Editor(s)
Dr. Richard W. Sawadogo
Senior Research Scientist in Biochemistry and Pharmacology, Institute for Health Sciences Research. Ouagadougou, Burkina Faso.

Short Biosketch

ISBN 978-81-19217-83-0 (Print)
ISBN 978-81-19217-82-3 (eBook)
DOI: 10.9734/bpi/rdmms/v10

This book covers key areas of medicine and medical science. The contributions by the authors include anemia, infertility, neoplasms, periodontitis, periodontitis-systemic disease interactions, stereotyping, androgenetic alopecia, frontotemporal hairline, drug treatments, fermented foods, prebiotics, probiotics, skin microbiome, multisystem inflammatory syndrome, Kawasaki disease, mucocutaneous manifestations,  chronic myeloid leukaemia, myeloproliferative disorder, spontaneous hematoma, superior thoracic artery, axillary artery, median nerve, brachial plexus, ophthalmoplegia, tolosa-hunt syndrome, steroid treatment, arterial stiffness, cardiovascular diseases. This book contains various materials suitable for students, researchers and academicians in the field of medicine and medical science.

 

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Chapters


Impact of Periodontal Disease on Overall Health

Prashanth Balakesavan, Sneha R. Gokhale , Vijay Deshmukh , Ray C. Williams

Research Developments in Medicine and Medical Science Vol. 10, 25 May 2023, Page 1-14
https://doi.org/10.9734/bpi/rdmms/v10/18646D

Periodontitis is a chronic inflammatory condition caused by a mixed microbial infection. It is the outcome of complicated interactions between bacteria and susceptible hosts.  The release of pro-inflammatory cytokines leads to a low grade systemic inflammation that has an effect on the systemic status of the patient. Periodontitis has been associated with several systemic conditions like cardiovascular diseases, diabetes, adverse pregnancy outcomes and respiratory infections. In recent years, the relationship of periodontitis and systemic health has been explored by numerous researchers and it has expanded the horizons of periodontal medicine. This chapter focuses on the effect of periodontitis on infertility, red blood cell parameters, chronic kidney disease, cancer and mortality. Substantial research indicates that oral health is an important component of general health, and individuals with periodontitis may be at risk for other diseases as well.

How Common is Gender Stereotyping among Rural Adolescents? : A Study from Western Maharashtra

Vivek Baliram Waghachavare , Girish Bhimrao Dhumale , Jitesh Hanmantrao Kadam

Research Developments in Medicine and Medical Science Vol. 10, 25 May 2023, Page 15-24
https://doi.org/10.9734/bpi/rdmms/v10/4689B

The present chapter assessed attitudes toward women, gender stereotyping, and gender biases among rural adolescents. Gender stereotyping plays a vital role in vocational choices. Stereotyping is "An oversimplified perception or conception, especially of persons or social groups”.

We conducted a cross-sectional study on 826 rural adolescents from Sept. 2016 to Aug. 2017. Statistical Analysis used descriptive statistics, the chi-square, and the Mann-Whitney U tests.

The mean age of 826 participants was 13.99 years, with 297 (36%) males. There was a significant correlation between all the scales and gender (p<0.05), with better attitudes among females. The participants were more likely to have a positive view toward women (83.9%) and have a positive view toward crime against women (79.1%). However, the majority of them had masculine bias (58.6%) and gender stereotyping (54.6%).  Even though adolescents had a more positive view of women generally, gender bias is still a serious issue.  

Aim: This study aims to investigate the clinical efficacy and safety of DR SKS Hair Growth Booster Serum – cocktail of micronutrients and multivitamins, in male and female patients with androgenic alopecia.

Background:  Androgenic alopecia is frequently encountered in dermatological practice; however, there is a lack of approved treatment. At present, only three therapies have been approved for on-label use in androgenetic alopecia  -minoxidil, finasteride, and lower-level laser therapy. Micronutrients are primary elements in the normal hair follicle cycle, and their role in androgenic alopecia is a growing matter of research nowadays.

