Editor(s)
Prof. Jaffu Othniel Chilongola
Department of Biochemistry and Molecular Biology, Kilimanjaro Christian Medical University College, Tumaini University, Tanzania.

 

ISBN 978-93-5547-060-7 (Print)
ISBN 978-93-5547-068-3 (eBook)
DOI: 10.9734/bpi/rdmmr/v8

 

This book covers key areas of Medicine and Medical Research. The contributions by the authors include Cutaneous Rhinosporidiosis, Disseminated, Nodules, Gestational trophoblastic disease, gestational trophoblastic neoplasia, chemotherapy, methotrexate,Epidemiology of Hemodialysis, end-stage renal disease, Coil embolization, hemoptysis, multidetector computed tomography , pseudoaneurysm,Visual impairment, obstructions and dissatisfaction in services,eye care facilities, mortality, morbidity, Survival, Pectoral nerve, pectoralis major muscle, nerve compression, Woven bone, carotis artery plaques, Turner syndrome, adolescent, delayed diagnosis, short stature, Cavernous sinus thrombosis , orbital cellulitis, high index of suspicion, Vascular Rehabilitation, Veno-Arterial-Lymphatic Rehabilitation, Ocular prosthesis, iris positioning, graph grid, eyewear method, Wound healing, chemo-surveillance, abnormal methylation enzymes, differentiation inducers, differentiation helper inducers, Sugar chain, postmortem brain, apoptosis, dentate gyrus, hippocampus, schizophrenia, Cerebral cortex, locus coeruleus, medulla oblongata, prenatal stress, noradrenaline, immunohistochemistry, Yoga, anorexia, psychiatric disorders, osteoporosis, childhood, extra pulmonary tuberculosis, Serum fluorescence, advanced glycation end products, diabetes duration, glycemic control, microvascular complications, Antioxidant nutricosmetics, growth factors for treatment of alopecia,and injectables for alopecia.This book contains various materials suitable for students, researchers and academicians in the field of Medicine and Medical Research.

 

Media Promotion:


Chapters


Disseminated Cutaneous Rhinosporidiosis : A Rare Case Presentation

Shyamala R., Gufran Ahmed, Hisham ., Leeja latiff

Recent Developments in Medicine and Medical Research Vol. 8, 29 October 2021, Page 1-5
https://doi.org/10.9734/bpi/rdmmr/v8/4405F

Rhinosporidiosis is a granulomatous illness of the mucous membranes of humans that causes polyposis in the nasal mucosa, conjunctiva, and other areas. Rhinosporidium seeberi causes the infection. We present the case of a 71-year-old man who has had several cutaneous painless nodular lesions over the right side of abdomen, left shoulder, back and over the medial aspect of right thigh since 5 years. He had previously undergone nasal surgery for nasal obstruction. The image of cutaneous rhinosporidiosis was revealed by a potassium hydroxide mount and histological testing. This case underscores that disseminated rhinosporidiosis has to be suspected with papillomatous lesions of skin associated with pharyngeal lesions.

Gestational Trophoblastic Neoplasia: Brief Overview

Sanjivani Wanjari

Recent Developments in Medicine and Medical Research Vol. 8, 29 October 2021, Page 6-15
https://doi.org/10.9734/bpi/rdmmr/v8/14038D

Gestational trophoblastic neoplasia is a unique neoplastic condition that arises from fetal trophoblastic tissues and can be considered as semi-allografts. Most of the gestational trophoblastic tumours are hydatidiform moles and are mostly benign. The malignant form of gestational trophoblastic disease is called Choriocarcinoma. The disease is common in Asian and African countries, incidence in India is about 1 in 400 pregnancies. Serum \(\beta\)-HCG assay is the main investigation for the diagnosis and management of GTN. This is important to detect persistent trophoblastic disease and hence follow up to two years is recommended. For complete and partial moles, surgical evacuation and follow up may be sufficient. Women with non-metastatic GTN and those with metastatic low-risk GTN can be treated with single-agent chemotherapy. Methotrexate is the drug of choice when single agent chemotherapy is used. Pre-treatment HCG levels more than 40,000 U/L are indicative of high risk GTN. They are treated with multi-agent chemotherapy. The most commonly used regimen is EMA-CO. After treatment the prognosis for GTN is now excellent, nearly 100% with low-risk disease and survival is nearly 86% in high-risk disease.

