Editor(s)
Dr. Triki Mohamed Amine
Department of Orthopaedic Surgery, Sahloul University Hospital, Sousse, Tunisia.

 

ISBN 978-93-5547-463-6 (Print)
ISBN 978-93-5547-479-7 (eBook)
DOI: 10.9734/bpi/idmmr/v5

 

This book covers key areas of Medicine and Medical Research. The contributions by the authors include obesity, overweight, non-communicable diseases, obesity paradox, heart rate variability, chronobiology, stem cell, toxicology, bone marrow transplants, multipotent stem cells, adipose tissue, hydatid cyst, anaphylactic shock, laproscopic surgery, Parkinson disease experimental model, endocannabinoid system, oral rehydration, bone grafting, fixed appliance therapy, orthodontic tooth movement, urinary Schistosomiasis, NCIC FPC filing sequence, juvenile polyp, bleeding per rectum, colonoscopy, orbital cellulitis, endoscopic marsupialization, anterior orbitotomy, cascade stomach, reflux symptoms, dyspepsia, tooth preparations, chronic myeloproliferative neoplasms, chronic myeloid leukemia, primary myelofibrosis, polycythemia vera, elderly patients, chemotherapy, attorney health care. This book contains various materials suitable for students, researchers and academicians in the field of  Medicine and Medical Research.

 

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Chapters


Health Impacts of Obesity: A Modern Era Pandemic

Shashi K. Agarwal

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 1-16
https://doi.org/10.9734/bpi/idmmr/v5/3201E

Obesity is a worldwide problem. It is usually diagnosed if the body mass index is >30, and/or a waist circumference >102 cm in men and >88 cm in women. Obesity is a chronic disease that increases the risk of heart disease, type 2 diabetes, obstructive sleep apnea, osteoarthritis, and many types of cancer. It reduces the health quality of life. It is a leading cause of global disability and mortality. It is, however, both preventable and treatable. Weight loss can be achieved by changing dietary patterns and exercising. Therapeutic interventions and surgical options are increasingly being instituted. Novel interventions like fecal transplantation appear promising. Even a loss of 5% to 10% of the total body weight is metabolically healthy. Prevention of obesity and a reduction in body weight in those with a BMI>30, will greatly improve the health of the world. It will also help bring health care costs down. This narrative review aims at highlighting the diagnostic criteria and the various factors that influence and cause obesity. It also summarizes its deleterious impact on humans, both in health and in disease. A look at the various modalities available for its mitigation is also discussed. This discussion should help health care providers to better manage their obese patients.  

Study on Heart rate Variability and Heart Rate under General Anesthesia in Rats of Both Sexes

P. Svorc, D. Petrasova, P. Svorc Jr

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 17-22
https://doi.org/10.9734/bpi/idmmr/v5/2413C

Objectives: It is known that general anesthesia weakens autonomic function and baroreflex control. Intravenous anesthetics may have different qualitative and quantitative effects on the peripheral autonomic nervous system (ANS) and, can thus, alter the activity of sympathetic or parasympathetic divisions of the ANS. Presently, there are relatively little data regarding sex differences in ANS activity or sex differences in ANS activities during anesthesia.

Aims: The primary objective of this study was to determine the impact of spectral powers of heart rate variability (HRV) on changes in heart rate (HR), total spectral power of HRV, and low-frequency (LF)/high-frequncy (HF) ratio in healthy, sexually mature rats of both sexes spontaneously breathing under zoletil anesthesia in the light (inactive) and the dark (active) period of their regimen day.

Materials and Methods: Experiments were performed using male and female zoletil-anesthetized (30 mg/kg [intraperitoneal]) Wistar rats after a four-week adaptation to a light-dark (LD) cycle (12h:12h). The animals were divided into four experimental groups (n=20 each) according to sex and light period. HR, spectral powers of HRV (very low frequency, LF, and HF), as well as LF/HF ratio were evaluated 20 min after administration of anesthesia.

