Journal of Acute Disease
Issue 1,2013 Table of Contents
2013(1):1-12.
DOI: 10.1016/S2221-6189(13)60087-6
Abstract:
Magnetic microspheres hold great promise for reaching the goal of controlled and site specific drug delivery. Magnetic microspheres as an alternative to traditional radiation methods which uses highly penetrating radiations that is absorbed throughout the body. I ts use is limited by toxicity and side effects. Now days, several targeted treatment systems including magnetic field, electric field, ultrasound, temperature, UV light and mechanical force are being used in many disease treatments ( e.g. cancer, nerve damage, heart and artery, anti-diabetic, eye and other medical treatments ) . Among them, the magnetic targeted drug delivery system is one of the most attractive and promising strategy for delivering the drug to the specified site. Magnetically controlled drug targeting is one of the various possible ways of drug targeting. This technology is based on binding establish anticancer drug with ferrofluid that concentrate the drug in the area of interest ( tumor site ) by means of magnetic fields. There has been keen interest in the development of a magnetically target drug delivery system. These drug delivery systems aim to deliver the drug at a rate directed by the needs of the body during the period of treatment, and target the activity entity to the site of action. Magnetic microspheres were developed to overcome two major problems encountered in drug targeting namely: RES clearance and target site specificity.
Magnetic microspheres hold great promise for reaching the goal of controlled and site specific drug delivery. Magnetic microspheres as an alternative to traditional radiation methods which uses highly penetrating radiations that is absorbed throughout the body. I ts use is limited by toxicity and side effects. Now days, several targeted treatment systems including magnetic field, electric field, ultrasound, temperature, UV light and mechanical force are being used in many disease treatments ( e.g. cancer, nerve damage, heart and artery, anti-diabetic, eye and other medical treatments ) . Among them, the magnetic targeted drug delivery system is one of the most attractive and promising strategy for delivering the drug to the specified site. Magnetically controlled drug targeting is one of the various possible ways of drug targeting. This technology is based on binding establish anticancer drug with ferrofluid that concentrate the drug in the area of interest ( tumor site ) by means of magnetic fields. There has been keen interest in the development of a magnetically target drug delivery system. These drug delivery systems aim to deliver the drug at a rate directed by the needs of the body during the period of treatment, and target the activity entity to the site of action. Magnetic microspheres were developed to overcome two major problems encountered in drug targeting namely: RES clearance and target site specificity.
2013(1):13-21.
DOI: 10.1016/S2221-6189(13)60088-8
Abstract:
In India, indigenous remedies have been used in treatment of sexual dysfunction since the time of Charaka and Sushruta. Plants have been always an exemplary source of drugs and many of the currently available drugs have been derived directly or indirectly from them. An aphrodisiac is defined as an agent that arouses sexual desire. Erectile dysfunction or sexual dysfunction ( ED or SD ) or male impotence is defined as the inability of a man to achieve and maintain an erection sufficient for mutually satisfactory intercourse with his partner. Sexual health and function are important determinants of quality of life. To overcome the problem of male sexual ( or ) erectile dysfunction, various Indian natural aphrodisiac plants potentials were preferred. The ethnobotanical information reports that about 200 plants possess aphrodisiac potential. Out of several Indian medicinal plants, 33 plants were reviewed. I n this review, studies on Indian medicinal plants were reviewed and their possible therapeutic applications were discussed. This review discusses about aphrodisiac potential of Indian medicinal plants, its botanical name, common name, family, extract, models used, part used and references, which are helpful for researchers to develop new herbal aphrodisiac formulations. In the recent years, interest in drugs of plant origin has been progressively increased.
In India, indigenous remedies have been used in treatment of sexual dysfunction since the time of Charaka and Sushruta. Plants have been always an exemplary source of drugs and many of the currently available drugs have been derived directly or indirectly from them. An aphrodisiac is defined as an agent that arouses sexual desire. Erectile dysfunction or sexual dysfunction ( ED or SD ) or male impotence is defined as the inability of a man to achieve and maintain an erection sufficient for mutually satisfactory intercourse with his partner. Sexual health and function are important determinants of quality of life. To overcome the problem of male sexual ( or ) erectile dysfunction, various Indian natural aphrodisiac plants potentials were preferred. The ethnobotanical information reports that about 200 plants possess aphrodisiac potential. Out of several Indian medicinal plants, 33 plants were reviewed. I n this review, studies on Indian medicinal plants were reviewed and their possible therapeutic applications were discussed. This review discusses about aphrodisiac potential of Indian medicinal plants, its botanical name, common name, family, extract, models used, part used and references, which are helpful for researchers to develop new herbal aphrodisiac formulations. In the recent years, interest in drugs of plant origin has been progressively increased.
2013(1):22-28.