Determination of Hemodialysis Status in an Egyptian Coastal City, Alexandria: An Epidemiological Study with a 3-year Prospective Mortality Observation

Abir Farouk Megahed, Reem Mohamed Farouk Saleh, Afaf Mohamed Fahmy, Nagy Sayed-Ahmed

Recent Developments in Medicine and Medical Research Vol. 8, 29 October 2021, Page 16-29
https://doi.org/10.9734/bpi/rdmmr/v8/2672E

Backgrounds: Hemodialysis (HD) represents the main modality of RRT in Egypt and it constitutes a burden on the health care budget. HD is a vital and lifesaving procedure so that many organizations, including governmental and non-governmental bodies, adopt it.  In Alexandria province of Egypt, HD service is provided through fifty-seven HD units, which are categorized into twenty-one nonprofit units and thirty-six private for-profit HD units. Our objectives were to study epidemiology and to assess the three-year survival of ESRD patients treated by HD in governmental hospitals in Alexandria province.

Methods and Design: In the year 2016; the data of the patients were collected from all the governmental hospitals in Alexandria province, which comprised seven HD units containing 687 patients. In a cross-sectional arm of the study, demographic data, vascular access, HIV, HBV and HCV serology, the possible etiology of chronic kidney disease (CKD), associated comorbidities, and the routine laboratory variables were included. Furthermore, in a prospective phase of the study, a three-year-survival rate of the studied HD patients was recorded.

Results: The total number of HD patients in Alexandria province during 2019 was totaled to be 3552 in all HD units, so the estimated HD prevalence rate would be around 710 ppm. Demographic data of the surveyed 687 patients in the governmental HD units showed their mean age; 50.78 years with more males, and their mean duration of HD; 55 months. It was also noted that there was no positive seroconversion regarding HCV, HBV nor HIV. Sixteen HCV antibody-positive patients received direct-acting antiviral drugs and were converted to HCV PCR-negative. HTN was more common etiology of CKD in males, while DM and combined DM and HTN were more common in females. The target hemoglobin level was present in around 37% of the studied HD patients. Most of the studied patients had serum calcium ranged from 8-10 mg /dl and 53% of them had serum phosphorus ranged from 3-5.5 mg /dl. Para-thyroidectomy was done for 2% of the studied patients while 4% of cases received cinacalcet. The 3-year, 5-year and 7-year survival rates were 92.5%, 87%, and 82% respectively.

Conclusion: The epidemiology of hemodialysis patients in Alexandria province is not different in many aspects from other published data about some Egyptian governorates however there is no published new epidemiology about the whole country. 11.2% of HCV Abs positive became PCR negative after antiviral management protocol.

Characteristics of ESRD Patients who have been on Long-term Hemodialysis Therapy in Egypt: A Clinical Approach

Abir Farouk Megahed, Nagy Sayed-Ahmed

Recent Developments in Medicine and Medical Research Vol. 8, 29 October 2021, Page 30-41
https://doi.org/10.9734/bpi/rdmmr/v8/2671E

Background: It is well-known that hemodialysis extends the life of end-stage renal disease (ESRD) patients, who would have otherwise died. Hemodialysis is the commonest modality of renal replacement therapy (RRT) in Egypt and many other countries. The characteristics of long-term patients on hemodialysis (HD) were not evaluated before in Egypt. We aimed at identifying the specific characteristics of the patients who have survived on hemodialysis for more than 20 years in Egypt.

