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   2014| March  | Volume 6 | Issue 3  
    Online since March 11, 2014

 
 
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LETTERS TO EDITOR
Western blot: Technique, theory and trouble shooting
Zhi-Qiang Liu, Tahrin Mahmood, Ping-Chang Yang
March 2014, 6(3):160-160
DOI:10.4103/1947-2714.128482  PMID:24741558
  7,861 3,858 30
REVIEW ARTICLES
Canagliflozin: A novel SGLT2 inhibitor for type 2 diabetes mellitus
Shaveta Kaushal, Harmanjit Singh, Pugazhenthan Thangaraju, Jasbir Singh
March 2014, 6(3):107-113
DOI:10.4103/1947-2714.128471  PMID:24741548
Diabetes Mellitus continues to be a major non- communicable disease with global burden of 366 million at present and projected to increase to 439 to 552 million by 2030, India being the hub of diabetes. Sodium glucose transporter 2 (SGLT2) inhibitors presents a new class of anti-diabetic drugs having an insulin-independent mechanism that offers a considerable advantage of increasing urinary glucose excretion without inducing hypoglycemia and promoting weight loss due to loss of 300 to 400kcal/day, Canagliflozin being the 1 st successful candidate of this group and became the first SGLT2 inhibitor to be FDA approved on March 29, 2013. In various clinical trials, it has shown promising results in controlling glycemia, causing weight loss, reducing systolic and diastolic BP and cardiovascular risk. There are some safety concerns associated with its use e.g. genital mycotic infections, increased urination, urinary tract infection and hyperkalemia, which need to be carefully addressed while using this drug.
  4,103 1,257 9
LETTERS TO EDITOR
Quality assurance for african laboratories: How soon can this be accomplished?
Gerald Dafe Forae
March 2014, 6(3):155-157
DOI:10.4103/1947-2714.128480  PMID:24741556
  3,104 188 -
ORIGINAL ARTICLES
Slow yogic breathing through right and left nostril influences sympathovagal balance, heart rate variability, and cardiovascular risks in young adults
Gopal Krushna Pal, Ankit Agarwal, Shanmugavel Karthik, Pravati Pal, Nivedita Nanda
March 2014, 6(3):145-151
DOI:10.4103/1947-2714.128477  PMID:24741554
Background: Specific nostril breathing is known to influence autonomic functions. Aim: The study was to assess the effects of right nostril breathing (RNB) and left nostril breathing (LNB) on heart rate variability (HRV) and cardiovascular functions. Material and Methods: Eighty-five student volunteers were divided into three groups: RNB group (n = 30), LNB group (n = 30), and control group (n = 25). RNB and LNB group subjects practiced right and left nostril breathing, respectively, every day 1 h for 6 weeks. The control group did not practice nostril breathing. Cardiovascular parameters and spectral indices of HRV were recorded before and after 6-week practice of nostril breathing. In RNB and LNB groups, prediction of rate-pressure product (RPP) by low-frequency to high-frequency ratio (LF-HF) of HRV was assessed by bivariate logistic regression. Results: HRV indices representing sympathetic activity were increased in the RNB group and indices representing parasympathetic activity were increased in LNB group following 6-week nostril breathing. Prediction of LF-HF to RPP, the marker of cardiovascular risks, was more significant (OR 2.65, P = 0.005) in the LNB group compared to the RNB group (OR 1.452, P = 0.016). Conclusions: Short-term practice of LNB improves vagal tone, increases HRV, and promotes cardiovascular health of medical students. Practice of RNB increases sympathetic tone and could jeopardize cardiovascular health.
