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http://www.webmedcentral.com/images/Header_Logo.giftext/html2011-11-28T17:24:12+01:00http://www.webmedcentral.com/Dr. Giacinto LibertiniA Test about the Knowledge of some concepts of Evolutionary Medicine in the Medical Field
http://www.webmedcentral.com/article_view/2529
The correct knowledge in the medical field of some basic concepts of Evolutionary Medicine is tested with the answers of physicians of various professional qualifications to a group of 14 questions. The answers obtained show not only that there is an almost complete ignorance of some basic concepts of Evolutionary Medicine, but that current opposite ideas are prevalent. The consequence is that diseases are prevented and cured assuming an erroneous framework in a health maintenance system organized on unscientific assumptions with disastrous consequences for the rates of morbidity and mortality.text/html2010-09-12T00:22:28+01:00http://www.webmedcentral.com/Mr. Vishal SharmaEpistaxis With Oseltamavir
http://www.webmedcentral.com/article_view/599
Oseltamavir is now being used on a large scale across the globe and this will contribute to the advancement of knowledge about side-effects and adverse events associated with use of oseltamivir. We would like to share our experience with regard to occurrence of epistaxis in two patients who were put on oseltamivir therapy for treatment of infection with novel strain of influenza (H1N1).text/html2010-09-06T20:51:30+01:00http://www.webmedcentral.com/Dr. Anoop TMGiant Hydatid Liver
http://www.webmedcentral.com/article_view/529
A 55 year old female presented with one month history of intermittent right upper quadrant and epigastric pain, fullness and generalised fatigue. The symptoms became progressively worse over the last one week along with nausea and vomiting. She had no significant past medical illness.On clinical examination, a right upper quadrant, firm and non tender mass was palpable, approximately 15 cm in diameter.The complete hemogram, renal and liver function tests were all within normal limits. Ultrasonography showed an enlarged enlarged liver with septations and a daughter cysts within right lobe. The computed tomogram of abdomen revealed a large complex multicystic lesion of size 13.6 x 11.7 x 11.3 cm (volume 940 cc) with numerous internal echoes in right & caudate lobes of liver and a daughter cyst with in it (Panel A & Panel B).The patient refused to undergo any surgical procedure. She was discharged from the clinic with Albendazole 400 mg twice a day for 6 weeks and patient did not come return for follow up.Hydatid diseases is a parasitic infection caused by the cestode tapeworm Echinoccocus granulosus. The dogs are the definitive host. In humans the hydatid disease commonly involves the liver (75%) and the lungs (15%). Humans get infected by contact with the definitive host. Surgery is the mainstay of treatment for hydatid cysts of the liver.text/html2010-09-25T09:27:29+01:00http://www.webmedcentral.com/Dr. Thomas F HestonMedical Mythology: Its Etiology, Prevention and Treatment
http://www.webmedcentral.com/article_view/744
Myths are widely held beliefs that are false or of unverifiable existence. In medicine, they are not just unproven theories or mistaken conclusions, rather, they are fictitious ideas that weave their way throughout the profession. In order to prevent and treat medical myths, they need to be recognized as a disease that is harmful to patient care. Using established principles of medicine, the myths then can be medically managed and a cure attempted. To accomplish this, the myths need to be understood in terms of their etiology and pathopsychology. A firm understanding of biostatistics and the principles of evidence based medicine is essential to the prevention, management, and cure of medical myths.text/html2010-10-02T19:40:11+01:00http://www.webmedcentral.com/Dr. Ervin MingomatajA familiar case of progressive relief of seasonal allergy-like symptoms during jaundice
http://www.webmedcentral.com/article_view/620
Two sisters 18 and 20 years old had been suffering from rhinorrhea, sneezing, and nasal obstruction in May and June for 10 years. Every year, after the reach of nasal symptomatic peak in May, the above mentioned symptoms relieved progressively, whereas in the meantime bilirubin level and jaundice intensity increased. Jaundice and hyperbilirubinemia lasted about four-five months, attenuating progressively after June. Every June, total bilirubinemia reached 10-18 mg/dl (with increased levels of direct and indirect fractions), whereas until November its level decreased at 1.5-3 mg/dl (normal range 0.3-0.9 mg/dl). Performed skin prick tests and specific IgE for Mediterranean aeroallergens in both cases were negative. The hepatological analyses such as ultrasound and biochemical investigation indicated for the presence of biliary cirrhosis for two sisters. Based on the clinical and laboratory findings, the diagnosis of probable seasonal allergic rhinitis associated with probable primary biliary cirrhosis was suggested.text/html2010-10-02T19:43:24+01:00http://www.webmedcentral.com/Dr. Ervin MingomatajAsthmatic patients may complain more often about eventual depressive symptoms than other chronic patients
http://www.webmedcentral.com/article_view/578