Subjects and Methods: During the years 2018 and 2019, the twenty-seven governorate health affairs Directories of the Egyptian Ministry of Health were contacted to participate in data collection. The dialysis physicians in each hemodialysis unit were sent a questionnaire form requesting to  submit information, on the characteristics of patients who have been on HD therapy for twenty years or more.

Results: Seventy-three patients were encountered from a total number of 26000 HD patients to have been on HD therapy; with a range between 20 and 30 years. Males constituted the majority of these patients. Sixty-eight patients were dialyzed through working arteriovenous fistulas (A-V fistulas). The mean urea reduction ratio (URR) of these patients was 0.65±0.095. Acute  intradialytic complications afflicted only 20.3% of these patients. More than three-quarters of the patients had a positive serology test for HCV antibodies. None of these patients has diabetes mellitus. On the other hand, complaints related to the skeletal system were present in 47.4% of the patients. There is a statistically significant higher rate of acute complications in the female gender and a statistically significant higher fertility rate after hemodialysis in the male gender.

Conclusion: Long-term dwellers on hemodialysis therapy are not unusual in Egyptian ESRD patients and their characteristics are reasonable.

Rare and Lethal Bleeding Cause of Pulmonary Tuberculosis

Saeed Albogami, Abdelfattah A. Touman

Recent Developments in Medicine and Medical Research Vol. 8, 29 October 2021, Page 42-48
https://doi.org/10.9734/bpi/rdmmr/v8/2674E

Background: Pulmonary aneurysms and pseudoaneurysms are caused by a variety of factors; however, Rasmussen's pseudoaneurysm refers to a focal dilation of a pulmonary artery branch into the adjacent tuberculous cavity. The incidence of such tuberculosis related pulmonary vascular complication is extremely rare, hence, under recognized by many physicians. Pulmonary pseudoaneurysms are challenging to treat because they cause life-threatening hemoptysis. Furthermore, unlike the majority of causes of massive hemoptysis, their bleeding originates in the pulmonary rather than bronchial arteries. Since this is associated with an extremely high death rate, prompt diagnosis and early therapies are required. Case description: We present a case of a young male who presented to our hospital with recurrent episodes of massive hemoptysis and was diagnosed with pulmonary tuberculosis. His hemoptysis persisted despite active treatment. In this case, we discuss the role of various diagnostic modalities as well as the available therapeutic options. Conclusion: Rasmussen's pseudoaneurysm is a rare and potentially fatal tuberculosis pulmonary vascular complication. It should be considered in the differential diagnosis of hemoptysis in patients known or suspected to have pulmonary tuberculosis. Prior to therapeutic interventions, multidetector computed tomography (MDCT) scanning is the investigation of choice to confirm the diagnosis and localise the source of bleeding. There is no head-to-head comparison of interventional radiology procedures and surgery in the treatment of pulmonary pseudoaneurysm, so the choice is dependent on availability and local expertise.

Hurdles in Eye Care Services – An Indian Scenario

Gaurav Dubey, Ragni Kumari, Jamshed Ali, Vibha Kumari, Prasenjit Das, Simi Afroz, R. K. Manik, Nitika Kumari, Rajeev Trivedi, Mahesh Chandra

Recent Developments in Medicine and Medical Research Vol. 8, 29 October 2021, Page 49-62
https://doi.org/10.9734/bpi/rdmmr/v8/10115D

