Journal of Medical Science and Technology

1 - 2

Authors: Dr Umakant Valvekar

Vitamin D is a fat soluble vitamin that we typically get from the sun. We can obtain vitamin D sparingly from milk products or fortified orange juice but this does not add up to much. More significant amounts are found in beef liver or salmon (but only the wild caught variety). Unfortunately few of us are eating these things in quantity. People need varying degrees of vitamin D depending on where they live and their diets.

25 - 33

Authors: Putcha Uday kumar,Pinninti SanthoshSushma

Over the past several decades considerable investment has been made in the early detection of cancer. Anincreasing number of early cancers diagnosed as asymptomatic malignancies or in some instances even aspremalignant lesions, can be attributed to moreefficient screening programmes and changes in clinical practice.The definitive diagnosis of cancer has however relied on histological evaluation of tissues. An ideal tumor markerwould be a protein or protein fragment that can be easily detected in patient’s blood or urine, but not detected inhealthy person. Today the most common use of tumor biomarkers is for detection of early disease and recurrentdisease. In the future better tests that may predict tumor outcome in advance and predict the response of individualtumors to particular therapeutic drugs may be developed. In recent years, the discovery of cancer biomarkers hasbecome a major focus of cancer research. Biomarkers are also useful for diagnosis, monitoring, disease progression,predicting disease recurrence and therapeutic treatment efficacy. With the advent of new and improved genomicand proteomic technologies it is possible to develop biomarkers that are able to predict outcomes during cancermanagement and treatment. This review is focused on recent approaches and practices in cancer biomarker researchand currently existing invasive techniques.

51 - 68

Authors: Anthony Kodzo-Grey Venyo

Endometriosis is well known and understood to occur in females but not in the male.The aim of the study was toreview the literature on endometriosis in the male by searching various internet data sources. Fourteen cases ofendometriosis have been reported in men so far. Endometriosis in the male tends to arise in the remnant of theMüllerian duct. Majority of cases tend to ensue, treatment for adenocarcinoma of the prostate gland by meansoestrogens.The disease could develop in relation to chromosomal abnormalities that affect: (a) the Müllerianinhibitory substance (MIS) / MIS gene, (b) abnormalities of the secretion of Müllerian inhibitory substance, (c)dysgenesis of the gonads, (d) dysgenesis of the testes) that are associated with Müllerian duct abnormalities, (e)dysgenesis of the kidney that are associated with Müllerian duct abnormalities. The disease may present withhaematuria (prostate); lump in the inguinal region, voiding and or irritating lower urinary tract symptoms; loindiscomfort, a palpable lump in the testis or epididymis. Microscopic examination of endometriosis lesions of thetestis and Müllerian duct remnant areas would tend to show the ensuing characteristics:A true cyst which has beenlined by cuboidal or columnar epithelium that contains hemosiderin laden macrophages within the stroma,Haemorrhagic fluid tends to be seen in the lumens, Even though endometrial tissue may not be predominant orconspicuous, careful examination of the specimen would usually reveal presence of endometrial stroma; Onimmunohistochemistry studies the epithelium on staining for cytokeratins stain positively with: CK7, CK8, CK18,Oestrogen receptors (ER), Progesterone receptors (PR), Epithelial membrane antigen, Calretinin, Cytokeratin 5/6,The stromal cells,exhibit positive staining for:Oestrogen receptor (ER), PR,CD10. Calretinin (Some of the cells may be positive) Complete excision of endometriotic lesions in the male tend to lead to cure and no recurrence.Endometriosis is rare but can occur in the male patient therefore clinicians should have a high index of suspicion for the disease.

72 - 74

Authors: Moono Silitongo

Single coronary artery is one of the rare anomalies of the coronary circulation. In this case report there was only one coronary artery arising from the right aortic sinus. The single right coronary artery had normal course and distribution and terminated as the posterior interventricular artery after giving off the circumflex artery which in turn terminated as the anterior interventricular artery.

