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  Most popular articles (Since June 28, 2017)

 
 
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EDITORIAL
Simulation in anaesthesia
Sanjeev Kumar Jain, Rohit Kumar Varshney
July-December 2018, 5(2):53-54
DOI:10.4103/ami.ami_88_18  
  495 4,106 -
ORIGINAL ARTICLE
Tarantula cubensis venom (theranekron®) selectively destroys human cancer cells via activating caspase-3-mediated apoptosis
Armin Ghasemi-Dizgah, Babak Nami, Nour Amirmozafari
January-June 2017, 4(1):74-80
DOI:10.5530/ami.2017.4.14  
Background: Tarantula cubensis venom (Theranekron®) is used as a homeopathic medicine which has shown anti-tumor effects in veterinary medicine. The aim of this study was to assess effect of Tarantula cubensis venom on apoptotic cell death of human cancer cell lines. Methods: HEK293, MCF7 and HN5 cell lines were used. The cells were treated with different concentrations of alcoholic extract of Tarantula cubensis (Theranekron®) for different periods of time. Cell morphology was studied by light microscopic observation. Cell proliferation was evaluated by MTT assay and death rate was assessed applying trypan blue staining. Apoptosis was assessed by DNA fragmentation, cleaved caspase-3 protein western blotting and ELISA caspase-3 activity assays. Results: Tarantula cubensis venom ruined cell adhesion, reduced cell proliferation, increased cell death rates and caused DNA fragmentation in human cells. An increased caspase-3 cleavage and hyper-activation of caspase-3 was detected in the cells treated with the venom. Results also showed a significantly higher toxicity and apoptosis levels in cancer cell lines MCF7 and HN5 compared with non-cancerous HEK293 cells. Conclusion: We conclude that Tarantula cubensis venom is selectively toxic for human cancer cells via inducing caspase-3- mediated apoptosis.
  2,471 201 -
EDITORIAL
Emotional quotient or intelligence quotient? Why not both?
Sanjeev Kumar Jain, Sanya Jain, Sonika Sharma, Nidhi Sharma
January-June 2018, 5(1):1-1
DOI:10.4103/ami.ami_28_18  
  1,155 1,176 -
ORIGINAL ARTICLES
Prevalence of sickle cell disease among children attending plateau specialist hospital, Jos, Nigeria
Nanbur Stephen, Nanyak Nden, Nanle Joseph Gusen, Patience Ringkat Kumzhi, Bonji Gaknung, Dauda Abimiku Auta, Lydia B Bulndi, Champion Mbursa, Vasantha P Kumari, Nannim Nanvyat
January-June 2018, 5(1):20-23
DOI:10.4103/ami.ami_60_17  
Background: An estimate of 250,000 children are born annually with sickle cell disease (SCD) worldwide and 75%–85% of the affected children are born in Africa; where mortality rates for those under age 5 years range from 50% to 80%. Objective: The present study was conducted to estimate the prevalence of SCD among children in Plateau State Specialist Hospital (PSSH), Jos, Nigeria. Methodology: Ethical approval was obtained from the Health Research Ethics Committee of the Hospital. Secondary data on age, gender, and region from the case notes of infants, children and/or adolescents; who received medical care in PSSH from 2012 to 2014 were used. Data were analyzed using frequency tables and Chi-square statistics. Results: The findings revealed that the prevalence of SCD in PSSH, Jos from 2012 to 2014 was 26.9/1000 population of pediatric patients. There was a gradual increase in the prevalence rate from 25.8/1000 in 2012 to 26.8/1000 in 2013 and 28.1/1000 in 2014. However, the case fatality rate of SCD gradually decreased from 15.4% in 2012 to 11.1% in 2013 and 10.3% in 2014. Chi-square test shows that the prevalence of the disease in relation to sex, age, and residence was not statistically significant (P > 0.05). Even though the case fatality rate of the disease decreased, its prevalence increased during the study. Conclusion: Therefore, preventive measure for SCD such as premarital genetic screening and counseling should be emphasized, especially in the southern and central geopolitical zones of Plateau state, where the prevalence was found to be higher.
