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   2013| March  | Volume 5 | Issue 3  
    Online since March 20, 2013

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Prenatal screening methods for aneuploidies
Madhusudan Dey, Sumedha Sharma, Sumita Aggarwal
March 2013, 5(3):182-190
DOI:10.4103/1947-2714.109180  PMID:23626953
Aneuploidies are a major cause of perinatal morbidity and mortality. Therefore, it is the most common indication for invasive prenatal diagnosis. Initially, screening for aneuploidies started with maternal age risk estimation. Later on, serum testing for biochemical markers and ultrasound markers were added. Women detected to be at high-risk for aneuploidies were offered invasive testing. New research is now focusing on non-invasive prenatal testing using cell-free fetal DNA in maternal circulation. The advantage of this technique is the ability to reduce the risk of miscarriage associated with invasive diagnostic procedures. However, this new technique has its own set of technical limitations and ethical issues at present and careful consideration is required before broad implementation
  6,480 769 11
Antioxidant enzymes and lipid peroxidation in Type 2 diabetes mellitus patients with and without nephropathy
Manjulata Kumawat, Tarun Kumar Sharma, Ishwar Singh, Neelima Singh, Veena Singh Ghalaut, Satish Kumar Vardey, Vijay Shankar
March 2013, 5(3):213-219
DOI:10.4103/1947-2714.109193  PMID:23626958
Background: Oxidative stress has been considered to be a pathogenic factor of diabetic complications including nephropathy. There are many controversies and limited studies regarding the antioxidant enzymes in diabetic nephropathy. Aim: This study was to evaluate the levels of antioxidant enzymes and lipid peroxidation in Type-2 Diabetes Mellitus (DM) patients with and without nephropathy. Materials and Methods: The study included 90 age and sex matched subjects. Blood samples of all subjects were analyzed for all biochemical and oxidative stress parameters. Results: The malondialdehyde (MDA) levels and catalase (CAT) activity were significantly increased and reduced glutathione (GSH) levels and activities of glutathione peroxidase (GPx) and glutathione reductase (GR) were significantly decreased in Type-2 DM with and without nephropathy as compared to controls and also in Type-2 DM with nephropathy as compared to Type-2 DM without nephropathy. There were an excellent positive correlation of glycohemoglobin (HbA1c) with MDA and a good negative correlation of GPx with GSH in controls. There were positive correlations of GR, CAT, and superoxide dismutase (SOD) with MDA in Type-2 diabetes patients with nephropathy. Conclusions: Intensity of oxidative stress in Type-2 diabetic patients with nephropathy is greater when compared with Type-2 diabetic patients without nephropathy as compared to the controls.
  4,376 753 49
Adherence to antiretroviral therapy among people living with HIV
Basavaprabhu Achappa, Deepak Madi, Unnikrishnan Bhaskaran, John T Ramapuram, Satish Rao, Soundarya Mahalingam
March 2013, 5(3):220-223
DOI:10.4103/1947-2714.109196  PMID:23626959
Background: Acquired immune deficiency syndrome (AIDS) is now considered as a manageable chronic illness. There has been a dramatic reduction in human immunodeficiency virus (HIV) related morbidity and mortality due to antiretroviral therapy. A high level of adherence (>95%) is required for antiretroviral therapy to be effective. There are many barriers to adherence in both developed and developing countries. Aim: The aim of our study was to determine adherence levels and factors influencing adherence to antiretroviral therapy among people living with HIV. Materials and Methods: Using a cross-sectional study design, 116 HIV positive patients receiving antiretroviral therapy for at least 1 year were interviewed using a semi structured questionnaire. The collected data was analyzed using Statistical Product and Service Solutions (SPSS) version 11.5. Chi-square test was done. A P value of < 0.05 was considered statistically significant. Results: Of 116 participants, 63.7% reported adherence ≥ 95%. Mean adherence index was 91.25%. Financial constraints, forgetting to take medication, lack of family care, depression, alcohol use, social stigma and side effects to antiretroviral therapy were barriers for adherence in our study. Conclusion: Adherence to antiretroviral therapy in south India is suboptimal. Intensive adherence counseling should be provided to all patients before initiation ofantiretroviral therapy. Health care providers must identify possible barriers to adherence at the earliest and provide appropriate solutions.
