Dr. Darko Nozic,
Clinics of Infectious and Tropical Diseases, Military Medical Academy, Belgrade, Serbia.

ISBN 978-93-5547-742-2 (Print)
ISBN 978-93-5547-749-1 (eBook)
DOI: 10.9734/bpi/cpms/v9

This book covers key areas of Medical Science.  The contributions by the authors include Exclusive breast-feeding, mother-to-child transmission, infant mortality, Menstrual hygiene,  Intratesticular, embryonal rhabdomyosarcoma, Acute myeloid leukemia, myeloid sarcoma , granulocytic sarcoma, Breast cancer, lung cancer, methyl-donors, apoptosis, complementary therapy, Ultrasound, pancreatitis,  Meniscal injury, menisectomy, meniscal repair, knee pain, Migraine, neuralgia, headache, Dentistry, health profession, emergency medicine,  clinical practice guide, COVID-19,  Thyroidectomy, laryngeal nerve injury,  vocal cord injuries, Acromegaly, growth hormone, pituitary adenoma, Insulin-like Growth Factor-I, psychiatric disorders, and schizophrenia. This book contains various materials suitable for students, researchers and academicians in the field of Medical Science.

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Exclusive Breast Feeding: Experiences of HIV Infected Mothers in Mangaung, South Africa

Selloane Phakisi, Johanna M. Mathibe-Neke

Current Practice in Medical Science Vol. 9, 16 August 2022, Page 1-12

The distribution of free formula milk to HIV-positive mothers was subsequently stopped, and these mothers were urged to breastfeed instead. This was also in accordance with the WHO's request that nations implement a single-feeding practise for mothers who are HIV-positive. The objectives of the study were to identify the feasibility of exclusive breast feeding in the context of HIV and the mothers experiences in this regard. Qualitative data was collected through in-depth unstructured interviews at a community health centre among mothers aged 18 years and above, who opted for exclusive breast-feeding. The examination of the data was done thematically. According to the study's findings, mothers reported good feelings like motivation, satisfaction, and knowledge. Some mothers chose not to breastfeed exclusively as a result of unpleasant experiences including anxiety, family pressure, and guilt. Socio-cultural factors and knowledge from healthcare professionals had the biggest impact on the experiences of participating mothers. The study's findings emphasise the necessity of stepping up advocacy, communication, and social mobilisation for exclusive breastfeeding among all communities.

Menstrual Hygiene among Reproductive Age Group Women in a Rural Area, Tamil Nadu

S. Sangeetha Balamurugan, S. S. Shilpa, Sheethal Shaji

Current Practice in Medical Science Vol. 9, 16 August 2022, Page 13-24

The purpose of this study is to evaluate menstrual hygiene practices and the impact of socio-demographic factors on menstrual hygiene among women of reproductive age group in a rural area. Menstrual hygiene management should be an imperative part of healthcare to safe guard the reproductive health of women. It is a cross-sectional community-based study that was carried out among 200 women of reproductive age group (15-45 years) in a rural field practice area of VMKV Medical College Hospital, Salem, using a simple random sampling technique. Majority of the study population, 36% (72/200) belonged to the 21-30 years age group. About 75% (150/200) were married. Majority of women 35% (70/200) were unskilled workers, 43.3% (86/200) had primary education and 54.3% (108/200) belonged to lower middle class. The mean age of menarche among the reproductive age-group women was 13.15 years. Majority of women 51.8% (104/200) used cloth during menstruation, about 45.7% (91/200) used the same cloth by washing and reusing every month. Socio-demographic characteristics and hygiene behaviours had a substantial impact on women during menstruation (P < 0.001). It was observed that the majority of rural women were engaged in unhygienic behaviour during menstruation. Hence, efforts should be made to create awareness about using sanitary pads and follow hygienic practices during menstruation,as a part of menstrual hygiene management (MHM) ,along with improving female literacy and general living conditions.