  1,833 270 -
PICTORIAL ESSAY
The study of different presentations of breast lumps in radiographic imaging
Shalini Saraswat, Amit Kumar
January-June 2014, 1(1):45-51
Introduction: Breast USG is an established and accurate tool for the primary evaluation of breast lumps and pathology. It also compliments X-ray mammography in further evaluation and characterization of breast masses and thus avoids surgeries in benign breast diseases and pathology. Method: For USG examination of the breast lumps, a linear-array transducer of 5-7 MHz frequency is required with a good resolution machine. Results: We present a pictorial essay on the role of USG in evaluation and characterization of various breast lumps and pathology. Conclusion: Breast sonography considerably improves the visualization and evaluation of lumps in mammographically radiodense breasts and helpful in the characterization of it, either as solid or cystic lesion. It also improves the specificity of X-ray mammography when used as an adjunct to it. It is also helpful in guiding FNAC/biopsy from the breast masses.
  1,998 60 -
ORIGINAL ARTICLE
Structure based virtual screening, docking and molecular dynamic simulation studies to identify potent mdm2-p53 inhibitors: Future implications for cancer therapy
B Vijay Raj, MV Raghavendra Rao, Yogesh Acharya
January-June 2017, 4(1):11-21
DOI:10.5530/ami.2017.4.3  
Objective: To identify the p53 binding pocket as well as active residues in mdm2 protein, and search for similar (or) better compounds to inhibit mdm2-p53 interactions in comparison to FDA approved drug (Nutlin) by ligand and structure based virtual screening methods, docking, and molecular dynamic simulation studies. Methods: A structure and ligand based virtual screening for mdm2 protein; targeting the key residues involved in their active binding of p53 peptide was conducted after obtaining structurally suitable compounds similar to Nutlin from ZINC database. These compounds are virtually screened onto the mdm2 protein targeting its active binding site where p53 binds. The best compound with highest binding affinity was taken up for further analysis using molecular dynamic simulations for further validating the docking studies and to reveal interactions during the conformational changes Results: We discovered several compounds that are potentially able to block the interaction between active residues of mdm2 and p53 complex, suggesting their capability to act as anti-cancer agents. As proven by our structure based virtual screening studies coupled with semi-flexible and flexible docking studies, compound ZINC59256947 was found to be the strongest inhibitors for mdm2 protein amongst all of those isolates from ZINC database. Conclusion: Our results suggest that, a simple, selective and reliable inhibition assay can be performed to search for novel inhibitors of p53-mdm2 interaction. Therefore this study provides a rationalization to the ability of a ZINC59256947, an isolate from ZINC database with strong binding affinity towards mdm2 protein, for future implications as anti-cancer agent.
  1,565 338 -
REVIEW ARTICLES
Nutrigenomics and nutrigenetics: Concepts and applications in nutrition research and practice
Rohin Garg, Nidhi Sharma, Sanjeev Kumar Jain
July-December 2014, 1(2):124-130
Nutrigenomics refers to the application of genomic principles in nutritional research, enables us to formulate associations between specific nutrients and genetic factors, e.g. the way in which food or food ingredients influence gene expression. It aims to identify the genes that influence the risk of diet-related diseases and also helpful to solve the mechanisms that underlie these genetic predispositions. In contrast, nutrigenetics reveals the coordination of genetic makeup of individuals with their responses to various dietary nutrients. It clarifies different responses to same nutrient by different individuals. Interaction of genetic background and diet with regard to development of chronic conditions as obesity, cardiovascular disease, hypertension and cancer are discussed in present review. These two branches of nutrition resemble with two sides of a coin, facing towards opposite sides but simultaneously, they are intimately attached with each other. Collective efforts by the scientific community are needed to strictly follow guidelines put forth regarding experimental designs, analysis, and data storage for nutritional research. This strategy will be helpful to generate a sound database useful for clinicians and dietetic practitioners.