  4,331 771 28
Bone morphogenetic proteins: Periodontal regeneration
Subramaniam M Rao, Gauri M Ugale, Shivaraj B Warad
March 2013, 5(3):161-168
DOI:10.4103/1947-2714.109175  PMID:23626951
Periodontitis is an infectious inflammatory disease that results in attachment loss and bone loss. Regeneration of the periodontal tissues entails de novo formation of cementum, periodontal ligament, and alveolar bone. Several different approaches are currently being explored to achieve complete, reliable, and reproducible regeneration of periodontal tissues. The therapeutic management of new bone formation is one of the key issues in successful periodontal regeneration. Bone morphogenetic proteins form a unique group of proteins within the transforming growth factor superfamily of genes and have a vital role in the regulation in the bone induction and maintenance. The activity of bone morphogenetic proteins was first identified in the 1960s, but the proteins responsible for bone induction were unknown until the purification and cloning of human bone morphogenetic proteins in the 1980s, because of their osteoinductive potential. Bone morphogenetic proteins have gained a lot of interest as therapeutic agents for treating periodontal defects. A systematic search for data related to the use of bone morphogenetic proteins for the regeneration of periodontal defects was performed to recognize studies on animals and human (PUBMED, MEDLINE, COCHRANE, and Google search). All the studies included showed noticeable regeneration of periodontal tissues with the use of BMP.
  4,237 836 17
Chlamydophila pneumoniae infection and cardiovascular disease
Rajnish Joshi, Bidita Khandelwal, Deepti Joshi, Om Prakash Gupta
March 2013, 5(3):169-181
DOI:10.4103/1947-2714.109178  PMID:23626952
Atherosclerosis is a multifactorial vascular inflammatory process; however, the inciting cause for inflammation remains unclear. Two decades ago, Chlamydophila pneumoniae (formerly Chlamydia pneumoniae) infection was proposed as a putative etiologic agent. We performed a PubMed search using the keywords Chlamydia and atherosclerosis in a Boolean query to identify published studies on C. pneumoniae and its role in atherogenesis, and to understand research interest in this topic. We found 1,652 published articles on this topic between 1991 and 2011. We analyzed relevant published studies and found various serological, molecular, and animal modeling studies in the early period. Encouraged by positive results from these studies, more than a dozen antibiotic clinical-trials were subsequently conducted, which did not find clinical benefits of anti-Chlamydophila drug therapy. While many researchers believe that the organism is still important, negative clinical trials had a similar impact on overall research interest. With many novel mechanisms identified for atherogenesis, there is a need for newer paradigms in Chlamydophila-atherosclerosis research.
  3,897 433 26
Immunomodulatory activity of aged garlic extract against implanted fibrosarcoma tumor in mice
Fatemeh Fallah-Rostami, Mohaddeseh Abouhosseini Tabari, Behzad Esfandiari, Hamid Aghajanzadeh, Manijeh Yousefi Behzadi
March 2013, 5(3):207-212
DOI:10.4103/1947-2714.109191  PMID:23626957
Background: Garlic is known as a medicinal herb with broad therapeutic properties ranging from antibacterial to anticancer and even anticoagulant. Aim: Current study was designed to evaluate antitumor effects of aged garlic extract (AGE) on fibrosarcoma tumor in BALB/c mice. Materials and Methods: WEHI-164 fibrosarcoma cells were implanted subcutaneously on day zero into right flank of 40 BALB/c mice aged eight weeks. Mice were randomly categorized in two separate groups: 1 st received AGE (100 mg/kg, intraperitoneally), 2 nd group as control received phosphate buffered saline, (PBS). Treatments were done three times per week. Tumor growth was measured and morbidity was recorded. Subpopulations of CD4+/CD8+ T cells were determined using flow cytometry. WEHI-164 cell specific cytotoxicity of splenocytes and in vitro production of gamma-interferon, (IFN-γ) and Interleukin-4, (IL-4) cytokines were measured. Results: The mice received AGE had significantly longer survival time compared to control mice. The inhibitory effect on tumor growth was seen in AGE treated mice. The CD4+/CD8+ ratio and in vitro IFN-γ production of splenocytes were significantly increased in AGE group. Conclusions: Administration of AGE resulted in improved immune responses against experimentally implanted fibrosarcoma tumors in BALB/c mice. AGE showed significant effects on inhibition of tumor growth and longevity of survival times.
