Rajesh Varma
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Acute intestinal obstruction in systemic lupus Erythematosus: Case report and review of the literature
No full textIntroduction: Gastrointestinal manifestations in systemic lupus erythematosus are common and may involve any segment of the digestive tract. Lupus enteritis is one of the manifestations responsible for abdominal pain. Its treatment is based essentially on corticosteroids. The use of immunosuppressive drugs is reserved for recurrent forms or in case of failure of corticosteroids.Materials and methods: We report a case of “acute intestinal obstruction in systemic lupus erythematosus” in the Department of Emergency visceral surgery.Results: Mrs. SQ, S, 24 years old, was diagnosed one week ago with systemic lupus erythematosus at the beginning of treatment, with a history of pancreatitis stage E, history of current illness goes back to 05 days before her admission by the installation of a sub-occlusive syndrome made of cessation of matter and gas associated with food vomiting, with cessation of matter and gas in the last 48 hours.Para-clinical The Abdomen without preparation showed hydroaeric levels. With an abdominal CT scan which showed: CT scan appearance in favor of bowel obstruction with evidence of a transitional level above the umbilical: inflammatory stenosis? The spontaneously hyper-dense appearance of the colonic lumen and some ileal intestines is most probably related to a digestive hemorrhage that could be part of lupus enteritis given the patient’s past history with the spontaneously hyper-dense appearance of the colonic lumen and ileal intestines most probably related to a digestive hemorrhage. And distension of the jejunal and some ileal coves, measuring: 36mm in maximum diameter, the seat of hydrophobic level with a transitional level above umbilical. Significant gastric distension. No parietal pneumatosis with no parietal enhancement defect.In view of the clinical symptomatology and the CT scan results, the patient underwent an exploratory laparotomy with the following findings: Absence of peritoneal effusion with the presence of a 3 cm distension of the bowel without any sign of flange, stenosis, or detectable obstacle, with the performance of multiple biopsies at the level of the greater omentum, the mesentery, and the anterior parietal peritoneumConclusion: Intestinal pseudo-obstruction is a rarely reported manifestation during systemic lupus erythematosus. It is a rare but potentially serious manifestation that can reveal the disease or occur during the course of the disease. The use of immunosuppressive drugs is reserved for recurrent forms or in case of failure of corticosteroids. However, recurrences are frequent. Azathioprine is an alternative therapy to control the disease.However, recurrences are frequent. Azathioprine is an alternative therapy to control the disease.</p
BAT’s specific Micro-RNA or Novel approach for treatment of obesity: A hypothesis
No full textBackground: Type 2 Diabetes (T2D) is associated with coronary microvascular dysfunction, which is thought to contribute to compromised diastolic function, ultimately culminating in heart failure with preserved ejection fraction (HFpEF). The molecular mechanisms remain incompletely understood, and no early diagnostics are available. We sought to gain insight into biomarkers and potential mechanisms of microvascular dysfunction in obese mice (db/db) and lean rats (Goto-Kakizaki) pre-clinical models of T2D-associated diastolic dysfunction.Methods: The microRNA (miRNA) content of circulating Extracellular Vesicles (EVs) was assessed in T2D models to identify biomarkers of coronary microvascular dysfunction/rarefaction. The potential source of circulating EV-encapsulated miRNAs was determined, and the mechanisms of induction and the function of candidate miRNAs were assessed in Endothelial Cells (ECs).Results: We found an increase in miR-30d-5p and miR-30e-5p in circulating EVs that coincided with indices of coronary microvascular EC dysfunction (i.e., markers of oxidative stress, DNA damage/senescence) and rarefaction, and preceded echocardiographic evidence of diastolic dysfunction. These miRNAs may serve as biomarkers of coronary microvascular dysfunction as they are upregulated in ECs of the left ventricle of the heart, but not other organs, in db/db mice. Furthermore, the miR-30 family is secreted in EVs from senescent ECs in culture, and ECs with senescent-like characteristics are present in the db/db heart. Assessment of miR-30 target pathways revealed a network of genes involved in fatty acid