  1,687 199 -
ORIGINAL ARTICLES
Effect of aging and lumbar spondylosis on lumbar lordosis
Francis Osita Okpala
January-June 2018, 5(1):14-19
DOI:10.4103/ami.ami_64_17  
Background: Lumbar lordosis (LL), the anterior convexity of the lumbar spine in the mid-sagittal plane, gives the spine some resilience and helps in protecting it from compressive forces because some of the force is taken by the anterior longitudinal ligaments. In aging and lumbar spondylosis, the intervertebral discs undergo the same degenerative changes though at different rates, and in both, while some authors reported a straightening of LL, others reported no significant change. This morphologic information would hopefully influence therapeutic decision-making, particularly in lumbar spondylosis, which though usually asymptomatic, is a common cause of low back pain. Aim: The aim of the study was to investigate the effect of aging and lumbar spondylosis on LL. Subjects and Methods: Lumbosacral joint angle (LSJA), an angular measure of LL, was retrospectively measured in 252 normal and 329 spondylotic adolescent and adult supine lateral lumbosacral spine archival radiographs, and data were analyzed with IBM SPSS Statistics 23.0 (New York, USA). Results: Normal LSJA range was 5°–39°; the mean was 18.7° and showed insignificant variation with gender and aging. Spondylotic range was 5°–40° and the mean (20.8°) differed from the normal mean by about 2°, which probably have inconsequential effect on the lumbar curvature, suggesting that the normal and spondylotic mean values are essentially equal. The spondylotic mean also showed insignificant variation with aging and inconsequential 1° gender difference in favor of females. Conclusion: LL is substantially maintained in aging and lumbar spondylosis.
  1,533 250 -
Empathy level among the medical students of national defence university of malaysia consuming toronto empathy scale
Mainul Haque, Siti Nur Najihah Binti Lutfi, Nur Syamirah Aishah Binti Othman, Halyna Lugova, Shahidah Leong Binti Abdullah
January-June 2018, 5(1):24-30
DOI:10.4103/ami.ami_73_17  
Background: Multiple research articles were continuously emphasizing that constructive effects of empathy improve patient care. Medical professional bodies often talk that medical doctors need to be competent in clinical skills and empathetic. There was enormous demand from patients that doctors should be empathetic and motivate listeners. Therefore, medical educators became highly concern about the issue whether their students possess empathetic qualities. The Aim of the Study: To measure the empathy level among the medical students and to perform validation and reliability study of the Toronto Empathy Questionnaire (TEQ). Materials and Methods: This was a cross-sectional study among medical students of the Defence University of Malaysia to measure empathy level. The TEQ was utilized to collect data. The data were collected in early second half of 2017. The universal sampling method was adopted, and data were analyzed with IBM SPSS Software. Results: The current study population holds an average level of empathy. Female medical students had statistically significantly (P = 0.001) higher scores than their male friends. There no statistically significant differences observed in the TEQ score between the year of study (P = 0.948) and type of admission (P = 0.065). Conclusion: The current study respondents possess an average level of empathy. Educational intervention can be incorporated to enhance empathy level which sequentially promotes patient care.
  1,348 240 -
ORIGINAL ARTICLE
Clinical practice guidance for the use of clomiphene citrate in Male Hormone Replacement Therapy (HRT)
Michael A. S Guth
January-June 2015, 2(1):14-18
DOI:10.5530/ami.2015.1.4  
Introduction: Inhibition of pituitary gonadotropin secretion in men by testosterone (T) is principally mediated by aromatization to estrogen (E), which inhibits hypothalamic secretion of gonadotropin-releasing hormone (GnRH). Material and Methods: Longitudinal clinical investigation unit-based evaluation of the clinical and biochemical response to E-receptor blockade. Initial monotherapy with 50 mg of clomiphene citrate (CC) daily for a period of 9 months, with diurnal morning peak testosterone and luteinizing hormone (LH) levels evaluated at three-month intervals thereafter. The patient then resumed hormone replacement therapy (HRT) using T cream with adjuvant CC therapy. Main Outcome Measures were Baseline and stimulated T and LH levels; effect on sexual function. Result(S): CC therapy resulted in complete normalization of pulsatile gonadotropin secretion, serum T level, and sexual function. Conclusion(S): Isolated hypogonadotropic hypogonadism (IHH) may result from an acquired defect of enhanced hypothalamic sensitivity to E-mediated negative feedback. Whereas direct T replacement therapy can further suppress endogenous gonadotropin secretion, treating IHH men with gonadotropins can stimulate endogenous T secretion and enhance fertility potential. Reversal of gonadotropin deficiency with CC was found to have a similar biological effect.