Methods: We did a cross-sectional, multicentre, retrospective study across 5 hair clinic chains in India (Mumbai, Hyderabad, Jabalpur, Balaghat and Nagpur). Eligible participants were patients with a confirmed diagnosis of androgenic alopecia, aged 18 years or older and any gender. Each patient received DR SKS Hair Growth Booster Serum, 1 ml in volume, once a month by mesotherapy/dermaroller/dermapen. This therapy lasted six months in total. All patients were subjected to 60-second hair counts test (Comb test), hair pulled test, global photographic assessment, trichoscopy assessment, patient self-assessment questionnaire, and safety assessment at baseline and 6-month after the treatment.

Results: There was a significant reduction in hair fall with bulb (<0.0001) and without bulb (<0.0001) 6-month after the treatment vs baseline. There was a significant improvement in number of hairs removed per pull (<0.0001), global photographic assessment score (<0.0001), hair growth rate (<0.0001), follicular hair density (<0.0001), vellus hair density (<0.0001), and terminal hair density (<0.0001) 6-month after the treatment vs baseline. Majority of patients (98%) were satisfied with six months treatment of DR SKS Hair Growth Booster Serum. No major adverse events were reported during the study.

Conclusion: DR SKS Hair Growth Booster Serum was found to be a safe and effective treatment for androgenic alopecia, with 98% patient self-assessment score.

Skin Microbiome a New Insight in Cosmetic Science-Future Aspects in Management of Skin Diseases and Maintenance of Healthy Skin

R. Chandrasekar , B. Sivagami , M. Niranjan Babu , B. Dharani Rathna , B. M. Bhargav , J. Tejovathi , K. Sowmya , M. Padmavathi , Shaik Mohammad Shareef , S. Diwakar

Research Developments in Medicine and Medical Science Vol. 10, 25 May 2023, Page 39-53
https://doi.org/10.9734/bpi/rdmms/v10/5666C

The human skin contains a diverse range of microorganisms that maintains local immune system in the body. An environmental condition like ultraviolet radiation also causes serious skin conditions. Skin microbiome a new insight in cosmetic technology for maintenance of healthy skin and management of skin diseases such as acute type acne and chronic skin diseases which include inflammatory skin conditions like eczema, (atopic dermatitis), psoriasis, polymorphic light eruption, and graft-versus-host disease (GvHD). The skin disorders caused by UV Radiation are chronic inflammation, immunological modulation, photoaging, skin cancer and skin tanning produced by sunburns, etc. Skin microbiota plays a significant role in maintaining skin tone and managing skin diseases through incorporation of probiotics and prebiotics. Human body contains good and harmful microorganisms which maintain the skin microbiome with the help of probiotics, prebiotics and postbiotics. Probiotics and prebiotics contain friendly bacteria and harmful bacteria present in the human body. Phototherapy a modern treatment used to treat neoplastic skin conditions including cutaneous T cell lymphoma and immunomodulators to maintain immunity in the body. This chapter brings an insight into a significant role of probiotics and prebiotics in the management of skin diseases, antioxidant properties, anti-inflammatory activity, anti-aging, anti-carcinogenic effects. In this chapter, we describe and share the future aspects on the potential advantages of novel treatment approaches that use microbes, probiotics, and prebiotics as modulators of the skin diseases.

Mucocutaneous Manifestations due to Covid-19 in Paediatric Age Group in a Tertiary Care Centre in Southern India: A Retrospective Study

Priyavathani Annie Malathy , S. Thamizhselvi , H. R. Poornima

Research Developments in Medicine and Medical Science Vol. 10, 25 May 2023, Page 54-68
https://doi.org/10.9734/bpi/rdmms/v10/19334D

This study throws light on the diversity in cutaneous manifestations due to COVID-19 in paediatric age group. Mucocutaneous lesions associated with SARS-CoV-2 infection are still under investigation, due to their polymorphic clinical aspect and incompletely understood pathogenic mechanism. Dermatological lesions described during COVID-19 infection can be brought on by a variety of inflammatory cytokines that enter the skin and reach different cells of the cutaneous immune system.

The study was an observational study done on paeadiatric COVID cases aged less than 12 years who were admitted in COVID isolation ward of Institute of Child Health, Rajiv Gandhi Government General Hospital conducted for 3 months from August 2020 to October 2020.