  2,891 422 12
Amlodipine-induced subacute cutaneous lupus
Alex G Ortega-Loayza, Calvin O McCall, Richard H Cooke, Ion S Jovin
March 2013, 5(3):246-247
DOI:10.4103/1947-2714.109218  PMID:23626966
  2,888 331 3
Acute renal failure and/or rhabdomyolysis due to multiple bee stings: A retrospective study
Prasanna R Deshpande, KK Ahsan Farooq, Manohar Bairy, Ravindra A Prabhu
March 2013, 5(3):235-239
DOI:10.4103/1947-2714.109202  PMID:23626962
  2,798 320 8
Assessment of knowledge, attitude, and practice in health care delivery
Sunil Raina
March 2013, 5(3):249-250
DOI:10.4103/1947-2714.109226  PMID:23626968
  2,316 496 5
Carotid intima media thickness as a reflection of generalized atherosclerosis is related to body mass index in ischemic stroke patients
Amit Shankar Singh, Virendra Atam, Munna Lal Patel, Shyam Chand Chaudhary, Kamal Kumar Sawlani, Liza Das
March 2013, 5(3):228-234
DOI:10.4103/1947-2714.109200  PMID:23626961
Background: Carotid artery intima media thickness reflects the ongoing process of atherosclerosis in the body. The pathologic process occurring in the obese patients in the vascular system is atherosclerosis which is an important cause of ischemic stroke. Body mass index is an indirect measure of obesity in general population. Aim: The study was to assess the role of carotid artery intima media thickness as a marker of atherosclerosis and its relation with body mass index in ischemic stroke patients. Materials and Methods: Body mass index of the all stroke patients was calculated by using formula body mass in kilograms divided by the square of height in meters. The patients were classified in four groups of body mass index according to Indian standards. Carotid sonography was done to assess the common carotid artery intima media thickness in millimeters by using high resolution 7.5 MHz sonography technique. Results: The average Carotid intima media thickness in this study was 9.23mm. There was a significant association found between increasing carotid artery intima media thickness and groups of body mass index (P- <0.05) in ischemic stroke patients. Conclusions: Body mass index as an indicator of obesity and carotid intima media thickness both are very important risk factors for ischemic stroke and are associated with each other.
  2,421 311 -
Socio-demographic characteristics of transsexuals referred to the forensic medicine center in southwest of Iran
A Hedjazi, M Zarenezhad, A Hoseinzadeh, R Hassanzadeh, Seyed Mohammad Vahid Hosseini
March 2013, 5(3):224-227
DOI:10.4103/1947-2714.109198  PMID:23626960
Background: Transsexualism or gender identity disorder affects person's gender identity. Aim: This study was to describe socio-demographic characteristics in a population of transsexuals. Materials and Methods: We studied 44 persons of both sexes with diagnostic criteria of gender identity disorder who were referred to the Legal Medicine Organization of Fars, southwest of Iran during the time period 2005-2010. The general practitioners examined the following socio-demographic characteristics and then recorded them in a semi-structured questionnaire, which was developed by the Forensic Medicine Center in Shiraz: Sex, age, educational level, place of residence, marital status, duration of treatment, and employment status. Results: A total of 44 persons (18 (40.9%) males versus 26 (59.1%) females) were referred for sex change during the study period. The sex ratio was 0.69:1. The mean age was 27.6 ± 2.9 years. The majority of patients were diploma and higher diploma education (77.3%), lived in urban areas (81.8%), were employed (56.9%), were single (93.1%), and were under six months of hormonal treatment (61.4%). Conclusions: It seems that social acceptance is lower for male to female transsexuals, since these patients have lower employment and literacy statuses. Further studies should be designed to evaluate and deeper analyze more socio-demographic, clinical, and psychiatric variables about transsexual patients.