  1,487 58 -
GUEST EDITORIAL
Female ejaculation - myth or fact?
Veronica Monet
January-June 2016, 3(1):4-5
DOI:10.5530/ami.2016.1.2  
  1,464 64 -
EDITORIAL
Homosexuality: A topic that invites a slew of controversies
Sanjeev Kumar Jain, Sanya Jain, Sonika Sharma, Nidhi Sharma
July-December 2017, 4(2):1-1
DOI:10.4103/ami.ami_54_17  
  1,304 210 -
REVIEW ARTICLE
Periodontitis and diabetes: A bidirectional, cyclical relationship - A brief review
Rakesh Agarwal, Rashmi Baid
July-December 2017, 4(2):46-49
DOI:10.4103/ami.ami_16_17  
Diabetes mellitus and periodontitis have been said to have a bidirectional cyclical relationship, with diabetes leading to oral disease, and periodontitis, in turn, exacerbating hyperglycemia. Periodontitis is recognized as the sixth major complication of diabetes, having increased prevalence and severity in patients with diabetes. Early diagnosis of diabetes in patients with periodontitis can lead to the prevention of major morbidity and mortality associated with the disease. Therapy for diabetes may also lead to the improvement of periodontitis. In this review, we are presenting the current knowledge of the interplay and interaction between these two entities and the available data regarding treatment of the two entities together.
  1,320 186 -
ORIGINAL ARTICLES
Morphological and skeletal abnormalities induced by α/β arteether on developing chick embryo
Vishram Singh, Lavlesh Kumar Mittal, Ram Kumar Ashoka
January-June 2018, 5(1):2-13
DOI:10.4103/ami.ami_82_17  
Introduction: Malaria continues to be one of the India's leading public health problem.α/β artether is one of the most common antimalarial drug used worldwide to treat chloroquine resistant malaria and malaria falciparum. The present study was designed to assess the teratogenic effects of α/β artether on developing chick embryo. Material and Methods: The study was performed on 300 fertilized eggs of white leg horn chicken.The eggs were divided in to five experimental groups A, B, C, D, E having 30 eggs each and five control groups a,b,c,d,e one each for every experimental group respectively having 30 eggs each. On 5th day of incubation eggs from experimental groups A, B, C, D and E were exposed to α/β artether with dose of 0.00039 mg, 0.000585 mg, 0.00078 mg, 0.00097 mg and 0.00117 mg whereas the control groups were treated with same amount of normal saline. Results: The results showed growth retardation and some significant morphological abnormalities like scanty feathers, subcutaneous hemorrhage and skeletal abnormalities like poor ossification of the bones, kyphosis and lordosis. Discussion: The drug is toxic specially when used in higher dose and for a long period. At present there is no alternative drug available for the treatment of chloroquine resistant malaria and malaria falciparum except α/β artether. Therefore α/β artether and other artemisinins should be used only after establishment of proper diagnosis in recommended dose only not in higher dose and not for a long duration.
  1,154 249 -
ORIGINAL ARTICLE
Autologous stem cells therapy, The first baby of idiopathic premature ovarian failure
M Edessy, Hala N Hosni, Y Shady, Y Waf, S Bakr, M Kamel
January-June 2016, 3(1):19-23
DOI:10.5530/ami.2016.1.7  
Introduction: Stem cells (sc) are the foundation cells for every organ, tissue and cell in the body. They are self sustaining and can replicate themselves for long periods of time. Stem cells can differentiate into different types of cells. Women below the age of forty and showing ovarian function loss are defined to have premature ovarian failure (POF). It is associated with sex steroid deficiency, amenorrhea, infertility, and elevated serum gonadotropins. Aim: To evaluate the therapeutic potential of autologous Mesenchymal sc (MSC) transplantation in women suffering from POF. Out of 112 high risk patients for POF(cases with amenorrhoea befor the age of forty), diagnosis was confirmed in10 cases. The ten POF patients were scheduled for MSC transplantation at Al- Azhar University Hospitals. MSC preparation from the bone marrow of the iliac crest was laparoscopically injected into the ovaries. Endometrial fractional biopsy was histopathologicaly (HP) and Immunohistochemically (IH) stained and evaluated according to Edessy stem cells score (ESS). Ovarian reserve was evaluated according to Edessy ovarian reserve score (EORS). Results: Showed that after transplantation two cases (20%) (ESS = 5 and 6) resumed menstruation after 3 months, one of them (10%) (Case no 5) (ESS = 6) got pregnancy after 11 months and delivered a healthy full term baby (Zeinab).Ten months after transplantation EORS of patient who developed pregnancy (case no 6) was found to be 7 after being 0 before therapy. EORS of the other menstruating case (case no 10) was 5 after being 0. The 2 menstruating cases showed focal secretory changes after being atrophic endometrium in case 5 and distorted proliferative endometrium in case 10. Conclusion: Stem cell transplantation is a good procedure and regarded as a real and hope to get healthy pregnancy and baby for cases of POF. It showed good clinical, HP and IH outcome.