A total of 191 swab-confirmed cases of COVID-19 aged less than 12 years were recruited in the study. Out of 191 cases, 19 had dermatological manifestations (10%). The most common type of dermatological manifestation noted in our study was maculopapular rash (n=8), followed by purpura (n=4), urticaria (n=3), angular cheilitis (n=2), palmar erythema (n=1), purpura with palmar erythema occurring together (n=1). Time latency between onset of first COVID symptom and occurrence of cutaneous lesion was 1 to 7 days. Mucocutaneous manifestations in MIS-C can be diverse with scarlatiniform rashes, morbilliform rashes, urticarial, reticulated eruptions, periorbital erythema and edema, palmoplantar erythema, lip erythema,lip cracking, conjuctival injection.

Children hospitalized with COVID-19 had various mucocutaneous manifestations which dermatologists and paediatricians should be aware of. Kawasaki disease like features during this pandemic should provoke the minds of treating doctors to consider diagnosis of Multisystem Inflammatory Syndrome in Children, thereby enabling timely intervention.

Cranial Ultrasound Evaluation of Normal Neonatal Cerebral Ventricular Dimensions to Establish Multi-parametric Nomograms and Reference Ranges

Niranjan Sahu , Satya Swarup Jena , Alayna Reddy Kandadhi

Research Developments in Medicine and Medical Science Vol. 10, 25 May 2023, Page 69-80
https://doi.org/10.9734/bpi/rdmms/v10/5224C

Present study aimed to determine the normal neonatal cerebral ventricular dimensions to develop reference ranges. Measurement of ventricular size is of prime importance in diagnosing various causes of neonatal ventricular dilatation and evaluating the need for intervention. The ventricular system of the brain is an interconnected series of cavities filled with cerebrospinal fluid (CSF) that cushions the brain. Though the presence of cerebral ventricles was known since ancient times, its function was obscure. A 7.5 MHz or higher transducer is used in case of premature infants. For adequate sound penetration of a larger infant head, 5 MHz transducer is used. High-frequency transducer (5 to 12 MHz) is used to provide high-quality images for scanning of near-field pathology.  Linear regression model was used for correlation. The FHW increased from 1.38 mm at 33 weeks to 1.59 mm at 40 weeks. The linear regression model showed a linear increase in the size with a corresponding increase in gestational age, showing a positive correlation of 0.16 (P value 0.027) which is significant. TOD showed negligible change with increasing gestational age, from 17.24 mm at 33 weeks to 17.17 mm at 40 weeks. The TVW study showed a slight increase in width with increasing age, from 1.20 mm at 33 weeks to 1.45 mm at 40 weeks gestation. VHR showed a negligible change with increasing gestational age, from 0.120 at 33 weeks to 0.100 at 40 weeks. The Levene index showed a slight increase, from 10.30 at 33 weeks to 11.64 at 40 weeks of gestation. When diagnosing pathologic ventricular dilatation and determining whether intervention is necessary, neuro-sonography has legitimate implications for the measurement of ventricular size. For typical preterm and term neonates, nomograms for various parameters (FHW, TOD, TVW, VHR, and Levene index) are established, along with corresponding reference ranges.  

Scapular Region Hematoma in a Chronic Myeloid Leukaemia (CML) Patient: A Rare Case Presentation

Vaibhav Raj Gopal , Akash Srivastava , Neha Yadav, Vineet Kumar Singh

Research Developments in Medicine and Medical Science Vol. 10, 25 May 2023, Page 81-87
https://doi.org/10.9734/bpi/rdmms/v10/10000F

Chronic myeloid leukaemia (CML) is a liquid tumour that occurs due to reciprocal translocation between chromosome   9   and   22   (Philadelphia   chromosome) leading to the birth of a fusion gene bcr-ABL that up- regulates tyrosine kinase activity and inhibits apoptosis. A 26 years male presented with complaints of sudden onset non traumatic spontaneous swelling over the left scapular region and progressively extending up-to the left anterior chest wall which was associated with dull aching moderate intensity pain. Swelling was warm, soft in consistency and tender. He also had hepato-splenomegaly. Myeloid hyperplasia and a noticeable leucocytosis were seen in the overall blood picture. The diagnosis of spontaneous hematoma with CML was confirmed by diagnostic aspiration after a CT scan of the thorax revealed a large hypodense lesion in the scapular and anterior chest wall region. The existing hematoma did not increase in size and no new bleeding complication happened after imatinib commencement. Surgical approach in such cases is selected only in presence of complications like expanding hematoma, superimposed infection, abscess or mass effect at vital locations.

