Dr. Pietro Scicchitano
Department of Cardiology, Hospital “F. Perinei” Altamura (BA), Italy.

ISBN 978-93-91595-66-1 (Print)
ISBN 978-93-91595-74-6 (eBook)
DOI: 10.9734/bpi/nfmmr/v5

This book covers key areas of medicine and medical research. The contributions by the authors include fingerprint pattern, ABO blood group, gender identification, blood pressure, exercise, sedentary lifestyle, waist-hip ratio, cardiovascular parameters, antibiotic assay, mitochondria, DNA damage, P53 tumor suppressor gene, lipid peroxide, cell perforation, cell rupture, oxidative phosphorylation, carcinogenesis, glycolysis, Warburg effect, microbiome, dysbiosis, immune suppression, pesticides, mechanism, clastogenic, epigenetic silencing, microRNA, haptonomy, parturient, psychodynamic interview, Psychological support, antigen, von willebrand factor, bleeding time, clotting time, multiple myeloma, epigenetics, DNA methylation, histone modification, histone acetylation, histone deacetylation, micro-RNA, cadaveric oath, doctor-patient relationship, silent teacher, anatomy teaching, cadaveric dissection, gonioscopy, acute respiratory distress syndrome, hyper infection, diabetes mellitus, SARS-CoV-2 infection, COVID-19, angiotensin converting enzyme 2, hypotheses, skin complications, high sensitivity c-reactive protein, metabolic syndrome, obesity, inflammation, cardiovascular disease, metabolic syndrome, rheumatoid arthritis, serology, sensitivity, antiCCP antibodies, tenderness, distension, maxillary molar distalization, anchorage, miniscrew, temporary anchorage devices, patient-physician relationship, paternalism, ante-natal seeking behaviour, analgesics, neuralgias, pregnancy. This book contains various materials suitable for students, researchers and academicians in the field of medicine and medical research.


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Study of Fingerprint Patterns in Relation to Gender and Blood Groups in Navi Mumbai, India

Amit Patil, Amrit Malik, Treza Shirole

New Frontiers in Medicine and Medical Research Vol. 5, 6 August 2021, Page 1-7

Introduction: Human identification can be made by using various physical and mental characteristics. Being unique, fingerprints can be used to identify an individual. The fingerprint is a greasy and oily impression of the friction ridges of the finger. A strong correlation has been found in earlier studies between the fingerprint pattern and gender and blood group.

Objectives: The objective of the study was to determine the correlation (if any) between the fingerprint pattern and blood group and gender.

Materials and Methods: The study was conducted on 170 subjects [70 males and 100 females] in the age group of 18-65 years. The fingerprint pattern of the study participants was compared with the gender and ABO-Rh blood group after taking their verbal consent.

Results: Amongst the ABO blood group, the most common blood group was B (36.47%), followed by O (35.88%), A (18.23%) and AB (9.4%). Rh + ve was the most common rhesus factor (95.88%). The loop was the most common pattern (62.35%), followed by whorl (32.94%) and arch (4.7%). There was a significant association between the fingerprint pattern and the ABO blood group (P-value < 0.05).

Conclusion: The present study confirms that loop is the most common fingerprint pattern while arch was the least common. The study revealed a significant association between the fingerprint pattern and the ABO blood group. No statistically significant association was found between the fingerprint pattern and gender.

Determination of Influence of Age and Regular Exercise on Blood Pressure in Males

M. K. Jayalakshmi, . Chandrashekhar

New Frontiers in Medicine and Medical Research Vol. 5, 6 August 2021, Page 8-13

Background: Both cross-sectional and longitudinal epidemiological studies have shown that sedentary life style elevates blood pressure and increased risk of hypertension and pre-hypertension among subjects with sedentary lifestyle. Sedentary life style increase the propensity to age related diseases and premature deaths. Inactivity may diminish life expectancy not only by predisposing to age related diseases but also it may influence the aging process itself by oxidative stress.

Objectives: To determine the influence age and exercise on blood pressure in sedentary and non sedentary subjects.

To compare the parameters between sedentary and non sedentary subjects.

Methods: 100 male healthy sedentary and non-sedentary subjects in the age group of 25-55 years were selected randomly from the general population of Gadag city. Depending upon the age, subjects were divided into three groups for analysis. Blood pressure was recorded and compared between three groups.