DOI: 10.1016/S2221-6189(13)60089-X
Abstract:
Objective: To Ananus comosus (A. comosus), has demonstrated a wide variety of biological activities which make it a good plant source for the treatment of many oxidative stress mediated diseases. The present study was aimed to evaluate therapeutic potential by assaying the activities of oxidative stress parameters in 7 , 12 dimethylbenz ( α ) anthracene induced breast cancer rats. Methods: A nimals were divided into five groups of six animals. Group I served as control, group II induced mammary carcinogenesis by 7 , 12 dimethylbenz ( α ) anthracene, group III and IV are treatment groups ( plant extract 250 mg/kg body weight and standard drug 10 mg/kg body weight ) and group Vserved as animals treated with plant extract alone. All the animals were sacrificed after 30 days treatment and breast tissues are used for the analysis of protein content, enzymic and non-enzymic antioxidants using standard protocols. Results: The oral administrations of ethanolic peel extract of A. comosus ( 250 mg/kg body weight ) to breast cancer bearing rats for 30 days demonstrated a significant ( P<0 . 05 ) increased in body weight, tissue weight, protein content, enzymatic and non enzymatic levels. The altered activities of lipid peroxidation and tumor weight in breast tissue of control and experimental cancer bearing rats were significantly ( P<0 . 05 ) were reverted to near normal levels by the administration of ethanolic extract suggesting that the extract have quenching capacity against free radicals thereby exhibiting anticancer potential of A. comosus in breast cancer bearing rats. Conclusions: Thus, modulatory effects of A. comosus on attenuating the lipid peroxidation and upregulation of oxidative stress key enzymes like enzymatic and non-enzymatic antioxidants, protein content afford a pledge for widespread use for the treatment of breast cancer in the future.
Objective: To Ananus comosus (A. comosus), has demonstrated a wide variety of biological activities which make it a good plant source for the treatment of many oxidative stress mediated diseases. The present study was aimed to evaluate therapeutic potential by assaying the activities of oxidative stress parameters in 7 , 12 dimethylbenz ( α ) anthracene induced breast cancer rats. Methods: A nimals were divided into five groups of six animals. Group I served as control, group II induced mammary carcinogenesis by 7 , 12 dimethylbenz ( α ) anthracene, group III and IV are treatment groups ( plant extract 250 mg/kg body weight and standard drug 10 mg/kg body weight ) and group Vserved as animals treated with plant extract alone. All the animals were sacrificed after 30 days treatment and breast tissues are used for the analysis of protein content, enzymic and non-enzymic antioxidants using standard protocols. Results: The oral administrations of ethanolic peel extract of A. comosus ( 250 mg/kg body weight ) to breast cancer bearing rats for 30 days demonstrated a significant ( P<0 . 05 ) increased in body weight, tissue weight, protein content, enzymatic and non enzymatic levels. The altered activities of lipid peroxidation and tumor weight in breast tissue of control and experimental cancer bearing rats were significantly ( P<0 . 05 ) were reverted to near normal levels by the administration of ethanolic extract suggesting that the extract have quenching capacity against free radicals thereby exhibiting anticancer potential of A. comosus in breast cancer bearing rats. Conclusions: Thus, modulatory effects of A. comosus on attenuating the lipid peroxidation and upregulation of oxidative stress key enzymes like enzymatic and non-enzymatic antioxidants, protein content afford a pledge for widespread use for the treatment of breast cancer in the future.
2013(1):29-32.
DOI: 10.1016/S2221-6189(13)60090-6
Abstract:
Objective: To examine the possible sub-acute toxic effect after 14 d oral administration with 0.3 g/kg, 0.6 g/kg and 0.9 g/kg of methanol leaves extract of Clinacanthus nutans (C. nutans) on liver and kidney functions in young male Sprague Dawley (SD) rats. Methods: This study was carried out according to OECD 407 guideline. A total of 24 young healthy male SD rats aged between 8-12 weeks old were used throughout the experiments. Each group consisted of six rats (n=6). All animals were observed twice daily until day-14. Body weight, food consumption and water intake were measured on day-3, 7 and day-14. Blood samples were collected and used to analyse the serum levels of AST, ALT, ALP, bilirubins, urea and creatinine in rats. Relative organ weights for liver, kidney, heart, spleen and lung were calculated. Results: From the results obtained, all the serum biochemical parameters, food and water intake, relative organs weight showed no significant changes when compared to the control group. No lethality and abnormal behavioural changes were seen in both control and treatment groups during experiment. Conclusions: For conclusion, repeatedly dosing of C. nutans extract at 0.3g/kg, 0.6g/kg and 0.9 g/kg up to 14 d was proven safe in male SD rats without causing any adverse effects and organ damages in male SD rats.
Objective: To examine the possible sub-acute toxic effect after 14 d oral administration with 0.3 g/kg, 0.6 g/kg and 0.9 g/kg of methanol leaves extract of Clinacanthus nutans (C. nutans) on liver and kidney functions in young male Sprague Dawley (SD) rats. Methods: This study was carried out according to OECD 407 guideline. A total of 24 young healthy male SD rats aged between 8-12 weeks old were used throughout the experiments. Each group consisted of six rats (n=6). All animals were observed twice daily until day-14. Body weight, food consumption and water intake were measured on day-3, 7 and day-14. Blood samples were collected and used to analyse the serum levels of AST, ALT, ALP, bilirubins, urea and creatinine in rats. Relative organ weights for liver, kidney, heart, spleen and lung were calculated. Results: From the results obtained, all the serum biochemical parameters, food and water intake, relative organs weight showed no significant changes when compared to the control group. No lethality and abnormal behavioural changes were seen in both control and treatment groups during experiment. Conclusions: For conclusion, repeatedly dosing of C. nutans extract at 0.3g/kg, 0.6g/kg and 0.9 g/kg up to 14 d was proven safe in male SD rats without causing any adverse effects and organ damages in male SD rats.
