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Showing posts from July, 2014
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Journal of Novel Physiotherapy and Physical Rehabilitation Research Article Validity of Ratings of Perceived Exertion in Patients with Type 2 Diabetes Purpose: To examine whether a subjective measure of moderate-intensity exercise (12-13 on Borg’s ratings of perceived exertion scale; RPE) corresponds to the target heart rate for moderate-intensity exercise (40-59% heart rate reserve; %HRR) and to determine the characteristics of those for whom RPE does not appropriately estimate exercise intensity. Methods: 3582 individuals with type 2 diabetes (age: 58.3±6.8 years; BMI: 35.9±5.9 kg/m 2 ) underwent a maximal exercise test and minute-by-minute HR and RPE were recorded. Linear regression was used to determine the %HRR corresponding to an RPE of 12 and 13 for each individual. Results: At an RPE of 12 or 13, 57% of participants fell within the target 40-59% HRR range, while 37% and 6% fell above and below this range, respectively. Participants
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Journal of Novel Physiotherapy and Physical Rehabilitation   Case Report     Novel Use of Optokinetic Chart Stimulation with a One -Off Epley's Manouvre in a Bed-Ridden, Difficult to Rehabilitate, Care of the Elderly Patient with Undiagnosed BPPV: A Case Report   Background and objective: Unrecognized BPPV leads to activity limitations. This case report aims to report on use of optokinetic chart stimulation and one off Epley’s manouvre to treat unrecognised BPPV in chronic Ménière’s disease. Methods: This is a single case study in a care of the elderly rehabilitation ward. An 85 year old patient was admitted with abdominal pain, vomiting, clamminess and sweating. She was treated with one off right ear Epley’s manoeuvre and daily optokinetic chart stimulation. Results: The Barthel index improved from 5/100 pre-intervention to 50/100 post- intervention and the Elderly Mobility Scale improved from 2/20 to 11/20. Conclusions: Recognising and treating
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Global Journal of Medical and Clinical Case Reports Case Report Concomitant Occurrence of Fibrous Dysplasia and Epilepsy: Report of an Unusual Case Fibrous dysplasia (FD) is a developmental anomaly in which normal bone is gradually replaced with fibrous connective tissue. There are two variants: monostotic and polyostotic. The diagnosis of fibrous dysplasia is generally made on the basis of clinical and radiographic findings .The association between epilepsy and craniofacial fibrous dysplasia is rather unusual. A clinician must be vigilant and cognizant of this association so that a prompt referral and treatment may be achieved. A case of fibrous dysplasia is presented here which was seen co-existing with epileptic seizures. http://www.peertechz.com/Clinical-Case-Reports/GJMCCR-1-105.php
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Global Journal of Medical and Clinical Case Reports Case Report The Effectiveness of a Home Exercise Program for a Young Athlete with Schmorl's Nodes: A Case Report Background and Purpose: Adolescent soccer players are often prone to low back pain and one source of low back pain incurred by adolescents is Schmorl's nodes, or end-plate disc herniations. Patients with low back pain due to Schmorl's nodes are often given home exercise programs to manage their symptoms and increase their core stability. The purpose of this case report is to describe the treatment and outcome for a young athlete with Schmorl's nodes causing low back pain and lower extremity weakness. Case Description: A 12 year-old female soccer player with a history of low back pain was referred to physical therapy with a diagnosis of Schmorl's nodes. Following 8 weeks of physical therapy, the patient was then discharged to a home exercise program. The patien
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Global Journal of Medical and Clinical Case Reports Case Report     Aggressive Angiomyxoma of the Cervix: A Unique Entity Introduction: Aggressive angiomyxoma is a mesenchymal tumour which presents rarely; usually in women in reproductive age group, as a mass in the pelvic tissue. Only exceptionally, has it been seen to originate from the uterus and cervix. Methods: We present a case of a 23-year-old woman who complained about abdominal pain and excessive vaginal bleeding three days after a spontaneous abortion. Examination revealed a large polyp arising from the cervix. Histopathologic examination of the polypectomy specimen revealed an aggressive angiomyxoma of the cervix. Immunohistochemistry was performed and the tumour was immunopositive for vimentin, desmin and smooth muscle actin. Management options are discussed, in light of need of fertility conservation. Result: Aggressive angiomyxoma can originate from the mesenchymal tissue of the cervix. Con