Results: Statistically significant increase in blood pressure in sedentary subjects and also in group two and three compared to group one which shows age factor is also important in developing hypertension.

Background: There is an excess of adipose tissue accumulation in obesity which is associated with more sympathetic activity resulting major potential mechanism contributing to increased risk of cardiovascular complications. Obesity is associated with coronary arterial diseases, type-2 diabetes mellitus, infertility, osteoarthritis, and colo-rectal cancers. Visceral fat is more atherogenic.

Methods: 100 sedentary healthy male subjects selected randomly in the general population of Davangere city. Anthropometric parameters like weight, height, waist and hip circumference were measured. With these, Body Mass Index (BMI), Waist Hip Ratio (WHR) were calculated. Correlation between BMI and WHR with cardiovascular parameters was made.

Objectives: To determine body mass index, waist hip ratio and cardiovascular parameters in sedentar Subjects.

To correlate body mass index, waist hip ratio with cardiovascular parameters in sedentary Subjects.

Results: There was statistically significant increase in body mass index, waist hip ratio, blood pressure and pulse rate was seen and there was positive correlation between body mass index, waist hip ratio with blood pressure and pulse rate in sedentary subjects.

Conclusion: Sedentary life style and obesity are associated with increase in body mass index, waist hip ratio, blood pressure and pulse rate. There is a positive correlation between Body Mass Index, Waist Hip Ratio with Pulse Rate, Systolic and Diastolic Blood Pressure.

With the discovery by Calghatgi [1] that three common antibiotics (Abs) increased mitochondrial reactive oxygen (ROS) and lipid peroxide (LP) and depleted their natural absorbant glutathione led me to investigate further the potential impacts of these genotoxic substances on carcinogenesis. The range of impacts on mitochondria and cellular DNA varied by antibiotic to those consistent with known prior contributions to carcinogenesis. Specific cancers probably increased by these changes were HCC, RCC (KCC), CRC, cancer of the esophagus. Tumor suppressor gene mutations resulting from LP were noteworthy in this regard and mutations induced in CRC were consistent with those found in carcinogenesis of CRC. In addition depression of short chain fatty acids in microbiomes were found which depress the immune system increasing risk of all cancers. Many cancers were increased according to epidemiological studies linking Abs with elevated odds ratios, with one concern in particular, fatal breast cancer. The impact of loss of functionality of the mitochondria was also linked to depression of the citric acid cycle and therefore ATP which deflected metabolism to glycolysis, the Warburg mechanism, also increasing risk of all cancers, favored by cancer cells. In conclusion, some portion of many cancer types are probably increased in likelihood by number, type and frequency of Abs treatment and chronic residue exposure which varies from individual to individual. This led me to propose a three pronged carcinogenesis mechanism for Abs. 1. Cancer critical mutations 2. Immune depression 3. loss of mitochondrial functionality leading to Warburg effects. Damage to mitochondria were also noted by common pesticides tested in China and more recently by covid spike protein [2] and cancer associations were also found for many pesticides supporting a similar contributory etiology. Heart health concerns were raised by these findings because of the myriad mitochondria in the heart and because of long term reliability needs. Studies suggesting hearts were affected by Abs and pesticide exposure were presented. Because of their geographical ubiquitousness and the huge range of diseases associated with mitochondrial dysfunction, antibiotics and pesticides and bacteriacidal biocides are of concern for biodiversity and life in general. I propose research steps to evaluate antibiotic safety and suggest directions for further research and make suggestions on ways to ameliorate Abs toxicity.

Recent Complicated Childbirth Aid Protocol Inspired by Luba-Kasai Therapeutic Practice

