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Zeitschriftendaten
Format
Zeitschrift
eISSN
1875-855X
Erstveröffentlichung
01 Jun 2007
Erscheinungsweise
6 Hefte pro Jahr
Sprachen
Englisch

Suche

Volumen 4 (2010): Heft 4 (August 2010)

Zeitschriftendaten
Format
Zeitschrift
eISSN
1875-855X
Erstveröffentlichung
01 Jun 2007
Erscheinungsweise
6 Hefte pro Jahr
Sprachen
Englisch

Suche

23 Artikel
access type Uneingeschränkter Zugang

Thai national guidelines for the use of antiretroviral therapy in pediatric HIV infection in 2010

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 505 - 513

Zusammenfassung

Abstract

With better knowledge and availability of antiretroviral treatments, the Thai National HIV Guidelines Working Group has issued treatment guidelines for children in Thailand in March 2010. The most important aspects of these new guidelines are detailed below. ART should be initiated in infants less than 12 months of age at any CD4 level regardless of symptoms and in all children at CDC clinical stage B and C or WHO clinical stages 3 and 4. For children with no or mild symptoms consider CD4-guided thresholds of CD4 <25% (children aged one to five years) or CD4 <350 cells/mm3 (children 5 years or older). The preferred first-line regimen in children aged < 3 years is AZT+3TC+NVP. For children >3 years of age the preferred regimen is AZT+3TC+EFV. If an infant has previously been exposed to NVP perinatally, use AZT+3TC+LPV/r as empirical first regimen. In adolescents, consider TDF+3TC+EFV. The preferred ARV treatment in children who failed first line regimens of 2NRTI+NNRTI (Salvage treatment) comprises 2NRTI (guided by genotype) +LPV/r, and an alternative regimen is 2NRTI (guided by genotype) +ATV/ r (use in cases with dyslipidemia who are six years or older). In cases with extensive NRTI resistance with no effective NRTI option available, double boosted PI with LPV/r+SQV or LPV/r+IDV can be considered. Consultation with an expert is recommended. Laboratory monitoring is recommended for CD4 and every six months. Viral load at least at 6 and 12 months after initiation or change of regimen, then yearly thereafter. More frequent viral load monitoring is advised for cases with unsuccessful virologic response, infants, children with imperfect adherence, or those using of third line regimens. Toxicity monitoring depends on the drug received, at least every six months, and more often as clinically indicated. These include, but are not limited to, complete blood count, renal function tests, liver function tests, urinanalysis, and lipid profiles. Therapeutic drug monitoring is recommended in cases that have ARV-related toxicity, receiving non-standard dosing or regimens, using double boosted PI, and in those with renal or hepatic impairment.

Schlüsselwörter

  • HIV
  • pediatrics
  • Thai guidelines
access type Uneingeschränkter Zugang

Thai national guidelines for antiretroviral therapy in HIV-1 infected adults and adolescents 2010

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 515 - 528

Zusammenfassung

Abstract

In Thailand, more than 150,000 patients are currently treated with antiretroviral drugs under the support of the National AIDS Program (NAP). The appointed Adults and Adolescents Committee consisted of 28 members who are experts in HIV research, patient care or health care policy. Relevant published literature, guidelines, and the most recent relevant clinical trials presented internationally were reviewed. Several peer review and clinical studies conducted in Thailand were included in the review process. Special considerations for patients with co-infection of tuberculosis or hepatitis B were incorporated. Appropriate cut-off of CD4+ T-cell counts when to commence ART among Thai patients have been considered. It is now recommended to start ART at CD4+ T-cell count <350 cells/mm3. For treatment-naive patients, the preferred initial therapy is a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimen containing lamivudine plus zidovudine or tenofovir. Stavudine will be phased out in a two-year plan at the national program level. Viral load and CD4+ T-cell counts should be monitored at least once and twice a year. To achieve long-term treatment success, enhancing adherence together with the proper management of antiretroviral-related toxicity is critical. In summary, the major changes from the Thai 2008 guidelines include commencing ART earlier. ART is recommended regardless of CD4+ T cell count if patients have an indication to treat their HBV co-infection. Preferred first regimen uses AZT or TDF, not d4T as the NRTI-backbone. Furthermore, efavirenz is now considered a preferred NNRTI, along with nevirapine.

Schlüsselwörter

  • Adolescent
  • adult
  • antiretroviral
  • HIV
  • Thai guidelines
access type Uneingeschränkter Zugang

Thai national guidelines for the prevention of motherto- child transmission of HIV: March 2010

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 529 - 540

Zusammenfassung

Abstract

Thailand has been one of the leading developing countries to implement a national program to prevent mother-to-child transmission (MTCT) of HIV. Although the recent transmission rate has been low, the goal is to eliminate MTCT altogether. The Thai National HIV Guidelines Working Group issued treatment guidelines to prevent MTCT in Thailand in March 2010. These guidelines will be implemented nationwide within a year. The most important aspects of these new guidelines are as follows: Treatment in HIV-infected pregnant women who have not been on antiretroviral treatment prior to pregnancy. Antepartum treatment is recommended for all pregnant women regardless of CD4 count with highly active antiretroviral therapy (HAART) containing zidovudine (AZT) + lamivudine (3TC) + lopinavir/ritonavir (LPV/r). Treatment should be started immediately irrespective of gestational age in women with CD4 count <350 cells/ mm3, and as early as 14 weeks of gestation in those with CD4 count >350 cells/mm3. After delivery, women with baseline CD4 count <350 cells/mm3 are referred for long-term care and HAART according to the National Adult HIV Treatment and Care Guidelines 2010. Women with CD4 count >350 cells/mm3 do not need HAART and can stop all drugs after delivery. The treatment in infants includes AZT syrup for four weeks and exclusive formula feeding. Treatment in HIV-infected pregnant women who conceive while on HAART. Women who are stable on HAART should continue the treatment during the whole period of pregnancy. Those who are taking efavirenz (EFV) and present during the first trimester should have EFV switched to another drug. Whenever possible, AZT should be used during pregnancy. Treatment in infants is similar to the above scenario. Treatment in women who present in labor without antenatal care. Single-dose nevirapine (SD-NVP) 200 mg must be given immediately along with oral AZT 300 mg every three hours until delivery, or oral AZT 600 mg given as a single dose. The tail therapy of AZT + 3TC + LPV/r for four weeks should be given unless these women have a CD4 count of <350 cells/mm3 and therefore require life-long HAART. SD-NVP should not be given if the women are to deliver within two hours. The infants in this situation should receive AZT + 3TC + NVP for four weeks. Treatment during delivery and mode of delivery. During labor, oral AZT 300 mg every three hours or oral AZT 600 mg given as a single dose is recommended regardless of antepartum antiretroviral (ARV) regimen or the woman’s history of AZT resistance. Elective caesarean section is suggested in women who did not receive HAART (including those without antenatal care), received HAART for less than four weeks prior to delivery, had poor adherence, or had incomplete viral suppression at 36 weeks of gestation.

Schlüsselwörter

  • HIV
  • mother-to-child transmission
  • Thai guidelines
access type Uneingeschränkter Zugang

d4T: keep it or abandon it?

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 541 - 546

Zusammenfassung

Abstract

Stavudine is a nucleoside analogue used widely for first-line treatment of HIV in developing and middleincome countries. The World Health Organization recommended that all patients should switch to stavudine (30mg BID). However, there is evidence from the dose-ranging trials that patients with body weight below 60kg should use a dose of 20mg BID. For patients who show adverse events on stavudine, a switch to other nucleoside analogues can be considered. This article reviews d4T to study if it should be kept or abandoned.

Schlüsselwörter

  • Dose reduction
  • resource limited setting
  • stavudine
access type Uneingeschränkter Zugang

Epidemiological patterns and risk factors associated with hepatitis B virus in Pakistani population

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 547 - 554

Zusammenfassung

Abstract

Hepatitis B virus prevalence is increasing in Pakistani population. National level estimates regarding the prevalence are missing. People are unaware of the risk factors involved in HBV transmission. The objective of the study was to review the prevalence, genotypes, and risk factors associated with HBV transmission in Pakistani Population. Literature search was done by using keyword HBV prevalence, genotypes and risk factors from Pakistani population at Pubmed, PakMediNet and Google scholar. Six different studies showed that the percentage prevalence of HBV in general population was 4.61±0.73%, and 21 different studies showed the percentage prevalence of 2.33±0.46% in blood donors. High prevalence of 7.94±1.49% and 12.86±4.52% were observed in multi transfused and IDU populations. Six different studies showed that the major prevalent genotype was D. Awareness regarding various risk factors involved in-viral transmission was very low. Prevalence of HBV was very high in multitransfused populations due to non-implementations of international standards regarding blood transfusions. Barbers were unaware of the risk factors associated with their shops in viral transmission. Practices of unsterilized dental and surgical instruments and recycling of syringes were major factors in viral transmission. Massive awareness and vaccination programs are required to decrease the future burden of HBV from Pakistani population.

