Recent Developments in Medicine and Medical Research Vol. 1

This paper aims to present a study of a relatively new combination procedure to treat AA. In our study we combined high negative pressure microdermabrasion (MD) with intra lesional steroid (ILST) injection. We compared the results of this combination with ILST alone also. Alopecia Areata (AA) is an auto immune condition that affects the skin's hair-bearing areas. The prevalence of alopecia areata has been rising in recent years. This condition affects 0.1-0.2%2 of humans, occurring in both men and women. AA occurs in people who are apparently healthy and have no existing skin disorders. Local irritants, such as capsicum lotion, topical steroids, and oral immuno suppressants, as well as oral and injectable steroids, are already in use. Hair regrowth is variable, either uniform or bushes-like, and recurrence is common.

The decrease of the cardiac electrical systole – short PR and QTc intervals in the same electrocardiogram, also known as “Electrocardiographic Breijo Pattern” - is increasingly studied by several authors. The vast majority of the time it can be overlooked in an electrocardiogram tracing. People who had this kind of electrocardiographic pattern had also suffered from a wide variety of symptoms. Nocturnal tachycardias, dizziness, seizures, and unexplained syncopal accesses were the main symptoms common to all patients. More than 127 cases have been studied and cross-checked by our research team so far. Its diagnosis is indispensable in eluding of the most heartbreaking consequence: avoidable death. Despite the fact that for many authors, the cardiac electrical systole comprises only from the beginning of the Q wave to the end of the T wave – that is, depolarization and repolarization of the ventricles, the atria are also part of it. Consequently, the P wave, as well as the PR segment, must be a part of the electrical cardiac systole. When there is a shortening of the PR interval along with a shortening of the QT interval, we should talk about: Decrease of cardiac electrical systole.

Objective: Currently, the consideration of the enlarged uvula as a cause of snoring and Obstructive Sleep Apnea (OSA) lacks data for objective interpretation. A uvula was often considered enlarged (i.e., longer, wider) if its length exceeded 15 mm or width exceeded 10 mm. This article focused on some concepts on how we can manage the enlarged uvula in cases of snoring and OSA. The purpose of the present article is to discuss the cost benefits of uvular surgery versus its preservation.

Conclusion: The direct correlation between the uvula and OSA needs to be reevaluated to maintain a balance between reserving its anatomical and physiological functions and surgically manipulating it as a part of palatopharyngeal surgery, yet further objective studies are needed to reach optimal results.

Background: Chronic anterior dislocations of the shoulder have been reported on since White’s comments in 1741. Anatomopathologically, such cases exhibit modifications of the injured tissues (fibrosis, neo-articulation, muscle contracture, capsular, ligamentous, bone and tendon lesions) because of the longstanding unreduced humeral head. We hypothesize that the clinical status of such cases and the different lesion patterns observed in them obviate the need for conservative treatment or the use of classic open procedures. Treatment decisions also depend on clinical symptoms; patients who do not have much disability are left unreduced.

Methods: The study reports on 53 non-randomized cases showing duration of dislocation of at least 3 weeks in patients aged between 20 and 75 years. The 53 patients were placed in three management categories: conservative, closed reduction and open reduction groups.

Results: The results were evaluated following Rowe’s evaluation of results for chronic unreduced dislocation of the shoulder. Among the 49% of patients with open management, the overall score averaged 74 points. In 4 cases, we performed a modified Boytchev procedure, and the overall rating units averaged 81 points.

Conclusion: These results show that the overall prognosis for surgical treatment is improved.

This study is a Level IV case series.

Different exogenous and endogenous factors effect on production speed and direction of cells in bone marrow. Earlier, it was shown, that liver fibrosis effects on the morphotypes of bone marrow cells. In this investigation, the bone marrow cells answer to liver fibrosis and electromagnetic radiation was investigated. The research objects were bone marrow cells` of different age rats. The "lifespan" of lymphocytes obtained from old animals (Wistar rats, 20 months) in the primary culture exceeded that of young animals (3 months). Fibrosis of the liver, which is induced by the administration of copper sulfate and carbon tetrachloride, reduced the "lifespan" of lymphocytes. Electromagnetic radiation (70 kHz 600 V / m) affects the number of cells in the bone marrow and induces apoptosis. A study of the effect of electromagnetic radiation for 4 hours for 1.3 and 5 days showed a U-shaped dependence of the response at the level of bone marrow cells.