Introduction: Recently published researches point out that asthmatics seem to be distinguished by a psychological profile described as halfway between patients with mood disorders or anxiety and general population. In our study we aimed to compare the prevalence of relationship somatic disease – eventual mood disorders between asthmatic patients and subjects suffering some other chronic disorders carried out in the main Outpatients Service of Tirana.Material and method: 79 consecutive asthmatic patients, 62 patients suffering diabetes, digestive disorders such as gastro-duodenal ulcers, or alcoholic hepatopathies, and 28 normal subjects were enrolled in this survey. All groups were homogenous with regard to sex and average age. The average age of subjects (109 f, 60 m) was 48.48 years ± 11.96 (SD). Included patients took regularly respective drugs but not psychotic ones, and female subjects at the time of study did not complain about menopausal disorders. Subjects were tested for eventual depressive symptoms due to a questionnaire prepared by Prof Dr HU Wittchen (www.depression.de/fragebogen/tx_fra_02.html).Results: The initial dada emerging from this research show that, asthmatic patients scored significantly higher than control group and other patients (mean ± SE respectively 4,35 ± 0,22; 1,14 ± 0,16; 2,48 ± 0,16). Female asthmatics scored a little higher than males (n. s.) and diabetic patients significantly higher than other non asthmatic subjects. Controls showed only DSS (3,6%), asthmatic patients showed DSS (34,2%) or ED (46,8%), and the rest of patients showed DSS (43,6%) and ED (only 4,8%). There was a weak correlation between asthma severity and questionnaire score (r = 0.275).Conclusions: We conclude that ED could be significantly more prevalent by asthmatics than by subjects who are suffering chronic digestive disorders or diabetes. These patients maybe need a special psychological check-up to clarify the eventual presence of the depressive disorders and the introduction of psychotropic treatment.text/html2011-04-04T18:16:26+01:00http://www.webmedcentral.com/Dr. Christine N Grace A Prospective Study on Anemia and Blood Transfusion in Critically ill Patients
http://www.webmedcentral.com/article_view/1836
Objective: To quantify the incidence of anemia and red blood cell (RBC) transfusion practice in critically ill patients and to examine the relationship of anemia and RBC transfusion in clinical outcomes.Design: The cohort study included 100 critically ill patients from King Abd El Aziz University Hospital, Saudi Arabia in 2010. Complete blood count was done detecting types and causes of anemia, and accordingly patients were divided into two groups - those who received blood transfusion versus those who did not. Anemic patients were identified, when having Hemoglobin (Hb) less than 14g/dl in males and Hb less than 12g/dl in females. The study contained 23% Saudi patients and 77% non-Saudi patients. There were 53% enrolled males and 47% females with an average age of 59.74 + 2.03 years. The data was analyzed based on the overall and the blood transfusion basis (50/50)Results: The study enrolled 100 patients, 50% of whom had blood transfusion. 82% of the patients in the ICU had anemia, mainly Normocytic Normochromic. There is an association between blood transfusion and mortality in critically ill patients, as 66% of patients, who had transfusion, died.Conclusion: Although critically ill patients with anemia have an increased risk of death, especially in the case of blood transfusion (66% of patients who received a transfusion died), however each of them must be assessed individually.
text/html2011-05-20T16:34:03+01:00http://www.webmedcentral.com/Dr. Christine N GraceMultiple Risk Factors for Non-Alcoholic Fatty Liver Disease in Obese Children and Adolescents
http://www.webmedcentral.com/article_view/1926
Background: Obesity is associated with many risk factors as fatty liver and a higher risk of death. Bariatric (weight loss) surgery for obesity is usually only considered in the last step to the morbid obese patients.Objective: The aim of this study was to evaluate the association between obesity and liver fat content in order to evaluate the risk factors associated with obesity in both children and adults.Design: The sample study was eligible for surgery that have a body mass index (BMI) greater than 40 or greater than 35 with some related conditions such as type fatty liver or type 2 diabetes mellitus which was detected by preoperative assessment which was conducted in 226 morbidly obese patients undergoing surgery for obesity. Assessment included blood tests in the form of investigations (blood picture, liver enzymes, lipid profile, blood sugar, insulin and glucagon hormones). Blood pressure was measured and liver ultrasound was done for the entire sample. Then the sample was divided into two groups according to liver condition (fatty liver and normal liver).Results: Of the 226 patients enrolled in the study, 97 (43%) has fatty liver and 129 (57%) has normal liver structure. The body mass index (BMI) of both groups (fatty liver and normal liver) for “children and adults” was of very high significance (p-value = 0.000) with average of 44.42±0.71 and 49.89±1.1 for normal liver patients and fatty liver patients respectively. Obesity has proven to appear more in childhood 162 (76.8%), followed by adults 30 (4.2%), and then at the age of puberty 19 (9%) while 15 (6%) was not detected. Liver enzyme assessment revealed that only serum bilirubin showed significance (p-value = 0.006) between the 2 groups of patients. Diabetes showed significance (p-value = 0.031) in fatty liver patients. For lipid profile and hypertension there was no significance.Conclusion: Obesity is becoming a major health problem as it is considered a risk factor in metabolic diseases and fatty liver. It is also becoming more popular in children increasing the incidence of its morbidity disorders due to the longer exposure. Bariatric surgery for morbid obesity with multiple risk factors is usually only considered when all other treatments have failed.
