultrasonography, and others. The early detection of cancer cells by molecular imaging and prompt treatment leads to better outcomes, which can potentially be assessed in early stage thorough molecular imaging. Different pathways, where this technique can be acted are cell metabolism & proliferation, hypoxia, apoptosis, angiogenesis. In the last decade, diagnostic methods involving molecular imaging have made advancement in the field of diagnosis and staging, target definition and response assessment of cancer. The most common used imaging technique is 18-FDG PET-CT scan, which has immense value in cancers of lung, breast, prostate, lymphoma and many more with increased sensitivity and specificity. Advancement in the understanding of the pathophysiology of cancer has led to developments of multimodality treatment concepts comprising surgery, radiotherapy, chemotherapy and molecularly targeted anti-cancer agents. It can be concluded, combined use of molecular imaging with these treatment modalities can prove to be a boon for cancer management.

Simple Carotid Space Abscess

Jasif Nisar , Suhail Amin Patigaroo

Current Practice in Medical Science Vol. 6, 14 July 2022, Page 94-101

Infections of the deep neck area are often polymicrobial, representing the normal resident flora of the contiguous mucosal surfaces from where the infection developed. The resident flora of the oral cavity, upper respiratory tract, and specific areas of the ears share many similar organisms due to their close anatomical links.  All patients with carotid space abscess should undergo an assessment for possible airway obstruction. For those who have evidence of airway impingement, maintenance of an adequate airway is a primary and urgent management issue. Needle aspiration should be avoided especially by less trained persons. Small abscesses may respond to intravenous antibiotics but when frank and large abscess is formed, incision and drainage is the treatment of choice.

Dens in dente was suggested by Busch in1897 implying the radiographic appearance of a tooth within a tooth. The term dens invaginatus, currently used, was introduced by Hallet 1953.The present report highlights a case of a type II Dens invaginatus involving a maxillary left canine associated with a large chronic periapical lesion treated with conventional endodontic treatment after ultrasonic removal of the invaginated tissue. These tissues were removed to better perform disinfection and instrumentation of the necrotic root canal system. Indeed Cone Beam Computed Tomography examination showed an evident communication from the dens invaginatus with the main root canal pulp. A post operative radiographic control revealed a dense and hermetic root filling, but infortunately, an apical shortage, due to an excessive use of collagen matrix was also evident.

Diagnosis of Renal Function and Structure for Sickle Cell Anemia in India during Vaso-occlusive Crisis (Voc)

Pandey Jyotsna, Mohanty Dipika , Mohapatra Nachiketa , Das Sreeya

Current Practice in Medical Science Vol. 6, 14 July 2022, Page 116-121

This present study reports severe renal derangement in four cases of Sickle cell Anemia during vaso-occlusive crisis.  Paucity of reports from India regarding renal function derangement in sickle cell anemia cases during Vaso-occlusive crisis prompted us to report this present study. Sickle cell disease (SCD) is one of the commonest severe monogenic disorders in the world, due to the inheritance of two sickle haemoglobin genes from both parents.
All the cases had low Hemoglobin level and high reticulocyte and LDH level. Examination of urine revealed proteinuria, red cells in excess, hyposthenuria. High levels of serum urea ranging from 47 to 200mg/dl, Creatinine 0.58 to 6.2mg/dl and urea nitrogen 22 to 93mg/dl. The U.S abdomen mainly showed bilateral enlargement of kidney with acute renal parenchymal changes. Present study establishes the fact that in about 6.6% of homozygous sickle cell anemia cases there is gross derangement of renal function during VOC. In one of the cases, a kidney biopsy indicated Focal and Segmental Glomerulosclerosis (FSGS), as well as cellular and fibrocellular crescents. Sickle RBC were found in the capillary lumina. Twenty to thirty percent of the patients had interstitial fibrosis and tubular atrophy. As a result, renal dysfunction during a sickle cell crisis is widespread in India. However, because it is an emergency, one must be conscious of this fact and treat it proactively.

Parkinson's disease (PD) is a multisystem disorder that affects dopaminergic neurons in the substantia nigra pars compacta (SNpc), resulting in a reduction in dopamine (DA) at their striatal terminals. The function of reduced DA in the striatum is replaced when Parkinson's disease is treated with levodopa or DA receptor agonists. Treatment with these drugs for an extended period of time has inconsistent therapeutic results and can result in undesired dyskinesia. As a result, finding innovative techniques to reduce, stop, or reverse the process of neurodegeneration is a critical unmet requirement in the treatment of Parkinson's disease. Natural compounds with neuroprotective properties are being researched as potential therapies. Curcumin is a polyphenolic substance extracted from Curcuma longa rhizomes (turmeric). It has been shown to have powerful anti-inflammatory, antioxidant, free radical scavenging, mitochondrial protecting, iron-chelating, MAO inhibitory properties, and is a prospective therapeutic and nutraceutical agent for the treatment of Parkinson's disease.

Drugs that Target Cellular Signaling Pathways for Breast Cancer Treatment

Nadeem Kizilbash, Marjan Assefi , Naila Mahmood, Sohila Nankali , A. Nanklai, Gholamreza Abdi

Current Practice in Medical Science Vol. 6, 14 July 2022, Page 148-160

The identification of genetic mutations and the exploration of several cellular signaling pathways has led to the development of a number of molecular targeting agents, which can be targeted in several ailments for therapeutic basis. Recently, many drugs have been introduced to treat breast cancer. These drugs are administered either orally or via an injection. These drug delivery systems minimize toxicity and improve efficiency. These new drugs and delivery mechanisms have replaced the older cumbersome strategies and have helped the patients in several ways. They offer greater benefits to patients and have reduced side effects.