2013(1):33-36.
DOI: 10.1016/S2221-6189(13)60091-8
Abstract:
Objective: To investigate glucose utilization capacity of bioactivity guided fractions of Hybanthus enneaspermus ( H. enneaspermus ) and Pedalium murex ( P. murex ) in isolated rat hemidiaphragm. Methods: Dried coarsely powdered plant material was extracted in ethanol using soxhlation technique, further extract was fractionated using solvents of varying polarity. Glucose utilization capacity of bioactivity guided fractions using isolated rat hemidiaphragm was performed in the present study. Results: The entire tested fraction showed increased glucose uptake capacity, and was found to be maximum in case of chloroform fraction of P. murex extract ( CHPM ) which was quite comparable to standard insulin ( P< 0 . 05 ) . Conclusions: In vitro glucose uptake by hemidiaphragm study showed increased utilization of the glucose by hemidiaphragm in the presence of different fractions. From these findings we can conclude that that different fraction of both plant materials had some extra pancreatic mechanism like glucose uptake by peripheral tissues
Objective: To investigate glucose utilization capacity of bioactivity guided fractions of Hybanthus enneaspermus ( H. enneaspermus ) and Pedalium murex ( P. murex ) in isolated rat hemidiaphragm. Methods: Dried coarsely powdered plant material was extracted in ethanol using soxhlation technique, further extract was fractionated using solvents of varying polarity. Glucose utilization capacity of bioactivity guided fractions using isolated rat hemidiaphragm was performed in the present study. Results: The entire tested fraction showed increased glucose uptake capacity, and was found to be maximum in case of chloroform fraction of P. murex extract ( CHPM ) which was quite comparable to standard insulin ( P< 0 . 05 ) . Conclusions: In vitro glucose uptake by hemidiaphragm study showed increased utilization of the glucose by hemidiaphragm in the presence of different fractions. From these findings we can conclude that that different fraction of both plant materials had some extra pancreatic mechanism like glucose uptake by peripheral tissues
2013(1):37-39.
DOI: 10.1016/S2221-6189(13)60092-X
Abstract:
Objective: To develop and explore the use of PEG ylated poly ( propylene imine ) dendritic architecture for the delivery of an anti bacterial bioactive, Trimethoprim. Methods: For this study, PEG ylated poly ( propylene imine ) dendritic architecture was synthesized and loaded with Trimethoprim and targeted to the resistant producing strains of both gram positive and gram negative. The antibacterial activity was carried out by agar well-diffusion method to compare zone of inhibition with standard drug and plain PPI dendrimer. Results: The study showed that the Trimethoprim loaded dendrimer has significant antibacterial activity than the plain PPI dendrimer, but standard drug was not shown zone of inhibition upon both microorganisms but Klebsiella pneumoniae ( K. pneumoniae ) the pure drug showed activity. Conclusions: In this study antibacterial activity of synthesized system is also relatively safer and holds potential to deliver any other antibacterial agent to the resistant producing strains.
Objective: To develop and explore the use of PEG ylated poly ( propylene imine ) dendritic architecture for the delivery of an anti bacterial bioactive, Trimethoprim. Methods: For this study, PEG ylated poly ( propylene imine ) dendritic architecture was synthesized and loaded with Trimethoprim and targeted to the resistant producing strains of both gram positive and gram negative. The antibacterial activity was carried out by agar well-diffusion method to compare zone of inhibition with standard drug and plain PPI dendrimer. Results: The study showed that the Trimethoprim loaded dendrimer has significant antibacterial activity than the plain PPI dendrimer, but standard drug was not shown zone of inhibition upon both microorganisms but Klebsiella pneumoniae ( K. pneumoniae ) the pure drug showed activity. Conclusions: In this study antibacterial activity of synthesized system is also relatively safer and holds potential to deliver any other antibacterial agent to the resistant producing strains.
2013(1):40-43.
DOI: 10.1016/S2221-6189(13)60093-1
Abstract:
Objective: To investigate the conventional technique involves treatment of femoral hernia an approximation inguinal ligament to pectineal ligament. In technique which uses mesh closure for femoral canal without tissue tension. Method: A prospective study from January 01. 2007-May 30. 2009. We analyzed 1 042 patients with inguinal hernia, of which there were 83 patients with 86 femoral hernia. Result: Femoral hernias were present in 7 . 96 % of cases. Males were 13 (15. 66 %) and 70 women (84. 34 %) . The gender distribution of men: women is 1 : 5.38 . Urgent underwent 69 (83 %) , and the 14 election (17 %) patients. A verage age was 63 years, the youngest patient was a 24 and the oldest 86 years. Ratio of right: left hernias was 3.4 : 1. With bilateral femoral hernias was 3. 61 % of cases. In 7 patients (8. 43 %) underwent femoral hernia repair with 9 Prolene plug. Conclusions: The technique of closing the femoral canal with plug a simple. The plug is made from monofilament material and is easily formed. This technique allows the reduction of recurrence and can be used safely, quickly and easily in elective and emergency situations.