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Global Journal of Medical and Clinical Case Reports Case Report     Compression Myelopathy Caused by Anterolisthesis and Hypertrophic Ligamentumflavum in the Adjacent Segment 11years after Cervical Laminoplasty-A Case Report and Review of the Literature Introduction: Symptomatic adjacent segment disease after anterior cervical decompression and fusion has been well described, but there have been few reports of symptomatic adjacent segment disease after cervical laminoplasty. Case report: The authors report on a 69-year-old female gradually developed gait disturbance due to C7 anterolisthesis and ligamentumflavum thickening with an onset 11 years after conventional C3-7 laminoplasty. The patient underwent laminectomy from C6 to T1 and was able to return to ambulation. However, she experienced further deterioration in her ambulatory status four years after the second surgery, due to further anterior slippage of C7.Finally; she underwent posterior decompress
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Imaging Journal of Clinical and Medical Sciences Case Blog Posttraumatic Anosmia Secondary to Cranial Base Contusion Head trauma is a common cause of anosmia; however, the diagnosis is typically late, owing to greater attention being given to the more life-threatening sequelae of the injury. Studies have cited olfactory dysfunction as occurring in approximately 30% of all head traumas [1]. http://www.peertechzimaging.com/IJCMS-1-107.php
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Imaging Journal of Clinical and Medical Sciences Case Blog A Painful Case of Debilitating Cutaneous Psoriasis Psoriasis is an immune mediated, chronic inflammatory, incurable condition of the skin that affects 2-3% of the population globally. It is associated with red, thick, scaly lesions [1], is more common in patients on higher latitudes, in Caucasians and may manifest itself with an underlying arthropathy. Psoriasis has a spectrum of presentations ranging from localized, mild disease to involvement of more than 90% of the body’s surface called erythrodermic form [2]. In as many as 4% of the patients with psoriatic the first sign of disease involves changes to the nail, however, these nail changes are seen in about half patients at some point in the course of the disease. Arthropathy, specifically, Psoriatic arthritis is also seen in about 5-10% of this patient population [3]. Pathogenesis involves the secretion of cytokines such as IL-2, Interferon- γ, TNF-α b
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Imaging Journal of Clinical and Medical Sciences Clinical Image Bilateral Congenital Colobomas and Vitiligo in a Blind Middle Aged Female Bilateral Congenital Colobomas and Vitiligo in a Blind Middle Aged Female http://www.peertechzimaging.com/IJCMS-1-105.php
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Imaging Journal of Clinical and Medical Sciences Clinical Image Extensive Pericardial Calcification in Constrictive Pericarditis Severe calcification of the pericardium with thickness measuring up to an impressive 1.2 cm leading to bi-atrial enlargement. http://www.peertechzimaging.com/IJCMS-1-104.php
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Imaging Journal of Clinical and Medical Sciences Clinical Image Isolated Right Testicular PAN (Polyarthritis Nodosa) presenting as Right Testicular Pain Patient is a 30 year old male with no significant past medical history who repeatedly sought medical attention for debilitating right testicular pain. http://www.peertechzimaging.com/IJCMS-1-103.php
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Imaging Journal of Clinical and Medical Sciences Clinical Image Incidental Finding of Mesothelioma after a Motor Vehicle Accident CTA Chest: The blue arrows point to the pleural calcification seen in this patient with asbestos exposure. http://www.peertechzimaging.com/IJCMS-1-102.php
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Imaging Journal of Clinical and Medical Sciences Clinical Image Bilateral Congenital Colobomas and Vitiligo in a Blind Middle Aged Female Bilateral Congenital Colobomas leading to blindness in this middle aged female. http://www.peertechzimaging.com/IJCMS-1-101.php
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Journal of HIV for Clinical and Scientific Research Research Article     Socio-demographic and immunological profile of HIV patients attending ART clinic in a tertiary care hospital in North India Background: The epidemiology of HIV should be understood especially with regard to various socio-demographic factors because the most effective approaches for its prevention and control are awareness and life style changes. Aim: This study was undertaken to determine the socio-demographic characteristics and immunological profile of HIV seropositive patients attending the antiretroviral therapy (ART) clinic of Lok Nayak hospital in New Delhi, India. Methods: Two hundred and fifty two, HIV seropositive subjects were enrolled in the study irrespective of their ART status. Subjects were staged as per the World Health Organization (WHO) staging system and the socio-demographic data and clinical signs and symptoms were recorded for all subjects on a predesigned perfor