text/html2011-05-18T10:20:44+01:00http://www.webmedcentral.com/Dr. Christine N GraceProspective Incidence Study of Diabetes Mellitus in Morbidly Obese Saudi Patients
http://www.webmedcentral.com/article_view/1927
Objective: The aim of this study is to evaluate the association between obesity and diabetes mellitus in a sample of morbidly obese Saudi patients.Design: 201 morbidly obese patients undergoing surgery for obesity were preoperatively assessed. Assessment included complete blood picture, liver enzymes, lipid profile, blood sugar and hormones. Blood pressure was measured and liver ultrasound was done.Results: 198 patients were enrolled in the study, from which 46 persons (23.23%) were diabetics and 22 (11.11%) were hypertensive. The body mass index (BMI) of both diabetic and non diabetic groups was of significance (p-value = 0.108). Obesity has proven to appear more in childhood 141 (71.21%), followed by in adults 30 (15.15%) and then at the age of puberty 17 ( 8.58%). There was a high significance (p-value = 0.005) in morbidly obese hypertensive patients having diabetes than in morbidly obese patients with normal blood pressure and do not suffer from diabetes.Conclusion: Obesity is becoming a major health problem as it is considered a risk factor in metabolic diseases. It is also becoming more popular in children increasing the incidence of its morbidity disorders due to the longer exposure. Abdominal obesity is a recognized risk factor for both type 2 diabetes mellitus and cardiovascular disease resulted in the metabolic consequences of obesity, such as insulin resistance and impaired glucose tolerance. In summary, fatty liver is relatively common in overweight and obese volunteers with type 2 diabetes mellitus (DM) and is an aspect of body composition related to severity of insulin resistance, dyslipidemia, and inflammatory markers.text/html2011-08-03T20:01:24+01:00http://www.webmedcentral.com/Dr. Simon B ThompsonNormative Values for 18-30 Ages of Benton Visual Retention Test Correct Scores and Intelligence Quotients: A Short Report for Clinical Comparison
http://www.webmedcentral.com/article_view/2057
The Benton Visual Retention Test (BVRT) is a well known test used to assess visual memory deficits and visual spatial abilities in patients. There is normative data available for the 18-30 age range though it is not comprehensive and does not cover the higher intelligence quotient ranges. Findings from two studies are presented in combination for use as normative correct score values.
text/html2011-08-16T19:15:54+01:00http://www.webmedcentral.com/Prof. Parvaiz A ShahPulmonary Tuberculosis with Deep Venous Thrombosis
http://www.webmedcentral.com/article_view/2093
Tuberculosis is commonly encountered in developing countries like India. It can present with uncommon hematological manifestations which if not appropriately heeded to can make real diagnosis elusive.The present case highlights rare cooccurrence of pulmonary tuberculosis with deep venous thrombosis, which may at times pose a diagnostic challenge.text/html2012-04-16T12:44:38+01:00http://www.webmedcentral.com/Mr. Muhammed R SiddiquiIs it Necessary for Adults to Continue a Phenylalanine Strict Diet After Diagnosis of Phenylketonuria During Childhood?