Schlüsselwörter

  • Genotypes
  • HBV
  • Pakistan
  • prevalence
  • risk factors
access type Uneingeschränkter Zugang

Symptomatic intraventricular xanthogranulomas

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 555 - 562

Zusammenfassung

Abstract

This article reviews symptomatic intraventricular xanthogranulomas, based on a case presentation. Bilateral xanthogranulomas of the choroid plexus were removed surgically from the lateral ventricles of a 12-year-old boy. At 9 years of age, he had evidence of increased intracranial pressure and was hospitalized. Dense enhancing masses were detected in computerized tomogram (CT) brain scan. The lesions were in the region of trigones with extension into the temporal horns and into the right occipital horn. The masses were brightly yellow and greasy. They measured 8.5 x 5.5 x 3.5 cm and 10 x 6.5 x 4.5 cm, respectively, and proved to be xanthogranulomas. Review of 35 reported symptomatic intraventricular xanthogranulomas revealed 11 lesions in the lateral ventricles in which six of them were bilateral. Twenty-two lesions were in the third ventricle, and two lesions were in the fourth ventricle. The lesion shows no significant sexual predilection. The patients’ average age is 37.6 years for males, 32.4 years for females, and 34.3 years for both sexes. The size of symptomatic lesions ranged from 1 to 3 cm in diameter but a few were large, up to 8 to 10 cm. The origin of foamy (xanthoma) cells in the xanthogranulomas arising in the choroid plexus is thought to be multicentric including the choroidal epithelium and stromal arachnoidal cells that have undergone xanthomatous changes. Increased intracranial pressure is the significant clinical feature of the intraventricular xanthogranulomas as in other mass lesions within the skull. Surgical extirpation is the treatment of choice if the lesion is accessible and the patient’s general condition is suitable.

Schlüsselwörter

  • Choroid plexus
  • increased intracranial pressure
  • xanthogranuloma
  • xanthoma
access type Uneingeschränkter Zugang

Prevalence of respiratory viruses isolated from dogs in Thailand during 2008-2009

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 563 - 569

Zusammenfassung

Abstract

Background: A highly contagious respiratory disease in canines is infectious tracheobronchitis or kennel cough characterized by inflammation of the upper respiratory tract. The cause of kennel cough has been associated with multiple or complex agents such as canine adeno virus (CAV), canine influenza virus (CIV), canine distemper virus (CDV), and canine para influenzavirus (CPIV). Objective: Study the prevalence of canine respiratory viruses detected from in Thailand during 2008-2009. Methods: Nasal swab samples collected from 102 healthy dogs and 109 dogs with respiratory diseases. Then CAV, CIV, CDV, and CPIV were detected by in-house nested PCR and further confirmed by nucleotide sequencing. Results: Nested PCR showed that primers designed and used in this study yielded high specificity without any non-specific amplification. The prevalence of CAV, CIV, CDV and CPIV in healthy dogs was 0%, 2.94%, 2.94%, and 0.98%, whereas that found in dogs with respiratory diseases was 9.17%, 1.83%, 2.75%, and 11.93%, respectively. In healthy dogs, co-infection with CPIV + CDV was detected in only 0.98%. On the other hand, dogs with respiratory symptoms showed multiple infections with CAV + CIV in 1.83%, CIV + CPIV in 0.92%, CAV + CPIV in 1.83%, and CAV + CDV + CPIV in 0.92%. Conclusion: The prevalence data obtained from this study may be useful for outbreak preventions and to raise awareness of potential transmission of the newly emerged canine influenza virus to humans.

Schlüsselwörter

  • Canine
  • prevalence
  • respiratory viruses
  • Thailand
access type Uneingeschränkter Zugang

Cost-effectiveness of budesonide/formoterol maintenance and rescue therapy in Thailand

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 571 - 578

Zusammenfassung

Abstract

Background: The prevalence of asthma has increased significantly in Thailand. Budesonide/formoterol maintenance and reliever therapy has been available for several years. However, cost-effectiveness of such treatment has never been examined in Thailand. Objective: Design a cost-effectiveness (CE) analysis conducted from a Thai healthcare perspective as a piggyback study accompanying a recent clinical trial. Methods: The CE analysis was conducted from the healthcare provider’s perspective. Data were collected from a six-month, double-blind, multi-national study involving 3321 symptomatic asthma patients randomized to either: bud/form maintenance and reliever therapy, bud/form 320/9 μg bid plus terbutaline as needed, or salmeterol/ fluticasone (salm/flut) 25/125 μg two inhalations bid plus terbutaline as needed. Efficacy was determined as the number of exacerbations per patient during a six-month period. Thai unit costs were collected from the national sources and expert opinions, and applied to the resource use data for a deterministic economic evaluation. Results: There were significantly fewer exacerbations in the bud/form maintenance and reliever therapy (0.12 events/patient/6 months) group vs. the bud/form (0.16 events/patient/6 months, p <0.01), or salm/flut groups (0.19 events/patient/6 months, p <0.001). Total direct costs (healthcare visits and drug costs) were 27.0% and 5.9% lower in the bud/form maintenance and reliever therapy group than in the bud/form and salm/flut groups, respectively. Conclusion: Bud/form maintenance and reliever therapy was associated with significantly fewer exacerbations, compared to other fixed combination treatments in a recent multi-national clinical trial. This might result in lower direct costs if applied to the Thai healthcare system.

Schlüsselwörter

  • Asthma
  • budesonide
  • cost-effectiveness analysis
  • formoterol
  • Thailand
access type Uneingeschränkter Zugang

Rod stiffness effect on adjacent segmental degeneration: a comparative long-term study

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 579 - 584

Zusammenfassung

Abstract

Background: Adjacent segment disease (ASD) is a major complication following spinal instrumentation and fusion. The search for of the rod flexibility factors responsible for junctional degeneration is still ongoing. Objective: Determine the rod stiffness and ASD following posterior instrumentation and fusion for lumbar spine and find the proper rod diameter for adult spinal instrumentation for fusion. Subject and methods: Retrospective evaluation of all patients requiring spinal instrumentation to determine the different rod diameter that predispose toward junctional degeneration was completed. All patients requiring spinal instrumentation over a one-year period were studied retrospectively. One-hundred eight-seven patients (mean age 61.6 years) who had undergone decompression and fusion with pedicle screw instrumentation were evaluated. The average follow-up was 4.2 years. The average number of levels fused was 2.9 segments (range: 1-8). Adjacent spinal level pre- and post-operatively was determined on the plain X-rays. Junctional degeneration was defined as new episode of degeneration of the adjacent level on radiologic finding. Asymptomatic patients did not demonstrate junctional degeneration on the routine post-operative X-rays. Results: ASD developed in 15 (8.0%) out of 187 patients, including compression fractures (n=2), spinal stenosis (n=6), and symptomatic disc collapse (n=7). There was a close correlation between the posterior instrument stiffness and the development of ASD (p=0.011). For fusion and fixation with 5.5 mm and 6.0 mm rod diameter, ASD occurred in four (3.7%) out of 108 patients and in 11 (13.9 %) out of 79 patients, resepectively. The incidences of ASD were greater when the posterior instrument used were stiffer in lumbar spine fusion. The pre-operative age, gender, and indication for surgery were not associated with the development of ASD. Conclusion: The prevalence of symptomatic ASD relatively increased with increasing stiffness of spinal implant. The diameter of the longitudinal rod strongly affected the fixator loads, and influenced the stresses in the vertebral endplates. The rod diameter had influence on the stresses in the adjacent spinal motion segment.

Schlüsselwörter

  • Adjacent degeneration
  • adjacent segment disease (ASD)
  • posterior spinal instrumentation stiffness
access type Uneingeschränkter Zugang

Chest radiographic findings in children with asplenia syndrome

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 585 - 594

Zusammenfassung

Abstract

Background: Early diagnosis of asplenia syndrome is important because prophylactic antibiotic and proper vaccination will prevent serious infection. Most children with asplenia syndrome present with symptoms of congenital heart disease. Chest X-ray is usually the first line imaging modality. Objective: Define useful findings in chest radiograph that could suggest the diagnosis of asplenia syndrome. Methods: Chest radiographs of pediatric patients who had asplenia syndrome diagnosed between January 1, 2002 and June 30, 2008 in a single institute were retrospectively reviewed for the positions of the visceral organs in the chest and abdomen. Results: Three hundred seventy one chest radiographs of 30 patients were reviewed. The mean age at diagnosis was 3 years old. Asplenia was diagnosed by ultrasound in 27 patients, by CT scan in two patients, and by damaged red blood cell scintigraphy in one patient. Six important findings detected from chest radiographs were, 1) bilateral minor fissures, 16 cases (53%), 2) bilateral eparterial bronchi, 16 cases (53%), 3) ipsilateral side of stomach and liver, 12 cases (40%), 4) ipsilateral side of minor fissure or eparterial bronchus and stomach, 10 cases (33%), 5) symmetrical transverse lie of the liver, nine cases (30%), and 6) contralateral side of minor fissure or eparterial bronchus and the liver in seven cases (23%). All except two patients (93%) had at least one of the above findings. All patients had congenital heart diseases. Most of the heart diseases were pulmonary atresia or pulmonary stenosis (88%) and single ventricle (85%). Conclusion: Chest radiographs have high sensitivity in suggesting the diagnosis of asplenia syndrome, when detecting one or more of the above findings, particular in patients with congenital heart disease and decreased pulmonary vasculature.