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Journal of HIV for Clinical and Scientific Research Research Article     Assessment of Level of Knowledge and Practice of Nursing and Midwifery Students on HIV Post Exposure Prophylaxis in Hawassa University, Ethiopia Background: Nurses, midwives and other health care workers are at risk from Human Immunodeficiency Virus (HIV) and other blood borne infections in the workplace. Post exposure prophylaxis of HIV is the only way to reduce risk of HIV after potential exposure to needle pricks, blood and body fluids. Objectives: The objective of this study is to assess the level of knowledge and practice of nursing and midwifery students regarding post exposure prophylaxis for HIV in Hawassa University, College of Medicine and Health Science in Ethiopia. Methods: Institution- based cross-sectional descriptive study was conducted from October to December 2013. A total of 185 students (comprising of 136 nursing and 49 midwifery) who were eligible for the survey we
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Scientific Journal of Genetics and Gene Therapy Research Article In LNCaP Cells Inhibition of BCL-2 by Antisense Oligonucleonucleotides Results in Compensatory Changes in Apoptosis Antisense oligonucleotides (oligos) have been evaluated for treating prostate cancer in both in vivo and in vitro models. Although most oligos contain a single mRNA binding site, our laboratory evaluates bi-specific oligos directed towards two proteins. This study evaluates the growth inhibition in vitro of the LNCaP cell line employing mono- and bi-specific oligos directed against BCL-2 [the second binding site was directed against the epidermal growth factor receptor (EGFR)]. These oligos were administered with lipofectin as part of a nanoparticle delivery system. Additionally, g, the expression of five apoptosis regulatory proteins, BCL-2, bax, caspase-3, clusterin and AKT-1 was evaluated by RT-PCR. LNCaP prostate tumor cells were incubated in the presence of
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Journal of Clinical Research and Ophthalmology Case Report Secondary Syphilis Presenting as Optic Neuritis in an Immunocompetent Patient: Case Report Purpose: The purpose of this report is to present a case of optic neuropathy as a manifestation of secondary syphilis in an HIV-negative patient. Methods: We describe a case of gradual loss of visual acuity in the left eye (LE) in a 53-year-old healthy woman. Results: The patient presented with visual acuity of 20/20 in the right eye and hand movements in the LE. Fundoscopy revealed swollen optic disc in the LE. Fluorescein angiography showed leakage of dye from the optic disc. Optical coherence tomography (OCT) confirmed the oedema in the left optic disc. Serologic testing was positive for venereal disease research laboratory (VDRL) and fluorescent treponemal antibody absorption (FTA-ABS), and negative for HIV antibodies. Conclusions: Ophthalmologic findings, including disc oedema, may be the presenting features of syphilis,
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Journal of Clinical Research and Ophthalmology  Case Report Valacyclovir as a Therapeutic Agent in Acute Retinal Necrosis: Two Case Reports Introduction: Acute retinal necrosis (ARN) is a rare, rapidly progressive viral retinitis. The current standard of care for ARN consists of intravenous acyclovir for 5-10 days, followed by oral acyclovir for an additional 6-12 weeks. Valacyclovir has superior plasma bioavailability to acyclovir as an oral preparation. The aim of this study is to add to the evidence of treating ARN with valacyclovir with 2 additional cases. Methods: 2 patients diagnosed with ARN received treatment with valacyclovir either as a monotherapy, or in combination with intravenous acyclovir. Results: All patients had significant improvement in visual acuity within 4 weeks of the initiation of treatment. In the sixth month follow-up none of them developed retinal detachment, which is one of the commonest sight-threatening complications of ARN. Conclusions: Val