  1,154 167 7
GUEST EDITORIAL
Potential of clinical pharmacology in developing rational prescribing
Mainul Haque
July-December 2017, 4(2):2-3
DOI:10.4103/ami.ami_41_17  
  1,123 155 -
ORIGINAL ARTICLE
Molecular characterization of extended spectrum β-lactamases, ampccephalosporinases and carbapenemases in klebsiellapneumoniae causing bacteremia at charles nicolle Hospital of Tunisia
Elaa Maamar, Samia Hammami, Sana Ferjani, Zaineb Hamzaoui, Asma Jlizi, M Saidani, A Slim, I Boutiba-Ben Boubaker
July-December 2016, 3(2):40-45
DOI:10.5530/ami.2016.2.10  
Purpose of the Study: This study was conducted to detect and characterize the genes encoding extended spectrum β-lactamases and associated β-lactamases (carbapenemases and Ambler Class C β-lactamases). Patients and Methods: In 2011, out of the 65 non-duplicative Klebsiellapneumoniae collected from blood culture at Charles Nicolle hospital of Tunisia, 36 were resistant to 3rd generation cephalosporin. Results: All strains showed a double disk synergy test positive. They were mainly isolated in intensive care unit (31%). They were frequently resistant to most antibiotics tested, except colistin and tigecyclin. Five isolates (13%) showed reduced susceptibility to carbapenems. blaCTX-M-15 was harbored by 35 strains and blaSHV-12 by one. blaCTX-M-15 were associated with blaTEM-1 (n=21), blaOXA-48 and blaCMY-2 (n=1) and blaOXA-48and blaTEM-1 (n=4). The conjugation wassuccessfulfor4/5 strains (3 harboring blaCTX-M-15 and one blaSHV-12). The plasmids carrying the blaCTX-M-15 were assigned to IncN or IncL/M only for 2 strains. The remaining blaCTX-M-15-carrying plasmid was negative for all of the replicons tested as well as the blaSHV-12-carrying plasmid. Conclusion: Our results confirm the spread of CTX-M-15 in our institution. To our knowledge, this is the first report of K. pneumoniae coproducing CTX-M-15, CMY-2 and OXA-48. The implementation of preventive measures against the spread of these multiresistant bacteria is needed.