Are TFPI and \(\beta\)-TG Indicators of Severity in COVID-19?

Rossella Cacciola , Elio Gentilini Cacciola, Veronica Vecchio, Emma Cacciola

Current Practice in Medical Science Vol. 6, 14 July 2022, Page 161-173

Background: Thromboembolic complications have been reported as a life-threatening major pathologic event in severe coronavirus disease 2019 (COVID-19) affecting the lung as evidenced by autopsy reports of alveolar damage and pulmonary intravascular microthrombi. The new coronavirus (CoV) does not appear to have intrinsic procoagulant effects itself. The coagulation changes in COVID-19 are likely a result of the inflammatory response. Significant inflammation is present in COVID-19, based on elevated interleukin-6 (IL-6). This inflammation associated with COVID-19 results in coagulopathy, based on elevated D-dimer (DD). An endotheliopathy appears to contribute to microvascular thrombosis in COVID-19. The aim of this study is to confirm the coagulation abnormalities in 100 severe COVID-19 patients having lung involvement and their association with the severity and prognosis.

Method: Inflammation, endothelial and coagulation indicators were performed and compared between severe and mild disease.

Results: IL-6 and TNF-a, and TF and VWF, exceeded in severe COVID-19 patients as well as D-dimer, TAT and Fibrinogen. As PF4 has a rapid removal from plasma, we also measured \(\beta\)-TG levels which exceeded the plasma levels of PF4 in severe COVID-19 patients as well as increased platelet adhesion was observed. Shortened CT and CFT, high MCF and low LY at 30 minutes were present in 100% of severe COVID-19 patients compared with mild COVID-19 patients.

Conclusions: It is reported that TFPI is a natural anticoagulant that lowers inflammation and coagulation. Therefore, we measured TFPI levels which exceeded without shutdown of the inflammation and coagulation documenting the clinical severity of severe COVID-19 patients.

Thyroid Cancer

Fernando Cordera, Rodrigo Arrangoiz

Current Practice in Medical Science Vol. 6, 14 July 2022, Page 174-239

Thyroid tumors include those that originate from follicular cells and those that arise from parafollicular cells (C cells). Differentiated thyroid cancer, which originates from follicular cells, includes papillary carcinoma, follicular carci-noma, oncocytic cell carcinoma (Hürthle), poorly differentiated carcinoma, and anaplastic carcinoma. The incidence of thyroid cancer has been increasing significantly, with an estimated incidence in the United States of America of 43,800 cases by the year 2022. This neoplasm is listed as the most common endocrine tumor and represents approximately 3% of all malignant tumors in humans, with 75% of cases occurring in women, and two-thirds of cases oc-curring in people under 55 years. The increase in the prevalence/incidence of low-risk thyroid cancer over the last 10 to 20 years has required a re-appraisal of the standard one-size-fits-all approach to differentiated thyroid cancer. This adaptation to a more individualized management of the patient with thyroid cancer has led to a much more risk-adapted approach to the diagnosis, initial therapy, adjuvant therapy, and follow-up of patients with differentiated thyroid cancer. This paper reviews the current understanding of the clinical presentation, diagnostic workup, and management of thyroid cancer centered on evidence-based medicine.

Prevalence and Otorhinological Symptoms of People with COVID-19 in Rivers State: A Prospective Descriptive Study

U. A. Oparaodu, G. C. Owhonda, F. E. Aaron , J. R. Inuele, S. T. Livingstone

Current Practice in Medical Science Vol. 6, 14 July 2022, Page 240-249

Coronavirus disease 2019 (COVID-19) has rapidly spread throughout the world, crossing all national borders. It is characterized primarily by symptoms of the lower respiratory tract, such as fever, cough, dyspnea, and chest tightness. COVID-19, on the other hand, causes upper respiratory tract symptoms such as nasal congestion, sore throat, and olfactory dysfunction. As a result, the purpose of this study was to assess the prevalence and otorhinologic / Ear Nose and Throat (ENT) symptomatology of individuals with COVID-19 in Rivers State. The study was a prospective descriptive analysis of all COVID-19-designated hospital patients in Rivers State who consented to participation.

According to the Nigerian procedure for sample collection and PCR diagnosis for SARS COV-2, 2223 samples overall, of which 137 (6.16 percent) were symptomatic and 2086 (93.84 percent) were asymptomatic. Age, sex, symptom beginning date, and sample collection date were all recorded. Using multiplex RT-PCR and Gene Finder by Osang Korea, a diagnosis of COVID-19 infection was made in accordance with the recommendations developed by the NCDC. Results showed that out of a total of 2223 patients examined, 206 showed positive COVID-19 results, and 2017 (91 percent) showed negative results. The study demonstrates that the prevalence of COVID-19 among symptomatic and asymptomatic patients in the study location is high and a cause for epidemiologic concern, as asymptomatic patients contribute a substantial burden and are carriers of COVID-19 infections. The research also revealed that ENT syndrome is the primary symptom of Covid 19.