Augustin Mubiayi Mamba

New Frontiers in Medicine and Medical Research Vol. 5, 6 August 2021, Page 32-43

Improved maternal health remains a major concern of the United Nations in general and of the World Health Organization in particular, which have placed an important place on the Millennium Development Goals (MDGs) as well as in the objectives for Sustainable Development (SDO). Curiously, among the causes of complications of childbirth and pregnancy, the emphasis is more on physiological than psychosocial deaths, whereas in our least developed countries, where the percentage of maternal is mortality, cultural and psychological problems expose women to unwanted pregnancies and psychic traumas that manifest themselves during parturition in the form of eclampsia, haemorrhage and work defects, thus leading the woman and her baby to the risk of death. In the present work, we have proposed a protocol to help childbirth, inspired by the therapeutic practices of our African cultures. Indeed, our ancestors were able to solve the complications of childbirth by speech. The interview with woman with complications around her life and relationships triggered a kind of catharsis in the latter, the labor of childbirth was normal again and the delivery was normal. The protocol comprises three components: psychodynamic interview, prophylactic psychoeducation, psychological support. This protocol is based on the humanistic theories of Carl Rogers and Maslow and the sophrology of Alfonso Caycedo and consists in subjecting the parturient to a relaxation exercise by alternate breaths and haptonomy in a helping relationship to allow communication between the woman and her child who is to be born. This study will have the merits of integrating our complicated childbirth assistance protocol into the psychotherapy arsenal already in place, in order to rightly improve maternal health in childbirth.

Background: Blood group plays a unique role in revealing the identity of an individual. Studies have shown that certain diseases and personality features vary among ABO blood groups. In addition, variations in terms of bleeding tendencies among these blood groups have also been unleashed. Hence a study was done to the find association of bleeding time (BT) and clotting time (CT) with ABO blood group.

Methods and Materials: This study had a cross-sectional study design and was done among 250 young adults aged between 18 and 24 years. Slide agglutination method was used to assess ABO blood group; while Dukes and capillary tube method were used to determine BT and CT respectively.

Statistical Analysis: Chi-square analysis was done to analyze the association of BT and CT with blood group. Statistical significance was considered when p value was less than 0.05.

Aim & Objectives: To determine the predominant ABO blood group  among the young adult population and  to find the association between ABO blood group  with bleeding time and clotting time and to assess the gender variation  in bleeding time and clotting time among the young adult population.

Conclusion: In this study, results have shown that blood group O was the predominant blood group among the study population and blood group O and B had prolonged BT and CT compared to other groups. Based on gender, females had higher CT compared to males.

Current knowledge of Epigenetic Events in Multiple Myeloma

Pavla Flodrova, Petra Luzna, Denisa Weiser-Drozdkova, Katerina Smesny Trtkova

New Frontiers in Medicine and Medical Research Vol. 5, 6 August 2021, Page 56-72

Multiple myeloma (MM) is a biologically heterogenic disease with adequate wide spectrum of chromosomal, genetic and epigenetic changes. Epigenetic modifications can influence gene activity without changing the DNA sequence. There are biochemical modifications that include DNA methylation and post-translational modification of histone proteins (histone methylation, histone acetylation and deacetylation), that play an important role in the pathogenesis of MM. Epigenetic modifications are mediated through very important specialized enzymatic molecules, e.g. DNA methyltransferases (DNMTs), ten-eleven translocation enzymes (TET), histone acetyltransferases (HATs) and histone deacetylases (HDACs). In a complex machinery, specific of micro-RNA molecules contribute to epigenetic processes. Not only in myeloma genesis, but epigenetics influences a drug resistance and prognosis of patients with MM as well.

Reverence Thru Cadaveric Oath: The Need of the Hour

Manisha R. Gaikwad

New Frontiers in Medicine and Medical Research Vol. 5, 6 August 2021, Page 73-76

In today’s scenario the doctor –patient relationship is getting from bad to worse because of the lack of communication skills in undergraduate students pursuing medicine. Acquiring knowledge through dissection of human body is an age-old concept started in 15th century by barber surgeons to demonstrate the structure of human body. Students pursuing medical profession have Anatomy as one of the three basic pre-clinical subjects in there very first year of medical career. Importance of cadaveric dissection for learning anatomy helps the students in developing spatial and tactile appreciation of the structures which cannot be obtained by prosected specimens, computerized learning aids or any other virtual dissection tables. Cadaver being their first teacher, students should be imbibed with the moral values and have gratitude towards the cadaver for helping them understand the structures of the body through dissection. Cadaveric oath recitation will help the students in developing empathy with the cadaver as a “SILENT TEACHER” and in the long run with the patients while serving the humanity by way of medical practice.

Purpose: To evaluate the normative data of anterior chamber angle in patients presenting to tertiary health care center using anterior segment spectral domain OCT (ASOCT) in central Indian.