biosynthesis and metabolism. Over-expression of miR-30e in cultured ECs increased fatty acid β-oxidation and the production of reactive oxygen species and lipid peroxidation while inhibiting the miR-30 family decreased fatty acid β-oxidation. Additionally, miR-30e over-expression synergized with fatty acid exposure to down-regulate the expression of eNOS, a key regulator of microvascular and cardiomyocyte function. Finally, the knock-down of the miR-30 family in db/db mice decreased markers of oxidative stress and DNA damage/senescence in the microvascular endothelium.Conclusion: MiR-30d/e represents early biomarkers and potential therapeutic targets that are indicative of the development of diastolic dysfunction and may reflect altered EC fatty acid metabolism and microvascular dysfunction in the diabetic heart.</p
Percutaneous Patent Ductus Arteriosus (PDA) closure: When and how to close Coil VS Occluder “step by step” cases report
No full textBackground: The PDA defines the pathological persistence after the birth of a fetal physiological communication between the aorta and the pulmonary artery frequently encountered in preterm infants and whose clinical and hemodynamic consequences depend on the importance of the shunt directly bound to the diameter of the canal.Percutaneous closure is the most frequent management modality with excellent immediate and long-term results (two modes of closure: using coil or Occluder).The surgery remains reserved for complex anatomies or associated with other surgical congenital anomalies.Case presentation: We detail in this document the two methods of percutaneous closure step by step illustrated by pediatric cases. The first case concerns a 7 years old girl of 17 kg weight with a history of heart murmur that presented in the TTE a PDA estimated at 1mm with LV dilation. The second case concerns a 12 years old girl of 30 kg weight with also a history of heart murmur that presented on TTE a PDA of 4.5mm with LV dilation.Therapeutic intervention: In the first case, we perform a closure with coil 5/5 by a unique femoral arterial approach as a standardized attitude in our center avoiding additional venous access. For the second case, we opted for closure with prosthesis N° 6/8 by a double femoral approach (arterial and venous access).Outcomes: The follow-up was favorable for both patients, with total sealing of the defect immediately after the procedures that persist during the 6 months of control.Conclusion: The closure of PDA in children is a challenging procedure whose safety requires a good pre-and per-procedural evaluation allowing the right choice of the method and size of the closing device.The respect of the different closure stages and the critical per procedural ultrasound and angiographic control reduce the rate of complications making this technique accessible and safe.In our series of 108 PDA closures by Coil in children, the unique femoral arterial approach is the standardized attitude in the first line in all patients avoiding additional venous access, which allows the Coil release in the basic technique while the arterial access allows opacification and measurement of the channel.The unique arterial approach has reduced the risk of local complications at the puncture site and the duration of the procedure without difference in closure efficiency and embolization risk.In our series of 92 PDA closures by Occluder in children the double femoral approach is the standardized attitude for all patients, the venous access allows the device release while the arterial access allows opacification/ measurement of the channel and control device deployment. </p
Pharmacogenetic application in a patient diagnosed with Schizophrenia and OCD: A case report
No full textIntroduction: The efficiency of psychiatric therapy depends on various factors and drug metabolism is one of them. The liver plays a significant role in drug metabolism through the P450 enzyme systems. However, pharmacogenetics aims to assist clinicians in determining the effectiveness of a particular drug and minimizing potential side effects. Case report: Here, we present a case to demonstrate the potential use of pharmacogenetics in clinical practice. A 33-year-old male patient with a diagnosis of schizophrenia and OCD had symptoms of sexual auditory hallucinations and obsessive images. According to the patient’s pharmacogenetic profile (CYP2D6, CYP2C9, CYP2C19, CYP1A2 and CYP3A4), the medication started by giving Risperidone 8 mg/day and Aripiprazole 5 mg/day. Aripiprazole was continued at 10 mg/day and then 20 mg/day in the presence of clinical findings. Olanzapine 10 mg/day and Sertraline 50 mg/day were given. In addition, 20 sessions of TMS and 20 sessions of tDCS, which are neuromodulation treatments, were applied. Results: The patient in question experienced some improvement and partial remission following a treatment plan based on pharmacogenetic analysis. In summary, pharmacogenetic testing can be a valuable tool in determining an appropriate treatment plan that maximizes clinical improvement while minimizing potential adverse effects associated with medication.</p