Results and Conclusions: Zoletil exerted a tachycardic effect in both sexes and in both light periods of the regimen day. In females, the autonomic nervous system was involved in HR changes in both light periods, while in males, HR exhibited no dependence on autonomic nervous system activity; as such, the authors speculate that it was predominantly determined by other factors. In females, HRV was determined by sympathetic and baroreflex activity in both light periods, while in males, HRV was determined by parasympathetic activity. LF significantly influenced LF/HF ratio in females, but not in males, while the effect of HF on the LF/HF ratio was negligible in both sexes and in both light periods.

A Brief Overview on Stem Cell and Toxicology

Doaa Abdel Wahab El Morsi

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 23-28
https://doi.org/10.9734/bpi/idmmr/v5/2399C

Undifferentiated cells were initially utilized as a part of bone marrow transplants in 1956. Since the late 1990’s when embryonic undifferentiated cells were found in people, the advances in undeveloped cell science have been rapid. However, a significant part of the work in the field of stem cell science is centered around comprehension ordinary advancement and disarranges of the human body and for toxicology screening (testing new medications) [1].

Multipotent stem cells could possibly help in the treatment of tissue that can’t recover itself. This would be of advantage for spinal cord injuries and injuries to tactile organs, which also have likewise constrained repair abilities. Once more, research on these particular cell types can aid scientists in discovering treatment choices for different issue, not necessarily just using stem cells themselves to treat the disorder [2]. This chapter aims to introduce stem cell in toxicology, a new era of in vitro toxicology that provides effective and efficient alternatives to classic toxicology tests.

Accidental traumatic intraperitoneal rupture resulting by anaphylactic shock is the well-known complication, unlike to the anaphylactic shock caused by the intravascular spread of cyst contents which is rare. One of the common complications of hydatid disease is cyst rupture after trauma or spontaneous rupture. This article reports an unusual case description about 13 years old boy, following a trauma admitted to the public hospital with few signs. Ultrasonography demonstrated a hydatid cyst in the liver with the drainage of the cyst contents into the right hepatic vein without free peritoneal fluid. A shortly afterwards anaphylactic shock developed and the patient transferred to our emergency. An abdominal laparoscopic examination, after stabilization of patient confirmed rupture of the cyst, which was treated laparoscopically. Additionally, the patient received albendazole. The aim is to evaluate the feasibility and safety of laparoscopy in the management of complicated Hepatic echinococcosis, duration of surgery and hospital stay. We think that laparoscopic surgery can be recommended in this kind of clinical presentation of Echinococcosis.

L-DOPA/Capsazepine or L-DOPA/Rimonabant Co-Administration in an Experimental Parkinson Disease Model: Behavioral and Cellular Consequences

José Luis Ordoñez-Librado, Ana Luisa Gutierrez-Valdez, Jesus Espinosa-Villanueva, Enrique Montiel-Flores, Patricia Aley-Medina, Javier Sánchez-Betancourt, Claudia Dorado-Martínez, Leonardo Reynoso-Erazo, Rocío Tron-Alvarez, Vianey Rodríguez-Lara, Maria Rosa Avila-Costa

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 35-60
https://doi.org/10.9734/bpi/idmmr/v5/2361C

Objective: using the 6-OHDA lesion in rats, we evaluated the ability of rimonabant or capsazepine with the addition of L-DOPA in: (1) the severity of LIDs, the dyskinetic effects were assessed using measures of abnormal involuntary movements (AIMs); (2) the protection of dopaminergic cell loss; and (3) in the cytological differences between treatments through analyzing the number of dendritic spines of the striatal medium-sized spiny neurons and the neuropile preservation. Oral co-administration of each antagonist with L-Dopa significantly decreased LIDs. Our data demonstrate that co-administration of L-DOPA with CB1 or TVPR1 receptor antagonists result in a very efficient treatment to reduce AIMs by conserving some functional dopaminergic cells, which implies the well-preserved synaptology of less denervated striatum. Thus, consistent with other reports, cannabinoid antagonist-based therapy would not only be aimed at alleviating specific motor symptoms but also at delaying/arresting the degeneration of striatal and substantia nigra compacta cells.