Design: 120 Consecutive patients presenting to ophthalmology out patient department of tertiary health care center were enrolled in a cross-sectional study.

Methods:All patients underwent comprehensive ocular examination. Ocular examination included best corrected visual acuity, refraction, anterior segment examination by slit lamp, fundus examination, gonioscopy by 3 mirror Goldmann contact lens, IOP measured by Goldmann applanation tonometer, OCT analysis of angle of AC .The duration of study was one year six months. This study was approved from the research and ethics committee of the institute. Informed consent was obtained. Data was analyzed by using SPSS 16.0

Results: In our study we have studied the AS-OCT parameters among normal subjects and results of 120 subjects were analyzed. It is noted that mean nasal & temporal AOD was less in females (0.4175 µm, 0.4613 µm) as compared to males (0.4583 µm, 0.4142 µm).This study found that older people had a narrower anterior chamber angle (measured in degrees) and shallower ACD (measured in millimeters).

Conclusion: Our study is the first study in central India done with SD-OCT to give normative data of anterior chamber parameters among normal subjects. These normative values will help us identify patients with abnormal values signifying anterior chamber abnormalities.

The Study of Acute Respiratory Distress Syndrome due to Strongyloides stercoralis in Lupus Nephritis

Umapati Hegde, Hardik Patel, Vipul Chakurkar

New Frontiers in Medicine and Medical Research Vol. 5, 6 August 2021, Page 85-91

Strongyloides stercoralis is an intestinal helminth that infects humans transdermally, endemic in tropical and subtropical rural regions. In immunocompetent subjects, the pulmonary disease caused by the parasite most commonly is asymptomatic to mild disease, but the same can be life-threatening in immunocompromised subjects. Twenty-one-year-old male suffering from class IV lupus nephritis was treated with steroids and Cyclophosphamide. After 1.5 months' therapy, he presented with diarrhoea, abdominal pain, and dyspnoea, which rapidly worsened to acute respiratory distress syndrome (ARDS) needing ventilation. Bronchoalveolar lavage (BAL)showed Strongyloides stercoralis. He was treated with IV antibiotics, Ivermectin, and Albendazole with good results. In this article, the authors summarize a case of hyper infection syndrome of strongyloidiasis in immunosuppressed patients and discuss the various aspects of Strongyloides stercoralis infection, emphasizing the parasite's life cycle and the treatment modalities. Corticosteroid administration can lead to the development of Strongyloides hyper-infection syndrome in endemic areas. Therefore, early suspicion, diagnosis, and treatment of Strongyloidiasis are needed to save life.

A Review on COVID-19 and Diabetes Mellitus: Unravelling the Hypotheses that Worsen the Prognosis

Radu Albulescu, Simona Olimpia Dima, Ioana Raluca Florea, Daniela Lixandru, Andreea Madalina Serban, Veronica Madalina Aspritoiu, Cristiana Tanase, Irinel Popescu, Sarah Ferber

New Frontiers in Medicine and Medical Research Vol. 5, 6 August 2021, Page 92-108

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the caused disease - coronavirus. COVID-19 represents an unattended threat for health and life. In the present review we are addressing several hypotheses that may explain why diabetic patients with SARS-CoV-2 infection are at higher risk of experiencing a severe form COVID-19 disease.

Determination of High Sensitivity C-Reactive Protein in Metabolic Syndrome

Prakash Kikkeri Gowdaiah, T. R. Mamatha, Dyaneshwar Nirgude, Prakash Basappa Hosamani

New Frontiers in Medicine and Medical Research Vol. 5, 6 August 2021, Page 109-114

Background: A persons personal risk of having cardiovascular disease and type 2 diabetes mellitus is significantly increased if they have metabolic syndrome. Obesity and type 2 diabetes have both become epidemic in India. Metabolic syndrome is a pro-inflammatory condition characterised by low-grade systemic inflammation. The biomarker C-reactive protein (CRP) is a reliable indicator of persistent systemic inflammation. Higher levels of high sensitivity C-reactive protein (Hs-crp) are linked to metabolic syndrome and its components, and can help predict the development of cardiovascular events in the future.