Exosome-driven epigenetic modulation of histone proteins: Pioneering anti-oncogenic and skin health applications
No full textThis article explores the use of exosomes in skin care and their potential for modifying epigenetic changes in fibroblasts and other immune regulatory cells of the skin. Exosomes are nanosized extracellular vesicles that play a vital role in intercellular communication by transporting various biomolecules such as proteins, lipids, and nucleic acids between cells. They are released by skin cells and contain various molecules that are essential for skin health, such as growth factors, cytokines, and extracellular matrix proteins. Recent studies have shown that exosomes can modify epigenetic changes in skin cells, particularly histones, and they have the potential to be used as a therapeutic agent in various skin disorders. This article discusses the use of exosomes in skin care and their potential for modulating epigenetic changes in skin cells in response to environmental factors, with a focus on histone modifications. </p
A model rural rehabilitation service station in China– Evaluation after 5 years
No full textA simple setup for rehabilitation training was established in 2007 in a rural area of Shanxi Province, China. It made use of an underused facility created for elderly people’s leisure time. Simple equipment for rehabilitation training was provided free for the users, and instructions were given by rehab experts, Traditional medical doctors, and social workers.This rural Service Station must be the first of its kind in rural China and deserves scrutinizes for its unique nature. After 5 years of service, a service evaluation of its service nature, service providers, users, and special orientations was completed. It is hoped that this Service Station could be taken as a model of similar rural development in China.</p
Growth and Yield Performance of Fluted Pumpkin (Telferia Occidentalis Hook F.) to Wood Shaving Biochar and Poultry Manure in Ikorodu, Lagos, Nigeria
No full textIn many tropical cropping systems, low soil fertility is a significant factor that hinders the development of vegetable crops. In order to get a good yield, it is necessary to increase the soil’s nutrient status to satisfy the crop’s needs, hence maintaining the soil’s fertility status. To determine the effects of Wood Shavings Biochar (WSB) and Poultry Manure (PM) on the performance of fluted pumpkin (Telferia occidentalis), this study was conducted at the Teaching and Research Farms, Department of Crop Production and Horticulture, Lagos State Polytechnic, Ikorodu, Lagos State, Nigeria. Five (5) treatments—7.5 t/ha WSB, 7.5 t/ha PM, 2.5 t/ha WSB + 5 t/ha PM, 5 t/ha WSB + 2.5 t/ha PM, and control—were administered to the plots two weeks prior to planting. The experiment was set up using a Randomized Complete Block Design (RCBD). Vine length, leaf count, vine girth, and leaf yield per plot were among the data obtained. They were statistically examined using Analysis of Variance (ANOVA), and the Duncan Multiple Range Test (DMRT) was used to compare the means of the treatments at a 5% level of probability. The results revealed that the optimum performance was provided by 2.5 t/ha WSB + 5 t/ha PM and 7. 5 t/ha PM, followed by 5 t/ha WSB + 2.5 t/ha PM and 7.5 t/ha WSB in terms of enhancing the soil nutrients, which in turn improved growth and yield. The fluted pumpkin planted in control gave the worst performances. The plots receiving 7.5 t/ha of WSB significantly reduced the soil acidity and increased soil’s concentration of Ca, K, and Mg respectively. While, 5 t/ha WSB + 2.5 t/ha PM significantly increased total N concentration, available P and organic matter. The study clearly showed that T. occidentalis leaves yield increased as a result of the addition of WSB and PM, hence WSB had the potential to increase the efficiency of nutrient utilization in the PM. For sustainable fluted pumpkin cultivation in the study area, utilization of 2.5 t/ha WSB + 5 t/ha PM and 7. 5 t/ha PM is therefore recommended.</p
Reducing weed impacts and yield losses by application of herbicides in summer-grown maize
