Dr. John Yahya I. Elshimali
Professor of Pathology and Oncology,
UCLA School of Medicine & Charles R. Drew University of Medicine and Science, California, USA.

ISBN 978-93-91312-41-1 (Print)
ISBN 978-93-91312-43-5 (eBook)
DOI: 10.9734/bpi/hmms/v6

This book covers key areas of medicine and medical science. The contributions by the authors include  maternal and infant bonding, breastfeeding, skin to skin contact, women, empowerment, encephalopathy, hypoxia, preterm birth, breast cancer, raman spectroscopy, automatic detection, biopsy, adaptative Neuro-Fuzzy Inference System, surgical relevance, midpoint of zygomatic arch, frontozygomatic suture, articular facet, vertebra, atlantoaxial joint, bifurcation, extremely angulation, plaque-plowing technique, locus of control, pregnancy, surgical procedure, laser therapy, tubarial glands, minor salivary glands, tubarial salivary glands, salivary glands, nasopharynx, torus tubaris, fossa of Rosenmüller, prostate cancer, breast cancer, double renal artery and accessory renal artery, coronavirus disease 2019, SARS-CoV-2, optimum therapy. This book contains various materials suitable for students, researchers and academicians in the field of medicine and medical science.


Media Promotion:


Maternal and Infant Bonding: A Concept Analysis

Lilian Kufakunesu, Christine Mary Kasu, Gladys Mugadza

Highlights on Medicine and Medical Science Vol. 6, 3 July 2021, Page 1-10

Maternal-infant bonding is a maternal-driven method that occurs mainly during a baby's first year of life, but can occur at any time during a child's life. It is a mother's affective state; maternal emotions and feelings toward the child are the most important indicators of maternal infant bonding. The first hour of life is crucial for any baby's development and for establishing a bond between a mother and her child.

Objective: The aim of the concept study was to explain the significance of maternal-infant bonding, as well as the obstacles to it and its implications.

Methods and Materials: The Walker and Avant concept analysis model was used, which examines characteristics, antecedence and implications, exemplars, and recommendations.

The literature quest took a month and a half, and it included bonding journals, PubMed and MEDLINE, as well as Google and Google Scholar. Twenty four studies that were found relevant to the concept of interest were included in the description of maternal and infant bonding. Maternal and infant bonding was encouraged in most of the studies.

Results: Preconception care plays an important role in the bonding process because it allows women to learn how to bond with their babies even before they are pregnant, rather than waiting until the baby is born.

Conclusion and Recommendations: The majority of health education sessions should involve maternal and child bonding, according to midwives and other health professionals.

Women Empowerment: A Concept Analysis

Tecla Masvikeni, Christine, Mary Kasu, Gladys Mugadza

Highlights on Medicine and Medical Science Vol. 6, 3 July 2021, Page 11-22

Women's empowerment is described as the ability to express oneself without disparaging the other.

This entails a joint dialogue and negotiation mechanism to address social needs. Empowerment is a multi-step process that increases understanding, builds capacity, and leads to increased engagement, decision-making power, influence, and transformative action.

Objective: The concept paper's aim was to provide a detailed explanation of women's empowerment. Materials and Methods: The concept analysis model of Walker and Avant was used to aid in the description of the concept of interest. Literature search was done from 1-30 August 2017 using women empowerment journal, PubMed, Medline, PMC, NCBI and Reference Manager. And 40 studies were found to be relevant to define and describe the concept of interest.

Results: Women's empowerment was thought to be a means of domination before it was defined and described in a theoretical context.

Magnetic Resonance Imaging (MRI) of the Brain in Cerebral Palsy Children

Niyati Sharma, Rajasbala Dhande

Highlights on Medicine and Medical Science Vol. 6, 3 July 2021, Page 23-36

Introduction: Cerebral palsy is one of the most frequent forms of severe childhood disability, and it has a unique link to preterm delivery. Cerebral palsy is a broad term that refers to a range of non-progressive motor deficits caused by brain injury before or shortly after birth. Muscle stiffness, involuntary movements, reduced mobility, seizures, and other symptoms are common. At present, cerebral palsy has no cure and it is managed symptomatically.

Aim: To investigate the various brain lesions in children with clinically diagnosed cerebral palsy, as well as the relationship between MRI brain results and the kind of cerebral palsy.

Materials and Methods: A total of 60 cerebral palsy cases were assessed using a history and clinical examination. Neuroimaging was used to evaluate children with cerebral palsy (MRI). A GE Sigma 1.5 Scanner was used for the MRI scans. Routinely, the scans obtained were T1 Weighted, T2 Weighted and FLAIR (axial, coronal and sagittal) sequences. In each patient, the images were assessed for any abnormal signal in the brain parenchyma, myelination of brain as per age of the baby and size of the ventricle.