Schlüsselwörter

  • Asplenia
  • chest X-ray
  • children
  • congenital heart disease
  • heterotaxia
  • minor fissure
  • situs ambiguous
access type Uneingeschränkter Zugang

Anterior displacement of anus: a common association with constipation in infancy

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 595 - 601

Zusammenfassung

Abstract

Background: Anterior displacement of the anus (ADA), a common congenital abnormality of anorectal region, has been recognized as a common cause of constipation. However, the more recent studies have failed to demonstrate an association between the anterior displacement and constipation self. Objective: Investigate the association between ADA and constipation. Methods: Four hundred and three neonates have been examined and their anal position index (API) has been determined. API less than 0.46 and 0.34 in males and females, respectively, is defined as ADA. A 6-month prospective cohort study has been conducted to evaluate the association between ADA and constipation. Results: Overall incidence of ADA is 24.8%, while the incidence is significantly higher in females than males (32.0% and 17.7%, respectively; p <0.01). Compared to the first child, later birth order, especially the second child, trends to have an increased risk of ADA (Odd ratio=1.75; 95%CI=1.06-2.90). Average maternal age of ADA is higher than control (28.2 and 26.6 years, respectively; p=0.02). Overall incidence of constipation is 10.1% without any difference between ADA group and control (12.0 and 9.5%, respectively). Nevertheless, at six months incidence of constipation is higher in ADA than in control (6.7% and 0.8%, respectively; p < 0.01). The incidences of ADA in infants with constipated events at 2, 4 and 6 months of age are 10.0%, 33.3%, and 71.4%, respectively. Conclusion: ADA is a common finding with reported incidence of one-quarter of neonates. Female genre, later birth order and higher maternal age are risk factors of ADA. Children with ADA have an increased tendency toward constipation corresponding with increasing age. API measurement during pediatric examination is recommended to achieve a complete evaluation of infancy constipation.

Schlüsselwörter

  • Anal position
  • anterior displacement
  • anus
  • constipation
  • infant
access type Uneingeschränkter Zugang

Anatomy of the facial nerve branching patterns, the marginal mandibular branch and its extraparotid ramification in relation to the lateral palpebral line

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 603 - 608

Zusammenfassung

Abstract

Background: Surgery of face and parotid gland may cause injury to branches of the facial nerve, which results in paralysis of muscles of facial expression. Knowledge of branching patterns of the facial nerve and reliable landmarks of the surrounding structures are essential to avoid this complication. Objective: Determine the facial nerve branching patterns, the course of the marginal mandibular branch (MMB), and the extraparotid ramification in relation to the lateral palpebral line (LPL). Materials and methods: One hundred cadaveric half-heads were dissected for determining the facial nerve branching patterns according to the presence of anastomosis between branches. The course of the MMB was followed until it entered the depressor anguli oris in 49 specimens. The vertical distance from the mandibular angle to this branch was measured. The horizontal distance from the LPL to the otobasion superious (LPL-OBS) and the apex of the parotid gland (LPL-AP) were measured in 52 specimens. Results: The branching patterns of the facial nerve were categorized into six types. The least common (1%) was type I (absent of anastomosis), while type V, the complex pattern was the most common (29%). Symmetrical branching pattern occurred in 30% of cases. The MMB was coursing below the lower border of the mandible in 57% of cases. The mean vertical distance was 0.91±0.22 cm. The mean horizontal distances of LPL-OBS and LPLAP were 7.24±0.6 cm and 3.95±0.96 cm, respectively. The LPL-AP length was 54.5±11.4% of LPL-OBS. Conclusion: More complex branching pattern of the facial nerve was found in this population and symmetrical branching pattern occurred less of ten. The MMB coursed below the lower border of the angle of mandible with a mean vertical distance of one centimeter. The extraparotid ramification of the facial nerve was located in the area between the apex of the parotid gland and the LPL.

Schlüsselwörter

  • Branching patterns
  • facial nerve
  • lateral palpebral line
  • marginal mandibular branch
  • parotid gland
access type Uneingeschränkter Zugang

Association of Helicobacter pylori with colorectal cancer development

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 609 - 618

Zusammenfassung

Abstract

Background: Helicobacter pylori (H. pylori) may be associated with colorectal cancer. However, the underlying mechanisms are still unclear. Objectives: Explore the serostatus of H. pylori cytotoxicity-associated gene A product (CagA) in patients with colorectal carcinoma, and assess the association of H. pylori with colorectal cancer via c-Myc and MUC-2 proteins at tumor tissues. Methods: H. pylori CagA IgG antibodies were screened using enzyme-linked immunosorbent assay (ELISA) in 30 patients with colorectal carcinoma and 30 cancer-free control subjects. Paraffin-embedded blocks were examined for the expression of c-Myc and MUC-2 protein by immunohistochemistry. Results: H. pylori CagA seropositivity increased significantly among colorectal cancer patients (p <0.05). The expression of c-Myc and MUC-2 in colorectal carcinoma patients was over-expressed (80%), and downexpressed (63%) in resection margins (p <0.05). c-Myc over-expression and MUC-2 down-expression were associated with CagA-positive rather than CagA-negative H. pylori patients. In 16 CagA seropositive vs. 14 CagA seronegative patients, the expression rate was 97.3% vs. 64.2% and 33.3% vs. 78.5% for cMyc and MUC-2, respectively. CagA IgG level was significantly higher in positive than in negative c-Myc patients (p= 0.036), and in negative than in positive MUC-2 patients (p= 0.044). c-Myc and MUC-2 were positively and inversely correlated with CagA IgG level (p <0.05). Conclusions: CagA-seropositive H. pylori is most probably associated with colorectal cancer development. Part of the underlying mechanism for such association might be via alterations in expression of MUC-2, which depletes the mucous protective layer in the colo-rectum, and c-Myc, which stimulates the growth of cancerous cells.

Schlüsselwörter

  • Helicobacter pylori
  • colorectal cancer
  • Cag-A
  • MUC-2
access type Uneingeschränkter Zugang

Effects of intense exercise on biochemical and histological changes in rat liver and pancreas

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 619 - 625

Zusammenfassung

Abstract

Background: Exercise has various effects on hepatic and pancreatic function. There is little information available for effects of exercise on histopathological changes in the liver and pancreas. Objective: Investigate the effect of intensive exercise on blood biochemical changes and histopathology in rat liver and pancreas. Materials and methods: Male Sprague-Dawley rats were randomly divided into five groups: 1 (normal control): no exercise, 2 (exercise 75% VO2max): running on treadmill at 75% VO2max and sacrificed immediately after exercise, 3 (exercise 75% VO2max+6 hours): running on treadmill at 75% VO2max and sacrificed at six hours after exercise, 4 (exercise 90% VO2max): running on treadmill at 90% VO2max and immediately sacrificed after exercise, 5 (exercise 90% VO2max+6 hours): running on treadmill at 90% VO2max and sacrificed at six hours after exercise. Samples of blood, liver and pancreas were collected at the end of each experiment. Results: The levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) increased significantly in group 2 and 4, compared with normal control. Serum total bilirubin (TB) and enzyme lipase increased significantly in group 4 compared with normal control. In all group of exercise, liver histopathology showed hepatocyte edema and necroinflammation, and pancreas showed congestion and edema. Conclusion: High-intensity exercise at 75% and 90% VO2max caused an increase of biochemical parametes in liver and pancreas. The levels of exercise also caused histopathology changes in the liver and pancreas.

Schlüsselwörter

  • Intense exercise
  • lipase
  • liver function
  • pancreas
access type Uneingeschränkter Zugang

Oral fluoropyrimidine-induced severe hyperlipidemia

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 627 - 630

Zusammenfassung

Abstract

Background: Severe hyperlipidemia secondary to capecitabine, an oral fluoropyrimidine, is a very rare condition. There are no reported cases of hyperlipidemia associated with Uracil/tegafur (UFT). Objective: Report UFT-induced severe hyperlipidemia. Method: A 71-year-old male patient with metastatic colorectal cancer receiving capecitabine treatment was hospitalized at the end of the eighth cycle with the complaint of fatigue. Capecitabine treatment was discontinued in the patient in whom severe hyperlipidemia was detected together with disease progression. Gemphibrozile 1200 mg/day was initiated; patient’s triglyceride level and serum cholesterol decreased from 1768 to 149 mg/dL and from 497 to 99 mg/dL, respectively, five weeks later. The patient started to receive UFT chemotherapy and after the second cycle, he presented to our hospital again with the complaints of fatigue, headache, and yellow vision. The investigations revealed a serum triglyceride level of 4115 mg/dL and a cholesterol level of 734 mg/dL. Results: UFT chemotherapy was discontinued and lipopheresis was administered for three consecutive days, and gemphibrozile was initiated again at a dose of 1200 mg/day. The clinical presentation might be due to oral fluoropyrimidine. Three weeks later, serum cholesterol and triglyceride levels decreased to 106 and 403 mg/dL, respectively. Conclusion: This case is a unique case of hyperlipidemia secondary to UFT. Monitoring of lipid levels, when using Fluoropyrimidine, as well as hemograms, liver and renal functions would be appropriate.