The aim of the study was to find out the etiology of isolated hepatomegaly in Bangladesh. A prospective cross sectional study was done at medicine department in a tertiary care hospital in Bangladesh. Consecutive one hundred hospital admitted patients having isolated hepatomegaly were included in the study. Hepatomegaly is usually associated with splenomegaly. However, sometimes there may be isolated hepatomegaly without splenomegaly in different pathological conditions. In our study we found that most common cause of isolated hepatomegaly was liver abscess (34.0%) followed by congestive cardiac failure (30.0%), Viral hepatitis (14%), secondaries in the liver ( 8%) primary hepatocellular carcinoma( 6%) and Fatty liver (2%). Among the liver abscess 59% were amebic & 41% were pyogenic abscess.

Background: Bone scan has a very highly sensitive role in detection bone metastases. Bone metastasis from stomach cancer occurs only rarely and it is known to have a very poor prognosis. Bone metastases in Gastric cancer are mainly osteolytic, and disruption of bone integrity and resulting in bone pain and pathological fracture.

In this study, we aimed to review the incidence, clinical characteristics, and related risk factors for bone metastases in patients with a primarily diagnosis of gastric cancer.

Methods: We retrospectively evaluated all patients who diagnosed with primary gastric cancer and underwent initially as staging working up with bone scintigraphy between 2010 and 2014 at Seoul St. Mary’s hospital, The Catholic University of Korea. Total numbers of primary diagnosis of gastric cancer patients were 1589/1721 (92.33%) patients received bone scan as initial staging work up. We further analyzed the patients according to eligibility criteria we created and the incidence of and the risk factors for bone metastases were investigated.

Results: Out of 1589 patients analyzed, bone metastases were clearly confirmed only in 15 patients (0.8%). The mean age was 59.0 ± 8.6 years (range 24–90) and a majority of patients were male (60%). Dominant histological type either poorly differentiated type or signet ring cancer type and Bormann’s classification type 3 was the majority. In the distribution of the gastric tumor in correlation to the upper, middle and lower third was not clinically variant. The mean tumor size among this group was 3.6 ± 2.3 cm (range 0.6–20 cm). All patients were advanced gastric cancer type clinically and the median follow-up period was 9 months. The incidence of bone metastases was (20%). In (80%) of patients had bone metastases and another site of metastases. Among these, most of the time associated regional lymph node metastases was found. Most patients had multiple bone metastases instead of a single bone lesion. The whole patients of bone metastases were advanced gastric cancers, and the most common metastatic site was the whole skeleton, followed by combined vertebra, rib and scapula.

Bone scintigraphy and PET-CT were mostly used together for diagnosing bone metastasis. The serum alkaline phosphatase at the time of diagnosis had increased in only 5 cases (35.71%) and there were clinical symptoms of bone pain in 8 cases (53.0%). Other variables also were not significantly valued like anemia, tumor markers like carcinoembryonic antigen (CEA) and cancer antigen 19-9 (CA19-9).Treatment was given to 14 cases (93.3%) and it was mostly chemo or concomitant chemoradiotherapy.

Conclusions: The preoperative bone scan was positive in 0.8% for bone metastasis in patients with gastric cancer. Suggesting that whole-body bone scan should not be performed routinely in patients with gastric cancer. For bone scan to be as cost-effective tool, may be needed for selected group of patients i.e. advanced stages of gastric cancer or clinically symptomatic patients. Serum ALK has poor correlation with early bone metastasis detection.

Background: Currently few rebiopsies are performed in relapses of advanced non small cell lung cancer. They not customary in clinical practice.of lung cancer. However, it is not possible to properly target treatments in cases of relapse without knowing the nature of new lesions.