Objective: To investigate the conventional technique involves treatment of femoral hernia an approximation inguinal ligament to pectineal ligament. In technique which uses mesh closure for femoral canal without tissue tension. Method: A prospective study from January 01. 2007-May 30. 2009. We analyzed 1 042 patients with inguinal hernia, of which there were 83 patients with 86 femoral hernia. Result: Femoral hernias were present in 7 . 96 % of cases. Males were 13 (15. 66 %) and 70 women (84. 34 %) . The gender distribution of men: women is 1 : 5.38 . Urgent underwent 69 (83 %) , and the 14 election (17 %) patients. A verage age was 63 years, the youngest patient was a 24 and the oldest 86 years. Ratio of right: left hernias was 3.4 : 1. With bilateral femoral hernias was 3. 61 % of cases. In 7 patients (8. 43 %) underwent femoral hernia repair with 9 Prolene plug. Conclusions: The technique of closing the femoral canal with plug a simple. The plug is made from monofilament material and is easily formed. This technique allows the reduction of recurrence and can be used safely, quickly and easily in elective and emergency situations.
2013(1):44-47.
DOI: 10.1016/S2221-6189(13)60094-3
Abstract:
Objective: The older population is one of the fastest growing segments of Serbian society. The aging population is also present in developed countries. Demographics the oldest region in the world is Europe. Serbia by the number colorectal cancer suffering among the countries with high risk of disease. In 2006, the number of new cases was around 4 000. Methods: In study retrospective review of 81 patients with malignant obstruction of the left-sided colon, where it underwent a total colectomy. Symptoms and signs of acute obstruction of the left-sided colon are complemented with radiological examination in all patients. The compulsory part of the preoperative examination digitorectal exam how to assess the function of the sphincter apparatus in terms of continence, and to view the rectum and the exclusion of the tumor. In poorly functioning sphincter apparatus was performed Hartmann's procedure, in order to avoid postoperative incontinence. Results: The primary anastomosis rate of 81 % in the elderly and 83 % of younger patients. In younger group 31 patients underwent a total colectomy with anastomosis and 6 total colectomy with end ileostomy. In older group there were 36 total colectomy with anastomosis and 8 with total colectomy with end ileostomy. A nastomotic leak occurred in 4 patients of elderly group and 2 patients in the younger group. Mortality (30 d) in the older group was 3 patients who had ASA IV, and younger group 2 patients (1 patient ASA III , 1 patients ASA IV). Of the 3 patients died from the older group, 2 patients were end ileostomy. Conclusions: Emergency resection and primary anastomosis for left-sided colon carcinoma can be performed with favorable outcome in the elderly. Years of age are not a decisive prognostic factor in colorectal surgery. The surgeon has a duty of careful selection of patients for resection with anastomosis for malignant obstruction of the left-sided colon, with adequate preoperative preparation and postoperative monitoring.
Objective: The older population is one of the fastest growing segments of Serbian society. The aging population is also present in developed countries. Demographics the oldest region in the world is Europe. Serbia by the number colorectal cancer suffering among the countries with high risk of disease. In 2006, the number of new cases was around 4 000. Methods: In study retrospective review of 81 patients with malignant obstruction of the left-sided colon, where it underwent a total colectomy. Symptoms and signs of acute obstruction of the left-sided colon are complemented with radiological examination in all patients. The compulsory part of the preoperative examination digitorectal exam how to assess the function of the sphincter apparatus in terms of continence, and to view the rectum and the exclusion of the tumor. In poorly functioning sphincter apparatus was performed Hartmann's procedure, in order to avoid postoperative incontinence. Results: The primary anastomosis rate of 81 % in the elderly and 83 % of younger patients. In younger group 31 patients underwent a total colectomy with anastomosis and 6 total colectomy with end ileostomy. In older group there were 36 total colectomy with anastomosis and 8 with total colectomy with end ileostomy. A nastomotic leak occurred in 4 patients of elderly group and 2 patients in the younger group. Mortality (30 d) in the older group was 3 patients who had ASA IV, and younger group 2 patients (1 patient ASA III , 1 patients ASA IV). Of the 3 patients died from the older group, 2 patients were end ileostomy. Conclusions: Emergency resection and primary anastomosis for left-sided colon carcinoma can be performed with favorable outcome in the elderly. Years of age are not a decisive prognostic factor in colorectal surgery. The surgeon has a duty of careful selection of patients for resection with anastomosis for malignant obstruction of the left-sided colon, with adequate preoperative preparation and postoperative monitoring.
Nora Burda
,
Vilma Mema
,
Ejup Mahmudi
,
Brikena Selimi
,
Sulejman Zhugli
,
Basri Lenajni
,
Illaz Bunjaku
2013(1):48-51.