  1,222 44 -
Heme iron polypeptide (proferrin®-ES) versus iron saccharate complex (ferrosac) for treatment of iron deficiency anemia during pregnancy
Ibrahim A Abdelazim, Mohannad Abu-Faza, Assem A. M Elbiaa, Hossam S Othman, Dareen A Alsharif, Walid Farok Elsawah
January-June 2017, 4(1):56-61
DOI:10.5530/ami.2017.4.11  
Objectives: Anemia is one of the world's leading causes of considerable perinatal morbidity and mortality. This study designed to compare the efficacy and safety of Heme iron polypeptide (Proferrin®-ES) versus iron saccharate complex (Ferrosac) in treatment of iron deficiency anemia during pregnancy. Methods: Two hundred and sixty (260) pregnant women with hemoglobin level below 10 gm/dl due to iron deficiency anemia were included in this study and randomized to receive either; intravenous Iron Saccharate (IV group) or oral Proferrin®-ES (PO group) for correction of iron deficiency anemia during pregnancy. Treatment efficacy checked by comparing pre-treatment values of hemoglobin, serum ferritin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and reticulocytes count by the 3-months` post-treatment values. Results: The 3-months` post-treatment hemoglobin level increased compared to the pre-treatment level without any significant difference between the two studied groups (from 8.5 ± 3.5 to 11.3 ± 1.3 gm/dl in PO group and from 8.7 ± 2.5 to 11.7 ± 0.9 gm/dl in IV group). In addition; the 3-months` post-treatment ferritin level, increased compared to the pre-treatment level without any significant difference between the two studied groups (from 19.4 ± 4.9 to 118.8 ± 7.1 ug/l in PO group and from 15.3 ± 5.6 to 122.3 ± 6.4 ug/l in IV group). 1.6% (2/124) of the studied women developed gastrointestinal intolerance and upset with oral Proferrin®-ES (insignificant difference and excluded from the study) and no other side effects recorded with oral Proferrin®-ES. Conclusion: HIP (Proferrin®-ES) is an effective, safe, well tolerable oral iron preparation as well as intravenous iron saccharate complex for treatment of iron deficiency during pregnancy; it increases the hemoglobin and replaces the depleted iron store.
  1,146 119 2
A study of knowledge and attitude of health care providers working at tertiary care hospitals of Lahore, Pakistan (having HIV/AIDS treatment facility) towards HIV/AIDS
Tahira Hafeez, Syed Hunain Riaz, Irtza Ali, Naila Irum
January-June 2017, 4(1):124-131
DOI:10.5530/ami.2017.4.22  
A very few health care providers look after HIV/AIDS people because of their poor knowledge and either their lack of positive attitude or usually both. The rationale of this study was to evaluate the knowledge and attitudes of health care providers (tertiary care hospitals in Lahore, having HIV/AIDS Treatment Facility) towards patients with HIV/AIDS. In this cross sectional study, a random sample of 180 healthcare providers was assessed for their knowledge and attitudes. In the questionnaire of knowledge, items were measured in the form of dichotomous scale. Whereas in the five domains of attitudes, items were measured as a five-point likert scale ranging from strongly disagree to strongly agree. Results were discussed in the outlook of two variables which showed that the presence of negative attitude and lack of awareness increase the level of stigma and discrimination. HIV in our country needs positive attitude of rendering care and effective control measures by creating awareness in the community. The study reinforced the need for an ongoing education focused on experiential learning, and professional socialization.
  1,136 121 -
ORIGINAL ARTICLES
Non invasive assessment of malignancy in solitary non palpable thyroid nodules: A comparative and complimentary evaluation of grey scale ultrasound and color doppler parameters –Way towards a new scoring system?
Abhishek Aggarwal, Jyoti Aggarwal, Seema Awasthi
January-June 2017, 4(1):1-6
DOI:10.5530/ami.2017.4.1  
Objectives: To assess the comparative as well as collective role of various grey scale (GS) ultrasonography (USG) and color doppler (CD) parameters in distinguishing benign from malignant thyroid nodules. To suggest a scoring system for predicting malignancy in thyroid nodules using this array of parameters. Methods: 140 patients with non palpable thyroid nodules were examined by five GS USG and three CD parameters. The results were compared with histopathological examination and evaluated statistically. Each GS and CD parameter was evaluated individually as well as collectively, comparatively. Total score was calculated by assigning each of these eight parameters a score of 0 to 2. Results: Scoring used in this study showed sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy of 87.5%, 90.6%, 70%, 96.7% and 80% respectively. These parameters were 85.4%, 86.2%, 60%, 96%, 80% for CD and 69.2%, 71.9%, 50%, 85.2% and 64% for GS. Two GS USG features showing p value < 0.05 were poorly defined margins and thick incomplete halo while on CD Resistivity index (RI) was found to be very highly significant (p < 0.0001) and Pulsatility index (PI) was highly significant (p < 0.001). Conclusion: Scoring system proposed in this study proved better than GS or CD individually for predicting malignancy in thyroid nodules. Amongst various GS and CD parameters RI showed highest statistical significance. Overall CD showed better accuracy, sensitivity, specificity than GS USG.
