International Research Journal of Medicine and Medical Sciences

Number 2, 2020

18-24
Differential diagnosis of focal hepatic lesions using ultrasound confirmed with histopathology

Authors: Rania Mohammed Ahmed, Sharifah Alkathiri, Waad Altalhi, Hatun Eid, Manar Alshalwai and Sara Alotaibi

Abstract

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Advances in imaging technology over the past decades have contributed to better characterization of hepatic lesions. This study aims to differentiate focal hepatic lesions from their ultrasound (U/S) features and compared the obtained results with histopathology. A descriptive retrospective study of 100 patients who had focal hepatic lesions were reviewed during the period from 2012 to 2019 at King Abdul-Aziz Specialist Hospital, Taif, KSA. The inclusion criteria were Adults Saudi patients, ages 18 and above. LG-9 and Philips ultrasound machines with 3.5 MHz transducers were used in this study. Age group (55 to 80 years) represented 44%, mean age was 49 years, 92% were married. Regarding shape of the lesions during U/S scan, 47% of irregular outline were malignant (p=0.00), 93% of the rounded lesions were benign (p=0.00),86% of well-defined lesions margins were benign in histopathology, 61% ill-defined margin lesions were malignant and 73% of hyperechoic lesions were hemangioma (p=0.02). Regarding nature of hepatic lesions during U/S, 87% of solid lesions were malignant (p=0.03), while 89% of cystic lesions were benign. 61% of hypoechoic lesions were malignant. 80% from vascular lesions under color Doppler were benign. U/S sensitivity and specificity were 93.5 and 98%, respectively. U/S is a useful tool in differentiation cystic hepatic lesions from solid (p=0.03). Comparable studies with large samples must be done in Taif region to provide data base for hepatic lesions.

25-29
Association of colorectal cancer and GIST tumors - A diagnostic and therapeutic challenge: A case report

Authors: Ciprian Cirimbei, Vlad Rotaru, Madalina Radu and Simona Elena Cirimbei

Abstract

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Number of views: 306

The association between colorectal cancer and gastrointestinal stromal (GIST) tumors is increasingly cited in medical literature as an argument in the plea for full exploration of patients with digestive malignancies. The coexistence of the two lesions is frequently diagnosed randomly, pre- or intraoperatively, and may raise diagnostic and therapeutic problems. We present a case of association of a recto-sigmoid junction cancer with a GIST gastric tumor with full imaging and anatomo-pathological description, as well as its surgical and oncological management. Pre-, intra- and postoperative histopathological examinations, correlated with immunohistochemical tests, are essential to determine the key points of the therapeutic strategic.

30-34
Correlation between increased interleukin-6 with insulin resistance in non-diabetic chronic obstructive pulmonary disease patients

Authors: Oky Aryanthana, I. B. Ngurah Rai and Wira Gotera

Abstract

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Number of views: 326

Chronic obstructive pulmonary disease patients (COPD) have been linked to systemic inflammation. The presence of a systemic inflammatory response is characterized by increased activation and mobilization of inflammatory cells into the circulation. Systemic inflammation is characterized by an increase in proinflammatory cytokines including IL-6, TNF-, and CRP. Increased IL-6 will cause insulin resistance and IL-6 is considered as a good predictive marker for insulin resistance. This research is an analytic cross sectional study. Affordable population is all COPD patients in the pulmonary policlinic at the Sanglah Hospital and Network Hospitals in the period of May to October 2019 who have met the criteria as a research sample. The association between increased IL-6 and insulin resistance was tested using spearmen analysis. The effect of confounding variables such as age, sex, nutritional status, smoking and steroid use, on the relationship of serum IL-6 and HOMA-IR index values were tested using partial correlation analysis. This study included 47 subjects, 42 male (89.3%) and 5 female (10.7%). Results of study, showed that there was no a significant correlation between IL-6 and HOMA-IR (r = -0.24; p = 0.09). Also, there is no influence of confounding variables on the relationship IL-6 and HOMA-IR. Age variables (r = -0.18; p = 0.21), gender (r = -0.18; p = 0.21), nutritional status (r = -0.14; p = 0.32), smoking (r = -0.17; p = 0.26), and steroid therapy (r = -0.18; p = 0.22). On the other hand, obesity status was strongly related to HOMA-IR (r = 0.64; p = 0.001). This study proves that there was no significant correlation found between the increase in serum IL-6 and the HOMA-IR index value. Nevertheless, obesity status is a factor that is very strongly associated with the HOMA-IR index value.

