Clinical Medicine Research

ISSN Online: 2326-9057 ISSN Print: 2326-9049

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Volume 2, Issue 4, July 2013

  • Authors: Aliagha Alishiri, Mostafa Naderi, Khosro Jadidi, Seyed Aliasghar Mosavi

    Abstract: Purpose: To compare the epithelial defect size after epithelial removal by Weck-Cel sponge (Medtronic) spatula and blunt scalpel hockey blade. Method: This prospective study comprised 100 cases of PRK with mean age of 26±5 years (range, 19 to 45) performed at Bina Eye Specialist Hospital from January to march 2012. The size of epithelium removal was the same in all patients and it was 8.5 mm2. Each patienst’s right eyes epithelium was removed by Weck spounge and it was removed by Haki spatula in the left eye. The residual epithelial defect size was measured in both eyes after 4 days from surgery. Result: Of 200 eyes that met the inclusion criteria, the mean preoperative spherical equivalent (SE) refractive error in right eyes was -2.6±1.5 (Range: -1 to -7 D) versus 2.6±1.4 (Range: -1 to -6.5D) in left eyes (P= 0.527 ). The mean epithelial defect size after 4 days in right eyes was 1.5+- 0.77 and it was 1.46 +- 0.77 in the left eyes (P = 0.623). Conclusion: This sudy showed that there is no difference between corneal epithelial defect size in two methods of PRK surgery after corneal epithelial removal .We consider both methods to be comparable in terms of efficacy and believe the choice of one method over the other rests on the surgeon’s decision and experience.

    Received: Apr. 6, 2013 Accepted: Published: Jun. 10, 2013

    DOI: 10.11648/j.cmr.20130204.11 View: Downloads:

  • Authors: Sarah Mangiafico, Ines Paola Monte, Vincenzo Lavanco, Lucio Raffaello Tropea, Antonio Andrea Arcidiacono, Maria Concetta di Pasqua, Letizia Santonoceto, Giovanni Millan, Corrado Tamburino

    Abstract: Atrial septal aneurysm when associated to other cardiac abnormalities, such as patent foramen ovale, Chiari network or Eustachian Membrane, is a well-known recognised risk factor for cerebral embolism. Aim of study is to assess if isolated atrial septal aneurysm could be considered statistically related to cryptogenic stroke, considering the strong clinical impact that this association could have on these patients outcome. 579 patients were investigated for a suspected patent foramen ovale using transthoracic echocardiography, in order to evaluate the presence of atrial septal aneurysm and to identify other potential cardiac embolic sources. The patients with atrial septal aneurysm underwent transcranic echodoppler and transoesophageal echocardiography examination with contrast solution during Valsalva manoeuvre.209/579 (36%) patients where we made diagnosis of atrial septal aneurysm. In this cohort of patients transcranic echodoppler showed a patent foramen ovale in 114/209 (54%), whereas transoesophageal echocardiography in 111/209 (53%); 6/114 (5%) pa-tients with a positive transcranic echodoppler had a normal transoesophageal echocardiography examination and 3/95 (3%) with normal transcranic echodoppler had a positive transoesophageal echocardiography. Transcranic echodoppler vs. transoesophageal echocardiography sensibility was 97% and specificity 94%. Only 13/98 (13%) of patients with isolated atrial septal aneurysm and 23/111 (26%) with patent foramen ovale had history of cryptogenic stroke. According to our data, isolated atrial septal aneurysm could not be considered an independent risk factor for cryptogenic stroke.

    Received: May 13, 2013 Accepted: Published: Jun. 20, 2013

    DOI: 10.11648/j.cmr.20130204.12 View: Downloads:

  • Authors: Evgeniya Sevostyanova, Vyacheslav Hasnulin

    Abstract: Background Cardio-vascular pathology is widespread in the North. It is more severe and hard than in moderate latitudes. There are little data available describing reactions of cardio-vascular system to changes of climatic, meteorological and helio-geophysical factors and their role in the development of the disease. The purpose of our study was to study the role of pathological reacting to climate and meteorological changes in development of cardio-vascular pathology in the North. Methods Clinical and physiological material of 1720 persons including 980 patients with cardio-vascular pathology (arterial hypertension I, II and coronary artery disease, stable angina pectoris) was studied. The complex of clinico-physiological, electrocardiographic and computer-analytical methods, including the original computer program “Screenmed” (registration by RosPatent №970035 from 29.01.1997) was used. The program includes a questionnaire for obtaining information about reacting of an organism to changes of climate, meteorological and helio-geophysical factors. The information of climate-meteorological and helio-geophysical factors was obtained from geophysical stations. Results The study indicates that most of patients with cardio-vascular pathology have high level of pathological meteosensitivity. The patients with arterial hypertension associated with coronary artery disease are most meteosensitive. A degree of pathological reacting to meteorological and geophysical factors determines an increase in complaints, clinical signs of a disease and electrocardiographic changes. Conclusion The study revealed significant association between pathological reacting to meteorological and helio-geophysical changes and the level of cardio-vascular disturbances. It has been found that pathological reacting of human organism to changes of climatic, helio-geophysical, meteorological and other biospheric factors of the environment is an important link in pathogenic mechanism of cardio-vascular pathology in the extreme conditions of the North.