Visual impairment affects livings in every aspect of life. Many organizations (W.H.O, IAPB, N.G.O.s, etc.) have initiated a campaign to eradicate preventable blindness under the scheme Vision 2020: The Right to Sight" by 2020. There are three primary considerations, including quality, reliability, and efficiency of eye care facilities, which may reduce vision loss worldwide. Poor practitioner-to-patient ratios, shortage of eye-care staff, insufficient infrastructure, weak state support and lack of medical, specialist or training programs are the hallmarks of obstacles to the usage of eye-care services in India. Significant obstacles to such programs for visually impaired people in rural areas are poor road infrastructure, transit facilities and distances from remote communities that influence surgery and eye care systems. Factors such as age, education, preferences, and psycho-social challenges influence the usage of healthy, affordable, and efficient eye care facilities. To prevent avoidable blindness, the advancement of eye treatment and understanding of appropriate eye care resources must be intense, and the consequences of inadequate eye care must be acknowledged. Rural communities' beliefs and cultural traits must be analyzed to have appropriate education and reduce worldwide vision and blindness. Eye care providers need to start educating people in early life about the role and use of health care resources. In this article we will discuss the current state of eyecare services, as well as the challenges faced by eye doctors in treating and managing eye problems, in this article. There are many hurdles to using eye care services, and administrators and providers must understand them.

Background: The care of severely unwell children continues to be one of the most demanding and difficult elements of paediatrics. The primary goal of the Paediatric Intensive Care Unit is to avoid death by closely monitoring and treating severely ill children who are at high risk of dying. There is a scarcity of data on paediatric critical care in developing countries. The efficacy of treatment can be determined by evaluating the outcomes of medical interventions. This aids in better decision making, improving care quality, and, if necessary, changing management's future direction. This study will also aid in the investigation of the causes of morbidity and mortality among children in our hospital. The study's goals and objectives are to evaluate the morbidity pattern and outcomes of admissions in the PICU of a rural teaching hospital, as well as to take measures to prevent morbidity and mortality by improving critical care facilities.

Methods: This was a retrospective study of cases admitted to our teaching hospital's paediatric ICU in the last two and a half years, taking into account the estimated sample size. Data will be gathered from the PICU and the Medical Records Department. The medical record will be used to study the details, which will then be analysed and interpreted based on the medical record details.

Results: A total of 417 patients were admitted to our PICU over the course of the study's 30 months. Of the total cases studied, Maximum i.e. 180(43.2%) had age below 1 year. The minimum – maximum range of age was between 1 day to 18 years. About 228(54.7%) cases were males and 189(45.3%) were females.  LRTI was the most common diagnosis, accounting for 61 (14.7%) of cases. The respiratory system was the most frequently involved system, accounting for 101 (21.8%) of all cases. 357 (85.6 %) of the total cases studied were discharged, 36 (8.6 percent) had DAMA (discharge against medical advice), and 24 (5.8%) expired.

Conclusions: Mortality was low in our PICU. Based on the findings of this study, we conclude that in our rural PICU, with better treatment protocols and skilled expertise/Pediatric Intensivist, we have a better chance of facilitating the care of critically ill patients and achieving a favourable outcome.

Determination of Isolated Lesion of the Lateral Pectoral Nerve due to Repeated Trauma

Faik Budak, Buket Özkara, Emre Aydin

Recent Developments in Medicine and Medical Research Vol. 8, 29 October 2021, Page 70-74
https://doi.org/10.9734/bpi/rdmmr/v8/5066F

We present two cases of progressive isolated damage to the lateral branch of the pectoral nerve with marked atrophy of the clavicular portion of the major pectoral muscle. In our patients, the mechanism of isolated lesions of lateral pectoral nerves have been attributed to repetitive external microtraumas and pressure on the nerve trajectory between the chest and shoulder during sports or occupational activities. With this case report, we aimed to consider that repetitive microtraumas can cause isolated nerve damage.

Evidence of Woven Bone Formation in Carotid Artery Plaques: A Recent Study

Mirzaie Masoud, Zaur Guliyev, Michael Schultz, Peter Schwartz, Johann Philipp Addicks, Sheila Fatehpur

Recent Developments in Medicine and Medical Research Vol. 8, 29 October 2021, Page 75-84
https://doi.org/10.9734/bpi/rdmmr/v8/1978C

Objective: Plaque morphology plays an important prognostic role in the occurrence of cerebrovascular events. Echolucent and heterogeneous plaques, in particular, carry an increased risk of subsequent stroke. Depending on the quality of the plaque echogenicity based on B-mode ultrasound examination, carotid plaques divide into a soft lipid-rich plaque and a hard plaque with calcification. During onset of thrombembolic events in arteresclerosis, vulnerable plaques play an important role.  The aim of this study was to investigate structural changes in the basement membrane of different carotid artery plaque types.