Study objectives: 1) Association of High sensitivity C reactive protein with metabolic syndrome 2)Study of High sensitivity C reactive protein as a surrogate marker of chronic inflammation in the metabolic syndrome

Materials and Methods: This cross sectional study included 50 patients with metabolic syndrome aged 18 and up, as well as 50 age and sex matched controls who visited the OPD or were admitted to the Bangalore Medical College medical department wards. The metabolic syndrome was diagnosed using the updated IDF criteria.For the measurement of hs-CRP, blood glucose, and lipid profile, a fasting blood sample was taken.At the same time, the waist circumference, height, and weight were measured.The information was tabulated and analysed.

Results: There was a statistically significant difference in values of various demographic parameters such as BMI, waist circumference, blood pressure, and biochemical parameters such as blood sugar and lipid profile between cases and controls. Patients with metabolic syndrome had higher mean value of hs-CRP (8.3±1.04 Vs 1.6±0.79mg/l) with a p value <0.001.

Conclusion: When compared to controls, patients with metabolic syndrome had considerably higher levels of hs-CRP, and hs-CRP levels rose linearly with the number of metabolic syndrome components. As a result, in patients with metabolic syndrome, hs-CRP can most likely be utilised as a proxy marker of chronic inflammation.

Rheumatoid Arthritis (RA) is an autoimmune based inflammatory pathology with involvement of joints that show early morning stiffness alongwith pain resulting in loss of function. It usually affects females aged 30 years or above. A total of 150 patients of Rheumatoid Arthritis were included in the present study of which 120 were females and 30 males (F:M=4:1). Serological tests were carried out in these patients. These test were analyzed for their sensitivity as well as specificity. Combination of various test were also assessed for their results. The objective ofpresent study is to analyse, age and sex of patient affected by Rheumatoid arthritis; and to determine whether combination of serological tests enhance specificity. as can be seen fmQuantitative Rheumatoidfactor estimation and Anti Rheumatoid antibodies assay gave the maximum specificity of 89.8%. A combination of serological tests is advisable rather than a single diagnostic test. This allows for the early diagnosis of Rheumatoid Arthritis so as to prevent complications by the disease.

Study on Role of CECT Abdomen in Intestinal Obstruction: A Clinical Approach

Mohammad Farooque G. Dudhwala

New Frontiers in Medicine and Medical Research Vol. 5, 6 August 2021, Page 120-127

Background: Intestinal obstruction, which can be either dynamic or adynamic, is a common clinical event. To avoid missing strangulation, the old adage "Never let the sun set or dawn on a clogged bowel" was taught. With its multiplanar reformatted imaging, helical CT can properly define the level, degree, origin, and problems associated with obstruction.

Aim: Aim of the study was to depict the spectrum of MDCT findings in cases of small and large bowel obstruction and correlation of CT scan with intraoperative findings and the cause of intestinal obstruction.

Methods: Contrast enhanced MDCT examination of 50 patients were prospectively included in the study who had evidence of clinical as well as MDCT evidence of bowel obstruction and in whom surgical/clinical follow-up for final diagnosis was available. CT scan was done in all the patients with MDCT (Brightspeed GE 16 slice system). The axial sections were reconstructed in coronal and saggital planes to determine site and cause of bowel obstruction.

Results: The commonest cause of intestinal obstruction in adults in this study series was adhesions/bands in 38% cases. Out of 47 operated patients for intestinal obstruction, CT findings matched with intraoperative findings in 43 patients (91%) whereas cause of intestinal obstruction matched with CT findings in 37 patients (74%).

Conclusions: Management decisions in intestinal obstruction remain notoriously difficult, relying on a combination of clinical, laboratory, and imaging factors to help stratify patients into conservative or surgical treatment. CT in these patients can help surgeon to go for surgery early and prevent complications.

Miniscrews Anchorage for Distalization of Maxillary Molars

A. Houb-Dine, F. Zaoui

New Frontiers in Medicine and Medical Research Vol. 5, 6 August 2021, Page 128-133

Miniscrew has greatly revolutionized the clinical and biomechanical approach of anchoring in orthodontics. Used as direct or indirect anchoring, the orthodontic miniscrews indications field is expanding due to their easy insertion, and their immediate loading ensuring an absolute anchoring. Our objective through this clinical case is to show the effectiveness of these miniscrews in the correction of the uncontrolled loss of anchoring.