Novel Pyruvate-Enriched Medical Solutions and Beverages

Zhou, Fang-Qiang

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 61-69
https://doi.org/10.9734/bpi/idmmr/v5/3303E

The objective of this review is to introduce novel uses of pyruvate-enriched fluids. Pyruvate has been extensively and intensively studied since a half century ago. An abundance of experimental research in both animals and humans, in vitro and in vivo, demonstrate that pyruvate is a unique anion, which is more beneficial in protection of multiple cell/organ metabolism and function than anions in commercial medical fluids and health beverages. The robust advantages of pyruvate action are mainly enhancement of anoxia/hypoxia tolerance, correction of hypoxic lactic acidosis and improvement of glucometabolic disorders in addition to anti-oxidative stress/inflammation and protection of mitochondria, leading to reversal of the Warburg effect in various pathogenic attacks, including severe hypoxia/ischemia, hypo/hyperglycemia, trauma/burn and sepsis. Many investigations in animals and humans, in vivo, reveal pyruvate protections with absence of clinical adverse effects. Innovative pyruvate-enriched fluids, both crystalloids and colloids, would be more favorable than current fluids in clinical resuscitation due to therapeutic effects additionally as a volume expander. Pyruvate-enriched oral rehydration salt (Pyr-ORS, equimolar pyruvate replacement of alkalizers in WHO-ORS) also would be more beneficial than WHO-ORS in oral rehydration, peri-operative fluid management and prehospital rescue. Alternatively, oral Pyr-ORS-based beverages may be favorable in plateau tourism, diabetes care and anti-aging. This review cited most important animal experiments and human tests with applicated pyruvate dosages, demonstrating the clinical effectiveness and safety and revealing innovative Pyr-ORS-based beverages as both medical care fluids when short of medical supply and functional drinks in endurance exercises. Pyruvate, as a novel nutritional componence, applications in clinical scenarios would be another most important medical advance in this century.

Correction of Skeletal Class II Malocclusion – An Accelerated Osteogenic Orthodontic Approach

A. Arif Yezdani

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 70-80
https://doi.org/10.9734/bpi/idmmr/v5/2437C

Selective alveolar decortication and periodontal augmentation with a bone graft were the two procedures used for the correction of the skeletal Class II malocclusion in the case reported. A 25-year-old male patient presented with a skeletal Class II malocclusion with increased bi-maxillary dentoalveolar protrusion, increased overjet, deep bite and imbricated & rotated mandibular incisors with bilateral presence of supernumerary teeth in the maxillary right and left premolar region. Extraction of the supernumerary tooth in the maxillary right and left premolar region as also the impacted UL5 was done. Pre-adjusted edgewise appliance, Roth’s prescription (0.022 x 0.028-inch slot) was strapped up and a week later full thickness labial and lingual flaps were reflected in the maxillary and mandibular arches. Circumscribed corticotomy cuts were done and subsequently augmented with a bone graft. Orthodontic treatment was commenced immediately after surgery and orthodontic adjustments were carried out every 2 weeks. The entire orthodontic treatment was completed in 9 months. The primary objective was to evaluate whether selective alveolar decortication could accelerate orthodontic tooth movement and reduce the duration of orthodontic treatment. It was observed that regional acceleratory phenomenon, triggered by alveolar decortication was responsible for the rapid correction of the malocclusion and augmentation with the bone graft further provided adequate bone volume for housing the teeth. This combined procedure might probably contribute to the decrease in the possibility of the tell-tale relapse.

Assessment of Urinary Schistosomiasis Distribution among School Children at Elkeriab and Tayba ELkababish Villages, Sudan

Osama Hafiz Elshazali , Qutoof Hashim Taha, Abubakr Ibrahim Ahmed

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 81-86
https://doi.org/10.9734/bpi/idmmr/v5/2402C

Introduction: Schistosoma infection is one of the main infections in the tropics and sub tropics; from a global public perspective Schistosoma is the most significant water based disease. Only second to malaria among parasitic diseases with regard to the number of people infected and those at risk. The reported incidence of S. haematobium in Sudan is between 0-20%.

Aim: The aim of the study was to estimate the distribution of urinary schistosomiasis among school children in East Nile locality, Khartoum State and to identify the risk factors relating to S. haematobium infections

Methodology: This is a descriptive cross sectional study, we screened all the school age children from the two villages of Elkeriab and Tayba Elkababish in the East Nile locality, Khartoum state for S. haematobium, by examining the urine, using wet preparation and filtration technique.