DOI: 10.1016/S2221-6189(13)60095-5
Abstract:
Objective: The purpose of the study is to prescribe and analyze the correlation of dry eye and Diabetes Mellitus Tip II , at Polyclinic of Specialties Nr. 2 Ophthalmology service, between May 2011 and June 2012. Methods: A total number of 223 patients diagnosed with Diabetes Mellitus Tip II underwent ocular examinations including 120 male and 103 female, aged from 24-73 years old. To confirm the presence of diabetes among these patients fasting blood glucose level was performed (normal limit <110 mg/dL ). History of disease, duration of diabetes, age, and sex was obtained by reviewing the medical records and direct patient interview. Also the patients complains: tearing photophobia, red eye, itching, foreign body sensation, blurred vision was recorded. From the study were excluded all conditions which affects the tear film stability and contact lens wearer. Results: A total of 118 patients (58 male/61 female) were diagnosed with dry eye syndrome of varying degrees. The diagnosis was made by heaving two or more positive tests performed as mentioned above, and referring to patients complains. Fourteen patients represent pinpoint corneal dye with fluorosceini, forty-six patients was positive to cotton swab test diminution of corneal sensitivity, eighty-nine patients was positive to Schirmmer test less than 10 mm, positive TBUT test less than 9 s was found to be the amount of seventy-one patients. Positive tear meniscus at inferior lid margin was found at fifty-six patients. Dry eye is a disorder of tear film because of tear deficiency or excessive tear evaporation which causes damage to the inter palpaberal ocular surface and is associated with symptoms of ocular discomfort. This ocular disorder is very common among general population with 28 % of the adults having dry eye syndrome. Early diagnosis and timely treatment, complications as secondary microbial infection and corneal ulceration could be avoided.Conclusions: In our study the Dry Eye Syndrome showed to have a high correlation with Diabetes Mellitus Tip II (about 52.9 %). Prevalence of Dry Eye was significantly higher at patients with longer duration of diabetes. Dry Eye seems to be an important contributing factor related to corneal abnormalities. Age and sex not seem to play any important role in this condition. Good glycemic control is important for prevention and control of Dry Eye Syndrome.
Objective: The purpose of the study is to prescribe and analyze the correlation of dry eye and Diabetes Mellitus Tip II , at Polyclinic of Specialties Nr. 2 Ophthalmology service, between May 2011 and June 2012. Methods: A total number of 223 patients diagnosed with Diabetes Mellitus Tip II underwent ocular examinations including 120 male and 103 female, aged from 24-73 years old. To confirm the presence of diabetes among these patients fasting blood glucose level was performed (normal limit <110 mg/dL ). History of disease, duration of diabetes, age, and sex was obtained by reviewing the medical records and direct patient interview. Also the patients complains: tearing photophobia, red eye, itching, foreign body sensation, blurred vision was recorded. From the study were excluded all conditions which affects the tear film stability and contact lens wearer. Results: A total of 118 patients (58 male/61 female) were diagnosed with dry eye syndrome of varying degrees. The diagnosis was made by heaving two or more positive tests performed as mentioned above, and referring to patients complains. Fourteen patients represent pinpoint corneal dye with fluorosceini, forty-six patients was positive to cotton swab test diminution of corneal sensitivity, eighty-nine patients was positive to Schirmmer test less than 10 mm, positive TBUT test less than 9 s was found to be the amount of seventy-one patients. Positive tear meniscus at inferior lid margin was found at fifty-six patients. Dry eye is a disorder of tear film because of tear deficiency or excessive tear evaporation which causes damage to the inter palpaberal ocular surface and is associated with symptoms of ocular discomfort. This ocular disorder is very common among general population with 28 % of the adults having dry eye syndrome. Early diagnosis and timely treatment, complications as secondary microbial infection and corneal ulceration could be avoided.Conclusions: In our study the Dry Eye Syndrome showed to have a high correlation with Diabetes Mellitus Tip II (about 52.9 %). Prevalence of Dry Eye was significantly higher at patients with longer duration of diabetes. Dry Eye seems to be an important contributing factor related to corneal abnormalities. Age and sex not seem to play any important role in this condition. Good glycemic control is important for prevention and control of Dry Eye Syndrome.
10 Incidence of the refractive errors in children 3 to 9 years of age, in the city of Tetovo, Macedonia
2013(1):52-55.
DOI: 10.1016/S2221-6189(13)60096-7
Abstract:
Objective: To determine the incidence of refractive errors at children 3 to 9 years of age in the area of Tetovo, Macedonia in rural and urban population. Methods: Population-based cross-sectional samples of children 3 to 9 years in rural and urban population were obtained through full ophthalmologic examination, and they underwent slit-lamp examination, ocular motility and refraction. They were presenting uncorrected and best-corrected visual acuity, along with refractive error under topical cycloplegia. Children 3 to 6 years of age with a visual acuity of 20/40 or worse and those 6 to 9 years of age with a visual acuity of 20/30 or worse underwent a complete ophthalmic examination to determine the cause of visual impairment. A spherical equivalent of -0.5 diopter (D) or worse was defined as myopia, +2.50 D or more was defined as hyperopia and a cylinder refraction greater than 0.75 D was considered astigmatism plus or minus. Results: The uncorrected visual acuity was 20/45 or worse in the better eye of 119 children, 59 male/ 60 female (5.1 % of participants). A ccording to results of cycloplegic refraction, 1.6 % of the children were myopic, 7.3 % were hyperopic and the incidence rate of astigmatism was approximately 0.7 %. In the multivariate logistic regression myopia and hyperopia were correlated with age (P=0.040 and P<0.002, respectively ). Conclusions: The study showed a considerable prevalence rates of refractive errors myopia, hypermethropia, astigmatism and amblyopia at children of 3-9 years of age in Tetovo. There was no correlation between sex of the children’s and the refractive errors founds. There was a correlation with the need for corrective spectacles and the refractive errors they represent. Refractive errors was registered in high percentage at rural area than in urban area. Although with best corrected vision the prevalence of impairment was less in urban than in rural populations, blindness remained nearly twice as high in the rural population as in the urban population with both baseline and best corrected visual acuity.