The hematoma was treated conservatively with antibiotics while imatinib therapy was initiated. Without the need for surgery, the swelling went away on its own.

The purpose of this study is to unfold the complexity of brachial plexus. These variations might not affect the functioning of upper limb of that individual but knowledge of these variations will be important to evaluate unexplained sensory or motor loss after trauma or during surgical interventions of upper limb.  Brachial plexus is complex network of nerves that are solely innervated to upper limbs. Information about its variations is important for anatomists, anesthesiologists, clinicians especially for surgeons during surgical explorations of the axilla and the arm region. It represents a rare pathology in the general population, with rates of incidence and prevalence difficult to quantify exactly. Most of these injuries determine relevant motor and sensory impairments of the upper limb, with disability and functional limitations. During routine dissection classes of first year MBBS students, we reported formation of only two trunks i.e. upper trunk (C5 and C6) and lower trunk (C7, C8 and T1) while middle trunk was completely absent in 70 year old male preserved cadaver. Other anomalies of the same plexus were also discovered, such as the fact that all three cords and their branches, regardless of their component parts, lie lateral to the axillary artery. Both musculocutaneous nerve and various lateral cord branches supplied the coracobrachialis.  The superior thoracic artery was encircled by a loop created by the joining of the medial and lateral pectoral nerves. The median nerve's lateral and medial roots were able to communicate with one another.  It also helps the clinicians for post traumatic evaluation and to explore peripheral nerve restoration of upper limb.

Tolosa Hunt Syndrome

Rajesh Hadia , Rahul Trivedi , Cyril Sajan , Varunsingh Saggu , Sunil Baile , Sunil Kardani , Hemraj Singh Rajput

Research Developments in Medicine and Medical Science Vol. 10, 25 May 2023, Page 96-105
https://doi.org/10.9734/bpi/rdmms/v10/6272A

The Tolosa-Hunt syndrome (THS) is an infrequent condition where the third, fourth, and/or sixth cranial nerves are affected by painful ophthalmoplegia due to non-specific inflammation in the cavernous sinus or superior orbital fissure, of an unknown etiology. THS has a yearly estimated incidence of one case per million people.  A 60-year-old male patient with diabetes, who had recently recovered from COVID-19, reported experiencing severe unilateral headache, ptosis, ophthalmoplegia, and vision loss in his right eye for the last 10 days. The patient was diagnosed with Tolosa-Hunt Syndrome, presenting with right-sided headache, periorbital pain, and double vision. Upon examination, he was found to have right-sided ptosis, right-sided trochlear and abducens nerve palsy, and partial right-sided oculomotor nerve palsy with hypoesthesia in the ocular division of the trigeminal nerve. Magnetic resonance imaging demonstrated little proptosis on the right side, as well as modest edema in the right periorbital soft tissues and a tiny enhancing soft tissue in the right cavernous sinus region, implying Tolosa-Hunt Syndrome of the head and orbit.  Steroid treatment provided relief from pain and ptosis within 72 hours, but there was no reversal of vision loss. The patient was discharged after 7 days with the headache subsiding. This case appears to be the first reported occurrence of Tolosa-Hunt Syndrome in Vadodara, Gujarat, India. Tolosa-Hunt Syndrome is diagnosed based on clinical presentation, normal tests, and magnetic resonance imaging and is treated with intravenous methylprednisolone (40 mg) once a day and other supportive care therapy. The syndrome is characterized by recurrent unilateral orbital pain, ipsilateral oculomotor paralysis, and a quick response to steroids.

Arterial stiffness exerts a number of adverse effects on whole body functions and disease risk, associated with mortality, recognized as a critical precursor of cardiovascular diseases. It is very much essential to understand the role of integrated approach of yoga therapy (IAYT) on preventing and reversing arterial stiffening. Physiological rectification includes participating daily in physical exercise, yoga & pranayama, performing aerobic exercise, taking satvic food, dealing honestly with others and joining for communal activities will bring parasympathetic in picture which only can reduce arterial stiffness. As per literature significant alterations to IAYT, are found in child hood period as compared to medium or old aged individuals. Readers are requested to read and understand the mechanism behind advantages of IAYT and how IAYT can bring down the arterial stiffness more in children than in aged subjects.