Results: The maximum number of children (36%) were from the age group 1-2 years followed by 30% in the age group of < 1 year and 18% in age group of 3-4 years. Out of 60 patients 61.66% were males and 38.33% females. The majority of patients were delivered pre-term (60%) followed by term delivery (40%). The majority of the patients had cerebral palsy of the spastic quadriplegia type. The most prevalent abnormality discovered on imaging was periventricular leukomalacia. One (%) of the patients had corpus callosum agenesis.

Conclusion: The MRI scans aid in the discovery of the pathologic origins of the illness, with MRI brain findings showing a high association with clinical results.

The association between the location of brain lesions, their structure, and clinical functions in children with CP suggests that more research is needed, as these are critical prerequisites for investigating reorganization and plasticity.

Automatic Detection of Breast Cancer Based on Raman Spectroscopy Using a Neuro-Fuzzy Approach

Francisco Javier Luna Rosas, Julio Cesar Martínez Romo, Marco Antonio Hernández Vargas, Claudio Frausto Reyes

Highlights on Medicine and Medical Science Vol. 6, 3 July 2021, Page 37-50

Breast cancer is caused by the presence of malignant cells in the female breast, a sickness that has recently expanded around the globe, not just in Mexico but also in other areas of the world. We provide an automatic Breast cancer classification approach in which a Raman signal is classified as coming from a biopsy of healthy tissue (class w1) or a biopsy of sick tissue  (class w2) ; to do so, we built patterns using Raman spectra accurately quantifying each Raman peak to supply naturally reduced data to a classifier; we used Adaptative Neuro-Fuzzy Inference System (ANFIS) classifier and high rates of correct classification were obtained. This provides essential clinical tools to professionals for the speedy and accurate automatic identification of breast cancer.We believe that our method could be used to treat various types of cancer, such as lung, prostate, and stomach cancers.

Morphometric Study of Pterion and its Clinical Significance: An Approach towards Anatomical Variations

Gyanaranjan Nayak, Biswa Bhusan Mohanty, Saurjya Ranjan Das

Highlights on Medicine and Medical Science Vol. 6, 3 July 2021, Page 51-58

Context- Pterion is an area formed by the union of frontal, parietal, temporal and sphenoid bones. It exhibits variations in the sutural pattern of fusion of constituent bones. Basing on this, the pterion can be classified into four varieties. According to Murphy, these are sphenoparietal, frontotemporal, stellate and epipteric. The anatomical location of the pterion is necessary for the surgical management of extradural haemorrhage, aneurysm and brain tumors located in the anterior and middle cranial fossae. Aim-The purpose of this study is to find out the prevalence of different varieties of pterion and determine the position of pterion using anatomical landmarks. Methods and materials- The present study included fifty skulls of unknown age and sex. The skulls were studied macroscopically for the anatomical variations of pterion. The distance between the centre of the pterion to the midpoint of zygomatic arch and pterion to the frontozygomatic suture was measured using Vernier Calipers.

Results- The sphenoparietal variety was the most common variety of pterion found in the study followed by the epipteric variety and the stellate variety respectively. The distance between pterion and back of the frontozygomatic suture was found to be 3.48±0.21 cm on the right side and 3.41±0.16 cm on the left side. The distance between pterion and the midpoint of upper border of the zygomatic arch was found to be 4.01±0.19 cm on the right side and 3.94±0.2 cm on the left side.

Conclusion- The findings will be helpful for radiologists and neurosurgeons.

Recent Morphometric Analysis of Axis Vertebra in Subjects of Indian Origin

Jasveen Kaur, Kamaljeet Kaur, Poonam Singh, Ajay Kumar

Highlights on Medicine and Medical Science Vol. 6, 3 July 2021, Page 59-66

Background: The axis vertebra has complex and extensive morphometric variability, and there are vital neurovascular structures nearby.Knowledge of this variability is important for neurosurgeons, orthopaedicians, otorhynologists, and other physicians who deal with spinal disorders and their consequences on a daily basis.

Objective: The goalwas to evaluate various morphometric dimensions of axis vertebrae and to compare with the available data.

Materials and Methods: 50 dried human axis vertebrae of Indian origin were studied in the Department of Anatomy at Dayanand Medical College and Hospital in Ludhiana. Vernier callipers, metric scales, and graph paper were used to measure various dimensions. The dimensions were measured in millimetres and statistically analysed using the paired t-test.

