International Research Journal of Medicine and Medical Sciences

118-124

Authors: Rubina Ghani, Mozaffer Rahim Hingorjo, Samia Perwaiz Khan, Uzma Naseeb, Shaista Emad, Afrasayab Khan Khattak, Alina Fatima Iqbal, Mauyur Sarhadi and Navneet Sarhadi

Previous studies have reported that metabolic syndrome (MetS) is associated with an increased risk of major cardiovascular events and levels of C-Reactive protein (CRP) can be considered as markers of MetS and its constituent components. Oxidative stress plays a major role in the development of MetS, and levels of gamma-glutamyl transferase (GGT) change with response to oxidative stress are also associated with MetS, which may be modulated by CRP. This study was conducted to identify the role of GGT and CRP as biomarkers in the diagnosis of MetS, a high-risk factor for cardiovascular diseases. One hundred and fifty patients meeting the diagnostic criteria of MetS and an equal number of controls were included in the study. The cases were selected from pathology and molecular biology laboratories, Karachi, while the controls came from the general population. Anthropometric indices of adiposity and blood pressure were recorded for both cases and controls. Blood samples were taken from all subjects to determine the levels of CRP and GGT. All those cases and control height, weight, hip waist circumference were noted and the comparison of CRP and GGT by applying students' t-test as markers for detection of metabolic syndrome. p-value 0.001 was considered as significant. This study suggests that in patients with metabolic syndrome were found to have raised the basal metabolic rate, C-reactive protein and GGT were synergistically associated with MetS independently of another confounding factor in the general population.

94-102

Authors: Rohit Mody, Debabrata Dash and Bhavya Mody

Hyperkalemia is one of the few potentially lethal electrolyte disturbances. Severe hyperkalemia (Serum potassium concentration > 6.5 mmol/L) occurs most commonly from renal failure or the release of potassium from cells and can cause circulatory shock, cardiac arrhythmias or cardiac arrest. Current BLS (Basic Life Support) and ACLS (Advanced Cardiovascular Life Support) protocol should be used to manage cardiac arrest associated with hyperkalemia. But early consideration should be given to using the selective method of therapeutic management in addition to standard ACLS protocols that can be provided rapidly, effectively in patients with cardiovascular instability. We describe here a case of chronic kidney disease and congestive heart failure who developed circulatory shock and eventually cardiac arrest due to hyperkalemia managed with Calcium Gluconate, Sodium Bicarbonate and Insulin along with standard advanced cardiovascular life support protocol.

60-67

Authors: Yoshiaki Endo, Tamaki Hirose, Masahiro Ishizaka, Yohei Sawaya, Akihiro Yakabi and Akira Kubo

This study aimed to reveal the extent of the adverse effects caused by the restrictions on going out due to the COVID-19 pandemic on physical function. The participants were 129 healthy older adults, aged 65 years and older, who lived independently without the need for long-term care. The presence or absence of disuse syndrome was investigated using a partially modified “Disuse Syndrome Inventory.” The address, age, and gender of the participants were also surveyed in a factor analysis of disuse syndrome. The effective response rate was 90.6% (n = 117). Disuse syndrome was observed in 38.5% (n = 45) of the participants, which was significantly higher in women compared to men, and in medium-sized to depopulated cities compared to large cities. It has become clear that a large number of older adults have disuse syndrome because of the travel and commute restrictions due to the COVID-19 pandemic. To return to normal life sooner, it is necessary to consider countermeasures as soon as possible.

9-18

Authors: B. Brankov and A. Zlatareva

The purpose of the study is to examine the opinion of the medical community on the need for further training on matters relating to drug policy (as a dynamic and rapidly changing area of healthcare policy bearing on the work of a number of healthcare specialists) and the attitudes to web-based forms of further training. The study was conducted among healthcare professionals (healthcare professionals means graduates in medicine and/or pharmacy – physicians, dentists, pharmacists and healthcare professionals and managers etc. who practice their occupation applying the set of regulatory standards governing drug policy) from three Balkan countries – Bulgaria, Slovenia and Croatia – who have completed a dedicated survey. Participation in the survey was voluntary and the polling was conducted on the basis of the ‘snowballing’ technique for survey dissemination and recruitment of respondents. The statistical processing of collected data relied on a correlational descriptive and regression analysis. The results reveal that respondents are aware of the need and are willing to pursue possibilities for further training on matters relating to drug policy. The correlational analysis has revealed interesting further data. A statistically significant negative correlation has been established between knowledge assessment and the method of updating and upgrading knowledge on matters relating to drug policy. The data suggests that according to the respondents self-learning and attending courses led by trainers who are subject-matter experts increases the evaluation of knowledge in the area of drug policy (rho = 0.-631, р = 0.002). Furthermore, the greater frequency of additional training events to improve current levels of knowledge is also a factor that increases self-assessment of being up to date on the latest developments in this area (rho = 0.577, р = 0.006). There is a need for further training in the area of drug policy and the preferred form of this type of training are the online and physical training events by guest trainers conducted by medical schools. In order to ensure that training conforms to a high-quality standard, a test should be taken at the end and a certificate attesting to the training should be issued as a quality assurance guarantee.

24-33

Authors: W. S. Ahmed, R. M. Gharib, H. M. Salah El-Din and H. A. El-Talawy

The aim of this research was to examine the impact of pelvic girdle stability training in children with hypotonic cerebral palsy on functional sitting control. Thirty children with hypotonic cerebral palsy in both sexes, with their ages ranging from two to four years were used in the study. There were fifteen children in the experimental group and fifteen children in the control group. The study group received pelvic girdle stability training program in addition to a selected program for upper limbs and trunk muscles strengthening exercises, while the control group received only the selected program for upper limbs and trunk muscles strengthening exercises. Results revealed significant difference of GMFM88 (sitting domain) (P < 0.01), stationary raw scores and stationary standard scores of PDMS-2 (P < 0.05) but no significant difference of age equivalent of PDMS-2 (P > 0.05). GMFM88, on the other hand, had a significant difference (sitting domain) (P < 0.05) but no significant difference of stationary raw scores, stationary standard scores and age equivalent of PDMS-2 (P > 0.05) in the control group. Paired t-test were conducted for comparison between pre and post treatment mean values of sitting domain and stationary scores in each group. From the obtained results of the present study, we conclude that pelvic girdle stability training program was more effective in generating core muscle activity for functional sitting control compared to traditional physical therapy of upper limbs and trunk muscles strengthening exercises in children with hypotonic cerebral palsy.

43-51

Authors: Parichehr Tootoonchi

Angiolipoma is the most common soft tissue tumor in human trunk and extremities, mostly affecting young male patients; however, in children, it occurs rarely and the most involved area has not been determined. A 9 year old girl was admitted to the pediatrics ward because of a newly arousal of pain associated with suddenly rapid increasing of the size of an old mass on the right side of her chest wall for almost one month without any history of trauma to the area; she had the lesion since her birthday. Otherwise, her physical examination and laboratory tests were unremarkable. Findings of different types of imaging of the mass were in favor of a benign chest wall lesion. A surgical excision was performed and histopathologic report of the lesion was consistent with typical features of a non-infiltrating angiolipoma. The patient recovered uneventfully with complete resolution of lesion. No recurrence of the tumor was observed in the patient in the following 30 months. This report seems to be the first documented case of congenital non-infiltrating angiolipoma of the chest wall in a child. Review of literature has shown that in children, angiolipoma is mostly a single, benign lesion commonly appears in the face or the spinal region, with complete recovery after a simple surgical excision and no recurrence.