Objective: To determine the incidence of refractive errors at children 3 to 9 years of age in the area of Tetovo, Macedonia in rural and urban population. Methods: Population-based cross-sectional samples of children 3 to 9 years in rural and urban population were obtained through full ophthalmologic examination, and they underwent slit-lamp examination, ocular motility and refraction. They were presenting uncorrected and best-corrected visual acuity, along with refractive error under topical cycloplegia. Children 3 to 6 years of age with a visual acuity of 20/40 or worse and those 6 to 9 years of age with a visual acuity of 20/30 or worse underwent a complete ophthalmic examination to determine the cause of visual impairment. A spherical equivalent of -0.5 diopter (D) or worse was defined as myopia, +2.50 D or more was defined as hyperopia and a cylinder refraction greater than 0.75 D was considered astigmatism plus or minus. Results: The uncorrected visual acuity was 20/45 or worse in the better eye of 119 children, 59 male/ 60 female (5.1 % of participants). A ccording to results of cycloplegic refraction, 1.6 % of the children were myopic, 7.3 % were hyperopic and the incidence rate of astigmatism was approximately 0.7 %. In the multivariate logistic regression myopia and hyperopia were correlated with age (P=0.040 and P<0.002, respectively ). Conclusions: The study showed a considerable prevalence rates of refractive errors myopia, hypermethropia, astigmatism and amblyopia at children of 3-9 years of age in Tetovo. There was no correlation between sex of the children’s and the refractive errors founds. There was a correlation with the need for corrective spectacles and the refractive errors they represent. Refractive errors was registered in high percentage at rural area than in urban area. Although with best corrected vision the prevalence of impairment was less in urban than in rural populations, blindness remained nearly twice as high in the rural population as in the urban population with both baseline and best corrected visual acuity.
2013(1):56-60.
DOI: 10.1016/S2221-6189(13)60097-9
Abstract:
Objective: To compare our institution with national benchmark times, and identify rate-limiting steps in the process by conducte a retrospective review of the turnaround times in 2009 at the Carilion Clinic Breast Care Center (CCBCC). To evaluate patient satisfaction with the turn around times. Methods: A retrospective chart review was performed to evaluate the time intervals from abnormal screening mammogram to diagnostic mammogram, diagnostic mammogram to biopsy, biopsy to MRI, and MRI to surgery of all patients seen for breast cancer in 2009. A patient survey was mailed out to all patients (131) managed from abnormal screening to surgery in 2009, assessing their satisfaction with the turnaround times from screening mammogram to call back, call back to diagnostic mammogram, diagnostic mammogram to biopsy, biopsy to results call, biopsy result to MRI appointment, MRI appointment to surgery consult, and surgery consult to surgery; and assessing possible reasons why patients may perceive the process to be delayed. The MEANS procedure was applied to evaluate the turnaround times, and a Box and Whisker Plot statistical comparison was made between patient satisfaction and turnaround times. Results: The mean turnaround time at the CCBCC in 2009 from abnormal screening mammogram to surgery was 45 d. This falls within the 75th %ile of the National Quality Measures for Breast Centers (NQMBC), established by the National Consortium of Breast Centers (NCBC). Of 131 surveys mailed out, 57 were returned (44%). The patient satisfaction rates for each interval ranged from 96%-100%, with an overall satisfaction rate of 98% for abnormal screening mammogram to surgery. Discussion: The CCBCC ranks at the 75% ile in overall turnaround times; however, this turnaround time included an interval of MRI, not previously measured in NQMBC benchmark. Rate-limiting steps were identified as the time from screening mammogram to diagnostic mammogram, and biopsy to surgery-specifically, the sub-interval MRI to surgery. Since 2009, the CCBCC has already improved the process for obtaining insurance approval and preauthorization for MRIs; and has added an additional breast surgeon to share the burden of benign cases, and a nurse practitioner to see post-op and follow up patients, improving the accessibility to the primary breast surgeon specialist. Consideration should be given to future time interval studies that evaluate breast cancer turnaround time including MRI to help establish benchmarks.
Objective: To compare our institution with national benchmark times, and identify rate-limiting steps in the process by conducte a retrospective review of the turnaround times in 2009 at the Carilion Clinic Breast Care Center (CCBCC). To evaluate patient satisfaction with the turn around times. Methods: A retrospective chart review was performed to evaluate the time intervals from abnormal screening mammogram to diagnostic mammogram, diagnostic mammogram to biopsy, biopsy to MRI, and MRI to surgery of all patients seen for breast cancer in 2009. A patient survey was mailed out to all patients (131) managed from abnormal screening to surgery in 2009, assessing their satisfaction with the turnaround times from screening mammogram to call back, call back to diagnostic mammogram, diagnostic mammogram to biopsy, biopsy to results call, biopsy result to MRI appointment, MRI appointment to surgery consult, and surgery consult to surgery; and assessing possible reasons why patients may perceive the process to be delayed. The MEANS procedure was applied to evaluate the turnaround times, and a Box and Whisker Plot statistical comparison was made between patient satisfaction and turnaround times. Results: The mean turnaround time at the CCBCC in 2009 from abnormal screening mammogram to surgery was 45 d. This falls within the 75th %ile of the National Quality Measures for Breast Centers (NQMBC), established by the National Consortium of Breast Centers (NCBC). Of 131 surveys mailed out, 57 were returned (44%). The patient satisfaction rates for each interval ranged from 96%-100%, with an overall satisfaction rate of 98% for abnormal screening mammogram to surgery. Discussion: The CCBCC ranks at the 75% ile in overall turnaround times; however, this turnaround time included an interval of MRI, not previously measured in NQMBC benchmark. Rate-limiting steps were identified as the time from screening mammogram to diagnostic mammogram, and biopsy to surgery-specifically, the sub-interval MRI to surgery. Since 2009, the CCBCC has already improved the process for obtaining insurance approval and preauthorization for MRIs; and has added an additional breast surgeon to share the burden of benign cases, and a nurse practitioner to see post-op and follow up patients, improving the accessibility to the primary breast surgeon specialist. Consideration should be given to future time interval studies that evaluate breast cancer turnaround time including MRI to help establish benchmarks.