Patients and Methods: Biopsies were taken from 10 male patients (average age; 75 + 1 years) and 7 females (68 + 3 years). The study population included patients suffering from a filiform stenosis of the carotid artery, 8 patients with acute cerebrovascular events and 9 with asymptomatic stenosis. Scanning electron and polarised light microscopic investigations were carried out on explanted plaques to determine the morphology of calcified areas in vascular lesions.

Results: By means of scanning electron microscopy, multiple foci of local calcification were identified. The endothelial layer was partially desquamated from the basement membrane and showed island-like formations. Polarised light microscopy allows us to distinguish between soft plaques with transparent structure and hard plaques with woven bone formation.

Conclusion: The major finding of our study is the presence of woven bone tissue in hard plaques of carotid arteries, which may result from pathological strains or mechanical overloading of the collagen fibers. These data suggest a certain parallel with sclerosis of human aortic valves due to their similar morphological characteristics. The detection of woven bony tissue suggests that inadequate strain favours the mineralization of carotid plaques.

A Case Report on Delayed Diagnosis of Turner Syndrome in a Short Statured Adolescent

I. O. Oluwayemi, A. O. Odeyemi, T. O. Ayeni

Recent Developments in Medicine and Medical Research Vol. 8, 29 October 2021, Page 85-88
https://doi.org/10.9734/bpi/rdmmr/v8/5198F

Turner syndrome has an incidence of 1/ 2500 female live births. Clinical signs such as lymphoedema in childhood, as well as short stature and delayed puberty, are common reasons for screening for Turner syndrome. Almost all affected females experience ovarian failure. We present a 15-year-old female with short stature and delayed puberty. Her mother remembered noticing swelling in both hands and feet as a child but made no sense of it. The patient's weight and height were both below the third percentile, and she exhibited no secondary sexual characteristics. The diagnosis was confirmed by the patient's karyotype (45, XO).Her serum estradiol level was low, her uterus was small, and her ovaries were atretic. Primarin was used to stimulate puberty for two years, during which she gained 3kg of weight, 4cm of height, and breast development from Tanner stage 1 to 4.   Clinicians must be on the lookout for common clinical signs of Turner syndrome in order to make an early diagnosis, refer, and manage affected children for optimal growth and development.

Septic Cavernous Sinus Thrombosis Associated With Bilateral Orbital Cellulitis: A Case Study of A 10 Year Old Rural Girl from Sub-Saharan Region

R. Mohammed-Nafi’u, A. S. Alhassan, E. J. Okon, V. Aliche, J. Asemoh, E. T. Nnadi

Recent Developments in Medicine and Medical Research Vol. 8, 29 October 2021, Page 89-100
https://doi.org/10.9734/bpi/rdmmr/v8/5047F

Septic Cavernous Sinus Thrombosis (CST) is a rare infective condition affecting the cavernous sinus in the brain associated with high morbidity and mortality, especially when appropriate and prompt intervention is delayed. Although there is limited data on CST globally, the low prevalence in developing countries may not be unconnected with factors such as poor health seeking behaviour of the people, inadequate healthcare facilities and the dearth of radio-imaging diagnostic techniques, as well as low level suspicion for CST amongst physicians. Here is a case report on a 10 year old indigent nomadic (Fulani) girl diagnosed to have septic cavernous sinus thrombosis and bilateral orbital cellulitis confirmed by enhanced computed tomography (CT) scan of the brain. The case would have been missed, were it not for the intervention of a “Good Samaritan” who facilitated her access to the right medical facility for timely intervention.