35-41
Occurrence of retromolar canal among a sample of Yemeni adults obtained from cone-beam computed tomography

Authors: Mohammed Ali Ahmed Shaalan Abd Ulrahman, Alhadi Yahya, Hassan Abdulwahab Al-Shamahy and Al Kasem MA Abbas

Abstract

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Retromolar canal (RMC) and Retromolar foramen (RMF) are anatomic variants in the retromolar area of the mandible. The anatomy of human mandible and its variations are very important for planning various surgeries like extraction of third molar, placement of ‎dental implants and ‎mandibular reconstruction. The aim of this study was to determine the occurrence of RMC among a Sample of Yemeni adults obtained from cone-beam computed tomography (CBCT). A retrospective cross sectional study was conducted in Sana’a city among a sample of Yemeni adult obtained from a CBCT images. CBCT images of 163 subjects (222 sides) were evaluated retrospectively. The subjects were 79 males (49.4%) and 84 females (51.6%). Of 163 subjects and 222 sides, a significant 53 (32.51%) subjects and 70 (31.53%) sides were found to have RMC (p < 0.05). Among these subjects, 17 (32%) had RMC bilaterally and 36 (68%) were unilaterally. The most common type was A1 (42.9%), followed by type B1 (32.9%). The mean vertical height of the RMC was 9.38 ± 2.30 mm and the mean width was 1.85 ± 0.38 mm. The mean distances of RMC to the second and third molars were (15.2 ± 2.53 mm and 5.60 ± 2.25 mm, respectively). All the mean values of the linear measurements were slightly higher in males than that of females. RMC occurrence in males was (35.4%) slightly higher than that of females (29.8%). There was no statistically significant difference between the right and left sides in the occurrence of RMC (31.9% and 31.1%, respectively) (P = 0.890). In conclusion, the RMC is present in a considerable proportion of Yemeni population 32.5%, which highlights the need to raise awareness among dental practitioners and maxillofacial surgeons.

42-56
Thermal and pH sensitivity of avian corona and influenza viruses: A model study for inactivation of SARS-CoV-2 (COVID-19) and other flu viruses

Authors: Mohammed Alimul Islam, Sumaiya Islam, Md. Enamul Haque, Md. Muklesur Rahman, Md. Asir Uddin, A.K.M. Khasruzzaman, Md. Mohiuddin Sharif, Md. Rajibur Rahman, Mohammad Robed Amin and Md. Mortuza Ali

Abstract

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Number of views: 264

Present study has been designed to clarify the mechanism of inactivation of the RNA enveloped viruses in-vitro. For that, avian Coronavirus (Avian Infectious Bronchitis Virus, AIBV) and Bird flu virus (Low Pathogenic Avian Influenza Virus, LPAIV, H9N2) were selected for this study. Both the viruses were subjected to heat (25 to 70°C and pH (1.0 to 14.0) treatment for 1 to 120 min and 30 s to 5 min respectively and their infectivity was checked by measuring virus titre through hemagglutination (HA) test, chicken embryo inoculation and RT-iiPCR. The results clearly indicates that both the viruses required 55°C for 90 min, 60°C for 60 min, 65°C for 15 min and 70°C for 2 and 3 min respectively to inactivate. Results of pH sensitivity using various detergents and chemicals exposure indicates that the agents having moderate acidic pH (5.0 to 6.0), neutral to moderate alkaline pH (7.0 to 10.0) and extreme alkaline pH (13.0 to 14.0) could inactivate AIBV within 20 to 30 s and the H9N2 virus was inactivated in pH range <3.0 and 13.0 to 14.0 within 5 min. The 70% ethanol or isopropanol was found highly effective to inactivate both the viruses in a minute. More interestingly, juice of various citrus fruits also exhibited antiviral activities in-vitro. Results of the present study indicated that the enveloped RNA viruses of any families could easily be inactivated using very cheap and available chemicals and detergents. Chicken embryos propagation and molecular detection by RT-iiPCR also indicated that ultra-acidic and extreme alkaline pH and higher temperature treatment successfully inactivated both the viruses. Finding of the present study also indicated that any viruses of the family coronaviridae including SARS-CoV-2 and other respiratory viruses of human and animal can be inactivated easily by exposure at high temperature and extremely low and high pH treatment.