Testicular Tumor in Children: A Rare Case Report

Severino Rey Nodar, Sirced Salazar, Carlos Cárdenas, Verónica García Yllán

Current Practice in Medical Science Vol. 9, 16 August 2022, Page 25-34

Male genital tract mesenchymal neoplasms are uncommon, with the majority occurring in the paratesticular and testicular adnexa. The most common sarcomas in children with this location are paratesticular embryonal rhabdomyosarcoma (RMS). Without any personal pathological history, a 4-year-old boy reported pain and a 2 month-old rise in the size of his left testicle. Physical examination revealed that the left scrotal sac was swollen, uncolored, indurated, and not particularly uncomfortable. No changes were visible in the right testicle.
The RMS is the second most common soft tissue tumour in children, after the head and neck region, and it most frequently develops in the genitourinary system. It is rare to develop primary intratesticular rhabdomyosarcoma.

Oral Myeloid Sarcoma

Shah Kajal, Panchal Harsha, Patel Apurva, Parikh Sonia, . Chinmay

Current Practice in Medical Science Vol. 9, 16 August 2022, Page 35-45

The terms "chloroma," "myeloid sarcoma," and "granulocytic sarcoma" (GS) all refer to a terrible subtype of myeloid leukaemia. Acute Myeloid Leukemia (AML) is a hematologic cancer that can occasionally colonise extramedullary locations like the skin, gingiva, central nervous system (CNS), orbit, liver, or, in rare cases, the tongue, leading to a variety of appearances. Here, we discuss the case of a 30-year-old man who arrived with hepatomegaly and a tongue ulcer that appeared to be malignant. After examination, it was determined that it was a myeloid sarcoma of the tongue and liver, which ultimately revealed an underlying AML.

Methyl-donors Induce Apoptosis and Attenuate Proliferation Pathways Mediated by Akt and Erk1/2 in Breast and Lung Cancer Cell Lines

Eva Kiss, Gertrud Forika, Reka Mohacsi, Magdolna Dank, Tibor Krenacs, Istvan Takacs, Zsuzsanna Nemeth

Current Practice in Medical Science Vol. 9, 16 August 2022, Page 46-67

We aimed to explore how methyl-donor treatments affect the growth, proliferation, apoptosis and the related pathways in hormone positive invasive breast cancer (MCF7 and T47D) and NSCLC lung cancer (A549 and H1650) cell lines. Methyl-donors are employed as an adjunctive support in oncotherapy and play critical roles in physiological processes catalyzed by coenzymes of the B vitamins. Our theory was that methyl-donors may directly inhibit tumor development and proliferation in addition to helping patients tolerate cancer treatment. Methyl-donor treatment significantly reduced the proliferation in all investigated cell lines, possibly through the downregulation of MAPK/ERK and AKT signaling. These were accompanied by the upregulation of the pro-apoptotic Bak, Bax both in MCF7 and H1650 cells, at reduced anti-apoptotic Mcl-1 and Bcl-2 levels in MCF7 and H1650 cells, respectively. The treatment induced downregulation of p-p53(Thr55) was likely to contribute to protecting the nuclear localization and apoptosis inducing functions of p53. The features that are being offered are known to increase the sensitivity of cancer treatment. In light of this, the observations are consistent with the theory that methyl-donors may protect p53 activities by promoting apoptotic signaling by downregulating both the MAPK/ERK and the AKT pathways in breast and lung cancer cell lines. Our results can emphasize the importance and benefits of the appropriate dietary supports in cancer treatments. However, further studies are required to confirm these effects without any adverse outcome in clinical settings.

Pediatric Pancreatitis: Demography, Etiology, Complications and Ultrasound Findings in a Tertiary Care Centre

Bhawana D. Sonawane, Prashant U. Titare, Pradip B. Rathod, Narendra G. Tembhekar, Aarti Anand

Current Practice in Medical Science Vol. 9, 16 August 2022, Page 68-79

Pancreatitis is less common in children and adolescents than in adults, and the causes in adults and children are different. The objective was to study demography, etiology, complications and detail ultrasound findings in pediatric pancreatitis. Retrospectively, 20 patients were evaluated for demographics, etiology, complications, and transabdominal ultrasound findings showing a common presentation in the 10- to 15-year-old age group with predominantly female patients. Acute and chronic pancreatitis were noted in two and eighteen cases, respectively. Idiopathic cause and chronic variant most commonly observed in our study population. Pseudocyst and ascites were the most common complications of pancreatitis found in our study. Ultrasound is an important first-line test that can be used in the diagnosis, classification, and follow-up of pediatric pancreatitis.