Schlüsselwörter

  • Adverse event
  • capecitabine
  • hypertriglyceridemia
  • oral fluoropyrimidine
  • UFT® drug
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Comparison between Pseudomonas aeruginosa siderophores and desferrioxamine for iron acquisition from ferritin

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 631 - 635

Zusammenfassung

Abstract

Background: Siderophore is an iron chelator produced by microorganism. Pseudomonas aeruginosa produces two siderophores (pyoverdin and pyochelin). Desferrioxamine is a siderophore used in thalassemia patients to treat an iron overload of vital organs. Objective: Compare the ability of pyoverdin, pyochelin, and desferrioxamine for iron mobilization from ferritin. Materials and Methods: In vitro experiment, the ability of P. aeruginosa siderophores and desferrioxamine for iron mobilization from ferritin was compared by using a dialysis membrane assay at pH values of 7.4 and 6.0. Stimulation of P. aeruginosa PAO1 growth by all siderophores was studied in glucose minimum medium. Results: All three compounds were capable of iron mobilization at both pHs. At pH 6.0, the most effectiveness compound was desferrioxamine (31.6%), followed by pyoverdin (21.5%) and pyochelin (13.7%) compared on weight basis, each at 10 μg/mL. At equimolar concentration, their activities were desferrioxamine (38.5±1.2%), followed by pyoverdin (32.0±4.8%) and pyochelin (26.7±1.9%), respectively. Conclusion: The most effective compound in iron mobilization from ferritin was desferrioxamine, followed by pyoverdin and pyochelin respectively.

Schlüsselwörter

  • Desferrioxamine
  • ferritin
  • Pseudomonas aeruginosa
  • pyochelin
  • pyoverdin
  • siderophores
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Detection of Neisseria gonorrhoeae in Palestinian women using polymerase chain reaction

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 637 - 640

Zusammenfassung

Abstract

Background: Neisseria gonorrohoeae is an exclusive human pathogen that primarily infects the urogenital epithelia. Infections caused by N. gonorrhoeae are considered the second major cause of sexually transmitted disease after Chlamydiae worldwide. Although the urethra and the uterine cervix serve as the initial sites for gonococcal infections in men and women, infection of the conjunctiva, pharynx, tendons, joints, as well as rectal mucosa are also reported. Objectives: The objectives of this study were to introduce molecular techniques such as polymerase chain reaction (PCR) to detect N. gonorrhoeae directly from endocervical swabs. In addition, it provides a picture of Neisseria gonorrohea infection among a sample of Palestinian women in West Bank. Methods: Two hundred and thirteen endocervical swabs were collected from sexually active married women with endocervical abnormalities attending healthcare clinics. DNA was extracted directly from the swabs and PCR was performed using specific primers targeting the orf1 region of the genome. Results: The results obtained indicated that the percentage of positive cases of N. gonorrhoeae among the women tested was 1.40%. Conclusion: Implementing guidelines for comprehensive screening of men and women with more sensitive tests may improve detection and management of sexually transmitted infections.

Schlüsselwörter

  • Endocervix
  • Neisseria gonnorhoeae
  • Palestine
  • PCR
  • sexually transmitted disease
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Anatomic direction of entry for botulinum toxin injection to treat the adductor spasmodic dysphonia in Thais

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 641 - 644

Zusammenfassung

Abstract

Background: Botulinum toxin injections into the thyroarytenoid (TA) muscle of the larynx is the most popular treatment for adductor spasmodic dysphonia. Injection is usually done by percutaneous transcricothyroid membrane with either electromyography (EMG) or fiberoptic laryngoscopy (FOL) to verify placement of the needle within the TA muscle. This procedure requires a working knowledge of three-dimensional anatomy of the larynx to establish the direction for the accurate placement of the needle. Objective: Find out the appropriate angles and depth of the needle for placement of percutaneous transcricothyroid membrane method of botulinum toxin injection by means of studying the larynges of Thai cadavers. Methods: The descriptive study was performed in 45 Thai freshly thawed cadavers. The angle of the needle from midline sagittal plane, the angle in superior relation to tracheal plane, and the depth from midline cricothyroid (CT) membrane to midlength of TA muscle were measured from the two views of photographs, anteroposterior and lateral. Results: The mean angle of 24.2±6.76° (mean±SD) from the midline sagittal plane in male and 24.9±7.6° in female were worked out. A mean angle in superior relation to the tracheal plane was 47.7±7.8° and 51.4±9.6° in male and female, respectively. The mean depth was 1.7±0.2 and 1.4±0.1 cm in male and female, respectively. Conclusion: The mean angles and depth of the needle insertion from the midline of CT membrane to the center of TA muscle in Thai laryngeal specimens were evaluated. These values were different from the studies in Caucasians, but it could provide a direct relationship to the build of the races. This knowledge may help laryngologists do this procedure more accurately with better outcome, especially in hospitals that have no EMG or FOL guide.

Schlüsselwörter

  • Anatomic direction of entry
  • botulinum toxin
  • spasmodic dysphonia
  • Thais
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Eye diseases associated with obstructive sleep apnea syndrome in an Asian population

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 645 - 650

Zusammenfassung

Abstract

Background: Sleep apnea syndrome is one of the leading causes of excessive daytime sleepiness. There is no literature exploring the prevalence of sleep-associated disorders in the eye of Asians with obstructive sleep apnea syndrome (OSA). Objective: Study the prevalence of eye abnormalities in Asian patients with OSA. Material and method: Asian patients with definite OSA diagnosis via the polysomnography were recruited into the study. Complete eye examination and special investigations were performed to define eye diseases: floppy eyelids, dry eyes, keratoconus, Fuchs’ endothelial dystrophy, recurrent corneal erosions, open-angle glaucoma, ophthalmoplegia, papilledema and optic neuropathy. Results: One-hundred Asian OSA patients were examined. We found that floppy eyelids, dry eyes, and normal tension glaucoma were more prevalent compared to the normal population. Abnormal endothelial change and papilledema were detected. Optic neuropathy and ophthalmoplegia were not found in this study, although some patients did have subnormal contrast sensitivity. Conclusion: There is a higher prevalence of floppy eyelids, dry eyes, and glaucoma in OSA patients. Complete eye examination is recommended in OSA patients to detect early eye abnormalities.

Schlüsselwörter

  • Dry eye
  • floppy eyelids
  • obtructive sleep apnea
  • normal tension glaucoma
  • papilledema
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Antibacterial efficacy of Bacopa monnieri leaf extracts against pathogenic bacteria

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 651 - 655

Zusammenfassung

Abstract

Background: Bacopa monnieri (Linn) Pennell (Scrophulariaceae) is widely distributed in tropical regions of Asia, and used in the treatment of cough or as an antiseptic. The traditional use of this plant suggests its possible antibacterial properties, but its efficacy has not been examined yet. Objective: Evaluate the antibacterial efficacy against pathogenic bacteria using the disk diffusion method. Materials and methods: Five different concentrations (500 μg, 1, 2, 5, 10, and 15 mg/mL) of crude leaf extracts of Bacopa monnieri (L.) Pennell were tested for antibacterial efficacy against seven Gram-positive and 11 Gramnegative bacteria. The sensitivity of plant fractions was tested using the disk diffusion method. Results: Maximum activity was revealed by ethyl acetate and methanol extracts, followed by aqueous, benzene, and petrol extracts. Phyto-chemical analysis of the plant leaf showed the presence of alkaloids, flavonoids, and saponins. Conclusion: This plant may be effective for treatment of different pathogenic diseases.

Schlüsselwörter

  • Antibacterial efficacy
  • Bacopa monnieri (L.) Pennell
  • crude extracts
  • traditional use
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Airflow inside the nasal cavity: visualization using computational fluid dynamics

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 657 - 661

Zusammenfassung

Abstract

Background: It is of clinical importance to examine the nasal cavity pre-operatively on surgical treatments. However, there is no simple and easy way to measure airflow in the nasal cavity. Objectives: Visualize the flow features inside the nasal cavity using computational fluid dynamics (CFD) method, and study the effect of different breathing rates on nasal function. Method: A three-dimensional nasal cavity model was reconstructed based on computed tomographic images of a healthy Malaysian adult nose. Navier-Stokes and continuity equations for steady airflow were solved numerically to examine the inspiratory nasal flow. Results: The flow resistance obtained varied from 0.026 to 0.124 Pa.s/mL at flow-rate from 7.5 L/min to 40 L/min. Flow rates by breathing had significant influence on airflow velocity and wall shear-stress in the vestibule and nasal valve region. Conclusion: Airflow simulations based on CFD is most useful for better understanding of flow phenomenon inside the nasal cavity.

Schlüsselwörter

  • CFD
  • inspiration
  • resistance
  • velocity
  • wall shear stress
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How not to fight a rabies epidemic: a history in Bali

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 663 - 670

Zusammenfassung

Abstract

Bali, an island, should never have been afflicted with canine rabies, but in 2008 a lack of surveillance allowed the import of an unvaccinated rabid dog from Flores, a distant island where canine rabies was similarly introduced in 1997 and has since become endemic. The initial rabies outbreak on Bali occurred in a remote village at the end of an isolated peninsula, but five months elapsed before the outbreak was officially recognized. Even then, rabies had yet to escape the peninsula. However, Bali officials relied on exterminating dogs as their primary control strategy. They did not vaccinate enough dogs on the neck of the peninsula to keep the outbreak confined, they prevented nongovernmental organizations and private citizens from vaccinating dogs until approximately a year after the outbreak started, they used unreliable indigenous vaccines of only short-term potency; killed vaccinated dogs, and they repeatedly disregarded the advice of visiting rabies control experts. Two years after the outbreak started, 44,000 people had received post-exposure vaccination after suffering bites from suspected rabid dogs. The number of human rabies deaths had doubled each six months since the first death occurred.