    Received: May 24, 2013 Accepted: Published: Jun. 20, 2013

    DOI: 10.11648/j.cmr.20130204.13 View: Downloads:

  • Author: B E Anders Ekedahl

    Abstract: Objectives: To examine what patients do when they have a prescription with a dosage where tablets must be split. Methods: Interviews were performed at 12 pharmacies across Sweden with pharmacy customers who had prescriptions with a dosage meaning that the tablets have to be divided to give the prescribed individual dose. Key findings: Of the 436 pharmacy customers interviewed, 255 (58.5%) reported they divided the tablets without tools and 162 (37.2%) used tools, the most common was a knife. Only few used a tablet splitter. Almost every third patient (31.4%) stated they had problems to divide the tablets. Conclusions: Patients’ difficulties in splitting tablets are common, but seem to be overlooked. Pharmacists should be permitted to adjust dispensing to a strength corresponding to the prescribed dosage level, price policies with flat prices need to be revised to eliminate economic incentives to prescribe dosages with split tablets and a computerised decision support should be developed signalling when there is a suitable strength for the prescribed individual dose.

    Received: May 16, 2013 Accepted: Published: Jun. 30, 2013

    DOI: 10.11648/j.cmr.20130204.14 View: Downloads:

  • Author: Alexander Trofimov

    Abstract: The biotropic influence of ionospheric electrical currents (electrojets) and electromagnetic disturbances in the zone of the auroral oval on the electrical and cardiovascular homeostasis of healthy people was the topic of research. This was an investigation of non-medicinal helio-magnetoprotective remedies. “Helio-magnetoprotective” drinking water, certified and patented in Russia, has been developed for and tested in the circumpolar region (town Dixon) on inhabitants-volunteers with high level of helio-magnetosensitivity. This water after exposure to the repeatedly weakened magnetic field of the Earth ( device TRODR) substantially changes its structure, forming, on data of high effective chromatography, resistant nanocluster formations with marked biocatalytic properties which are enhanced with the use of the special informational holograms. Drinking water is treated using translucent holograms in this device is innovation technology. Helio-magnetoprotective water, according to our data, appears to be able to vary the degree of functional dependence of cardiovascular and other systems of both healthy and sick people on extreme impacts of heliogeophysical factors. Protective effect was assessed by changing in the vector of significant correlations: direct dependencies after drinking water became significantly reversed. Electrocardiographic parameters (R, PQ, QT), electrical conductivity in the cutaneous projections of acupuncture points, heart rate, and the blood pressure of the test subjects were registered three times: in the background conditions, 10 minutes after taking control water, and 10 minutes after receiving the same amount of helio-magnetoprotective water. The intensity of the polar electrojets and cosmic noise was determined by the methods of vertical sounding of the ionosphere and the riometer. The state of the polar magnetosphere was estimated according to the value of the Ak-index. It has been shown that the electrical and hemodynamic parameters of healthy people in the Far North are significantly altered during the periods of increased magnetic-ionospheric activity. Based on additional magnetic testing, the helio-magnetosensitivity of an organism increases during periods of increased level of cosmic noises as registered by riometers. Use of helio-magnetoprotective drinking water reduces the biotropic impacts of cosmophysical factors on human functional systems. The use of helio-magnetoprotective drinking water for prophylactic measures is effective against hello-dependent diseases, crisis states, and their life-threatening hemodynamic consequences for people living near the world’s Polar Regions and an other places.

    Received: May 22, 2013 Accepted: Published: Jun. 30, 2013

    DOI: 10.11648/j.cmr.20130204.15 View: Downloads:

  • Authors: Sara M. Gregory, Beth A. Parker, Jeffrey A. Capizzi, Adam S. Grimaldi, Priscilla M. Clarkson, Stephanie Moeckel-Cole, Justin Keadle, Stuart Chipkin, Linda S. Pescatello, Kathleen Simpson, C. Michael White, Paul D. Thompson

    Abstract: We investigated the relationship between changes in 25-hydroxyvitamin D (25OHD) and changes in aerobic fitness (VO2max)over 6 months in healthy adults (n = 213, mean ± SD age 44.8 ±16.4 yr, range 20-76 yr, 109 women). 25OHD status was defined as deficient (DEF: 25OHD <50 nmol•L-1, n = 16), insufficient (INS: 25OHD > 50 nmol•L-1 but < 75 nmol•L-1, n = 57), and sufficient (SUF: 25OHD >75 nmol•L-1, n = 140). Tertiles for 25OHD change were computed (lowest: < -17.5 nmol•L-1, n = 67; middle: -17.5 to 9.1 nmol•L-1, n = 75; highest: > 9.1 nmol•L-1, n = 71). Baseline 25OHD level (β = -0.003; p = 0.83) and change in 25OHD level (β = 0.01; p = 0.50) were not significant predictors of changes in VO2max. Changes in VO2maxwere similar between 25OHD status groups (p = 0.55; DEF = -1.7 ± 2.1, INS = -0.4 ± 3.2; SUF = -0.3 ± 3.1 ml•kg-1•min-1), and 25OHD change tertiles (p = 0.28; lowest = -0.3 ± 2.7, middle = -0.8 ± 3.5, highest = -0.3 ± 2.9 ml•kg-1•min-1). Changes in vitamin D over a 6-month period were not associated with changes in aerobic fitness. Aerobic fitnessis not impacted by temporal variations in 25OHD.