Investigation of Patient-Physician Relationship and Ante-natal Seeking Behaviour in Public Hospitals, Ogun State, Nigeria

S. O. Aluko-Arowolo, M. Solarin Thomas, O. Ogundimu Ayobami

New Frontiers in Medicine and Medical Research Vol. 5, 6 August 2021, Page 134-145

The role of the patient-physician relationship as an underpinning factor that may inhibit or stimulate early pregnancy booking among women in Ijebu, Ogun State, was investigated in this study. The study used a survey and an in-depth interview as part of a triangulation strategy. Ijebu-Ode accounted for 32.2 % (141) of the whole sample, whereas Ijebu-Igbo accounted for 64.8% (259) of the total sample. A structured questionnaire was given to 400 consenting women who were attending ante-natal clinics (ANC) sessions in hospitals in Ijebu-Ode and Ijebu-Igbo who were chosen at random. Furthermore, a stratified sampling procedure was used to choose ten percent of the women for in-depth interviews. In addition, ten in-depth interviews (IDIs) with gynaecologists, nurses, and other health care professionals were undertaken. The study discovered a non-cordial relationship between physicians and antenatal patients, which contributes to late pregnancy booking and inconsistent ANC attendance by pregnant women. Many pregnant women avoid ANC because of the physician's uncooperative style, which includes not paying enough attention and using aggressive, unclear, and ambiguous language that are incomprehensible to patients who are hardly literate. According to the findings, women's early pregnancy booking may be influenced by their proximity and reciprocal relationship with their doctor. As a result, it is recommended that physicians pay close attention to their patient relationships, and that appropriate government, agency, and non-governmental organisations (NGOs) foster the transmission of maternal health education.

Study on Chronic Pain Management in Roman Coloniae

Valentine J. Belfiglio

New Frontiers in Medicine and Medical Research Vol. 5, 6 August 2021, Page 146-151

The presented study discusses the use of analgesics by medical personnel in the colonies and at field hospitals located in the urban capitals of the colonies was an important aspect of providing immediate care to Roman veterans after injuries or other causes of chronic pain. Upon completion of twenty years or more of active military service, Roman legionnaires received financial benefits from the Roman State and free plots of land in Italy or Roman conquered lands. These outposts in Roman conquered territory served as a buffer between the Roman State and potential Roman enemies, helped to suppress insurrections in the territories they occupied and helped to Romanize these territories. The coloniae varied in size and population from a few hundred to several thousand people. Adequate medical care is indispensable to the survival and prosperity of any community of people. The larger coloniae had hospitals and health care professionals to support the colonists living there. Smaller colonies had a medical clinic with a smaller staff. Managing chronic pain suffered by ranchers and farmers was a major concern for the medici (physicians) who lived and worked in the coloniae. The veterans and their families sometimes required pain management for their functionality and quality of life.

Study on the Altered Gonadal Expression Levels of the Adipokine Lipocalin-2 and the 24p3 Receptor in the Offspring of Obese Rats

Edgar Castrejón, Leticia Manuel-Apolinar, Leticia Damasio, Rebeca López-Ballesteros, MarÍa Cristina Revilla-Monsalve, Elsa de la Chesnaye

New Frontiers in Medicine and Medical Research Vol. 5, 6 August 2021, Page 152-163

Currently, metabolic syndrome constitutes both a medical and an economic problem that affects most countries. Obesity, which is one of its components, affects millions of individuals worldwide. Numerous studies have described an association between high circulating levels of the adipokine lipocalin?2 (Lcn2) and different components of the metabolic syndrome. The latter is of concern because obesity occurs jointly with a state of chronic inflammation, causing dysregulation in adipokine synthesis, often associated with the development of other cardiometabolic alterations. Also, it is known that an obesogenic environment during pregnancy alters the fetal expression of different molecules, including adipokines. We recently demonstrated that mRNA and protein expression of Lcn2 and its receptor (24p3R) is dysregulated in gonads collected from the offspring of obese rats at different times of development. From the results obtained, we concluded that maternal obesity changes the expression of Lcn2 and 24p3R in the gonads of the offspring of obese rats, possibly through fetal programming. The consequences of this dysregulation for the offspring's gonadal function remain to be determined.