Results: 1205 school children were screened for S. haematobium, 105 (8.7%) tested positive for Schistosoma, the infection rate was higher in Tayba Elkabish compared to Elkeriab (p value = 0.01) and in male more than females ( p value = 0.01).

Conclusion: S. haematobium infection is still a common infection in school age children in rural areas especially within irrigated schemes, mainly affecting males. Schistosoma control programs have reduced the prevalence of S. haematobium infection but still there is a long road towards the eradication of Schistosoma.

NCIC FPC Filing Sequence Formula

A. J. Washington

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 87-91
https://doi.org/10.9734/bpi/idmmr/v5/3306E

The NCIC FPC Filing Sequence Formula can be used in a physiological study on the combination of fingerprint patterns and their frequency for each digit. It was designed as applicable to genetics or any other discipline that encompasses the phenomenon of human physical structure. Theoretically, fingerprint classifications are listed chronologically according to their appearance upon the person of individuals; an advanced computational formula for educational institutions and the criminal justice system. Conclusions can be drawn from any research project that is developed with the implementation of the calculation methods provided in this article.

Study on Colonoscopic Polypectomy in Children

Tanveer Akhtar, K. L. Venkatesh, Anand Alladi, Siddappa .

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 92-95
https://doi.org/10.9734/bpi/idmmr/v5/15372D

Colonoscopic polypectomy is one of the current methods in pediatric age group. The diagnosis and treatment of juvenile polyps requires a combination of obtaining accurate history, digital rectal examination and colonoscopy. Juvenile polyps can be due to hereditary, genetic, hamartomatous malformation.

Materials and Methods: From November 2008 to December 2010, 30 patients presenting with recurrent bleeding per rectum, underwent digital rectal examination, colonoscopy and colonoscopy removal of polyps using snare.  

Results: 26 cases showed solitary polyp. 4 children showed multiple polyps. In 14 cases polyp was found in the posterior wall within 8 cms of the anal verge (rectum).In 16 children it was found to be beyond 8 cms.

Conclusion: Colonoscopy in all children with h/o bleeding per rectum after DRE and proper preparation helps for resection of polyp and visualization of the proximal colon for its multiplicity.

Assessment of Combined Surgical Approach in a Late Case of Orbital Cellulitis

Akshay Jawahirlal Bhandari, Somen Misra, Pratik Gogri, Neeta Misra

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 96-101
https://doi.org/10.9734/bpi/idmmr/v5/2415C

Orbital cellulitis refers to infection of the ocular adnexal structures posterior to the orbital septum. The infection most commonly originates from the sinuses. Mucopyoceles are infected cysts of mucous content that affect the paranasal sinuses most commonly the frontal sinus. Many of these lesions have an intraorbital extension causing vision threatening ocular complication like orbital cellulitis and intracranial extension causing life threatening neurological complication like meningitis. We treated a 12-year-old female patient of acute orbital cellulitis secondary to frontoethmoidal mucopyocele with combined surgical approach- transnasal endoscopic and open surgical drainage.

A Propos Cascade Stomach – A Commentary

Daniel Benharroch, Roberto Umansky

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 102-107
https://doi.org/10.9734/bpi/idmmr/v5/2443C

The clinician does not usually deny the diagnosis of a cascade stomach based on imaging. A specific treatment is rarely necessary, with the exception of initiating therapy for reflux symptoms or dyspepsia. As a result, gastroenterologists are rarely interested in cascade stomach. Occasionally, further features are described in a patient presenting the radiological upper gastroenterological series of this condition. It remains to prove that such unusual symptoms represent coincidental, but non-specific features of the ailment. A patient diagnosed with a cascade stomach, who exhibited heterogeneous upper abdominal complaints, the majority of which are not associated, as a rule, with this condition, is herein reported.

‘From Theory and Practice’ of Retention and Resistance form of Tooth Preparations for All Ceramic Restorations: A Digital Imaging Study

Alex M. Muruppel, Joyce Thomas, Sudeep Saratchandran, Dinesh Narendran, Sheeba Gladstone, Milen M. Rajeev

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 108-119
https://doi.org/10.9734/bpi/idmmr/v5/4614F

Background: Retention and resistance forms are the characteristics of a preparation that prevent castings from becoming uncemented, debonded, or cement failures, which are one of the top three reasons for the replacement of castings

Aim: This study aims to discern an actually achieved degree of taper in a clinical situation, and the textbook recommended degree of taper. Furthermore, it also assessed how resistance and retention form correlate with the degree of taper of tooth preparation.