Objectives: Clarify current status and explore needs of rebiopsy.

Design: This paper comprehensively summarizes the available literature about rebiopsy and broadly discusses the importance of rebiopsy in advanced non small cell lung cancer.

Results: Altogether 560 abstracts were used as material for further analysis. Of which 19 articles were about clinical rebiopsy in lung cancer and were reviewed in detailed manner.

Conclusions: This review shows that rebiopsy is feasible in non small cell lung cancer, and success rates can be high if accompanied by adequate evaluation before biopsy. Its use may resolve the difficulties in sampling bias and detecting changes in cancer characteristics. In cases where treatment was selected based on tissue characteristics that then change, the treatment selection process must be repeated while considering new characteristics of the tumor. However, before performing rebiopsy adequate evaluation of risks for complications should be performed including anatomic and technical aspects of accessing tumor. Rebiopsy may be used to predict therapeutic resistance and consequently redirect targeted therapies. Such knowledge may resolve the difficulties in sampling bias, and also in selecting pre-existing clones or formulating drug-resistant ones. Rebiopsy should be performed more often in non small cell lung cancer. Rebiopsy is done after the initial biopsy that provided the diagnosis.

The leaf-like traumatic fibroma (LTF) is a benign fibrous lesion of the connective tissue. Its clinical characteristics feature a flattened pedicle aspect, adapting well to the palate, resembling a leaf. Its color is usually pink, similar to the adjacent epithelium. The growth is slow. The lesion may be larger than 2 cm in diameter. It may be present in the oral cavity for a long time. The LTF is commonly associated with poorly adapted removable complete or partial prostheses which cause a flattening of the lesion against the palate. This report presents an unusual case of an LTF in a dentate patient who did not use any type of prosthesis. Instead, the lesion was related to an injury caused by food trauma, which is an unusual etiology for this type of lesion. We reported the mechanical pressure of the tongue and the action of negative intraoral pressure, as possible modifying agents in causing the characteristic shape of the lesion. Treatment consists of conservative surgical removal since its recurrence is rare.

Background: Multi drug resistance (MDR) in bacterial infections has been an ever growing problem worldwide. To combat this some of the old drugs like fosfomycin used in the past are revived. The aim of our study was to know the susceptibility of fosfomycin for the drug resistance isolates from non - urinary samples. Most of the studies showed less susceptibility of fosfomycin to Pseudomonas aeruginosa. The objectives of the study were (i) To determine the susceptibility of fosfomycin  against Methicillin sensitive and Resistant Staphylococcus aureus, ESBL producing Escherichia coli, Klebsiella species and Metallo Beta Lactamase producing Pseudomonas aeruginosa isolated from the specimens other than urine and to evaluate the agreement between the two methods, disk diffusion and agar dilution methods performed as per CLSI guidelines.

Methods: First isolate of each species per patient (n=250) were tested for susceptibility to fosfomycin concomitantly by the disk diffusion and agar dilution methods described by CLSI guidelines and comparison of the two methods were studied.

Results: Staphylococcus aureus and ESBL E. coli were showing 100% susceptibility, Whereas ESBL producing Klebsiella species showed 88% susceptibility to fosfomycin 200 \(\mu\)g/disc and 80% and 72% by agar dilution method as per CLSI and EUCAST criteria. For MBL producing Pseudomonas aeruginosa, 90% isolates were susceptible to fosfomycin 200 \(\mu\)g/disc and in agar dilution (60%) (\(\le\)32 \(\mu\)g/ml) were susceptible as per EUCAST criteria. Disk diffusion method showed good agreement for S. aureus and E. coli whereas moderate agreement for Klebsiella species and very poor for Pseudomonas aeruginosa.

Conclusion: Fosfomycin can be considered as an alternate drug to treat infections with multi drug resistant bacteria, not only for the UTI but for systemic infections also. This is achievable with establishment of breakpoint values and zone diameter for all common isolates.