Meniscal Injuries: Review

Khalid Muzzafar

Current Practice in Medical Science Vol. 9, 16 August 2022, Page 80-88

Meniscal injuries are common cause of pain and functional impairment in knee. Proper clinical examination and evaluation is must to diagnose the injury. Treatment in form of physical therapy can help sone patients, while surgical options like meniscal repair, partial menisectomy or total menisectomy is needed in some patients. Proper rehabilitation after surgery is required to get good functional results.

Current Updates on Migrane: Diagnosis and Management

B. Niveditha, Mutum Sangeeta Devi, Khumukcham Sophia, D. K. S Lakshminrusimhan

Current Practice in Medical Science Vol. 9, 16 August 2022, Page 89-112

Migraine is a complex, less well understood neurovascular disorder and it is not just a headache. It presents with a myriad of symptoms due to the pathophysiological processes uniting cortical depolatization, brainstem dysfunction, meningeal vasodilatation and excitation of sensory pain structures as remote as the cervical nucleus caudalis. In the management of migraine, patients are usually in the practice of use of medications purchased over the counter including compound analgesics, triptan or ergot derivatives. Most of the physicians commonly encounter patients with headaches. Hence a rational manner of approaching the patient with these conditions, allows a specific diagnosis of migraine to be made quickly and safely. In this chapter we have attemptd to explain the less understood aspects of this disorder including pathogenesis, management and latest updates regarding treatment.

Quality Assessment of Clinical Practice Guidelines (CPG) for Management of Paediatric Dental Emergencies Applicable (PDEA) during COVID-19 Pandemic

Jessica Arieta-Miranda, Abad Salcedo Alcaychahua, Gary Pereda Santos, Manuel Chavez Sevillano, Rosa Lara Verastegui, Daniel Blanco Victorio, Gilmer Torres Ramos

Current Practice in Medical Science Vol. 9, 16 August 2022, Page 113-145

The present study evaluates the quality of Clinical Practice Guidelines (CPG) related to the management of paediatric dental emergencies applicable to the COVID-19 pandemic, through the use of the measuring instrument AGREE II (Appraisal of Guidelines for Research and Evaluation in Europe).
We conducted a thorough web search of CPG among the top CPG compilers. : In addition, a thorough search was conducted among the major national and international dental organisations as well as reputable websites in order to find CPG that fulfil the inclusion criteria.
An overall Five (05) out of twenty-three (23) selected CPG, were classified as “acceptable” according to AGREE II. These five guides were evaluated to determine their “Recommendation degree”. According to the quality evaluation criteria and recommendation degree of the AGREEII instrument, only one CPG (AUGE clinical guide for ambulatory dental emergencies- Chile, 2011) was considered a “Rec-ommended” CPG, but applicable only among Spanish- speaking coun-tries. It would be advisable to work on this guide, using English as an international language.
High, middling, and low quality CPG were determined using the quality assessment and recommendation degrees criteria from AGREE II. Only one CPG had a score of 75% or above, earning the designation "highly recommended". Therefore, in order to ensure their quality, it is advised that both current and future CPG updates develop them using the available tools and procedures.