Materials and Methods: Scanned digital images of 114 die preparations for all ceramic restorations (n = 114) were collected from a dental laboratory. All the images were also analyzed digi- tally using Adobe Photoshop® software to analyze the degree of taper (angle of convergence) of each preparation and then applied the Zuckerman’s circle, and the Lewis perpendicular methods were used to measure the resistance form.

Results: For the current study, the overall average degree of taper was found to be 20.9° (range, 2–80°), which is more than what is recommended by most previous studies and also sharply greater than the textbook ideal of 3 to 6°. Mean degree of taper for maxillary was 17.56° (anterior—10.50°, posterior—23.7°), and for mandibular teeth, it was 25.22° (anterior—15°, posterior—28.45°). Out of the 64 analyzed images of maxillary teeth, 61 presented resistance form, while 3 were without it. Out of the 50 mandibular teeth analyzed, 38 possessed resistance form, whereas 12 were without. All the anterior teeth showed resistance form irrespective of the arch.

Conclusion: The degree of taper showed a significant relation- ship with resistance and retention form, which was inversely proportional to each other. The recommended “degree of taper” is not always the clinically achievable as advocated in textbooks, as it is modified by various factors in the actual clinical situation.

Clinical Significance: The study provides scientific background regarding the relationship between the degree of taper with resistance and retention form, and the relationship was found to be inversely proportional to each other. The recommended “degree of taper” is not always the clinically achievable as advocated in textbooks, and it is modified by various modifying or limiting factors in the actual clinical situation.

Study on Nasal Parameters of Medical Students (n=61) in South Indians: A Clinical Analysis

Mukherjee Ankita Atin, Shivaam Kesarwaani

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 120-125
https://doi.org/10.9734/bpi/idmmr/v5/15243D

Background: The shape of the nose indicates the ethnicity, race, age and sex. Both genetic and environmental factors influence the shape of the nose. Anthropometric parameters vary with age, sex, and ethnic background, and several authors have attempted to document the normative values which may serve as references.

Materials and Methods: This study includes measurement of different parameters of nose among 61 South Indian medical students (34 females;27 males) which were statistically analysed.

Results: 1) Morphological width of the nose -3.3cm (males) and 2.9 cm(females).2) Columella Length -1.8 cm (males) and 1.6 cm(females).3) Columella Width -0.59 cm(males) and 0.57 cm(females).4) Alar Width -0.52 cm (males) and 0.45 cm (females). 5).The most common type of cheek alar groove was cheek type followed by labial and tube type in both males and females.

Conclusion: All the measurements can be used for evaluation of nasal deformity, treatment planning and post surgical evaluation of the correction achieved during rhinoplasty.

Reliability and Validity of the Functional Assessment of Currently Employed Technology Scale (FACETS)

Charles M. Lepkowsky, Stephan Arndt

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 126-133
https://doi.org/10.9734/bpi/idmmr/v5/1815A

Introduction: Health protocols have not included technology as a specific area of assessment or treatment. The Functional Assessment of Currently Employed Technology Scale (FACETS) was created for this purpose. FACETS is a ten-item questionnaire that assesses five functional domains. The current study was carried out to determine the validity and reliability of FACETS.

Methods: Using 423 previously deidentified FACETS forms from clinical records, analyses such as Cronbach's alpha, McDonald's omega, confidence intervals for alpha and omega, multiple group factor analysis, Fleming's index of scale fit, and differential item (domain) function were carried out (DIF).

Results: Internal consistency and factor validity for the 10 FACETS items and intra-domain correlations were high. The factor scale fit index calculated by Fleming indicated an excellent fit. With the exception of one domain, all domains contain enough unique information to produce differential item functioning.

Discussion and Conclusions: For the five domains, FACETS demonstrated high internal consistency reliability, strong general factor validity, and strong factor validity.