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Journal of Clinical Research and Ophthalmology  Surgical Technique Hydro-visco-implantation Technique for Wound-assisted Foldable Intraocular Lens Implantation During Microincision Cataract Surgery We have described a hydro-visco-implantation technique (simultaneous use of sodium hyaluronate and balanced salt solution) for wound-assisted intraocular lens (IOL) implantation and passive removal of ophthalmic viscosurgical device (OVD). In the technique, the capsular bag was filled approximately up to half with OVD, and anterior chamber was formed by bimanual irrigation cannula with continuous irrigation mode from the side port. Sometimes after adequate tonus is provided, continuous mode could be off to reduce wash effect on OVD during injection of IOL. Injection of foldable IOL with the support of wound edges was completed. While the continuous irrigation mode was on, firm downward pressure was applied with the tip of aspiration canula to the posterior lip of main
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  Journal of Clinical Research and Ophthalmology Research Article The Association of Dry Eye Symptoms with Socioeconomic Factors and quality of Life Purpose: Dry eye is a common condition with significant morbidity and socioeconomic burden. The associated demographic factors that worsen utility in dry eye patients were not known. There were many questionnaire instruments advocated for dry eye documentation but none of these have been shown to correlate to quality of life (QoL). We aimed at examining the health related utility values in a group of dry eye patients and their associations. Methods: This was a hospital based prospective cross-sectional study conducted at the dry eye clinic of Singapore National Eye Centre. Patients with dry eye symptoms were randomized to one of the two validated symptom questionnaires, Standard Patient Evaluation of Eye Dryness (SPEED) or Symptom Assessment in Dry Eye (SANDE) questionnaires. All patients underwe
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Journal of Clinical Research and Ophthalmology Research Article The "Crocodile Technique": A New Ophthalmic Surgical Technique to Remove Subretinal Proliferative Tissue Associated with Retinal Detachment Purpose: To describe the "crocodile technique", a new ophthalmic surgery technique for removing subretinal proliferative tissue (SPT) associated with retinal detachment. Materials and Methods: Subjects were 21 patients who had retinal detachment with SPT. Their follow-up terms were all greater than 3 months. We undertook the crocodile technique during their subretinal surgery. The crocodile technique is a new ophthalmic technique for removing SPT using vitreous forceps, without using subretinal forceps, in small-gauge vitrectomy. After performing sufficient peripheral vitrectomy, a small intentional retinal tear was created above the SPT. The SPT was then stabilized while grasped by vitreous forceps in the subretinal spa
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Journal of Cardiovascular Medicine and Cardiology         Research Article     Efficacy and Safety of Different Energy Settings for Atrial Fibrillation Ablation using the Duty-cycled Radiofrequency Ablation Catheter (PVAC) In recent years, new ablation catheters have been developed to facilitate atrial fibrillation (AF) ablation procedures, including the multi-electrode pulmonary vein ablation catheter (PVAC), capable of using different proportions of unipolar and bipolar energy. The purpose of this study was to evaluate the acute efficacy, as well as safety, when using the two different energy settings for the PVAC catheter. Methods and Results: Thirty-five patients with a mean age of 62 ± 7.7 years with paroxysmal (54%) or persistent AF were included in the study and randomized to 4:1 versus 2:1 bipolar/unipolar energy setting with the PVAC device. The mean number of applications with the PVAC catheter was 41 ± 10 and 51 ± 15 (p = 0.3) respecti
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Journal of Cardiovascular Medicine and Cardiology Short Communication Progression in Diagnosis and Treatment of Resistant Hypertension Introduction: Resistant Hypertension (RH) is a major risk factor of numerous diseases. RH is a challenging clinical problem,many factors affect blood pressure (BP) control. Correct diagnosis and appropriate drug therapy are pretty important to get BP controlled. We aim to attract physicians’ attention to adopt correct measures to diagnose and treat RH. Method: Articlesare obtained from the Internet, www.pubmed.com, Medline and several authors via e-mail. Result and Conclusion: 1.Using a systematic approach to find out the causes of RH and the distinctions between pseudo-resistance and true resistance areof importance for treatment. 2. Following the current treatment guidelines and using the standardized way to establish a flowchart to manage the patientsare the correct methods for BP control. 3. In the ab