Schlüsselwörter

  • Dog control
  • immunoglobulin
  • method for culling
  • rabies
  • vaccines
  • vector dogs
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World Rabies Day (September 28, 2010): the continuing effort to ‘make rabies history’

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 671 - 671

Zusammenfassung

23 Artikel
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Thai national guidelines for the use of antiretroviral therapy in pediatric HIV infection in 2010

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 505 - 513

Zusammenfassung

Abstract

With better knowledge and availability of antiretroviral treatments, the Thai National HIV Guidelines Working Group has issued treatment guidelines for children in Thailand in March 2010. The most important aspects of these new guidelines are detailed below. ART should be initiated in infants less than 12 months of age at any CD4 level regardless of symptoms and in all children at CDC clinical stage B and C or WHO clinical stages 3 and 4. For children with no or mild symptoms consider CD4-guided thresholds of CD4 <25% (children aged one to five years) or CD4 <350 cells/mm3 (children 5 years or older). The preferred first-line regimen in children aged < 3 years is AZT+3TC+NVP. For children >3 years of age the preferred regimen is AZT+3TC+EFV. If an infant has previously been exposed to NVP perinatally, use AZT+3TC+LPV/r as empirical first regimen. In adolescents, consider TDF+3TC+EFV. The preferred ARV treatment in children who failed first line regimens of 2NRTI+NNRTI (Salvage treatment) comprises 2NRTI (guided by genotype) +LPV/r, and an alternative regimen is 2NRTI (guided by genotype) +ATV/ r (use in cases with dyslipidemia who are six years or older). In cases with extensive NRTI resistance with no effective NRTI option available, double boosted PI with LPV/r+SQV or LPV/r+IDV can be considered. Consultation with an expert is recommended. Laboratory monitoring is recommended for CD4 and every six months. Viral load at least at 6 and 12 months after initiation or change of regimen, then yearly thereafter. More frequent viral load monitoring is advised for cases with unsuccessful virologic response, infants, children with imperfect adherence, or those using of third line regimens. Toxicity monitoring depends on the drug received, at least every six months, and more often as clinically indicated. These include, but are not limited to, complete blood count, renal function tests, liver function tests, urinanalysis, and lipid profiles. Therapeutic drug monitoring is recommended in cases that have ARV-related toxicity, receiving non-standard dosing or regimens, using double boosted PI, and in those with renal or hepatic impairment.

Schlüsselwörter

  • HIV
  • pediatrics
  • Thai guidelines
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Thai national guidelines for antiretroviral therapy in HIV-1 infected adults and adolescents 2010

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 515 - 528

Zusammenfassung

Abstract

In Thailand, more than 150,000 patients are currently treated with antiretroviral drugs under the support of the National AIDS Program (NAP). The appointed Adults and Adolescents Committee consisted of 28 members who are experts in HIV research, patient care or health care policy. Relevant published literature, guidelines, and the most recent relevant clinical trials presented internationally were reviewed. Several peer review and clinical studies conducted in Thailand were included in the review process. Special considerations for patients with co-infection of tuberculosis or hepatitis B were incorporated. Appropriate cut-off of CD4+ T-cell counts when to commence ART among Thai patients have been considered. It is now recommended to start ART at CD4+ T-cell count <350 cells/mm3. For treatment-naive patients, the preferred initial therapy is a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimen containing lamivudine plus zidovudine or tenofovir. Stavudine will be phased out in a two-year plan at the national program level. Viral load and CD4+ T-cell counts should be monitored at least once and twice a year. To achieve long-term treatment success, enhancing adherence together with the proper management of antiretroviral-related toxicity is critical. In summary, the major changes from the Thai 2008 guidelines include commencing ART earlier. ART is recommended regardless of CD4+ T cell count if patients have an indication to treat their HBV co-infection. Preferred first regimen uses AZT or TDF, not d4T as the NRTI-backbone. Furthermore, efavirenz is now considered a preferred NNRTI, along with nevirapine.

Schlüsselwörter

  • Adolescent
  • adult
  • antiretroviral
  • HIV
  • Thai guidelines
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Thai national guidelines for the prevention of motherto- child transmission of HIV: March 2010

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 529 - 540

Zusammenfassung

Abstract

Thailand has been one of the leading developing countries to implement a national program to prevent mother-to-child transmission (MTCT) of HIV. Although the recent transmission rate has been low, the goal is to eliminate MTCT altogether. The Thai National HIV Guidelines Working Group issued treatment guidelines to prevent MTCT in Thailand in March 2010. These guidelines will be implemented nationwide within a year. The most important aspects of these new guidelines are as follows: Treatment in HIV-infected pregnant women who have not been on antiretroviral treatment prior to pregnancy. Antepartum treatment is recommended for all pregnant women regardless of CD4 count with highly active antiretroviral therapy (HAART) containing zidovudine (AZT) + lamivudine (3TC) + lopinavir/ritonavir (LPV/r). Treatment should be started immediately irrespective of gestational age in women with CD4 count <350 cells/ mm3, and as early as 14 weeks of gestation in those with CD4 count >350 cells/mm3. After delivery, women with baseline CD4 count <350 cells/mm3 are referred for long-term care and HAART according to the National Adult HIV Treatment and Care Guidelines 2010. Women with CD4 count >350 cells/mm3 do not need HAART and can stop all drugs after delivery. The treatment in infants includes AZT syrup for four weeks and exclusive formula feeding. Treatment in HIV-infected pregnant women who conceive while on HAART. Women who are stable on HAART should continue the treatment during the whole period of pregnancy. Those who are taking efavirenz (EFV) and present during the first trimester should have EFV switched to another drug. Whenever possible, AZT should be used during pregnancy. Treatment in infants is similar to the above scenario. Treatment in women who present in labor without antenatal care. Single-dose nevirapine (SD-NVP) 200 mg must be given immediately along with oral AZT 300 mg every three hours until delivery, or oral AZT 600 mg given as a single dose. The tail therapy of AZT + 3TC + LPV/r for four weeks should be given unless these women have a CD4 count of <350 cells/mm3 and therefore require life-long HAART. SD-NVP should not be given if the women are to deliver within two hours. The infants in this situation should receive AZT + 3TC + NVP for four weeks. Treatment during delivery and mode of delivery. During labor, oral AZT 300 mg every three hours or oral AZT 600 mg given as a single dose is recommended regardless of antepartum antiretroviral (ARV) regimen or the woman’s history of AZT resistance. Elective caesarean section is suggested in women who did not receive HAART (including those without antenatal care), received HAART for less than four weeks prior to delivery, had poor adherence, or had incomplete viral suppression at 36 weeks of gestation.

Schlüsselwörter

  • HIV
  • mother-to-child transmission
  • Thai guidelines
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d4T: keep it or abandon it?

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 541 - 546

Zusammenfassung

Abstract

Stavudine is a nucleoside analogue used widely for first-line treatment of HIV in developing and middleincome countries. The World Health Organization recommended that all patients should switch to stavudine (30mg BID). However, there is evidence from the dose-ranging trials that patients with body weight below 60kg should use a dose of 20mg BID. For patients who show adverse events on stavudine, a switch to other nucleoside analogues can be considered. This article reviews d4T to study if it should be kept or abandoned.

Schlüsselwörter

  • Dose reduction
  • resource limited setting
  • stavudine
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Epidemiological patterns and risk factors associated with hepatitis B virus in Pakistani population

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 547 - 554

Zusammenfassung

Abstract

Hepatitis B virus prevalence is increasing in Pakistani population. National level estimates regarding the prevalence are missing. People are unaware of the risk factors involved in HBV transmission. The objective of the study was to review the prevalence, genotypes, and risk factors associated with HBV transmission in Pakistani Population. Literature search was done by using keyword HBV prevalence, genotypes and risk factors from Pakistani population at Pubmed, PakMediNet and Google scholar. Six different studies showed that the percentage prevalence of HBV in general population was 4.61±0.73%, and 21 different studies showed the percentage prevalence of 2.33±0.46% in blood donors. High prevalence of 7.94±1.49% and 12.86±4.52% were observed in multi transfused and IDU populations. Six different studies showed that the major prevalent genotype was D. Awareness regarding various risk factors involved in-viral transmission was very low. Prevalence of HBV was very high in multitransfused populations due to non-implementations of international standards regarding blood transfusions. Barbers were unaware of the risk factors associated with their shops in viral transmission. Practices of unsterilized dental and surgical instruments and recycling of syringes were major factors in viral transmission. Massive awareness and vaccination programs are required to decrease the future burden of HBV from Pakistani population.