57-60
Incidence of anti-HCV found among clinical trial participants during eligibility screening at NovumPRS from 2005 to 2011

Authors: Jeffrey Morgan and Darin Brimhall

Abstract

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Number of views: 280

Hepatitis C (HCV) is a contagious viral illness and is the most common blood borne infection in the United States. It frequently remains undiagnosed until the ominous symptoms of liver disease, cirrhosis, or hepatocellular carcinoma become evident. This is because most acute infections follow an asymptomatic course. Center for Disease Control (CDC) Viral Surveillance data revealed the incidence rate for hepatitis C in the U.S. to be around 0.3 cases per 100,000. This means that nearly 4 million Americans have been exposed to HCV. World-wide 170 million people are affected by HCV. It is also known that despite these staggering numbers that the majority of HCV infected people go undiagnosed. Novum Pharmaceutical Research Services (NovumPRS) is a private, for profit, Clinical Research Organization (CRO) that has been recruiting and screening adult volunteers for Phase 1 bioequivalence and bioavailability drug studies since the early 1970’s. Three sites collectively completed approximately 150 to 170 studies annually; and screened approximately 90,000 participants during the 2005 to 2011 period we reviewed. In this paper, we present our data regarding the 0.8% positive anti-HCV incidence found on screening laboratory evaluation for clinical trial volunteers prior to consideration for randomized trial enrollment at the three research facilities. Race/ethnicity and socioeconomic status were not considerations made in the reporting of our findings here. A positive anti-HCV test disqualified individuals from participation in all Phase I randomized trials conducted at our research organization not specifically related to hepatitis. All screened participants who tested positive were informed of these findings and appropriate reporting from our research organization to the epidemiology department at the appropriate state health agency was then carried out.

61-66
Assessing the functional and histological effect of low-level laser therapy on spinal cord compression induced injuries on Wistar rats

Authors: Hiba A. Awooda and Lojun Aljazoly

Abstract

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Number of views: 267

Low-level laser therapy (LLLT) has become an increasingly mainstream modality, especially in the areas of physical medicine and rehabilitation. This study aimed to determine the functional and histological changes that occur at the lower thoracic - upper lumber segments associated with the irradiation with LLLT in compression-induced injuries in Wistar rat’s spinal cord. Eighteen rats were randomized into three groups; six rats in each. Group A (sham) with laminectomy only, group B laminectomy plus cord compression injury and finally group C had laminectomy plus cord compression injury plus irradiated with LLLT two times, one after 2 hours from the injury and another after 24 hours from the first dose, each of these doses lasted for 42 minutes. The lesion site for group C directly was irradiated to the spinal direction with a 905 nm diode laser with an output power of 25 mW. The functional recovery was measured by locomotor test (BBB scale) and the histopathological changes were assessed in all groups after two weeks. Rats treated with laser showed a significant improvement in the locomotor functions compared to spinally injured rats. While histopathological evaluations in group C showed mild changes in comparison with group B that suggested significant recovery of the spinal cord compression injury. These findings demonstrated that the 905 nm wavelength laser is a promising neuroprotective non-invasive treatment for improving functional recovery after spinal cord injury.

67-75
Prospective study to identify the presence and prevalence of personality traits and other influences relevant to cosmetic surgery interest, patient selection and surgical outcome in a diverse aesthetic surgery practice

Authors: Jeffrey Morgan, Micheal Rodriguez, Alex Zuriarrain and Zoran Bursac

Abstract

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Number of views: 272

The key to a successful cosmetic surgery procedure lies in the selection of the patients. An anonymous voluntary participant study to evaluate whether not very well studied personality traits and secondary influences related to the decision to have cosmetic surgery could be negative predictors for cosmetic surgery patient selection and potentially surgical outcomes was performed. The mean Rosenberg Self-Esteem Scale score was 35.30 (SD = 4.22), indicating overall, the subjects had high self-esteem. Rosenberg score was 3 units lower for those that reported it would matter if no one thought the results looked good at least a little. There was a statistically significant difference in scores of Rosenberg based on age group. The mean Short Form-12 Mental Component Summary score was 51.93 (SD = 8.99), indicating that overall, the mental health of the subjects in this study may be slightly above the average. Short Form-12 scores were borderline significantly higher by almost two units for those that reported it would matter if no one thought the results looked good. The mean score on Body Image Questionnaire was 52.95 (SD = 5.48), indicating overall, subjects had a moderate level of body satisfaction. There was no statistically significant difference in scores of Body Image Questionnaire. The mean Dependent Personality Questionnaire score was 11.50 (SD = 2.88), indicating overall, subjects had mild to moderate level of dependent personality. Dependent Personality questionnaire yielded a significantly higher score for those that reported it would matter if no one thought the results looked good a little compared to not at all. Dependent Personality Questionnaire was borderline significantly lower for those reporting other race compared to white. The mean Beck’s Depression Inventory score was 4.90 (SD = 6.22), indicating overall, subjects had very mild depressive symptoms. When Beck’s was converted to a descriptive classification the majority of the subjects were considered to have minimal depression (86%) or normal ups and downs (84%). Beck’s was lower by over 5 units for women 31-45 compared to over 46.