http://www.webmedcentral.com/article_view/613
Phenylketonuria is an inherited metabolic disorder whereby the sufferers are unable to produce phenylalanine hydroxylase, an enzyme that is required to metabolise the amino acid phenylalanine. If there is a deficiency of this enzyme, phenylalanine levels rise to potentially serious levels which can lead to mental retardation and other problems. In most developed countries, babies are screened for the disease within a few days of birth. If diagnosed, the common treatment for Phenylketonuria is a phenylalanine restricted diet which the sufferer must follow for at least a number of years. Beyond childhood, the diet is maintained, relaxed or discontinued. This review involved the critical appraisal of four studies regarding the risk of discontinuing the special diet. The studies offered varying views; some argued diet discontinuation had no significant effect on cognition and mental capacity, whilst one view was that the diet should be maintained into adulthood. It was concluded that the safest thing to do would be to continue the diet but at a higher phenylalanine intake. However, it must be stressed that this particular topic is one that requires further research.text/html2013-12-19T09:03:51+01:00http://www.webmedcentral.com/Dr. Rajeshwari S VhoraProfile of Acute Respiratory Infection among adult patients during H1N1 outbreak in a tertiary care centre in Pune
http://www.webmedcentral.com/article_view/4468
Background: During the spring of 2009, a pandemic influenza A (H1N1) virus emerged and spread globally. We describe the profile of Acute Respiratory Infection (ARI) during H1N1 outbreak in a tertiary care centre in Pune.”Methods: This was retrospective observational study. Information was collected from records on 100 consecutive cases of ARI admitted in the hospital. It was compiled from day of admission till final outcome which was either survival or mortality. Clinical history & physical examination were carried out, including serial SOFA (Sequential Organ Failure Assessment) score. Laboratory data included examination of throat sample & Endotracheal tube secretion by a real-time reverse-transcriptase– polymerase-chain-reaction (rRT-PCR)Results: Out of total 100 cases, 68% were viral & 12% were bacterial,& for the rest 20% cases etiological agent could not be determined (undetermined). All viral cases were positive for H1N1 Influenza virus. In Bacterial group 10 cases were positive for Klebsiella pneumonia & 2 cases positive for S.pneumoniae. Mean age in this study was 39.82 yrs ( SD12.611). Fever & cough were most common symptoms. Duration of symptom prior to admission was in range of 1day -12 days. Tachypnea,. Tachycardia, low mean arterial pressure (MAP) & High SOFA scores were associated with poor survival.Conclusion: Mortality was higher in ARI cases where, microbial etiology could not be found. Delay in presentation & Hypoxia were associated with high mortality in ARI cases during H1N1 outbreak.text/html2014-06-17T12:25:56+01:00http://www.webmedcentral.com/Dr. Ishrat H DarTicarcillin Sodium / Potassium Clavulanate (Timentin) Induced Subcutaneous Hemorrhage - A Case Report
http://www.webmedcentral.com/article_view/4652
A 72 year old elderly male who was a known case of COPD was admitted to the hospital with one week history of productive cough, exertional breathlessness and generalized body swelling suggestive of an acute exacerbation with congestive cardiac failure. Patient was in hypotension, X-ray chest revealed a consolidation in the right lower lobe, complete blood count showed leucocytosis and blood culture grew Pseudomonas aeruginosa. A diagnosis of sepsis syndrome was made and the patient was started on Ticarcillin Clavulanate and supportive therapy. Two days after treatment the patient developed a diffuse subcutaneous hemorrhage in the whole of the chest and the abdominal wall. (Figure A, B, C). Though the patient was not on any kind of antiplatelet or anticoagulant therapy still the development of hemorrhage was an enigma. Platelet count, bleeding and clotting time, prothombin time, activated partial thromboplastin time, hepatitis serology and liver functions were normal. A diagnosis of Timentin induced subcutaneous hemorrhage was made. The patient died after 5 days owing to multi organ failure. Timentin is known to cause thrombocytopenia, leucopenia, neutropenia, eiosinophilia, reduction of hemoglobin or hematocrit, abnormalities of coagulation, platelet aggregation and prolongation of prothrombin time and bleeding time more in patients with renal impairment. Subcutaneous bleeding manifestations have occurred acutely after the use of this drug at the injection sites though rare. Activated partial thromboplastin time (APTT) has been shown to increase with the use of Ticarcillin resulting in increased bleeding tendency [1-3].Treatment includes withdrawal of the offending drug and symptomatic treatment.text/html2014-11-10T10:49:51+01:00http://www.webmedcentral.com/Dr. Giacinto LibertiniPrevention of Refractive Defects of Vision by Means of Evolutionary Medicine
http://www.webmedcentral.com/article_view/4753
The paper in pdf format is available as supplementary file.
I strongly recommend that you read the article in this format.
In modern medicine, important advances are, in general, achieved through innovative technologies or sophisticated drugs.
In this work, I propose an effective prevention of a very widespread group of diseases, i.e. the refractive vision defects, through the use of known information and the application of simple measures that do not require special technologies or sophisticated drugs.
The proposed method is the application of simple concepts of Evolutionary Medicine. A brief introduction to them is indispensable for an understanding of what is to be put forward.text/html2015-10-05T08:09:37+01:00http://www.webmedcentral.com/Dr. Aneet D PatelA rare presentation of triple a syndrome with prominent neurological and hematological Features: A case report
http://www.webmedcentral.com/article_view/4985
Triple A (AAA) syndrome was first described by Jeremy Allgrove in 1978 as uncommon. We reported a 30-year-old woman who presented in our clinic with symptoms of Adrenal Failure, Achlasiacardia and alacramia with a rare hematological manifestation rarely seen.