2013(1):61-65.
DOI: 10.1016/S2221-6189(13)60098-0
Abstract:
Objective: Carotid endarterectomy-related pseudoaneurysms are rare lesions challenging to be treated with conventional open surgery. Endovascular stent-graft has been rarely adopted with encouraging results. We present a case of a huge carotid pseudoaneurysm treated with a stent- graft and managed with a stent-graft and reviewed the available literature on the management and results of this technique for these challenging lesions.
Objective: Carotid endarterectomy-related pseudoaneurysms are rare lesions challenging to be treated with conventional open surgery. Endovascular stent-graft has been rarely adopted with encouraging results. We present a case of a huge carotid pseudoaneurysm treated with a stent- graft and managed with a stent-graft and reviewed the available literature on the management and results of this technique for these challenging lesions.
2013(1):66-69.
DOI: 10.1016/S2221-6189(13)60099-2
Abstract:
Fifty-seven years old Malay lady, post menopausal with co-morbid of diabetes mellitus and hypertension presented with three months history of bilateral painful red eyes associated with double vision. Examination revealed both eyes proptosis, corkscrew vessels with present of bruit, secondary narrow angle with raised intraocular pressure, 6 th cranial nerve palsy, and bilateral venous stasis retinopathy. CT angiogram showed bilateral dilated superior ophthalmic veins with cerebral angiogram findings of bilateral indirect carotid cavernous fistula involving small meningeal vessels. Indirect or dural cavernous sinus Fistula can easily be missed or misdiagnosed. Trivial injury especially in the predisposing patient can initiate the occurrence.
Fifty-seven years old Malay lady, post menopausal with co-morbid of diabetes mellitus and hypertension presented with three months history of bilateral painful red eyes associated with double vision. Examination revealed both eyes proptosis, corkscrew vessels with present of bruit, secondary narrow angle with raised intraocular pressure, 6 th cranial nerve palsy, and bilateral venous stasis retinopathy. CT angiogram showed bilateral dilated superior ophthalmic veins with cerebral angiogram findings of bilateral indirect carotid cavernous fistula involving small meningeal vessels. Indirect or dural cavernous sinus Fistula can easily be missed or misdiagnosed. Trivial injury especially in the predisposing patient can initiate the occurrence.
2013(1):70-72.
DOI: 10.1016/S2221-6189(13)60100-6
Abstract:
Rhinolithiasis is a rare condition involving a mineralized mass located in the nasal cavity. It may be endogenous or exogenous in origin. The fact that it appears with different symptoms can make diagnosis difficult. Rhinolithiasis was diagnosed as a result of endoscopic examination in two patients previously diagnosed with sinusitis and with no lessening of symptoms despite numerous applications of medical treatment. Rhinolithiasis should be considered in long-term fetid nasal discharges and unilateral nasal obstructions, and the patient should be referred to an ear, nose and throat specialist for endoscopic examination.
Rhinolithiasis is a rare condition involving a mineralized mass located in the nasal cavity. It may be endogenous or exogenous in origin. The fact that it appears with different symptoms can make diagnosis difficult. Rhinolithiasis was diagnosed as a result of endoscopic examination in two patients previously diagnosed with sinusitis and with no lessening of symptoms despite numerous applications of medical treatment. Rhinolithiasis should be considered in long-term fetid nasal discharges and unilateral nasal obstructions, and the patient should be referred to an ear, nose and throat specialist for endoscopic examination.
Fesih Aktar
,
Sinan Akbayram
,
Necmettin Akdeniz
,
Sirac Aktar
,
Cihangir Akg ü n
,
Murat Do ? an
,
H ü seyin ? aksen
,
Ahmet Faik Oner
2013(1):73-75.
DOI: 10.1016/S2221-6189(13)60101-8
Abstract:
Herpes zoster (HZ) is often associated with painful erythematous vesicular eruptions of the skin or mucous membranes. A pproximately 10 % to 30 % of the population will suffer from HZ during their lifetime. HZ is infrequent in healthy children. However, diminished cellular immunity seems to increase risk of reactivation because incidence increases with age and in immunocompromised states. We report a 7-year-old girl with acute myeloblastic leukemia HZ infection on the right palmar, elbow and forearm region (C7, C8 and T1 dermatomes). We want to indicate unusual localization of HZ on the acute myeloblastic leukemia child patient.