Assessment of Digital Panoramic Radiographs in Saudi Population: A Study based on Kvaal's Method

Hosam Samir Alharbi , Ahmad Majed Alharbi , K. Shaul Hameed, Ramy Elmoazen , Abdulmajeed Obaid Alenazi

Research Developments in Medicine and Medical Science Vol. 10, 25 May 2023, Page 143-153
https://doi.org/10.9734/bpi/rdmms/v10/4807E

This study aims to use Kvaal's method to estimate the chronological age of patients using digital panoramic radiographs and verify the validity of regression equations proposed by Kvaal et al. in the Saudi population. In forensic science, age estimation, particularly age estimation utilizing teeth, plays a significant role in identifying unknown human bodies. The emergence of second molars is thought to have been used by the Romans to assess draught eligibility. Kvaal et al. published a new approach for calculating the chronological age of individuals based on the age-pulp size relationship on periapical dental radiographs in 1995. Digital panoramic radiographs are commonly employed in dental practice because they allow for the acquisition of pictures of six teeth in one ray. There was no statistical difference between the assessed and chronological ages when the Kvaal approach was applied to Saudi members. A total of 74 digital orthopantomograms were randomly selected from Qassim University dental clinic in Saudi Arabia, ranging in age from 18 to 64 years (mean age 32 years). The radiographs were taken in between 2018-2021 according to inclusion and exclusion criteria. Age estimation with dental radiographs, in particular, is noninvasive and can be utilized for both the living and the dead. Most age estimations based on dental radiographs employ the decrease in pulp cavity due to aging, as described by Kvaal et al. utilizing periapical radiograph. As per this investigation, a future examination should utilize an enormous example size with a good portrayal of tests from different age groups, nationalities, and genders.

Using of PCR Technique for Prenatal Diagnosis of Sickle Cell Disease

Praneeta J. Singh, A. C. Shrivastava, A. V. Shrikhande

Research Developments in Medicine and Medical Science Vol. 10, 25 May 2023, Page 154-172
https://doi.org/10.9734/bpi/rdmms/v10/5249E

In present study, prenatal diagnostic facility for couples carrying sickle cell gene was established with the aim to prevent birth of affected fetus and to calculate the sensitivity of ARMS-PCR by comparing results with baby’s Hemoglobin pattern on follow up HPLC. Sickle cell disease (SCD) is common in Central India and causes significant morbidity and mortality. There is a scarcity of prenatal diagnostic facilities in close proximity to the SCD population. This is a pilot study in our region with the goal of establishing a prenatal diagnostic facility in Central India for couples carrying the sickle cell gene in order to help them make an informed decision about a foetus affected with SCD, as well as calculating the sensitivity of the polymerase chain reaction (PCR) technique in our setup with follow-up high performance liquid chromatography (HPLC) of the baby's blood sample. Follow-up HPLC was done to detect baby’s Hb pattern. Prenatal diagnosis of sickle cell anemia was offered in total 37 cases out of which one (2.7%) fetal sample was inadequate. Total 26 (70.27%) fetuses had AS Hb genotype, 3 (8.11%) had AA Hb genotype and 3 (8.11%) had SS Hb genotype while remaining 4 (10.81%) were given AA/AS Hb genotype. All couples with SS fetuses opted for MTP. Follow up HPLC was performed in 24 cases, out of which 18 (75%) were correlated and 6 (25%) were mismatched. In present study sensitivity of ARMS-PCR was 75%. ARMS-PCR is a simple technique to be established initially for providing rapid prenatal diagnosis to the couples with known sickle cell mutation. The sensitivity of ARMS-PCR can be increased by using suitable techniques to detect maternal cell DNA on society can thus be reduced by sensitising couples with the sickle cell gene through proper genetic counselling and providing the option of Medical Termination of Pregnancy for affected foetuses. More couples will benefit in the future if we raise awareness about the safety and efficacy of modern prenatal diagnostic techniques.