Schlüsselwörter

  • Genotypes
  • HBV
  • Pakistan
  • prevalence
  • risk factors
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Symptomatic intraventricular xanthogranulomas

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 555 - 562

Zusammenfassung

Abstract

This article reviews symptomatic intraventricular xanthogranulomas, based on a case presentation. Bilateral xanthogranulomas of the choroid plexus were removed surgically from the lateral ventricles of a 12-year-old boy. At 9 years of age, he had evidence of increased intracranial pressure and was hospitalized. Dense enhancing masses were detected in computerized tomogram (CT) brain scan. The lesions were in the region of trigones with extension into the temporal horns and into the right occipital horn. The masses were brightly yellow and greasy. They measured 8.5 x 5.5 x 3.5 cm and 10 x 6.5 x 4.5 cm, respectively, and proved to be xanthogranulomas. Review of 35 reported symptomatic intraventricular xanthogranulomas revealed 11 lesions in the lateral ventricles in which six of them were bilateral. Twenty-two lesions were in the third ventricle, and two lesions were in the fourth ventricle. The lesion shows no significant sexual predilection. The patients’ average age is 37.6 years for males, 32.4 years for females, and 34.3 years for both sexes. The size of symptomatic lesions ranged from 1 to 3 cm in diameter but a few were large, up to 8 to 10 cm. The origin of foamy (xanthoma) cells in the xanthogranulomas arising in the choroid plexus is thought to be multicentric including the choroidal epithelium and stromal arachnoidal cells that have undergone xanthomatous changes. Increased intracranial pressure is the significant clinical feature of the intraventricular xanthogranulomas as in other mass lesions within the skull. Surgical extirpation is the treatment of choice if the lesion is accessible and the patient’s general condition is suitable.

Schlüsselwörter

  • Choroid plexus
  • increased intracranial pressure
  • xanthogranuloma
  • xanthoma
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Prevalence of respiratory viruses isolated from dogs in Thailand during 2008-2009

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 563 - 569

Zusammenfassung

Abstract

Background: A highly contagious respiratory disease in canines is infectious tracheobronchitis or kennel cough characterized by inflammation of the upper respiratory tract. The cause of kennel cough has been associated with multiple or complex agents such as canine adeno virus (CAV), canine influenza virus (CIV), canine distemper virus (CDV), and canine para influenzavirus (CPIV). Objective: Study the prevalence of canine respiratory viruses detected from in Thailand during 2008-2009. Methods: Nasal swab samples collected from 102 healthy dogs and 109 dogs with respiratory diseases. Then CAV, CIV, CDV, and CPIV were detected by in-house nested PCR and further confirmed by nucleotide sequencing. Results: Nested PCR showed that primers designed and used in this study yielded high specificity without any non-specific amplification. The prevalence of CAV, CIV, CDV and CPIV in healthy dogs was 0%, 2.94%, 2.94%, and 0.98%, whereas that found in dogs with respiratory diseases was 9.17%, 1.83%, 2.75%, and 11.93%, respectively. In healthy dogs, co-infection with CPIV + CDV was detected in only 0.98%. On the other hand, dogs with respiratory symptoms showed multiple infections with CAV + CIV in 1.83%, CIV + CPIV in 0.92%, CAV + CPIV in 1.83%, and CAV + CDV + CPIV in 0.92%. Conclusion: The prevalence data obtained from this study may be useful for outbreak preventions and to raise awareness of potential transmission of the newly emerged canine influenza virus to humans.

Schlüsselwörter

  • Canine
  • prevalence
  • respiratory viruses
  • Thailand
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Cost-effectiveness of budesonide/formoterol maintenance and rescue therapy in Thailand

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 571 - 578

Zusammenfassung

Abstract

Background: The prevalence of asthma has increased significantly in Thailand. Budesonide/formoterol maintenance and reliever therapy has been available for several years. However, cost-effectiveness of such treatment has never been examined in Thailand. Objective: Design a cost-effectiveness (CE) analysis conducted from a Thai healthcare perspective as a piggyback study accompanying a recent clinical trial. Methods: The CE analysis was conducted from the healthcare provider’s perspective. Data were collected from a six-month, double-blind, multi-national study involving 3321 symptomatic asthma patients randomized to either: bud/form maintenance and reliever therapy, bud/form 320/9 μg bid plus terbutaline as needed, or salmeterol/ fluticasone (salm/flut) 25/125 μg two inhalations bid plus terbutaline as needed. Efficacy was determined as the number of exacerbations per patient during a six-month period. Thai unit costs were collected from the national sources and expert opinions, and applied to the resource use data for a deterministic economic evaluation. Results: There were significantly fewer exacerbations in the bud/form maintenance and reliever therapy (0.12 events/patient/6 months) group vs. the bud/form (0.16 events/patient/6 months, p <0.01), or salm/flut groups (0.19 events/patient/6 months, p <0.001). Total direct costs (healthcare visits and drug costs) were 27.0% and 5.9% lower in the bud/form maintenance and reliever therapy group than in the bud/form and salm/flut groups, respectively. Conclusion: Bud/form maintenance and reliever therapy was associated with significantly fewer exacerbations, compared to other fixed combination treatments in a recent multi-national clinical trial. This might result in lower direct costs if applied to the Thai healthcare system.

Schlüsselwörter

  • Asthma
  • budesonide
  • cost-effectiveness analysis
  • formoterol
  • Thailand
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Rod stiffness effect on adjacent segmental degeneration: a comparative long-term study

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 579 - 584

Zusammenfassung

Abstract

Background: Adjacent segment disease (ASD) is a major complication following spinal instrumentation and fusion. The search for of the rod flexibility factors responsible for junctional degeneration is still ongoing. Objective: Determine the rod stiffness and ASD following posterior instrumentation and fusion for lumbar spine and find the proper rod diameter for adult spinal instrumentation for fusion. Subject and methods: Retrospective evaluation of all patients requiring spinal instrumentation to determine the different rod diameter that predispose toward junctional degeneration was completed. All patients requiring spinal instrumentation over a one-year period were studied retrospectively. One-hundred eight-seven patients (mean age 61.6 years) who had undergone decompression and fusion with pedicle screw instrumentation were evaluated. The average follow-up was 4.2 years. The average number of levels fused was 2.9 segments (range: 1-8). Adjacent spinal level pre- and post-operatively was determined on the plain X-rays. Junctional degeneration was defined as new episode of degeneration of the adjacent level on radiologic finding. Asymptomatic patients did not demonstrate junctional degeneration on the routine post-operative X-rays. Results: ASD developed in 15 (8.0%) out of 187 patients, including compression fractures (n=2), spinal stenosis (n=6), and symptomatic disc collapse (n=7). There was a close correlation between the posterior instrument stiffness and the development of ASD (p=0.011). For fusion and fixation with 5.5 mm and 6.0 mm rod diameter, ASD occurred in four (3.7%) out of 108 patients and in 11 (13.9 %) out of 79 patients, resepectively. The incidences of ASD were greater when the posterior instrument used were stiffer in lumbar spine fusion. The pre-operative age, gender, and indication for surgery were not associated with the development of ASD. Conclusion: The prevalence of symptomatic ASD relatively increased with increasing stiffness of spinal implant. The diameter of the longitudinal rod strongly affected the fixator loads, and influenced the stresses in the vertebral endplates. The rod diameter had influence on the stresses in the adjacent spinal motion segment.

Schlüsselwörter

  • Adjacent degeneration
  • adjacent segment disease (ASD)
  • posterior spinal instrumentation stiffness
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Chest radiographic findings in children with asplenia syndrome

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 585 - 594

Zusammenfassung

Abstract

Background: Early diagnosis of asplenia syndrome is important because prophylactic antibiotic and proper vaccination will prevent serious infection. Most children with asplenia syndrome present with symptoms of congenital heart disease. Chest X-ray is usually the first line imaging modality. Objective: Define useful findings in chest radiograph that could suggest the diagnosis of asplenia syndrome. Methods: Chest radiographs of pediatric patients who had asplenia syndrome diagnosed between January 1, 2002 and June 30, 2008 in a single institute were retrospectively reviewed for the positions of the visceral organs in the chest and abdomen. Results: Three hundred seventy one chest radiographs of 30 patients were reviewed. The mean age at diagnosis was 3 years old. Asplenia was diagnosed by ultrasound in 27 patients, by CT scan in two patients, and by damaged red blood cell scintigraphy in one patient. Six important findings detected from chest radiographs were, 1) bilateral minor fissures, 16 cases (53%), 2) bilateral eparterial bronchi, 16 cases (53%), 3) ipsilateral side of stomach and liver, 12 cases (40%), 4) ipsilateral side of minor fissure or eparterial bronchus and stomach, 10 cases (33%), 5) symmetrical transverse lie of the liver, nine cases (30%), and 6) contralateral side of minor fissure or eparterial bronchus and the liver in seven cases (23%). All except two patients (93%) had at least one of the above findings. All patients had congenital heart diseases. Most of the heart diseases were pulmonary atresia or pulmonary stenosis (88%) and single ventricle (85%). Conclusion: Chest radiographs have high sensitivity in suggesting the diagnosis of asplenia syndrome, when detecting one or more of the above findings, particular in patients with congenital heart disease and decreased pulmonary vasculature.