Herpes zoster (HZ) is often associated with painful erythematous vesicular eruptions of the skin or mucous membranes. A pproximately 10 % to 30 % of the population will suffer from HZ during their lifetime. HZ is infrequent in healthy children. However, diminished cellular immunity seems to increase risk of reactivation because incidence increases with age and in immunocompromised states. We report a 7-year-old girl with acute myeloblastic leukemia HZ infection on the right palmar, elbow and forearm region (C7, C8 and T1 dermatomes). We want to indicate unusual localization of HZ on the acute myeloblastic leukemia child patient.
Siti Hajar Mat Abu
,
Hanizasurana Hashim
,
Roslin Azni Aziz
,
Norfariza Ngah
,
Adil Hussein
,
Noriah Othman
2013(1):76-78.
DOI: 10.1016/S2221-6189(13)60102-X
Abstract:
Primary intraocular lymphoma (PIOL) is an uncommon subset of primary central nervous system lymphoma (PCNSL). We report a rapid progressive of this disease in a 73 years old lady who presented with one year history of left eye floaters, associated with deterioration of left vision. Examination revealed left eye vitritis and typical vitreous clumps. Left vitrectomy and vitreous biopsy was performed with result showed few singly dispersed atypical lymphoid cells. She was diagnosed to have Primary Intraocular lymphoma and was started on intravitreal methotrexate. Initially she responded well but later the tumour spread to liver, breast and brain within a year. She finally succumbed to the disease. High index of suspicion of PIOL is mandatory in all elderly patients presenting with panuveitis. Co-management with the Neurologist is vital in the continuous management of these patients in view of the high rate of mortality.
Primary intraocular lymphoma (PIOL) is an uncommon subset of primary central nervous system lymphoma (PCNSL). We report a rapid progressive of this disease in a 73 years old lady who presented with one year history of left eye floaters, associated with deterioration of left vision. Examination revealed left eye vitritis and typical vitreous clumps. Left vitrectomy and vitreous biopsy was performed with result showed few singly dispersed atypical lymphoid cells. She was diagnosed to have Primary Intraocular lymphoma and was started on intravitreal methotrexate. Initially she responded well but later the tumour spread to liver, breast and brain within a year. She finally succumbed to the disease. High index of suspicion of PIOL is mandatory in all elderly patients presenting with panuveitis. Co-management with the Neurologist is vital in the continuous management of these patients in view of the high rate of mortality.
2013(1):79-81.
DOI: 10.1016/S2221-6189(13)60103-1
Abstract:
Psychotic manifestations are uncommon in neurocysticercosis. This article describes a ten year girl presented with manic–psychotic manifestation for which she was under treatment with antipsychotics for eight months. Eventually she developed generalized tonic clonic seizure and CT scan of brain revealed small isodense right posterior parietal lesion of 5 mm size with perifocal edema. CECT revealed intense nodular post contrast enhancement. This highlights the possible misdiagnosis of a case of neurocysticercosis as an organic psychotic disorder so it should be considered as a differential diagnosis in patients with neurological as well as psychiatric manifestations in endemic area like India.
Psychotic manifestations are uncommon in neurocysticercosis. This article describes a ten year girl presented with manic–psychotic manifestation for which she was under treatment with antipsychotics for eight months. Eventually she developed generalized tonic clonic seizure and CT scan of brain revealed small isodense right posterior parietal lesion of 5 mm size with perifocal edema. CECT revealed intense nodular post contrast enhancement. This highlights the possible misdiagnosis of a case of neurocysticercosis as an organic psychotic disorder so it should be considered as a differential diagnosis in patients with neurological as well as psychiatric manifestations in endemic area like India.
2013(1):82-84.
DOI: 10.1016/S2221-6189(13)60104-3
Abstract:
A 10-day old preterm neonate, appropriate for the date, was admitted for lethargy and feeding intolerance. By culturing its blood, the antibiogram of the causative bacterium was ascertained by both Kirby-Bauer disc diffusion method and the Vitek 2 system. Due clinical steps were taken for survival of the baby. The baby was suffering from septicemia. The causative bacterium was Klebsiella pneumoniae (K. pneumoniae). The isolated strain was found resistant to a total of 17 antibiotics; the strain was positive for extended spectrum β -lactamase production and resistant to two carbapenems, imipenem and meropenem. The baby could not survive. The baby was infected with an appalling strain of K. pneumoniae with a capacity to produce metallo β -lactamase overriding carbapenems, which is found to present in the state of Odisha, India.
A 10-day old preterm neonate, appropriate for the date, was admitted for lethargy and feeding intolerance. By culturing its blood, the antibiogram of the causative bacterium was ascertained by both Kirby-Bauer disc diffusion method and the Vitek 2 system. Due clinical steps were taken for survival of the baby. The baby was suffering from septicemia. The causative bacterium was Klebsiella pneumoniae (K. pneumoniae). The isolated strain was found resistant to a total of 17 antibiotics; the strain was positive for extended spectrum β -lactamase production and resistant to two carbapenems, imipenem and meropenem. The baby could not survive. The baby was infected with an appalling strain of K. pneumoniae with a capacity to produce metallo β -lactamase overriding carbapenems, which is found to present in the state of Odisha, India.
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