Objective-To highlight the clinical presentation, management as well as create awareness on the   need for a high index of suspicion and early diagnosis of children with CST in order to reduce   morbidity and mortality in a resource constraint settings.

Rehabilitation of Patients with Vascular Diseases

Castor Leonardo Maduro-Maytín, Marina Maduro-Maytín

Recent Developments in Medicine and Medical Research Vol. 8, 29 October 2021, Page 101-109
https://doi.org/10.9734/bpi/rdmmr/v8/4891F

A supervised Vascular Rehabilitation program has demonstrated the improvement of the absolute walking distance and the elimination of pain at rest of peripheral obstructive arterial origin, the adequate treatment of chronic venous insufficiency, the healing of arterial and venous vascular ulcers even in patients previously amputees or disabled to walk and reverse the chances of further amputations, allowing patients to be more functionally independent. In patients with lymphedema, it stops and reverses the pathology.

 Our work plan is a scientific and evidence-based medical evaluation to determine the degree of vascular health of the legs and to organize a personalized therapeutic plan. The high prevalence and incidence of these pathologies, their high cost of treatment, studies and research, the loss of working hours and all the importance in the quality of life of the people who suffer from them, make this issue of great importance in the present.

Determination of Precise Iris Positioning in Ocular Prosthesis Using an Eyewear

M. P. Manjita, A. A. Meena, C. Vidya, R. Praveen

Recent Developments in Medicine and Medical Research Vol. 8, 29 October 2021, Page 110-115
https://doi.org/10.9734/bpi/rdmmr/v8/4966F

Positioning the iris to the ideal symmetrical position is a critical step in the fabrication of an ocular prosthesis. Any asymmetry in this position leads to a squinted eye look which leaves a psychological impact on the patient.  A correctly placed iris lends a natural and aesthetic appearance to the ocular prosthesis. This case report illustrates the use of transparent graphic grid held in position using a spectacle frame which is easier to use without the need of any assistance.

Study about Wound Healing, Evolution of Cancer and War on Cancer

Ming C. Liau, Linda Liau Baker

Recent Developments in Medicine and Medical Research Vol. 8, 29 October 2021, Page 116-124
https://doi.org/10.9734/bpi/rdmmr/v8/2652E

This review highlights the impact of wound onto the evolution and therapy of cancer. The objective of this review is to explore the mechanism of wound healing and its relationship to the evolution and therapy of cancer. Wound healing requires the proliferation and the terminal differentiation (TD) of progenitor stem cells (PSCs), which are the precursors of cancer stem cells (CSCs).Healing wound is not a big deal. If the functionality of chemo-surveillance is intact such as healthy people who can maintain a steady level of wound healing metabolites functioning as differentiation inducers (DIs) and differentiation helper inducers (DHIs).Wounds are always successfully healed without having to put up any effort, just to let the nature to do the healing. Medications such as suture and antibiotics are subsidiary to speed up the healing or to prevent infection. Acute wound affects the functionality of chemo-surveillance only temporarily, which is quickly recovered to return to the normal state. It is the chronic wound such as persistent infectious diseases or exposure to toxic chemicals including carcinogens for a long time that produces damaging effect on the functionality of chemo-surveillance.Chronic wound prompts the production of inflammatory cytokines to cause excessive urinary excretion of wound healing metabolites to affect wound healing. Without sufficient wound healing metabolites to terminate the proliferation of PCSs, it is very easy for PSCs to evolve into CSCs. It takes only a single hit to silence TET-1 enzyme to complete the transition, which is well within the reach of PSCs equipped with abnormally active methylation enzymes (MEs).CSCs can then progress to faster growing cancer cells by the activation of oncogenes or the inactivation of (AML). Cancer due to wound not healing properly is not unique to MDS and AML. It is rather a common phenomenon. War on cancer can be easily won if the battle is conducted following the nature’s course to heal the wound, just like the success of wound healing without having to put up any effort in healthy people. Therefore, the best strategy to win the war on cancer is to restore the functionality of chemo-surveillance by the employment of DIs and DHIs and to prevent the loss of wound healing metabolites through anti-cachexia chemicals such as phenylacetylglutamine. Then the nature will take its course to stop the proliferation of cells with abnormal MEs that include CSCs, PSCs, and all cancer cells. Destruction strategy to kill cancer cells is definitely counter indication. It creates more damages to the functionality of chemo-surveillance to stop the growth of cells with abnormal MEs. Inability of destruction strategy to put away CSCs is a deciding factor to deny the success of destruction strategy to win the war on cancer.