Periodontal disease is an inflammatory process that causes periodic destruction of the periodontal attachment apparatus [1]. The advancement of knowledge on the pathogenesis of periodontal destruction and the role of nutrients in it has heightened interest in determining the relationship between periodontal disease and nutrition [2]. It is also critical to understand that genotype and dietary interactions influence periodontal disease risk [3]. Nutrients regulate periodontal health and have a key role in inflammatory and immunological responses [4].

Nutrigenomics focuses on the finding and understanding of molecular-level interactions between nutrients and genomes using genomic methods in nutritional studies [3]. It gives information on the impact of nutritionon metabolic pathways and homeostatic control and allows toknow the disturbances arising in this regulation, at its earliest [5]. This chapter provides a detailed description of role of nutrition in periodontal disease and recommends the daily nutritional intake necessary for prevention of periodontal disease [3].

Among low- and middle-income countries (LMIC), cervical cancer is the fourth most common malignancy in women. Cervical cancer is detected using a variety of approaches, including the conventional Pap smear (CPS), Liquid Based Cytology, and supplementary techniques such as Cell Block with immunocytochemistry. Another approach being promoted as a key screening tool is the VIA. HPV DNA testing and other molecular diagnostics have been at the forefront of screening efforts.

All of the above methods were used in this study by using cost-effective in-house procedures to see if they could be useful in clinical settings. We found them valuable in light of the need for greater work and people training in order to improve cervical cancer diagnosis. There is a need for a uniform policy of screening of women at the primary health care center level with increasing the awareness of the different methods among the public.

During the epidemic seasons in 2010 and 2012, epidemic outbreaks were recorded in several health districts in Burkina Faso. Climatic conditions, poverty and poor population immunity make it possible for the emergence of recurrent meningitis outbreaks by Neisseria meningitidis.

Objective: Describing the epidemiology characteristics and response during epidemics of 2010 and 2012.

Patients and Methods: It consisted in a descriptive cross-sectional study which was conducted during epidemics of 2010 and 2012. Data were collected in health districts. Meningitis cases are defined as suspect, probable or confirmed cases according to WHO definitions. The data were entered and analyzed using Epi Info 3 5 1.

Outcomes: Twelve districts had crossed their epidemic threshold in 2010 and thirteen in 2012. The isolated bacteria were dominated by Neisseria meningitidis X in 2010 and Neisseria meningitidis W in 2012. The average age of patients was 12 years in 2010 and 9 years in 2012. The sex ratio was 1.3 in 2010 and 1.3 in 2012 in favor of the male. The modal age group was that of 5 and 14 years respectively in 2010 and 2012. Three health districts had a vaccine response with uncombined polysaccharide vaccine ACYW.

The appropriate management of cases and children immunity strengthening remain major strategies against meningitis epidemics. It is important to acquire combined tetravalent ACYW vaccine for adapted vaccine response in case of epidemics.

In the Rig-veda, the word "nadi" signifies "stream." It is important to understand the term "Stream," which underpins the entire Nadi concept. In other terms, every channel through which energy flows is referred to as Nadi. Tantra's artistic side has its own set of rules. It isn't a tradition without rules, nor does it approve of anything dramatic, sensational, novel, or unconventional. Tantra offers a structured and orderly view of art based on an understanding of the universe's occult and spiritual rules.

[1] Yogis made the fewest anatomical correlations on this subject because it was well known at the time that these are the main path or tract through which consciousness travels, or because it was not necessary for them. Tantric and Yogic Gurus both mention the conducting pathways, but they do so in distinct ways. Because they are made up of subtle matter, they cannot be seen with the naked eye, and we are unable to conduct any tests at this level to demonstrate that they are the nerves that we met during the dissection of the human body. So the quest for “Nerves” in the physical body can be clearly identified, but those Nadis or Nerves in the astral body have yet to be identified.