Results: The mean of maximum anteroposterior diameter (max.APD) and maximum transverse diameter (max.TD) of Superior Articular Facet (SAF) was measured as 17.42mm±1.73 and 15.31mm±1.44 on the right side, 17.64mm±1.51 and 15.17mm±1.48 on left side. On the right and left sides, the mean distance from the SAF's lateral most edge to the midline was 22.56mm± 2.37 and 22.40mm± 2.16, respectively. On the right, the mean distance from tip of the transverse process to the midline was26.45mm± 2.85, while on the left, it was26.03mm± 2.64. The mean Height of Dens was measured as 13.83mm ± 1.52, mean Width of Dens as 9.57mm ± 0.85. Width of Pedicle was measured as 10.52mm ± 1.99 and 10.61mm ± 1.67on right and left sides, respectively.

Conclusion: Knowing these dimensions can help with safe osseous fixation planning.

We aim to present a new way to introduce the “Pull back balloon assisted wiring technique” to solve markedly angulated bifurcated lesions. We describe a clinical case of 50 -year –old man with crescendo chest pain and dyspnea, who underwent a coronary angiogram showed critical stenosis of bifurcation septal branch – LAD. Unable to access LAD due to extremely angulated take-off. The last resource technique when no other options are available in the Plaque-plowing technique, pull back balloon assisted wiring to modify the angle of bifurcation. This technique may be useful in the appropriate anatomical and clinical setting.

Background: Preconception care interventions are directed toward the promotion of women’s health and well-being before pregnancy.

Aim: To evaluate an educational preconception program on empowering the Egyptian premarital women with the concept of self-efficacy and locus of control behaviors.

Methods: A quasi-experimental, quantitative, (pre/ post one group) research design was used with 84 premarital females recruited conveniently from five primary health care centers located at Port- Said City, Egypt. Data collection: By using 2 main tools which were locus of control scale, and the self-efficacy of diet and physical exercises used to assess self-efficacy of adults for diet (fat, salt) and exercise.

Results: Total mean of women age was 23.26 ± 4.2, majority were bachelor’s degree of education, and unemployed. A highly statistically significant difference was reported between pre and post total mean score of internal and external locus of control, self-efficacy of eating healthy foods and motivation behavior related physical exercises at p-value < 0.000.

Conclusion: The application of preconception educational intervention had a positive effect on empowering a sense of locus of control and self-efficacy behaviors among studied participants, which evidenced by a statistically significant difference between pre-test and post-test of multidimensional locus of control through improving their self-efficacy regarding eating and exercises.

Recommendation: Incorporate of preconception educational programs to be an integral part of the services provided by PMCs and to ensure the dissemination of information related to locus of control behaviors, healthy lifestyles and motivation behavior of regular physical exercises that warrant the improvement of reproductive health and pregnancy outcomes for future Egyptian mothers.

Recent Development and Studies: Skin Resurfacing and Face-Lift in the Same Surgical Procedure

Aristides Arellano-Huacuja, Anja Arellano-Montalvo

Highlights on Medicine and Medical Science Vol. 6, 3 July 2021, Page 94-99

When performing a Facelift procedure, we mostly focus on the skin laxity; however, to truly rejuvenate a patient´s face we need to take care of the quality of the skin. Performing any type of Laser procedure in combination with a Facelift will take care of the patient´s sagging, wrinkles, open pores, blemishes, scars, etc. The main objective of this study was to develop the best combination of surgery and laser treatment in order to obtain a technique that is reproducible in different types of patients and that guarantees a good result, little recovery time and no adverse effects.

More than 3873 cases have been done with this procedure since 1994, minimal complications have been observed. The facelift and skin resurfacing techniques are performed during the same surgical procedure, in order to save time and improve the patient’s recovery.

We started using the facial rejuvenation with surgical procedure technique, SMAS plication and skin resurfacing in one surgical stage in 1994. However, it is needed between 2 to 6 weeks to recover from the skin Resurfacing with CO2 laser. This procedure takes more recovery time and produces more edema, redness and patient discomfort. For that reason, we began in 2000 to perform facial rejuvenation and skin resurfacing with Erbium: YAG and CO2 Lasers (Derma K device). We can also perform blepharoplasty in the upper eyelid and perform the transconjunctival approach in the lower eyelid with the CO2 laser in the cut (ablative) mode.

There are about 500-1000 minor salivary glands in the body, and most of them are located in the oral cavity or oropharynx. They are small and embedded in the aero-digestive tract entrance of the head and neck region. Minor salivary glands located in the nasopharynx are relatively less in number and the major pathologies associated with these glands are rare. Tubarial gland or tubarial salivary gland is recently reported as a pair of macroscopic salivary glands in the nasopharynx. The remote location of the glands, the rarity of major pathologies involved, and non-recognized functional significance might have made them elusive before. A brief review of minor salivary glands and tubarial glands is attempted. It is an evolving field in medicine, pathology, and characterization of diseases of the nasopharynx especially the diseases of salivary gland origin have gained renewed interest recently.