  2,687 412 10
Ovarian granulosa cell tumor: Clinical features, treatment, outcome, and prognostic factors
Divya Khosla, Kislay Dimri, Awadhesh K Pandey, Rohit Mahajan, Romeeta Trehan
March 2014, 6(3):133-138
DOI:10.4103/1947-2714.128475  PMID:24741552
Background: Granulosa cell tumors are rare neoplasms characterized by long natural history and favorable prognosis. Aims: The objective of this study was to determine the clinical presentation, treatment, outcome, and prognostic factors for patients of granulosa cell tumors. Materials and Methods: A retrospective analysis of 26 patients of granulosa cell tumor of ovary from 2002 to 2011 was carried out. The records of all patients were analyzed to determine clinical presentation, treatment, survival, and prognostic factors. Results: The median age of the patients was 50 years (range, 17-71 years). Abdominal pain was the most common presenting symptom. The median follow-up was 71.4 months (range, 21.6-149.9 months). The estimated 5 and 10 year overall survival (OS) was 84.6 and 72.5%, respectively. Event-free survival (EFS) was 76.5 and 52.9% at 5 and 10 years, respectively. Advanced stage was significant independent poor prognostic indicator for both OS and EFS. Conclusion: Majority of the patients with granulosa cell tumors of the ovary present in early stage. Surgery is the primary treatment modality for granulosa cell tumors. Advanced stage and presence of residual disease were associated with inferior survival, but only prospective studies can ascertain their definite role.
  2,310 577 11
LETTERS TO EDITOR
Western blot: Protein transfer overview
Janay Gibbons
March 2014, 6(3):158-159
DOI:10.4103/1947-2714.128481  PMID:24741557
  2,144 650 -
ORIGINAL ARTICLES
Factors influencing medical students' choice of future specialization in medical sciences: A cross-sectional questionnaire survey from medical schools in china, malaysia and regions of south asian association for regional cooperation
Arun Kumar, Kasturi Mitra, Sangeetha Nagarajan, Bibek Poudel
March 2014, 6(3):119-125
DOI:10.4103/1947-2714.128473  PMID:24741550
Background: In future, increase in the number of healthcare professionals is dependent on the career interest among present undergraduate medical students. Based on their interest to pursue their specialty, the availability of medical doctors in each specialty could be done. Aims: This study was to find out future career interest and factors that influence undergraduate medical students to choose their future specialization. Materials and Methods: The study was carried out among first-year medical students from five countries. The students were asked to complete an 8-item questionnaire. Two thousand one hundred fifty three participants were enrolled in the study. Data were analyzed in Microsoft-Excel and Statistical Package for the Social Sciences. Results: Of the 2153 participants, only 1470 responded. Among the 1470 participants, 169 participants were excluded due to the ambiguity in responses, finally making it to 1301participants. Among them, Anatomy (49.3%) followed by Biochemistry (26.7%) and Physiology (24%) were the most preferred subjects. Conclusions: Anatomy was the most preferred basic science subject among the other subjects and the students were interested to pursuing surgery in future. Furthermore, the most preferred future specialties were surgery, internal medicine and pediatrics with gender variations; males preferring surgery and females in obstetrics and gynecology.
  2,202 481 3
Relationship between type 2 diabetic retinopathy and periodontal disease in Iranian Adults
Ahmad Ahmadzadeh Amiri, Avideh Maboudi, Adele Bahar, Asadollah Farokhfar, Fatemeh Daneshvar, Hamid Reza Khoshgoeian, Mehdi Nasohi, Alireza Khalilian
March 2014, 6(3):139-144
DOI:10.4103/1947-2714.128476  PMID:24741553
Background: Periodontal disease in diabetic patients can compromise a patient's ability to maintain a proper metabolic control and may be associated with diabetic complication. Aims: This study was designed to evaluate the frequency of periodontal disease in patients with type 2 diabetes mellitus (DM) and how this was related with the presence of diabetic retinopathy (DR). Materials and Methods: A comparison was made of periodontal parameters (plaque index (PI), community periodontal index of treatment needs (CPITN), periodontal disease severity measured in quartiles of probing depth (PD), and clinical attachment loss (CAL)) in a group of diabetic patients with retinopathy (n = 84) versus a group of diabetic patients without retinopathy (n = 129). In addition, 73 age- and sex-matched individuals were selected to serve as the control group. Analysis was performed to evaluate the relationships between periodontal disease and DR. Results: In terms of PI, no statistically significant differences were observed, so, oral hygiene was similar in both groups. Diabetic patients with retinopathy had greater CPITN (P < 0.001) and more severe periodontal disease (P < 0.001) than no retinopathy. Also, our results indicated a relationship between type 2 DM and periodontal disease. Conclusions: The patients with diabetes retinopathy appear to show increased periodontal disease susceptibility.