In terms of AI (Artificial Intelligence), so much progress has been made in two years ... The first thing that comes to mind is mathematician Alan Turing who, when philosophizing about a problem that pretended not to attend a part, concluded with: Writing papers that could be the cornerstone of current computer technology [1]. All efforts to equip computer systems with certain capabilities are summarized under the term AI (Artificial Intelligence) [2]. The subject is intriguing and can even terrify you, because of course conflict arises as events and potential dangers loom around the corner. It is not that AI (artificial intelligence) opens a door that is forbidden a priori (if a metaphysical similarity is possible), but rather that it reveals a very fundamental challenge, namely its correct development. The task of infusing an intelligent machine with complicated concepts like justice, kindness, and love is already complicated, but work is already being done on it. What would Turing think of an intelligent machine?
High-performance machines are present in medicine today and will continue to be so. Jesús Moreno, doctor of the Spanish Society for Laparoscopic and Robotic Surgery says: "In 10 years, robots will be used more often in the operating room." 4 The updated history of robotic surgery [3] begins with the PUMA 560 (\(^{\circ}\) r), which has developed into 2 prototypes, PROBOT (\(^{\circ}\) r) and ROBODOC (\(^{\circ}\) r) for prostatectomy or trauma surgery. The AESOP, an endoscopic system for abdominal surgery, is primarily a robotic arm that carries a laparoscopic camera. Towards the end of the century, the ZEUS (\(^{\circ}\) R) robot appeared and expanded its range of application to include the integration of urology. The Zeus robot is a large 3-armed robot; a left and a right arm simulate the surgeon's arms plus a third arm controlled by an AESOP voice control. This is how the DA VINCI (\(^{\circ}\) r) robotic surgery system was created, consisting of 3 elements: a visualization trolley, the surgeon's console (arms with 7 sliding areas and a computer system with 3D images) and the mobile car (with more arms). This robot was developed by the SRI (Standford Research Institute), the first copy of which came on the market in 1997 [4] and was visibly approved by the FDA. Perhaps its downside is that it is still a large robot with many connections.
In the 21st century, we've seen gigantic advances in robotic surgery, both in terms of models and sizes.
Also impressive. (I would say downright scary) Or the author Isaac Asimov? Who was still far from the digital age when he published his book I Robot in 1950? Today, the two of them could be witnesses of AI (artificial intelligence) in any of its magnitudes and magnificence, which act as digital assistants not only for mobile phones, but also for social networks such as Facebook, Microsoft or Google [5]. But be careful, Nick Bostrom emphasizes in an interview this year:
If we cannot control it, we could give room to the reality of a super-intelligent system that could prioritize the achievement of its own values at the expense of our own [6]. Two years ago, before this interview, the Swedish philosopher had already said about superintelligence.

Mobile genetic elements (MGEs) make up a large part of the DNA of eukaryotes, in particular, almost 45 % of the human genome. Numerous data show the diverse role of these elements in the genome - from plasticity factors to mutability or stability. They discuss their role in the evolution of genomes and the evolution of gene regulation. The purpose of this work was to investigate the distribution of MGEs in human MGMT gene and their regulatory potential. It is shown that in the human MGMT gene MGEs are present both in the intron sequences and in the promoter region. In the intron sequences, MGEs form composite cluster structures that are the source of various regulatory sequences and have the potential to form alternative promoters. In the promoter region, three sequences of MGEs were identified: two LTR-repeats and a fragment of the DNA-transposon. The MGEs fragments in the promoter region of human MGMT also enriched with potential cis-regulatory sequences that may be involved in the regulation of this gene.

Skin is the largest organ of the human integumentary system, that interacts with the environment and role in protecting the body from pathogens and toxic chemicals. It comes into touch with the environment directly or indirectly in daily life from many sources such as skincare products available in the markets. In this work, we look at a list of a few chemicals that have been shown to treat skin disorders but also cause serious acute diseases. Most skin care products contain sodium lauryl sulphate, diethanolamine, nanoparticles (zinc oxide, titanium oxide), monoethanolamine, triethanolamine, propylene glycol, and butylene glycol, which have both beneficial and harmful effects. The main objective of this study is to give clarity about the skincare products that involve certain chemicals which have been proven to be harmful to the human body.