  1,057 198 -
Accuracy of detection rate and intraoperative sentinel lymph node assessment in early-stage cervical carcinoma
Begoña Díaz de la Noval, Javier De Santiago Garcia, Alicia Hernández Gutiérrez, Ignacio Zapardiel Gutierrez, Mariana Díaz Almirón, Laura Yébenes Gregorio, David Hardisson Hernaez, María Dolores Diestro Tejeda
July-December 2017, 4(2):9-15
DOI:10.4103/ami.ami_3_17  
Objective: This article shows our experience on sentinel lymph node (SLN) biopsy in early-stage cervical carcinoma since the technique was introduced in our Institution. The main objective is to analyze the detection rate (DR) of metastatic SLNs, identifying prognostic factors for an increased risk of nodal metastases. Our second aim was to compare the accuracy of nodal metastases DR between intraoperative analysis and postoperative ultrastaging. Materials and Methods: Forty-one women with the International Federation of Gynecology and Obstetrics stages IA2-IIA1 who underwent laparoscopic surgical treatment applying the SLN technique, from December 2011 to June 2016, at La Paz University Hospital, were included. The sentinel node was identified using technetium and methylene blue dye or indocyanine green near-infrared fluorescent imaging, analyzed intraoperatively, and compared to deferred ultrastaging. Results: SLN DR was 100%, with a bilaterality rate of 83%. Twelve (26.8%) patients had metastatic nodes, 11 of them (91.7%) detected by SLN technique, of which 9 (81.8%) had only the sentinel node affected. False-negative rate was 2.4% after ultrastaging procedure. Metastatic SLN detection with ultrastaging was 45.5% higher than the intraoperative analysis, 63.6% of which had low tumor burden. The global detection of patients with nodal metastases after SLN technique was 21.9% higher than pelvic lymphadenectomy. Conclusions: Our preliminary results corroborate that SLN biopsy selectively maps metastatic nodes and ultrastaging increases the detection of metastatic SLNs, predominantly due to low tumor burden.
  1,031 142 -
Expression of paired Box-2 gene product in renal tumors as a diagnostic immunomarker
Muhammad Shabbir, Mulazim Hussain Bukhari, Shahida Niazi
July-December 2017, 4(2):4-8
DOI:10.4103/ami.ami_6_17  
Objective: This study was aimed at evaluating the usefulness of paired box-2 gene (PAX-2) in the diagnosis of renal tumors. Materials and Methods: This study included 60 renal tumors. The newly prepared hematoxylin and eosin stained slides of all cases were evaluated and the diagnoses were confirmed or revised for each tumor according to the 2004 World Health Organization classification of renal tumors. Representative and consecutive sections of each tumor were submitted for anti-PAX-2 antibody immunohistochemistry. The pattern of staining (nuclear or cytoplasmic) was also noted. PAX-2 expression in tumors was correlated with low- and high-nuclear grades (Fuhrman nuclear grades). Results: The 45/60 (75%) cases showed PAX-2 nuclear immunoexpression. The frequency of positivity in renal tumors was seen in 29/34 (85.5%) and 12/15 (80%) cases of clear cell RC, papillary RCC, respectively. The PAX-2 was positive in 20/45 cases for score 1+. The 16/45 cases were categorized into score 2+, and 9/45 cases were categorized into score 3+. Conclusion: PAX-2 is a diagnostically useful marker for primary renal tumors and is inversely proportion to the grades of the renal tumor.