79 - 82

Authors: T Venkata Krishnan1, T Arun2, K Sandeep3, M Jahnavi

The exact prevalence of cirrhosis is not known because the disease is often silent. Nearly 30% to 40% of cases are discovered at autopsy, indicating that in a substantial proportion of people, the disease goes undetected during life. Signs and symptoms: Organs commonly affected by haemochromatosis are the liver, heart, and endocrine glands. Haemochromatosis may present with the following clinical syndromes. Cirrhosis of the liver: Varies from zonal iron deposition] to fibrosis (cirrhosis). Diabetes due to selective iron deposition in pancreatic islet beta cells leading to functional failure and cell death. Cardiomyopathy, Arthritis (calcium pyrophosphate deposition in joints), Testicular failure; Slate grey discoloration of the skin, Joint pain and bone pain. Routine treatment in an otherwise-healthy person consists of regularly scheduled phlebotomies (bloodletting). When first diagnosed, the phlebotomies may be fairly frequent, perhaps as often as once a week, until iron levels can be brought to within normal range. The major etiology of liver cirrhosis in Indian remains HCV. Our survey revealed the prevalence of NASH-related LC in Japan and the frequency of HCC. Future changes in etiology must be considered in establishing preventive or educational strategies, as well as in developing new treatment strategies.

1-2

Authors: Dr S. Jothi Arunachalam

Responsibilities and humane attitude start with the dreaming about becoming a doctor. Most of the biology students want to become a doctor, which is regarded as noble profession. In this aspect I would like to share few things regarding the relationship of a medical student with their teacher (he is also being a medical professional). In the day to day life of a medical student i.e., academic career, clinical knowledge in diagnosing a disease, treating the sufferers, depends on the foundation laid by the teaching medical professional. And I feel this relationship of a medical student with his teacher should start very early i.e., from the day one of their career after entering into a medical college.

8 - 13

Authors: Dr. Umakant Valvekar1*, Dr. S.Viswanathan1

Prolactin secretion is controlled by hypothalamus which secretes prolactin inhibiting factor. Thyroid releasing factor (TRF), and thyroid stimulating hormone (TSH) have positive effect on prolactin secretion and can lead to galactorrhoea. Hyperprolactinaemia causes anovulation, amenorrhea, galactorrhoea, and reduced fecundity. With this background, the present study was planned to find out the prevalence of hyperprolactinaemia and hypothyroidism in women with infertility. Total 100 women patients of age range between 23 to 39 years were recruited for the study. Of the 100 women, 60 women were diagnosed as primary infertility and the remaining 40 were diagnosed as secondary infertility. Serum prolactin levels and thyroid stimulating hormone (TSH) levels were measured in all women. Patients were categorized based on their serum prolactin levels and TSH levels to find out the prevalence of hyperprolactinemia and hypothyroidism. The present study shows high prevalence of hyperprolactinemia and hypothyroidism in infertile women.

29 - 32

Authors: Dr S. Jothi Arunachalam

Internal jugular vein (IJV) thrombosis is an extremely rare vascular disease. It is usually secondary to intravenous drug abuse, prolonged central venous catheterization or deep head-neck infections or trauma. Associated malignancies are uncommon and not well documented in the etiology of IJV thrombosis. A 50-year-old female presented with complains of neck swelling on left side for past two weeks and with no ear or nose complaints. On examination of neck presented swelling along the anterior border of the left sternocleidomastoid muscle. An ultrasound scan of the neck neck revealed left IJV thrombosis. The patient was referred to vascular surgeon for further treatment.

38 - 45

Authors: Malladi Ramakrishna1*, Putcha Udaykumar2, Pinninti Santosh Sushma 2

Oral cancer is the sixth most common neoplasm occurring globally with an incidence rate of 6, 40,000 cases diagnosed annually. 90% of the oral cancers are squamous cell carcinomas. Although oral cancer has got multi-faceted etiology alcohol consumption and tobacco chewing are the major risk factors. These pre-disposing factors are leading to the wide range of genetic events leading to cancer progression. Despite, the significant advances in the understanding of etiopathogenesis and molecular basis of the disease as well as continuing improvement in the management strategies, OSCC prognosis remains dismal. It is widely recognized that novel, more effective approaches to diagnosis, prevention and treatment are urgently needed. The major etiological factors for oral cancer development are potentially preventable through discontinuation of hazardous habits and vaccination in case of viral infections. Primary prevention of the disease appears as a challenging goal. However possibilities for secondary prevention appear achievable i.e early detection and treatment at an early stage during the process of carcinogenesis. The ongoing of genetic and epigenetic events that govern oral carcinogenesis at the molecular level holds great promise for identifying novel diagnostic and prognostic biomarkers as well as therapeutic bio targets. Intensive research efforts have analyzed a large number of potential molecular biomarkers for the better assessment of the risk of OSCC development and progression. Further biomarkers may play a prominent role in guiding individualized oral cancer treatment, according to which selection of the most appropriate therapeutic intervention will be based on the knowledge of a given tumor susceptibility to a specific anticancer treatment.