Lectins are proteins which specifically bind (or crosslink) carbohydrates. Recent studies have shown the importance of glycosylation in pathogenesis of diseases. We detected lectin-positive spherical deposits (SPD), 3-10 micron in diameter, in the molecular layer of dentate gyrus of hippocampus in dementia, Down' s syndrome, and schizophrenia. The present study is aimed at elucidating the nature and significances of SPD in etiology of neuropsychiatric illnesses. In schizophrenia, SPD was observed without exception, regardless of having history of pharmacotherapy. By using multi-labeling histochemical methods, single strand DNA was co-localized in hippocampal SPD of schizophrenia with lectin, including GSI-B4 for galactose, and UEA-I for fucose, suggesting that SPD formation in schizophrenia is related to apoptotic processes. The molecular basis of SPD formation should further be investigated in brains with neuropsychiatric illnesses.

Yogic Help for Anorexia Nervosa: A Recent Study

Mrunmayee Kulkarni

Recent Developments in Medicine and Medical Research Vol. 8, 29 October 2021, Page 139-142
https://doi.org/10.9734/bpi/rdmmr/v8/5256F

Anorexia nervosa is considered as eating disorder which affects a person mentally. It is more often seen in young generation these days who have the fear of gaining weight which thus affects them psychologically. This can be treated either with medication but the following article encourages about how the disorder can be treated using various yoga asanas or positions.

Determination of Clinical Profile of Childhood Extrapulmonary Tuberculosis

Dhara K. Gosai, Jigar B. Gosai, Omprakash S. Shukla

Recent Developments in Medicine and Medical Research Vol. 8, 29 October 2021, Page 143-150
https://doi.org/10.9734/bpi/rdmmr/v8/13884D

Background: Tuberculosis is the world's second leading cause of death from an infectious disease, being second only to AIDS. There is a lack of good data on the prevalence of all types of tuberculosis among children in India; most surveys have focused on pulmonary tuberculosis. The current study aimed to investigate the clinical profile of various types of childhood EPTB. The current study sought to investigate the clinico-epidemiological profile of various forms of childhood EPTB.

Objectives: To observe the agewise distribution of various forms of extrapulmonary tuberculosis in children and to analyse demographic profile and different clinical presentations of childhood extrapulmonary tuberculosis .

Methods: Retrospective analysis of clinical profile of 100 patients of childhood EPTB in the age group of 6 months to 12 years.

Results: In our study, 62 percent of the cases were aged 0-5 years, 38 percent were aged 5-12 years (P = 0.041), with a male to female ratio of 1.9:1. 96 percent (P = 0.016) of the patients belonged to the lower socioeconomic class (P = 0.01). The distribution of EPTB was - TBME (46%), disseminated TB (21%), pleural effusion (12%), abdominal TB (10%), TB lymphadenitis (7%), Osteoarticular (4%). 28% of the patients had mild to moderate malnutrition (PEM Grade-I,II) and 46% (PEM Grade-III,IV) were severely malnourished. 66% of the patient were BCG vaccinated & history of Koch’s contact were present in 28% of the all cases. Fever was present in 97 percent of CNS tuberculosis patients, followed by altered sensorium and convulsion in 80%, tonic posturing in 60%, and abnormal movements in 4%. The most common sign was tonic posturing in 60%, with the crack pot sign positive in 41%. Fever (100%), anorexia (90%), weight loss (80%), abdominal pain (50%), and hepatomegaly were common findings in 100% of cases of abdominal tuberculosis.