Background: Thyroidectomies are often performed surgical procedures that entail the partial or complete removal of the gland depending on the nature and pathology of the goitre. The Recurrent Laryngeal Nerve Injury (RLNI) represents nearly half of all the complications of thyroid surgery. Vocal cord paresis or paralysis, due to iatrogenic injury of the recurrent laryngeal nerve, is one of the main problems in thyroid surgery. Although many procedures have been introduced to prevent the nerve injury, still the incidence of recurrent laryngeal nerve palsy varies between 1.5-14%. The aim of this study is to Estimate the recurrent laryngeal nerve palsy concerning different types and indications of thyroid surgery. A cohort retrospective study of 705 patients with different kinds of goiters admitted to Al-Sadder teaching hospital and Al-Ameer private hospital in Najaf city- Iraq, for thyroid surgery. The current study is based on a single surgeon's experience from 1 October 2007 to 30 June 2018, with a mean follow-up time of 37 months. Seven hundred five patients underwent various thyroidectomies for various purposes. The majority of patients have benign multinodular goitres (67.4 percent). Indications for surgery for toxic multinodular goitres, which have been observed in (19.15 percent). Malignancy was observed in (14.3%), while the least frequent reasons for surgery in our sample were Hashimoto's thyroiditis and Grave's disease (7.6%% and 3.4%), respectively. Temporary recurrent laryngeal nerve injuries have been seen in (0.69%) of subtotal surgery rising to (10%) (p=0.05), for patients having recurrent goitres. The overall permanent recurrent laryngeal nerve injuries were (0.99%) ranging from (0%) in subtotal up to (5%) (p=0.027) in cases for recurrent goitres. Total thyroidectomy is preferred since it will lessen the need for repeat surgery, which is accompanied by a considerably higher rate of nerve injury, even though partial thyroidectomy is associated with a low rate of recurrent laryngeal nerve injury.

Proteomics in Human Healthcare: A Tool in Disease Diagnosis

Rahul Suman, Aditi Chauhan, Thomson Soni, Vijay Prabha

Current Practice in Medical Science Vol. 9, 16 August 2022, Page 159-177

Proteins are the most relevant markers of cell functions as they represent the functional output of a cell. Systematic studies of the human proteome from both body fluids and tissue samples may be a dynamic and powerful approach towards better understanding numerous malignancies where traditional methods of diagnosis may not be enough. Alterations in the protein profiles may be detected in cells in their normal non-diseased states. Further comparing them with that of diseased state can extend the base information regarding the underlying pathogenesis of a disease. Proteomics has been making giant strides towards uncovering basic biological processes and aiding in better knowhow of some complex biological phenomena involved in some major diseases. This chapter will focus on such studies where various body fluids and tissue samples have been put to several proteomic studies to understand the pathologies of some diseases. Body fluids such as plasma, urine, sputum, CSF, seminal fluid, cervicovaginal fluid, etc., as well as various tissues such as tissues from brain, breast, liver, ovary, vagina, etc., have been used by researchers to study diseases associated with these tissues. Furthermore, continuous advancements and refinements in proteomic techniques will usher healthcare into a revolutionary era of early diagnosis, prognosis and ultimately lead to successful treatment of these human malignancies.

Comprehensive Review on a Complicated Endocrine Disorder (Acromegaly)

Sanjita Das, . Divya

Current Practice in Medical Science Vol. 9, 16 August 2022, Page 178-186

The purpose of this article is to make people familiar with signs and symptoms as well as treatment of acromegaly. Acromegaly is a disease or ailment that results in excessive bodily tissue growth and the malfunction of other metabolic processes. It is brought on by the hypersecretion of growth hormone from the anterior pituitary. Middle-aged persons are most commonly affected by acromegaly, which is typically brought on by a benign (non-cancerous) tumor. Patients with acromegaly have pain in the joints, physical deformities, deepening of voice, bulging chest, protruding lower jaw, large feet and hands, oily skin, vision disorder or erectile dysfunction (impotence). Acromegaly occurs after the fusion of growth plates while gigantism occurs before the fusion of growth plates. It is concluded that any disease management strategy must focus on the needs of patients and do everything possible to improve patients’ healthcare experience and minimize their treatment burden. The present study may be helpful for a systematic and targeted research for more convenient management of acromegaly.

Has the DSM Failed?

Sumit Anand

Current Practice in Medical Science Vol. 9, 16 August 2022, Page 187-196

The DSM’s atheoretical and consensus-driven diagnostic classification system has become increasingly problematic to implement into clinical practice, by creating diagnostic confusion between diagnoses. . Neither has it properly incorporated decades of research on etiology, in order to inform diagnostic clarity. Instead it instructs clinicians to use algorithmic/iterative methods of making diagnoses, contrary to longstanding clinical training traditions.., Academic institutions in the United States are now mostly reliant on the DSM. making it a paradoxical impediment to the authentic understanding of psychiatric disorders as well as their treatments.