  2,368 343 6
New guidelines for diagnosis of gestational diabetes: Pathology-based impact assessment
Ezekiel Uba Nwose, Ross Stuart Richards, Phillip Taderera Bwititi, Eugene George Butkowski
March 2013, 5(3):191-194
DOI:10.4103/1947-2714.109184  PMID:23626954
Background: A recent study indicated an average of 19.5% abnormal oral glucose tolerance in antenatal clients per year. Aim: The purpose of this study was to determine the impact on gestational diabetes cases due to new guidelines for diagnosis and classification of hyperglycaemia in pregnancy. Materials and Methods: This study reviewed the archived clinical pathology data on oral glucose tolerance tests performed between January 1999 and December 2008 on antenatal clients ( N = 615). The cases were reviewed to determine changes if any in percentage of gestational diabetes due to new guidelines. Results: Over the 10 years period, a yearly average of additional 10.8% antenatal cases suggestive of gestational diabetes was observed due to the new recommended thresholds. Further, the average yearly incidence would have increased from 8.8 cases to 16.2 cases, which translates to almost 46% increase in the prospective numbers of gestational diabetes. Conclusions: This report presents the extent of how the new recommended guidelines for diagnosis and classification of hyperglycaemia in pregnancy could increase the prevalence of gestational diabetes. It also provides pathology-based evidence for the epidemiology of gestational diabetes mellitus and allows for planning the costs that would be attendant to the full implementation of the new guidelines.
  2,198 416 5
Hypertension association with serum lipoproteins, insulin, insulin resistance and C-peptide: Unexplored forte of cardiovascular risk in hypothyroidism
Purvi Purohit, Ranjana Mathur
March 2013, 5(3):195-201
DOI:10.4103/1947-2714.109187  PMID:23626955
Background: There is a gross dearth of correlative data for cardiovascular diseases. Aim: We aimed to explore the association of systolic and diastolic blood pressure with anthropometric and biochemical parameters of hypothyroid patients in order to establish any correlation that may exist and be useful in an early diagnosis and management against cardiovascular risk. Materials and Methods: The study included 100 healthy controls and 150 newly diagnosed hypothyroid patients. Subjects were evaluated anthropometrically and biochemically for fasting blood sugar, triiodothyronine, thyroxine, thyroid stimulating hormone, Insulin, C-peptide, lipid profile, apo-B and apo-A 1 . The results were statistically analysed using unpaired t-test and Spearman's coefficient of Correlation. Results: The hypothyroids had a female preponderance (73.3%) however; their biochemical profiles were comparable with those of male counterparts. They had raised Body Mass Index, hypertension, hyperinsulinemia, insulin resistance, raised C-peptide, dyslipidaemia with raised apo-B and reduced apo-A 1 and strong association of systolic and diastolic blood pressure with insulin, insulin resistance, C-peptide and Total cholesterol/HDLc (TC/HDLc). Conclusion: Strong association of hypertension with serum insulin, IR, C -peptide and TC/HDLc hints significant contribution towards cardiovascular risk in hypothyroid adults of Jodhpur.
  2,182 339 3
Sister Mary Joseph's nodule: What lies beneath?