    Received: Jun. 18, 2013 Accepted: Published: Jul. 10, 2013

    DOI: 10.11648/j.cmr.20130204.16 View: Downloads:

  • Authors: Carlo Rostagno, Rostagno Perfetto

    Abstract: The relationships between pulmonary hypertension multiple myeloma, monoclonal protein and finally drug treatment of plasma cell diseases are complex and not fully elucidated. Pulmonary hypertension has been reported as a rare complication of multiple myeloma (MM), more frequently in patients with POEMS syndrome. More recently pulmonary hypertension has been described during thalidomide treatment for refractory MM. We report a case of severe pulmonary hypertension associated with MM, pleural and cardiac amyloidosis. A revision of literature follows.

    Received: Jun. 8, 2013 Accepted: Published: Jul. 20, 2013

    DOI: 10.11648/j.cmr.20130204.17 View: Downloads:

  • Authors: Alemayehu Belay, Zelalem Alamrew, Yibeltal Berie, Bisratewongel Tegegne, Gebeyaw Tiruneh, Amsalu Feleke

    Abstract: Background: Tuberculosis and HIV have been closely linked since the emergence of AIDS. The aim of this study is to assess magnitude of Tuberculosis and its associated factors among HIV patients at Felege Hiwot Referral Hospital in Bahir Dar city. Methods: Institutional based Cross-sectional study was conducted in September 2012 in Bahir Dar city. Systematic sampling technique was employed to collect the data; both primary and secondary data were collected by interviewing HIV cases and reviewing their cards. The data were analyzed in bivariate and multivariate analysis using SPSS version 20. Result: The study was conducted among a total of 385 HIV cases. The prevalence of Tuberculosis was 10.1%. This study declared that body mass index (BMI), CD4 count and functional status were significant predictors of tuberculosis (TB). Besides, HIV cases whose BMI less than 18.5 were more than five times more likely to develop TB compared to those with BMI greater than 24.5 (AOR= 5.24, 95%CI:1.01-27.13), individual HIV cases whose CD4 count less than 200 were more than seven times likely to develop Tuberculosis compared to those whose CD4 count greater than 500 (AOR= 7.33, 95%CI:1.57-34.28), besides, the study explored that respondents who were bed redden and ambulatory were more than eight and six times more likely to develop Tuberculosis compared to those respondents who were able to work respectively (AOR=8.61, 95%CI: 1.83-40.40 and AOR=6.22, 95%CI: 1.40-7.65). Conclusion: This study showed that magnitude of TB among HIV cases was 10.1%. HIV patients, whose BMI less than 18.5, CD4 count <200/μL, ambulatory and bedridden patients should be closely supervised by increasing patient round frequency and providing special nutritious food. TB/HIV co-infected patients should get all services in TB clinic. The Hospital should provide fast triaging systems for coughing patients and reducing their waiting time for services.

    Received: Jun. 21, 2013 Accepted: Published: Jul. 20, 2013

    DOI: 10.11648/j.cmr.20130204.18 View: Downloads:

  • Authors: Samira Telfah Alaani, Abdulkadir Abdulkareem Miri'e

    Abstract: We present 3 sporadic cases of congenital left hand Acheiria, a rare congenital defect, In one case (male), left hand Acheiria is associated with left radial hemimelia , in the other 2 cases (both are females) ,there is only congenital absence of left hand ( Acheiria) ,with completely normal left forearm & other 3 limbs. The absence of any contributory family or drug history and the normal chromosomal study in the 3 cases lead us to the belief that their occurrence may be linked to environmental contamination. To the best of our knowledge, there is dearth of information on these anomalies in the literatures, & their management remains achallenge.

    Received: Jul. 7, 2013 Accepted: Published: Aug. 20, 2013

    DOI: 10.11648/j.cmr.20130204.19 View: Downloads:

  • Authors: Alena ADAMIKOVA, Jiri BAKALA, Jana PATEROVA, Martin SLABAK, Stepan SVACINA

    Abstract: Diabetic cardiomyopathy is defined as a finding of systolic and diastolic left ventricular dysfunction, myocardial dilation and left ventricular hypertrophy without the presence of macroangiopathy and hypertension. Causes include metabolic changes, myocardial fibrosis, microangiopathy as well as cardiovascular autonomic neuropathy leading to sympathetic denervation and alteration of myocardial perfusion. It comprises abnormalities in the control of heart rate as well as central and peripheral vascular dynamics. The diagnosis of diabetic cardiomyopathy affects significantly the prognosis in patients with diabetes. Echocardiography and nuclear medicine methods are used for diagnosis.

    Received: Aug. 6, 2013 Accepted: Published: Aug. 30, 2013

    DOI: 10.11648/j.cmr.20130204.20 View: Downloads:

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