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Global Journal of Cancer Therapy Review Article Genetic Polymorphisms and Cisplatin- Related Nephrotoxicity Abstract: Cisplatin is one of the most widely applied antineoplastic agents used to treat different types of solid tumours. However, its use is limited by serious side- effects including nephrotoxicity. Cisplatin accumulates in proximal tubule and forms nephrotoxins that causes proximal cell injury and thereby leads to nephrotoxicity. Cisplatin enters these proximal cells by organic transporter molecules (OCT). Genetic polymorphism of these molecules and other membrane transport proteins that regulate cisplatin accumulation may influence cisplatin- related nephrotoxic outcome. Variations of DNA repair enzymes, e.g., ERCC1, eIF3, MMS 19L, and metabolic enzymes involved in platinum detoxification, e.g., GSTT1, GSTM1 may also have important role in the generation of nephrotoxicity. Polymorphisms of these genes can be used as predictive tools for such adverse- events in an
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Global Journal of Anesthesiology Review Article Spinal Anesthesia for Laparoscopic Cholecystectomy In 1985, the first laparoscopic cholecystectomy was performed, and the introduction of laparoscopic cholecystectomy proved to be a new era in the management of cholelithiasis. In his only start, only patients who were good surgical risks, with non acute disease and no prior abdominal surgeries were selected for the procedure. However, as experience was gained, the pool of patients expanded to encompass those who were otherwise candidates for conventional cholecystectomy. To perform the surgery laparoscopically, there is a need to create a space between the abdominal wall and the viscera. If cholecystectomy was performed under anesthesia in high-risk patients, there is no explanation for the procedure to become routine in healthy patients. http://www.peertechz.com/Anesthesiology/GJA-1-101.php
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Additional volumetric modulated arc therapy to vertebral metastases abutting the previously irradiated site Abstract Introduction: Lung cancer frequently causes metastases to the spine, especially to the thoracic vertebrae, which sometimes compress the spinal cord and induce irreversible palsy. Many patients suffering from metastatic spinal tumors need to undergo repetitive radiotherapy. In such situations, intensity-modulated radiotherapy including volumetric modulated arc therapy can reduce the dose delivered to the spinal cord at the junction. Case Report: The authors describe a case of thoracic vertebral metastases from lung cancer treated with two courses of radiotherapy. In the second course, volumetric modulated arc therapy was adopted and a columnar-shaped planning target volume with a concave portion was configured. Conclusion: The authors propose an approach aimed at realizing both junctional safety and the conformality of the spinal column, which m
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Safety of the novel vector vaccine against Brucella abortus based on recombinant influenza viruses expressing Brucella L7/L12 and OMP16 proteins, in cattle This paper presents the results of a study of the safety of new vector vaccine against B. abortus based on recombinant influenza A subtype H5N1 or H1N1 (viral constructs vaccine formulation) viruses expressing Brucella ribosomal protein L7/L12 and Omp16, in cattle. To increase the effectiveness of the vaccine, adjuvants such as Montanide Gel01 or chitosan were included in its composition. Immunization of cattle (5 animals per group) with the viral constructs vaccine formulation only, or its combination with adjuvants Montanide Gel01 or chitosan, were conducted via the conjunctival method using cross prime (influenza virus subtype H5N1) and booster (influenza virus subtype H1N1) vaccination schedules. Vaccine candidates were evaluated in comparison with the positive ( Brucella abortus ) and negative (PBS) controls. Compr
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Talar Neck Fractures: An Overview Talar injuries are infrequently encountered in practice as the majority require a high energy force such as road traffic accident or fall from height and they are often presented as complex injuries. Talar neck fracture accounts for half of these injuries. Because of the high rate of avascular necrosis (AVN) and posttraumatic arthritis associated with these injuries, it is difficult to predict the prognosis of AVN with the current classification systems. The anatomical position, difficulty of surgical approaches and its complex blood supply add to the challenges. Early recognition and a robust management plan are essential in treating such injuries. Failure to recognize a displaced talus fracture can result in Osteonecrosis, osteoarthritis, malunion or non-union which affects the hind foot function and results in pain, loss of motion and deformity. The integrity of this bone is vital for the function of the ankle, subtalar and mid tar