Schlüsselwörter

  • Asplenia
  • chest X-ray
  • children
  • congenital heart disease
  • heterotaxia
  • minor fissure
  • situs ambiguous
access type Uneingeschränkter Zugang

Anterior displacement of anus: a common association with constipation in infancy

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 595 - 601

Zusammenfassung

Abstract

Background: Anterior displacement of the anus (ADA), a common congenital abnormality of anorectal region, has been recognized as a common cause of constipation. However, the more recent studies have failed to demonstrate an association between the anterior displacement and constipation self. Objective: Investigate the association between ADA and constipation. Methods: Four hundred and three neonates have been examined and their anal position index (API) has been determined. API less than 0.46 and 0.34 in males and females, respectively, is defined as ADA. A 6-month prospective cohort study has been conducted to evaluate the association between ADA and constipation. Results: Overall incidence of ADA is 24.8%, while the incidence is significantly higher in females than males (32.0% and 17.7%, respectively; p <0.01). Compared to the first child, later birth order, especially the second child, trends to have an increased risk of ADA (Odd ratio=1.75; 95%CI=1.06-2.90). Average maternal age of ADA is higher than control (28.2 and 26.6 years, respectively; p=0.02). Overall incidence of constipation is 10.1% without any difference between ADA group and control (12.0 and 9.5%, respectively). Nevertheless, at six months incidence of constipation is higher in ADA than in control (6.7% and 0.8%, respectively; p < 0.01). The incidences of ADA in infants with constipated events at 2, 4 and 6 months of age are 10.0%, 33.3%, and 71.4%, respectively. Conclusion: ADA is a common finding with reported incidence of one-quarter of neonates. Female genre, later birth order and higher maternal age are risk factors of ADA. Children with ADA have an increased tendency toward constipation corresponding with increasing age. API measurement during pediatric examination is recommended to achieve a complete evaluation of infancy constipation.

Schlüsselwörter

  • Anal position
  • anterior displacement
  • anus
  • constipation
  • infant
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Anatomy of the facial nerve branching patterns, the marginal mandibular branch and its extraparotid ramification in relation to the lateral palpebral line

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 603 - 608

Zusammenfassung

Abstract

Background: Surgery of face and parotid gland may cause injury to branches of the facial nerve, which results in paralysis of muscles of facial expression. Knowledge of branching patterns of the facial nerve and reliable landmarks of the surrounding structures are essential to avoid this complication. Objective: Determine the facial nerve branching patterns, the course of the marginal mandibular branch (MMB), and the extraparotid ramification in relation to the lateral palpebral line (LPL). Materials and methods: One hundred cadaveric half-heads were dissected for determining the facial nerve branching patterns according to the presence of anastomosis between branches. The course of the MMB was followed until it entered the depressor anguli oris in 49 specimens. The vertical distance from the mandibular angle to this branch was measured. The horizontal distance from the LPL to the otobasion superious (LPL-OBS) and the apex of the parotid gland (LPL-AP) were measured in 52 specimens. Results: The branching patterns of the facial nerve were categorized into six types. The least common (1%) was type I (absent of anastomosis), while type V, the complex pattern was the most common (29%). Symmetrical branching pattern occurred in 30% of cases. The MMB was coursing below the lower border of the mandible in 57% of cases. The mean vertical distance was 0.91±0.22 cm. The mean horizontal distances of LPL-OBS and LPLAP were 7.24±0.6 cm and 3.95±0.96 cm, respectively. The LPL-AP length was 54.5±11.4% of LPL-OBS. Conclusion: More complex branching pattern of the facial nerve was found in this population and symmetrical branching pattern occurred less of ten. The MMB coursed below the lower border of the angle of mandible with a mean vertical distance of one centimeter. The extraparotid ramification of the facial nerve was located in the area between the apex of the parotid gland and the LPL.

Schlüsselwörter

  • Branching patterns
  • facial nerve
  • lateral palpebral line
  • marginal mandibular branch
  • parotid gland
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Association of Helicobacter pylori with colorectal cancer development

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 609 - 618

Zusammenfassung

Abstract

Background: Helicobacter pylori (H. pylori) may be associated with colorectal cancer. However, the underlying mechanisms are still unclear. Objectives: Explore the serostatus of H. pylori cytotoxicity-associated gene A product (CagA) in patients with colorectal carcinoma, and assess the association of H. pylori with colorectal cancer via c-Myc and MUC-2 proteins at tumor tissues. Methods: H. pylori CagA IgG antibodies were screened using enzyme-linked immunosorbent assay (ELISA) in 30 patients with colorectal carcinoma and 30 cancer-free control subjects. Paraffin-embedded blocks were examined for the expression of c-Myc and MUC-2 protein by immunohistochemistry. Results: H. pylori CagA seropositivity increased significantly among colorectal cancer patients (p <0.05). The expression of c-Myc and MUC-2 in colorectal carcinoma patients was over-expressed (80%), and downexpressed (63%) in resection margins (p <0.05). c-Myc over-expression and MUC-2 down-expression were associated with CagA-positive rather than CagA-negative H. pylori patients. In 16 CagA seropositive vs. 14 CagA seronegative patients, the expression rate was 97.3% vs. 64.2% and 33.3% vs. 78.5% for cMyc and MUC-2, respectively. CagA IgG level was significantly higher in positive than in negative c-Myc patients (p= 0.036), and in negative than in positive MUC-2 patients (p= 0.044). c-Myc and MUC-2 were positively and inversely correlated with CagA IgG level (p <0.05). Conclusions: CagA-seropositive H. pylori is most probably associated with colorectal cancer development. Part of the underlying mechanism for such association might be via alterations in expression of MUC-2, which depletes the mucous protective layer in the colo-rectum, and c-Myc, which stimulates the growth of cancerous cells.

Schlüsselwörter

  • Helicobacter pylori
  • colorectal cancer
  • Cag-A
  • MUC-2
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Effects of intense exercise on biochemical and histological changes in rat liver and pancreas

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 619 - 625

Zusammenfassung

Abstract

Background: Exercise has various effects on hepatic and pancreatic function. There is little information available for effects of exercise on histopathological changes in the liver and pancreas. Objective: Investigate the effect of intensive exercise on blood biochemical changes and histopathology in rat liver and pancreas. Materials and methods: Male Sprague-Dawley rats were randomly divided into five groups: 1 (normal control): no exercise, 2 (exercise 75% VO2max): running on treadmill at 75% VO2max and sacrificed immediately after exercise, 3 (exercise 75% VO2max+6 hours): running on treadmill at 75% VO2max and sacrificed at six hours after exercise, 4 (exercise 90% VO2max): running on treadmill at 90% VO2max and immediately sacrificed after exercise, 5 (exercise 90% VO2max+6 hours): running on treadmill at 90% VO2max and sacrificed at six hours after exercise. Samples of blood, liver and pancreas were collected at the end of each experiment. Results: The levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) increased significantly in group 2 and 4, compared with normal control. Serum total bilirubin (TB) and enzyme lipase increased significantly in group 4 compared with normal control. In all group of exercise, liver histopathology showed hepatocyte edema and necroinflammation, and pancreas showed congestion and edema. Conclusion: High-intensity exercise at 75% and 90% VO2max caused an increase of biochemical parametes in liver and pancreas. The levels of exercise also caused histopathology changes in the liver and pancreas.

Schlüsselwörter

  • Intense exercise
  • lipase
  • liver function
  • pancreas
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Oral fluoropyrimidine-induced severe hyperlipidemia

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 627 - 630

Zusammenfassung

Abstract

Background: Severe hyperlipidemia secondary to capecitabine, an oral fluoropyrimidine, is a very rare condition. There are no reported cases of hyperlipidemia associated with Uracil/tegafur (UFT). Objective: Report UFT-induced severe hyperlipidemia. Method: A 71-year-old male patient with metastatic colorectal cancer receiving capecitabine treatment was hospitalized at the end of the eighth cycle with the complaint of fatigue. Capecitabine treatment was discontinued in the patient in whom severe hyperlipidemia was detected together with disease progression. Gemphibrozile 1200 mg/day was initiated; patient’s triglyceride level and serum cholesterol decreased from 1768 to 149 mg/dL and from 497 to 99 mg/dL, respectively, five weeks later. The patient started to receive UFT chemotherapy and after the second cycle, he presented to our hospital again with the complaints of fatigue, headache, and yellow vision. The investigations revealed a serum triglyceride level of 4115 mg/dL and a cholesterol level of 734 mg/dL. Results: UFT chemotherapy was discontinued and lipopheresis was administered for three consecutive days, and gemphibrozile was initiated again at a dose of 1200 mg/day. The clinical presentation might be due to oral fluoropyrimidine. Three weeks later, serum cholesterol and triglyceride levels decreased to 106 and 403 mg/dL, respectively. Conclusion: This case is a unique case of hyperlipidemia secondary to UFT. Monitoring of lipid levels, when using Fluoropyrimidine, as well as hemograms, liver and renal functions would be appropriate.

Schlüsselwörter

  • Adverse event
  • capecitabine
  • hypertriglyceridemia
  • oral fluoropyrimidine
  • UFT® drug
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Comparison between Pseudomonas aeruginosa siderophores and desferrioxamine for iron acquisition from ferritin

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 631 - 635

Zusammenfassung

Abstract

Background: Siderophore is an iron chelator produced by microorganism. Pseudomonas aeruginosa produces two siderophores (pyoverdin and pyochelin). Desferrioxamine is a siderophore used in thalassemia patients to treat an iron overload of vital organs. Objective: Compare the ability of pyoverdin, pyochelin, and desferrioxamine for iron mobilization from ferritin. Materials and Methods: In vitro experiment, the ability of P. aeruginosa siderophores and desferrioxamine for iron mobilization from ferritin was compared by using a dialysis membrane assay at pH values of 7.4 and 6.0. Stimulation of P. aeruginosa PAO1 growth by all siderophores was studied in glucose minimum medium. Results: All three compounds were capable of iron mobilization at both pHs. At pH 6.0, the most effectiveness compound was desferrioxamine (31.6%), followed by pyoverdin (21.5%) and pyochelin (13.7%) compared on weight basis, each at 10 μg/mL. At equimolar concentration, their activities were desferrioxamine (38.5±1.2%), followed by pyoverdin (32.0±4.8%) and pyochelin (26.7±1.9%), respectively. Conclusion: The most effective compound in iron mobilization from ferritin was desferrioxamine, followed by pyoverdin and pyochelin respectively.