1-4

Authors: Hani Awad Mustafa Rwashdeh

To assess the effects of preoperative administration of Hartmann’s and Voluven 6% solutions on perioperative blood glucose level during general anesthesia and surgery. Our prospective, randomized and double-blind study included 126 patients, of both sexes, aged 34-52years, classed I physical status by the American society of anesthesiologists and scheduled for various elective intermediate type of surgical interventions performed under general anesthesia at Prince Hashem bin Abdullah the second hospital, Aqaba, Jordan, during the period Dec.2012-Oct.2014. Patients were divided into three groups in a random fashion according to the preoperative administered solution.

13 - 17

Authors: B Kodandaramu, T. Madhu Chaithanya, Basawaraj Munge, Ranjitha N, Mamata Bandopadhyay

Asthma is a chronic obstructive condition, it is not considered as a part of chronic obstructive pulmonary disease as this term refers specifically to combinations of disease that are irreversible such as bronchiectasis, chronic bronchitis, and emphysema. Male guinea male pigs were selected for the experiment. Animals were weighed with the help of weighing machine. The guinea pigs weighing 450gm on average were selected for the experiment. The study was conducted in MIMS (Maharajah’s Institute of Medical Sciences). In this study evaluated the anti-asthmatic effect of ethanol extract of piper betel Linn in guinea pigs by using histamine chamber 24 guinea pigs were selected and are divided into four groups each containing 6 guinea pigs (i.e., group I, II, III and IV respectively). Comparison of control group with standard group the mean difference of preconvulsive time at 1st hour was -222.50 with 95% confidence interval from -237.26 to -207.74 with a p value of <0.001. Comparision of control group with test - 1 group the mean difference of preconvulsive time at 2nd hour was -195.20 with 95% confidence interval from -229.21 to -161.19 with a p value of <0.001. Bronchial asthma is an inflammatory condition so anti-inflammatory activity of piper betel linn, may be the reason for reducing bronchial asthma. Present study shows protection against histamine induced experimental bronchial asthma in guinea pigs which may be due to anti-inflammatory activity, antioxidant action and antihistaminic action.

23 -27

Authors: Dr. Ravi Paul, Dr. Webster Musonda, Dr. Thankian Kusanthan

The most common mental health problems on college campuses are anxiety disorders. Specialized schools such as medical school is recognized as one of the most stressful environments that often exerts a negative effect on the academic performance, physical health and psychological well-being of a student. Challenges such as maintaining relationships with friends and resisting alcohol abuse are among the many factors of anxiety disorder; and have a direct impact on a students’ academic performance. Recent work has suggested that having an anxiety disorder without history of mood disorder does convey increased risk for suicidal ideation. Hence, unless awareness is raised that will provoke students to seek help; this silent otherwise manageable condition will continue taking its toll on future professionals. This study therefore was to identify symptoms of awareness and symptoms of anxiety disorders amongst University students.