Background: Chronic myeloproliferative neoplams (CMN) are totally the most common chronic leukemias among the elderly persons in the structure of morbidity by hematologic malignancies with primary bone marrow involvement, being characterized in the advanced stages by a severe, relapsing evolution and unfavorable prognosis, with negative socio-economic impact.

Objectives of the Study: Evaluation of the diagnosis and management options in chronic BCR-ABL-positive and BCR-ABL-negative myeloproliferative neoplasms in elderly patients in order to upgrade an approach to hematologic oncology care.

Material and Methods: A clinico-analytical, descriptive, prospective-retrospective study was accomplished along with the narrative review of the international literature on the subject. The study included 91 elderly patients with chronic myeloid leukaemia (CML), primary myelofibrosis (PMF), and polycythemia vera (PV) who were followed and treated at the Institute of Oncology from 1995 to 2021. In regard to the impact scale, 29 relevant primary sources were distinguished and selected with a scientific, reproducible and transparent approach to the subject under discussion, followed by the data extraction and analysis.

Results: Thirty-four (37.3%) patients with PMF, 26 (28.6%) – with CML and 31 (34.1%) – with PV were diagnosed in the elderly age groups and followed up by our study. The age group of 60-69 years dominated in CML (22 cases or 84.6%), constituting 25 (80.6%) cases in PV, and 25 (73.5%) - in PMF. The one- and 5-year overall survival (OS) in CML patients aged greater than or equal to 60 years treated with tyrosine kinase inhibitors (TKIs) was 97.6% and 79.8%, being lower as compared with the same indicators in the totality of CML. In elderly PV patients the OS over one year constituted 100%, over 5 years – 93.5%, over 10 years – 76.4%, being lower within 5-10 years than those registered in all patients with PV (over one year – 100%, 5 years – 98.6%, 10 years – 85.9%). Although the relapse rate was lower in patients treated with busulfan as compared to those managed with hydroxycarbamide, there was no significant difference in the OS of the elderly PV patients undergoing chemotherapy with these antineoplastic agents. As stipulated in the recent bibliographic databases, a significant rate of patients with CMN experienced the reduced work hours, discontinued employment, and medical disability: PMF – 38%, 35%, 33%, and PV – 33%, 28%, and 15%, respectively.

Conclusions: The long-term results of treatment in elderly patients with CMN proved to be inferior to those in CMN totality because of the development of age-related diseases and vascular events on the account of the increased values of leukocytes and platelets. The targeted treatment with TKIs remains a first-line management option for CML patients of 60 years and more. In the elderly PV patients no significant difference was revealed in short- and long-term outcomes of chemotherapy with busulfan and hydroxycarbamide in combination with phlebotomy, being totally superior to those in PMF patients.

Advanced Proposals to Improve Advanced Directives in Portugal

João Carlos Macedo

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 142-147
https://doi.org/10.9734/bpi/idmmr/v5/1691A

This article describes the current state of Advance Directives (living wills and/or  attorney health care in the event of inability to express one) in Portugal. It investigates the reasons for the low number of registered advance directives and proposes two ways to increase citizens' adherence: Setting up a counselling in the national health system and the standard form.

Cause of Entrapment Syndromes in Gastrocnemius Muscle: A Prospective Study

Shinde Amol A., Patel Dinesh K. , Bharambe Vaishaly K.

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 148-154
https://doi.org/10.9734/bpi/idmmr/v5/1755A

Gastrocnemius injuries have been one of the leading causes of calf injuries. Medial head of gastrocnemius is more commonly involved. Accessory heads of gastrocnemius have given rise to entrapment syndromes in the popliteal fossa. 60 formalin embalmed lower limbs were meticulously dissected. Any variation in number of heads, origin, insertion and nerve supply of gastrocnemius muscle is noted. Popliteal artery entrapment syndrome has been reported due to aberrant course of popliteal artery or accessory heads of gastrocnemius or plantaris muscle compressing a normal popliteal artery. Bilateral variation is seen in 10% cadavers. Three (6.66%) and four (8.33%) headed gastrocnemius muscles are reported. Knowledge of additional heads of gastrocnemius is important while autografting and using imaging techniques for entrapment syndromes. During imaging exams for polpliteal entrapment syndromes and neurovascular compression, the radiologist will benefit from learning about the accessory heads of the gastrocnemius.