  998 166 -
ORIGINAL ARTICLE
Effectiveness of Benson's relaxation therapy on reduction of stress among primigravid mothers
Simi Paramban, Sireesha Bala, J Krishna Sowmya, M V. Raghavendra Rao, Praveen Kottath Veetil
July-December 2016, 3(2):133-140
DOI:10.5530/ami.2016.2.27  
Objectives: The study attempt to assess the effectiveness of Benson's relaxation therapy on reduction of stress among primigravid mothers attending the outpatient department in a selected hospital at Kannur, with the objectives of evaluating the stress among the primigravid mothers before and after the Benson's relaxation therapy and to associate the level of stress with selected demographic variables. Methods: A total of 30 primigravid mothers after third month of gestation were selected for the study. The information regarding background data were collected from the primigravid mothers by self-administered rating scale and the level of hemoglobin status was noted from the health records. Selected primigravid mothers were given pretest questionnaire and Benson's relaxation therapy was administered to all group members for 20 minutes and instructed to continue this for a period of 15 days. Post-test using rating scale was conducted 15 days after the administration of Benson's relaxation therapy. Result: The result of the study shows that the post-test mean stress score was less than the pre-test mean stress score. The obtained mean difference between the pre-test and post-test regarding stress score was statistically significant. Hence research hypothesis “there will be a significant difference in the stress scores before and after Benson's relaxation therapy among the primigravid mothers” has been retained. Conclusions: It was inferred that primigravid mothers who practiced Benson's relaxation therapy had significant decrease in post-test stress score. Also there was significant association with the level of stress and some demographic variables.
  1,065 94 -
ORIGINAL ARTICLES
A study of snakebite envenomation cases admitted to egyptian national poisoning center
Ahmed Salah Gouda, Nagla A Elnabarawy, Sayed M Badawy
July-December 2017, 4(2):34-40
DOI:10.4103/ami.ami_48_17  
Introduction: Snakebite is an Egyptian health problem since ancient Egypt. Meanwhile, there is still no controlled geographical and medical studies on locally prevalent snake family intoxication. Aim and Methods: The present study aimed to investigate local snakebites presentations, management, prognosis, and the effect of the polyvalent antivenom, locally produced by the Holding Company for Biological Products and Vaccines (VACSERA) through the year 2015. Results: A total of 87 snakebites caused by venomous and nonvenomous species were recorded. Most cases were middle-aged males. Most cases presented in summer and in the evening time. Two major groups of venomous Egyptian snakes were identified, Viperidae and Elapidae species, based on history, characteristic symptoms, and laboratory findings. Most snakebites (56 cases) were reported to be nonvenomous bites (64.4%). Twenty-one cases (24.1%) of snakebites were reported to be venomous bites by Elapidae snakes and 10 cases (11.5%) were reported to be venomous bites by Viperidae snakes. Antivenom was administered before referral to 37 (42.5%) of cases, and 19 only of them were victims of venomous snakes. Thirty-six (41.3%) patients received antivenom during admission including all cases of the venomous bites and 8.9% of nonvenomous bites' cases. Conclusion: Patients who had moderate or severe symptoms were effectively treated with VACSERA's polyvalent antivenom, with doses related to the severity grading and snake species identification. Additional antivenom doses were repeated on the bases of the clinical condition. Many snakebite victims referred from primary health centers received inadequate or nonnecessary doses of antivenom. No cases of anaphylaxis were recorded. There were no mortalities with current National Center for Clinical and Environmental Toxicology's protocol of treatment.
  1,053 103 1
Premarital sexual relationships: Contraceptive knowledge and practice among iranian youths
Fariba Taleghani, Effat Al Sadat Merghati Khoie, Mahnaz Noroozi, Mahgol Tavakoli, Ali Gholami
July-December 2017, 4(2):41-45
DOI:10.4103/ami.ami_66_17  
Objective: The youths' sexual behaviors are counted as the main priorities of the public health due to the high prevalence of unwanted pregnancies, illegal abortions, and sexually transmitted infections. This research was carried out to explain the youths' contraceptive knowledge and practice in premarital sexual relationships. Methods: This qualitative research was carried out on 30 single boys and girls aged 18–24, living in Isfahan, Iran, who had already started sexual activities. Data collection was done with semi-structured interviews. The data were analyzed by using conventional content analysis. Results: Two main categories were extracted including inadequate awareness regarding contraception (with subcategories “unreliable information sources” and “gender inequality in familiarity with contraceptive methods”) and inappropriate contraceptive practice (with sub-categories “use of unreliable contraceptive methods” and “gender inequality in applying contraceptive methods”). Conclusion: Sexual health education programs should equip the youths with adequate knowledge on contraception and use of reliable contraceptive methods. Furthermore, attempts should be made along with tackling gender inequality is very significant for youths' sexual and reproductive health security.
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