Schlüsselwörter

  • Desferrioxamine
  • ferritin
  • Pseudomonas aeruginosa
  • pyochelin
  • pyoverdin
  • siderophores
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Detection of Neisseria gonorrhoeae in Palestinian women using polymerase chain reaction

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 637 - 640

Zusammenfassung

Abstract

Background: Neisseria gonorrohoeae is an exclusive human pathogen that primarily infects the urogenital epithelia. Infections caused by N. gonorrhoeae are considered the second major cause of sexually transmitted disease after Chlamydiae worldwide. Although the urethra and the uterine cervix serve as the initial sites for gonococcal infections in men and women, infection of the conjunctiva, pharynx, tendons, joints, as well as rectal mucosa are also reported. Objectives: The objectives of this study were to introduce molecular techniques such as polymerase chain reaction (PCR) to detect N. gonorrhoeae directly from endocervical swabs. In addition, it provides a picture of Neisseria gonorrohea infection among a sample of Palestinian women in West Bank. Methods: Two hundred and thirteen endocervical swabs were collected from sexually active married women with endocervical abnormalities attending healthcare clinics. DNA was extracted directly from the swabs and PCR was performed using specific primers targeting the orf1 region of the genome. Results: The results obtained indicated that the percentage of positive cases of N. gonorrhoeae among the women tested was 1.40%. Conclusion: Implementing guidelines for comprehensive screening of men and women with more sensitive tests may improve detection and management of sexually transmitted infections.

Schlüsselwörter

  • Endocervix
  • Neisseria gonnorhoeae
  • Palestine
  • PCR
  • sexually transmitted disease
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Anatomic direction of entry for botulinum toxin injection to treat the adductor spasmodic dysphonia in Thais

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 641 - 644

Zusammenfassung

Abstract

Background: Botulinum toxin injections into the thyroarytenoid (TA) muscle of the larynx is the most popular treatment for adductor spasmodic dysphonia. Injection is usually done by percutaneous transcricothyroid membrane with either electromyography (EMG) or fiberoptic laryngoscopy (FOL) to verify placement of the needle within the TA muscle. This procedure requires a working knowledge of three-dimensional anatomy of the larynx to establish the direction for the accurate placement of the needle. Objective: Find out the appropriate angles and depth of the needle for placement of percutaneous transcricothyroid membrane method of botulinum toxin injection by means of studying the larynges of Thai cadavers. Methods: The descriptive study was performed in 45 Thai freshly thawed cadavers. The angle of the needle from midline sagittal plane, the angle in superior relation to tracheal plane, and the depth from midline cricothyroid (CT) membrane to midlength of TA muscle were measured from the two views of photographs, anteroposterior and lateral. Results: The mean angle of 24.2±6.76° (mean±SD) from the midline sagittal plane in male and 24.9±7.6° in female were worked out. A mean angle in superior relation to the tracheal plane was 47.7±7.8° and 51.4±9.6° in male and female, respectively. The mean depth was 1.7±0.2 and 1.4±0.1 cm in male and female, respectively. Conclusion: The mean angles and depth of the needle insertion from the midline of CT membrane to the center of TA muscle in Thai laryngeal specimens were evaluated. These values were different from the studies in Caucasians, but it could provide a direct relationship to the build of the races. This knowledge may help laryngologists do this procedure more accurately with better outcome, especially in hospitals that have no EMG or FOL guide.

Schlüsselwörter

  • Anatomic direction of entry
  • botulinum toxin
  • spasmodic dysphonia
  • Thais
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Eye diseases associated with obstructive sleep apnea syndrome in an Asian population

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 645 - 650

Zusammenfassung

Abstract

Background: Sleep apnea syndrome is one of the leading causes of excessive daytime sleepiness. There is no literature exploring the prevalence of sleep-associated disorders in the eye of Asians with obstructive sleep apnea syndrome (OSA). Objective: Study the prevalence of eye abnormalities in Asian patients with OSA. Material and method: Asian patients with definite OSA diagnosis via the polysomnography were recruited into the study. Complete eye examination and special investigations were performed to define eye diseases: floppy eyelids, dry eyes, keratoconus, Fuchs’ endothelial dystrophy, recurrent corneal erosions, open-angle glaucoma, ophthalmoplegia, papilledema and optic neuropathy. Results: One-hundred Asian OSA patients were examined. We found that floppy eyelids, dry eyes, and normal tension glaucoma were more prevalent compared to the normal population. Abnormal endothelial change and papilledema were detected. Optic neuropathy and ophthalmoplegia were not found in this study, although some patients did have subnormal contrast sensitivity. Conclusion: There is a higher prevalence of floppy eyelids, dry eyes, and glaucoma in OSA patients. Complete eye examination is recommended in OSA patients to detect early eye abnormalities.

Schlüsselwörter

  • Dry eye
  • floppy eyelids
  • obtructive sleep apnea
  • normal tension glaucoma
  • papilledema
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Antibacterial efficacy of Bacopa monnieri leaf extracts against pathogenic bacteria

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 651 - 655

Zusammenfassung

Abstract

Background: Bacopa monnieri (Linn) Pennell (Scrophulariaceae) is widely distributed in tropical regions of Asia, and used in the treatment of cough or as an antiseptic. The traditional use of this plant suggests its possible antibacterial properties, but its efficacy has not been examined yet. Objective: Evaluate the antibacterial efficacy against pathogenic bacteria using the disk diffusion method. Materials and methods: Five different concentrations (500 μg, 1, 2, 5, 10, and 15 mg/mL) of crude leaf extracts of Bacopa monnieri (L.) Pennell were tested for antibacterial efficacy against seven Gram-positive and 11 Gramnegative bacteria. The sensitivity of plant fractions was tested using the disk diffusion method. Results: Maximum activity was revealed by ethyl acetate and methanol extracts, followed by aqueous, benzene, and petrol extracts. Phyto-chemical analysis of the plant leaf showed the presence of alkaloids, flavonoids, and saponins. Conclusion: This plant may be effective for treatment of different pathogenic diseases.

Schlüsselwörter

  • Antibacterial efficacy
  • Bacopa monnieri (L.) Pennell
  • crude extracts
  • traditional use
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Airflow inside the nasal cavity: visualization using computational fluid dynamics

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 657 - 661

Zusammenfassung

Abstract

Background: It is of clinical importance to examine the nasal cavity pre-operatively on surgical treatments. However, there is no simple and easy way to measure airflow in the nasal cavity. Objectives: Visualize the flow features inside the nasal cavity using computational fluid dynamics (CFD) method, and study the effect of different breathing rates on nasal function. Method: A three-dimensional nasal cavity model was reconstructed based on computed tomographic images of a healthy Malaysian adult nose. Navier-Stokes and continuity equations for steady airflow were solved numerically to examine the inspiratory nasal flow. Results: The flow resistance obtained varied from 0.026 to 0.124 Pa.s/mL at flow-rate from 7.5 L/min to 40 L/min. Flow rates by breathing had significant influence on airflow velocity and wall shear-stress in the vestibule and nasal valve region. Conclusion: Airflow simulations based on CFD is most useful for better understanding of flow phenomenon inside the nasal cavity.

Schlüsselwörter

  • CFD
  • inspiration
  • resistance
  • velocity
  • wall shear stress
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How not to fight a rabies epidemic: a history in Bali

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 663 - 670

Zusammenfassung

Abstract

Bali, an island, should never have been afflicted with canine rabies, but in 2008 a lack of surveillance allowed the import of an unvaccinated rabid dog from Flores, a distant island where canine rabies was similarly introduced in 1997 and has since become endemic. The initial rabies outbreak on Bali occurred in a remote village at the end of an isolated peninsula, but five months elapsed before the outbreak was officially recognized. Even then, rabies had yet to escape the peninsula. However, Bali officials relied on exterminating dogs as their primary control strategy. They did not vaccinate enough dogs on the neck of the peninsula to keep the outbreak confined, they prevented nongovernmental organizations and private citizens from vaccinating dogs until approximately a year after the outbreak started, they used unreliable indigenous vaccines of only short-term potency; killed vaccinated dogs, and they repeatedly disregarded the advice of visiting rabies control experts. Two years after the outbreak started, 44,000 people had received post-exposure vaccination after suffering bites from suspected rabid dogs. The number of human rabies deaths had doubled each six months since the first death occurred.

Schlüsselwörter

  • Dog control
  • immunoglobulin
  • method for culling
  • rabies
  • vaccines
  • vector dogs
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World Rabies Day (September 28, 2010): the continuing effort to ‘make rabies history’

Online veröffentlicht: 13 Apr 2018
Seitenbereich: 671 - 671

Zusammenfassung

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