Neoplasms, Breast & Prostate Cancer Mortality Rates in the UK and 20 Major Developed Countries 1989-91 v 2013-15 – A Comparative Study

Colin Pritchard, Brian Birch, Tamish Hickish, Emily Rosenorn-Lanng

Highlights on Medicine and Medical Science Vol. 6, 3 July 2021, Page 113-124

Introduction: Britain’s cancer survival results have been criticised as being significantly higher than twenty Major Developed Countries (MDC). Hence this comparison of current UK Total Age-Standardised-Death-Rates (ASDR), female Breast and Prostate cancer mortality rates with twenty (MDC) between1989 to 2015 to determine any significant change.

Method: WHO data ASDR per million (pm) for Total, Breast and Prostate cancer mortality rates examined for the years 1989-91 to 2013-15. Confidence Intervals (+/- 95%) are used to determine any significant differences between the UK and other country’s outcomes over the period. Chi square tests for each nation’s Breast and Prostate mortality.

Results: Every country’s Total ASDR, Breast and Prostate cancer mortality fell except Greece and Japan.

Total ASDR Male cancer mortality rates ranged from Portugal 1653pm to Sweden 1232pm. UK at 1475pm were 10th but had been 6th highest.

Total ASDR Female rates went from Denmark’s 1176pm to Japan’s 740pm, the UK 1092pm now 5th but previously had been second highest.

No country’s Total rates fell significantly more than Britain’s who had significantly bigger reductions than four other countries for both sexes.

Breast mortality ranged from Ireland’s 206pm to Japan’s 99pm, UK rates fell significantly more than five countries.

Whilst Breast mortality fell in every country Norway and UK had significantly bigger reductions in Breast than Prostate deaths, conversely France’s Prostate rates fell more than Breast mortality.

Prostate mortality went from Norway 213pm Japan’s 60pm, the UK 167pm and five countries had greater reductions than Britain.

Conclusions: Results reflect well on UK services for Total and Breast cancers, showing the NHS achieving more with proportionately less as Britain spends less on health than most MDC. The need how to improve UK prostate results are briefly discussed, such as a public information campaign to match the successful Breast cancer aware programme of the 1990’s.

Bilateral Duplication of Renal Arteries: A Case Report

Prajkta A. Thete, Mehera Bhoir, M. V. Ambiye

Highlights on Medicine and Medical Science Vol. 6, 3 July 2021, Page 125-129

Routine dissection of a male cadaver revealed the presence of bilateral double renal arteries. On the right side the accessory renal artery originated from the abdominal aorta just above the main renal artery. On the left side the accessory renal artery originated from the abdominal aorta about 1 cm above the main renal artery.

Numerous reports have appeared in literature describing variations in renal vascular anatomy. Knowledge of the variations of renal vascular anatomy has importance in exploration and treatment of renal trauma, renal transplantation, renal artery embolization, surgery for abdominal aortic aneurysm and conservative or radical renal surgery.

Recent Pharmacological Advances of Drugs and Vaccines Used in COVID-19

Edwin Dias, Archana Aithal, Ranjit Shail

Highlights on Medicine and Medical Science Vol. 6, 3 July 2021, Page 130-151

Coronavirus originated pandemic disease also called Corona Virus Disease 2019 (COVID-19) is spread all over the world resulting in asymptomatic condition to severe acute respiratory syndrome (SARS) called SARS-CoV-2. It poses a difficult challenge to scientists, researchers, and practitioners to discover effective drugs for prevention and treatment. By using a huge amount of clinical data obtained from many SARS-CoV-2 infected people, clinicians are trying to gather accurate evidence for effective treatment and also developing a suitable vaccine system for the prevention of spread of infection. With no proven therapies which can treat and prevent SARS-CoV-2 developed until now, there is an opportunity for new researchers in virology to make an attempt at this crucial time. Currently, two strategies are active. The first is on developing completely new molecules to prevent and treat this disease, or the second is on testing the effectiveness of already available antivirals and other drugs for possible potential recovery and prevention. This includes testing several antivirals (Remdesivir, Favipiravir, etc) and antimalarials (Chloroquine, Hydroxychloroquine, etc) for their potential therapies. Studies show that the most promising therapy is the use of antiviral Remdesivir. Remdesivir has shown the potential ability to exhibit in- vitro activity to control COVID-19. The drug is currently being tested by ongoing randomized trials. Until a widely accepted drug reaches the global market, different antiviral treatment strategies are used under urgent investigation plan. In this chapter, we review the latest research developments related to the systematic treatments for COVID-19 reported from various research labs in different countries. The chapter also provides a summary of various clinical research experience, intermediate results, and treatment guidance to combat the novel coronavirus epidemic based on pharmacotherapeutic analysis, along with insights to the attempts on vaccine development across the world in order to curb the COVID pandemic.