No full textA field trial was conducted at Holeta Agricultural Research Station and Medegudina, Central Ethiopia, during the summer season of 2021 to study the effects of different weed control methods against annual grasses and broadleaf weeds in summer planted Maize. The experiment included five treatments; COYOTE 440 SE 3L ha-1, Primagramgold 660 SC 3L ha-1, twice hand weeding, weed-free and weedy check. Major weeds in the fields were Polygonum nepalense, Raphanus raphanistrum, Guizotia scabra, Galinsoga pulviflora, Corrigiola capensis, Caylusea abyssinica, Plantago lanceoleta, Spergula arvensis, Medicago polymorpha, and Phalaris paradoxa. The result signified that the most dominant weed species was Polygonum nepalense with a relative density of 18.28 %. Statistically non-significant results due to all treatments being recorded on ear per plant and 1000 kernel weights at both locations. The results showed that the most effective treatment with higher weed control efficacy (100%) and reduced weed dry weight (0.00 kg/ha) was weed-free. The application of COYOTE 440 SE produced maximum stand count (90 m2), Grain yield (4266 kg/ha), and minimum yield loss (1.49%) while statistically non-significant results were produced in cob per plant and thousand kernel weights. Hence, the study concludes that COYOTE 440 SE 3L ha-1 and weed-free could be more effective as compared to all other treatments without compromising on maize grain yield loss due to weeds.</p
A Narrative review of exercise and metabolic disease of the heart
No full textAccording to the WHO’s report, the number of people with diabetes worldwide is increasing, and the prevalence of type 2 diabetes in adults who is over 18 years old has risen from 4.7% in the 1980s to 8.5% in 2014. Among them, the prevalence of diabetes in low- and middle-income countries has even reached as high as 9.3% over the decades. Metabolic-Associated Fatty Liver Disease (MAFLD) is not only affecting the liver but is also considered a problem for the heart, as there is about 25% of the patients suffer from the cardiovascular syndrome. Around the world, the elderly population is growing rapidly. The elderly population is growing faster than expected, with Taiwan becoming an aged society in 2018. One of the health issues associated with aging is the population with cardiovascular disease increases. Patient care may result in huge expenditures on the national economy, society, family care, medical resources, and drugs. This article adopts perspectives from literature reviews using databases such as Cochrane Library, PubMed (Medline), Up-to-date and Google scholar using three main methods: search for keywords cardiovascular disease, physical fitness, exercise prescription intervention, quality of life, cardio metabolic disease, etc.; search for related articles on physical activity and cardiovascular disease, neuroendocrine, molecular biology, etc.; combined with case-control studies, systematic review and meta-analysis, analytical research, and randomized control studies to explore the effects of physical activity intervention and the fitness level of the elderly on the epidemiology of the cardiovascular disease, prevention of cardio metabolic disease, improvement of quality of life. Understanding which types of exercise intervention help improve the quality of life of patients with cardiovascular disease. This article aims to propose exercise prescriptions for physical fitness to prevent cardiovascular disease; be used as a reference for health promotion in the world, provide guidance on cardiovascular disease prevention and cardiovascular disease care for the elderly, and construct guidelines on physical fitness and exercise prescriptions in Taiwan. </p
Oral and physiological benefits of cranberries
No full textCranberries are known to prevent urinary tract infection and it is also helpful in maintaining oral health. Cranberry juice is a widely consumed and recommended beverage for preventing urinary tract infections. Clinical studies in women have shown that cranberries help to stop the recurrence of infection, as the evidence showed the presence of various extracts of cranberries in the patients’ urinary tracts, proving the effectiveness and the mechanism. The primary compound involved in the fight against the infection is Proanthocyanidin A which is now the focus of studies to treat common diseases such as Helicobacter pylori-associated gastritis, as well as dental caries and periodontal disease, from which it is speculated the mechanism involves disrupting the bacterial adhesion. </p