Saeed Ahmed, Saira Rashid, Pongsathorn Kue-A-Pai, Wisit Cheungpasitporn
March 2013, 5(3):252-252
DOI:10.4103/1947-2714.109228  PMID:23626970
  2,307 208 1
Allele frequencies of the epidermal growth factor receptors polymorphism R521K in colorectal cancer patients and healthy subjects indicate a risk-reducing effect of K521 in Syrian population
Ola Haj Mustafa, Abdul Rezzak Hamzeh, Lina Ghabreau, Nizar Akil, Ala-Eddin Almoustafa, Amal Alachkar
March 2013, 5(3):202-206
DOI:10.4103/1947-2714.109189  PMID:23626956
Background: Colorectal cancer contributes heavily to cancer morbidity and mortality worldwide. Numerous therapies are currently in use, including monoclonal antibodies against cellular components involved in tumorigenesis such as epidermal growth factor receptors (EGFRs). Studies showed the polymorphism [R521K] GàA in the EGFR gene to be involved in both colorectal cancer susceptibility and clinical response to therapeutics (e.g., Cetuximab). Aim: We aimed at uncovering allele frequencies of this polymorphism among Syrian colorectal cancer patients and healthy individuals. Materials and Methods: Forty-seven patients with colorectal cancer were included in a case-control study along with 48 healthy subjects, all native Syrians. Individuals were genotyped using PCR-Restriction Fragment Length Polymorphism (PCR-RFLP) and results were statistically analyzed to elucidate significant differences between the two groups. Results: Allele frequencies were 40.4% (G/G), 57.4% (G/A) and 2.1% (A/A) in colorectal cancer patients and 41.6% (G/G), 43.7% (G/A) and 14.5% (A/A) in healthy subjects. The A/A genotype was significantly lower in colorectal cancer patients than in the control group. Conclusions: Homozygosity for the A allele is linked to reducing the risk of developing colorectal cancer in Syrian patients. The lower prevalence of (A/A) locally may predict sub-optimal rates of clinical response to Cetuximab compared with populations with higher frequencies of the A allele. Larger scale investigations are needed for a stronger conclusion.
  2,059 298 3
Hematologic recovery of pancytopenia after treatment of Hashimoto's thyroiditis and primary adrenal insufficiency
Hamid Shaaban, Tejas Modi, Yashpal Modi, Ibrahim W Sidhom
March 2013, 5(3):253-254
DOI:10.4103/1947-2714.109231  PMID:23626971
  2,046 274 1
Hydatid cyst of liver complicated with Budd-Chiari syndrome and portal vein thrombosis
Khalid Rasheed
March 2013, 5(3):242-244
DOI:10.4103/1947-2714.109206  PMID:23626964
  1,895 309 1
Pyogenic renal abscess masquerading as malignancy
Mayank Baid, Utpal De, Manoranjan Kar
March 2013, 5(3):240-241
DOI:10.4103/1947-2714.109204  PMID:23626963
  1,791 233 -
Chasing eosinophilia in Loeffler's syndrome: A case of strongyloidiasis in upstate New York
Saeed Ahmed, Saira Rashid, Nischala Ammannagari, Wisit Cheungpasitporn
March 2013, 5(3):248-248
DOI:10.4103/1947-2714.109220  PMID:23626967
  1,642 212 1
Dengue hemorrhagic fever and acute compartment syndrome
Somsri Wiwanitkit, Viroj Wiwanitkit
March 2013, 5(3):245-245
DOI:10.4103/1947-2714.109210  PMID:23626965
  1,472 299 -
Stent dislodgement: A rare complication of subclavian artery aangioplasty and stenting
Saeed Ahmed, Supawat Ratanapo, Narat Srivali, Wisit Cheungpasitporn
March 2013, 5(3):251-251
DOI:10.4103/1947-2714.109227  PMID:23626969
  1,387 196 -