  1,880 389 9
Prevalence of temporomandibular disorder in children and adolescents from public schools in Southern Portugal
Beatriz Minghelli, Iara Cardoso, Melani Porfírio, Roberta Gonçalves, Sabina Cascalheiro, Vera Barreto, Andreia Soeiro, Leandro Almeida
March 2014, 6(3):126-132
DOI:10.4103/1947-2714.128474  PMID:24741551
Background: The prevalence of temporomandibular disorder (TMD) in children and adolescents is in the range of 6-68% and can be triggered or aggravated by emotional stress. Aim: The study was to investigate the prevalence of TMD in Portuguese children and adolescents and its association with emotional stress. Materials and Methods: The sample comprised 3,260 students aged 5-19 years. The questionnaire was used to assess the presence of TMD, and was applied in a single moment. Results: TMD was observed in 821 (25.2%) students. The most common symptoms of TMD were: if considered tense or nervous (52%), have headaches (36.8%), and habit of clenching or grinding teeth (27.3%). The girls had a 1.36 higher probability of developing TMD than boys (95% CI: 1.14-1.63; p < 0.001); moreover, students from the older age group had a 2.31 higher probability of developing the disorder (95% CI: 1.85-2.89; p < 0.001). Students who considered themselves tense or nervous presented 8.74 higher probability (95% CI: 7.03-10.86; p < 0.001) of developing TMD. Conclusion: This study showed a high prevalence of TMD in children and adolescents in southern Portugal, and revealed a significant association between this dysfunction and the levels of emotional stress. Female students, older students, and those considered tense or nervous have a higher probability of developing TMD.
  1,767 443 7
The two sides of opioids in cyclical vomiting syndrome
Shreyas Saligram, Klaus Bielefeldt
March 2014, 6(3):114-118
DOI:10.4103/1947-2714.128472  PMID:24741549
Background: Cyclical vomiting syndrome is increasingly recognized in adults, with recent reports suggesting 'coalescing attacks' in one third of the patients. We hypothesized that the common need for opioid treatment may contribute to coalescing attacks through development of opioid dependence and withdrawal, triggering cyclical vomiting syndrome. Aim: This study was to review iatrogenic opioid dependence as the potential cause for triggering cyclical vomiting syndrome. Materials and Methods: A retrospective review was performed to identify patients treated for cyclical vomiting syndrome by a single physician between Jan and December of 2010. Demographic data, clinical presentation, treatment, cumulative opioid prescription during hospitalizations and emergency room visits and days of inpatient stay were abstracted from the chart. Results: Forty-one patients (mean age 37.5.6 ± 2.6 years; 66% female) were seen within this timeframe. In eleven patients (27%) with ongoing opioid use, the initial cyclical illness had progressed and eventually coalesced. A cohort of 23 patients was followed for at least 6 months (12.3 ± 1.7 months). The best single predictor of repeat hospitalizations was the cumulative opioid dosage. Conclusion: Continued use of opioid therapy is a poor prognostic marker of cyclical vomiting syndrome and may contribute to disease coalescence, with dependence and withdrawal triggering recurrent episodes.
  1,750 317 2
CASE REPORT
Synchronous metastasis of prostate adenocarcinoma to the stomach and colon: A case report
Hiren Patel, Abhishek Kumar, Hamid Shaaban, Nhat Nguyen, Walid Baddoura, Michael Maroules, Sohail Shaikh
March 2014, 6(3):152-154
DOI:10.4103/1947-2714.128478  PMID:24741555
Context: Prostate cancer is the leading cancer diagnosis in males. The most common metastatic site of metastases in patients with prostate cancer is the axial skeleton and local lymph nodes. Rarely has there been a description of metastatic prostate cancer to the stomach, esophagus, small bowel, and rectum. Case Report: We report an unusual case of a patient who was diagnosed with prostate cancer with synchronous metastasis to both the stomach and sigmoid colon. A 71-year-old African American man with a history of prostate cancer was admitted with a hemoglobin level of 6.1 g/dl, which had decreased from the baseline value of 8 g/dl. He underwent an esophagogastroduodenoscopy, which revealed a nodule in the fundus of stomach; a biopsy of the nodule was done. The patient also underwent a sigmoid polypectomy. Both surgical specimens were histopathologically consistent with metastatic adenocarcinoma of prostatic origin. Conclusion: To the best of our knowledge, this is the first case report in literature of synchronous metastasis of prostate cancer to both the stomach and sigmoid colon.
  1,469 264 2
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