34 - 39

Authors: WMMS Bandara, AJIS Rathnayake, BWMTJ Basnayake, MKOK De Silva, D. Edirisinghe, KG Somasiri

Regular physical exercises have shown to improve the biochemical indices of cardiometabolic diseases. This study was carried out to assess the effect of the length of physical exercises on these biochemical parameters in healthy young men. Ninety participants who are undergoing regular physical exercises during military training and thirty controls were recruited in this study. They were categorized into four groups; Non–exercised control group (NE), exercised for 6 months (E6M), exercised for 18 months (E18M) and exercised for 30 months (E30M). Thirty participants were included in each group. Plasma HDL-cholesterol, triglycerides (TG), total cholesterol (TC), glucose and haemoglobin levels were measured using enzymatic techniques and colorimetric methods. LDL- cholesterol level was calculated using the standard equation. A significant reduction in mean TG was observed in all groups that underwent regular exercises (p<0.05). LDL-cholesterol and TC levels were also significantly low in groups E18M and E30M. HDL-cholesterol levels were significantly high in groups who exercised for more than 18 months (p<0.005 in E18M and p<0.01 in E30M). Plasma glucose was significantly reduced after 18 months of exercise (p<0.05). Plasma haemoglobin levels showed an increase with exercises but it was significantly reduced in E30M (p<0.05). In addition exercised groups showed improved BMI values. Results of this study imply that exercise during military training improves the risk factors of cardiometabolic diseases such as body composition, lipid profiles and glucose levels favorably. Further the improvements become significant when the duration of the exercises ≥18 months.

45 - 68

Authors: Anthony Kodzo-Grey Venyo

Inflammatory myofibroblastic tumours of the kidney and renal pelvis (IMTK& IMTRP) are rare and less than 100 cases have been reported. IMTKs/IMTKRPs have been diagnosed incidentally or following presentations of loin / abdominal pain, haematuria or palpable abdominal / loin mass. Radiological imaging features of the disease tend to show a cystic or solid or heterogeneous renal mass with slight contrast-enhancement. Diagnosis is made by pathological examination of biopsy or partial / radical nephrectomy specimens which tend to show spindled cells in myxoid background admixed with variable extra-cellular collagen, lymphocytes, plasma cells, and siderophages. IMTKs/IMTRPs stain positively for SMA, vimentin and HHF35 and CD34 but negatively with desmin, AlK-1, keratin and p53. \radiological imaging features of IMTKs/IMTRPs are non-specific. Most IMTKs/IMTRPs have been treated by renal sparing excision (partial nephrectomy / completed excision of the lesion) or radical surgery (nephrectomy / radical nephrectomy) without any subsequent recurrence. Conservative management of one case has resulted in resolution of the lesion. In one case radical surgical treatment of an invasive disease has been ensued by death due to complications of the invasive disease and treatment. One asymptomatic case following two-years of observation developed worsening pain requiring nephrectomy. There is no consensus on the treatment options. It is not clear whether or not there are certain pathological features of IMTKs/IMTRPs which could predict possible aggressive biological behaviour. Complete excision of IMTKs and IMTRPs tend to be associated with no recurrence but at times conservative management may result in resolution of the lesion. Perhaps if radiological-guided biopsies of slightly contrast-enhanced lesions of the kidney/renal pelvis are undertaken more IMTS would be diagnosed pre-operatively to allow for conservative treatment and renal sparing surgery in cases of small non-invasive IMTK/RPs. A global multi-centre trial would be recommended to streamline lesions that should be managed: conservatively, by renal-sparing or radical surgery.

90 - 94

Authors: Sara Al Ganem, Hanaa Bamefleh, Ali Nawaz Khan, Anthony Kodzo-Grey Venyo

Appropriate radiological imaging techniques including High Resolution CT scan of the chest (HRCT) are now available that detect ground-glass-opacities (GGOs) in the lung which are not detected by plain Chest X-rays. The aim of the study was to report a case of an-incidentally detected GGO during follow-up assessment for colonic cancer. A 54-year-old woman who had been having yearly appropriate radiological imaging follow-up assessments at yearly intervals pursuant to having colonic resection for colon cancer was found incidentally to have a sub-centimetre ground-glass-opacity in the lung which had subsequently increased in size minimally. Microscopic examination and immunohistochemistry of the excised lung lesion showed a primary adenocarcinoma of lung origin, in early in situ phase. Literature review had shown that GGOs have minimal or no invasive growth and limited resection of curative intent is justified, therefore it is important that these GGOs are detected by means of appropriate radiological imaging in order to provide minimal resection at an early phase of the disease. Developments in radiological imaging had enabled early detection of adenocarcinoma in situ of the lung in our case. Developments in radiological imaging techniques, now enables early detection of GGOs which enables limited curative resection of the lesions.