Conclusion: Childhood EPTB is most common in children over the age of one year, those from lower socioeconomic classes, and those who are severely malnourished. CNS tuberculosis is characterised by fever, altered sensorium, convulsions, and abnormal movements, whereas abdominal tuberculosis is characterised by fever, anorexia, weight loss, and abdominal pain.

Associations of Serum Fluorescent Advanced Glycation End Products, Glycemic Control, Vascular Complications and Duration of Diabetes Mellitus

Nivedita L. Rao, Greeshma B. Kotian, Shaheena Yasser

Recent Developments in Medicine and Medical Research Vol. 8, 29 October 2021, Page 151-159
https://doi.org/10.9734/bpi/rdmmr/v8/9093D

Introduction: Advanced glycation end products (AGEs), glycemic control and diabetes duration, all have roles in the development of vascular complications that are associated with morbidity and mortality in diabetic patients. Understanding the associations between serum fluorescence of advanced glycation end products, glycemic control, microvascular complications and duration of diabetes mellitus therefore, becomes vital. Significantly higher serum fluorescence of AGEs and higher incidence of microvascular complications have been found in diabetic patients of higher age with poorer glycemic control and longer diabetes duration. Poor glycemic control was associated with disease duration, hypercholesterolemia, high level of low density lipoprotein, hypertension and income level of the patients. Significant positive correlations have been found between serum fluorescence of AGEs, duration of diabetes mellitus, glycated haemoglobin and fasting glucose levels. Observations made from key study findings indicate that intensive glycemic control and therapeutic strategies that target molecular mechanisms involving AGEs are warranted in older patients with longer diabetes duration who are at higher risk of developing diabetic microvascular complications.

Study on Antioxidants and Growth Factors in the Treatment of Alopecia with Injectables

Ana Mery Da Silva Leite, Marcela Sene Fiorese, Force Tefo Thema, E. Marcela Avelina Bataghin Costa

Recent Developments in Medicine and Medical Research Vol. 8, 29 October 2021, Page 160-165
https://doi.org/10.9734/bpi/rdmmr/v8/1949C

Alopecia can be caused by a variety of reasons, both intrinsic (organic) and extrinsic (environmental), including a lack of vitamin complexes, stress, hormonal abnormalities, genetic inheritance, chemical effects, and medication use. The use of antioxidant shampoos and conditioners with hair stimulation has become common practise in Brazil.The most common is androgenetic alopecia (AGA), which causes premature fillet unit ageing, follicle micro-inflammation, and hair growth inhibition. (AGA) is a slow, painless and silent micro-inflammation triggered by factors such as climbing, chemical action caused by the use of cosmetics, body stress, hormonal disorders, menstrual irregularity, weight loss, systemic disease, use of medication to treat cancer and iron deficiency.The hair fibre growth cycle is harmed (catagen, telogen and anagen). So, a low-protein, low-vitamin diet is concerning; a multivitamin supplement is required. Today, medications are regarded as a watershed in the treatment of alopecia, associating a scheduled and targeted active induction technique. When using a mix of LED and Laser therapy, microagulching is vitally crucial. Calculated as men and women's complaints upon exposure to certain aspects of everyday life, as well as a decrease in the creation of reactive elements that might cause disruption and fall. It is recommended that nutritional supplements with antioxidant and anti-fall activity, as well as the use of growth factors, be used, as well as potential in-hibitors of hair ageing and with fall and alopecia. The goal of this study was to conduct a literature review on the scientific background and how aesthetic applications of antioxidants and growth factors in the treatment of alopecia can benefit patients.