Association of Vitamin D Deficiency with Knee Osteoarthritis (KOA) in Population of Tamil Nadu, India

Regupathy Annamalai, Amar Nagesh Kumar G.

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 155-162
https://doi.org/10.9734/bpi/idmmr/v5/3211E

The objective of this study is to evaluate the serum 25-OH vitamin D status in patients with knee osteoarthritis (KOA) scheduled for joint replacement along with healthy individuals for comparison. This pilot study conducted in and around the Chennai city and rural places of Tamil Nadu population. Study subjects were selected during the medical camps conducted by our teaching hospital in and around the Chennai city and rural places of Tamil Nadu. . This study showed that about 5 patients out of 10 with knee osteoarthritis were vitamin D deficient with serum levels <10 ng/ml. The study also tried to correlate serum levels of vitamin D with related anthropometric predisposing factors such as age, gender, and BMI. A significant association with gender was observed, with female patients having lower serum levels of vitamin D. Identification of high risk subjects and correction of risk factors such as low level serum 25-OH vitamin D in KOA patients will give beneficial effects and even decreases fracture risk in elderly people.

Sentinel Lymph Node (SLN) Metastases in Breast Carcinoma Whole Slide Image (WSI) through Densenet Deep Learning Network: An Approach towards Clinical Management and Treatment

Rajasekaran Subramanian, R. Devika Rubi, Abhay Krishna Kasavaraju, Samayk Jain, Swathi Guptha, Suraj Raghavendra Pingali

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 163-171
https://doi.org/10.9734/bpi/idmmr/v5/15302D

This paper envisions a new and faster sentinel lymph metastases classification model which will help the pathology experts to perform fast and accurate diagnosis. This paper discussed a CNN based image classification model, to classify breast lymph node metastasis from WSI images, called DenseNet-161. Breast cancer intends to spread throughout the body. Cancer cells spread locally by infecting nearby healthy tissue. And it can spread throughout a region by infecting adjacent lymph nodes, tissues, or organs. CNN model initially learns the features from the training data. Subsequently after fitting the training data well it tries to generalize and make accurate predictions for the incoming new data which it has not seen earlier. Overfitting refers to a model that models the training data too well. The noise persists even after using the thresholding pre-processing strategy, necessitating extra pre-processing before training the model. Furthermore, increasing the dataset size by data-augmentation will significantly increase the accuracy.

Study on Association of Systemic Diseases on Tooth Loss and Oral Health

Farzeen Tanwir, Chander Kumar

Issues and Developments in Medicine and Medical Research Vol. 5, 4 February 2022, Page 172-182
https://doi.org/10.9734/bpi/idmmr/v5/15270D

Aim: To evaluate the level of oral hygiene in patients of various systemic illnesses.

Materials and Methods: A total of 450 patients from Pakistan Institute of Medical Sciences, Capital Development Authority, Islamic International Dental College, Islamabad and Jinnah Postgraduate Medical Center, Karachi, suffering from diseases such as diabetes mellitus, cardiovascular disorders (with and without diabetes mellitus), respiratory disorders, gastrointestinal disorders, hepatic disorders, renal disorders, bone/joint disorders and hypertension were selected. Dental examination was performed to calculate the number of missing teeth, decayed, missing and filled teeth (D.M.F.T.) and decayed, missing and filled surfaces (D.M.F.S.) scores in order to compare oral health between different disease groups.

Results: Age, gender, number of missing teeth, D.M.F.T. and D.M.F.S. scores were significantly associated with the systemic diseases (p <0.05). The diseases causing poor oral hygiene in descending order of severity were as follows: cardiovascular disorders, diabetes mellitus with cardiovascular disorders, diabetes mellitus, bone/ joint disorders, hypertension, renal diseases, hepatic disorders, gastrointestinal disorders and respiratory diseases.

Conclusion: Patients with systemic diseases have greater risk of compromised oral hygiene, tooth loss, high D.M.F.T. and D.M.F.S. scores showing the association between systemic diseases and oral health. There is a need for collaboration between dentists and medical physicians to improve the health of the patient.