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Sociodemographic, HIV Risk Behavior and Attitudinal Characteristics that Discriminate Urban, Crack-Using African- American Men Reporting Involvement in Concurrent Sexual Partnerships
No full textAbstract: A number of studies have found that involvement in concurrent sexual partnerships (sexual partnerships that overlap in time) increases sexually transmitted infection (STI) risk, and that such partnerships may be a major determinant of the rate of human immunodeficiency virus (HIV) spread. In the U.S., such partnerships may be relatively more common among African-Americans than among other racial groups, likely reflective of the sizable “shortage†of African-American males in inner-city locales—as well as in some rural areas, such as the U.S. South—largely attributable to this group’s relatively higher rates of incarceration and other forms of institutionalization, military enlistment, and mortality. Concurrent partnerships also may be relatively common arrangements among crack cocaine users, who frequently report high numbers of sexual partners and often have been found to report elevated HIV rates. While studies have found sexual concurrency to be associated with a host of sociodemographic, sexual history, and behavioral characteristics, relatively little has been published detailing the norms, attitudes, and psychological functioning of those who maintain concurrent partnerships. Utilizing a high risk (for HIV) sample of 152 not-in-treatment male African-American crack cocaine smokers recruited from street settings in 2 major U.S. cities, this study attempts to identify those variables—from amongst measures of sociodemographics, drug use and sexual behavior, condom use attitudes, primary relationship norms, and psychological and social functioning—that discriminate men who are and are not involved in concurrent sexual partnerships. Nearly half of the study sample reported being regularly sexually involved with both a main partner and at least one casual partner. However, little evidence was found to suggest that such involvement is indicative of overarching deficits in mental health or of unusual deviation from prevailing community behavioral norms, nor was evidence found suggesting that sexual concurrency is a marker for inveterate risk taking across other dimensions of HIV risk behavior. Implications for preventive intervention development are discussed
Case Study: Novel Approach to HIV-Associated Neuropathy Platelet Rich Plasma Successful in Treating HIV-Associated Peripheral Neuropathy
No full textDistal symmetrical peripheral neuropathy (DSPN) is the most common neurologic complication of Human Immunodeficiency Virus (HIV) infection. DSPN is a distressing pain syndrome and infected patients have limited treatment options for alleviating symptoms. Platelet Rich Plasma has been found to be effective in relieving pain associated with chronic and acute musculoskeletal conditions as well as arthritic conditions. We tested the hypothesis that platelet rich plasma alleviates symptoms of HIV-associated DSPN. A 50year-old African American patient was referred for long-standing bilateral leg neuropathy. The patient was treated with an injection of platelet rich plasma therapy ever two weeks for 12 weeks. The treatment outcomes were pain intensity, pain relief, sensory perception, quality of life, mood, and function. After the first therapeutic injection of platelet rich plasma, the patient reported significant improvement in pain relief, sensory perception, and range of motion. The therapy was effective in relieving pain so the patient discontinued use all other pain medications including Vicodin and Neurontin.This case report provides evidence that platelet rich plasma is effective in relieving painful numbness, tingling and burning related to HIV-associated DSPN. Platelet rich plasma may be a valuable option for treatment of symptoms associated with DSPN among HIV patients
Curcumin: A Culinary Herb and Its Health Benefits
No full textAbstract: Curcumin, present in Curcuma longa, a traditional Indian spice, has many important biological mechanisms to improve health of aging organisms. It inhibits nuclear factor kappa beta (NFkB) decreasing both inflammation and cell survival, which is important to avoid proliferation of cancer cells and decrease brain, endothelial and myocardial damage. Curcumin also decreases inflammation by other membrane systems, such as protein kinases. This traditional spice also elicites higher antioxidant activity that can potentially enhance neuronal survival, decreasing the risk of neurodegenerative disorders of the CNS (e.g. Alzheimer’s disease). By its capability to trigger apoptosis of different target tumoral cells, curcumin has been considered as a new promise anti-cancer quimiopreventive agent. It is speculated that dietary curcumin could perform many important biological mechanisms affording a better quality of life during human lifespan
New Tool for Screening of Whole Blood for Early Detection of Breast Cancer Antigen (CA153)
No full textNanostructured materials play an important role in the design of new tools for medical use. Therefore materials such as maltodextrins were excellent candidates for the design of stochastic microsensors used in the screening of whole blood for breast cancer biomarker. The results obtained for the assay of breast cancer antigen in whole blood using this microsensor (by applying a potential of 125mV vs Ag/AgCl and performing measurements specific to stochastic sensing described in detail in the article) were in agreement with those obtained using the standard method, ELISA (Enzyme-Linked Immunosorbent Assay utilized a monoclonal anti-CA 15-3 antibody directed against intact breast cancer antigen, CA 153 for solid phase immobilization - on the microtiter wells. The concentration of CA 153 was directly proportional to the color intensity of the test sample.) for serum samples. The limit of determination obtained for breast cancer antigen (0.5mU/mL) when assayed in whole blood, proved that the microsensor is a good tool (in terms of sensitivity, selectivity, and fast response) for early screening of whole blood for breast cancer
Case Report: Infantile Orbital Lymphangioma with a Rare ENT Presentation
No full textAbstract: We are reporting a rare case of 22-year-old Malay female with history of left orbital swelling which was noted since the age of 2 month and treated conservatively. Four years later noted the swelling increase gradually in size involving the bridge of the nose associated with proptosis and left intermittent epistaxis. Examination revealed a soft and boggy swelling at the medial canthus of the left orbit extending to the nasal bridge with mild proptosis. Left intranasal endoscopic examination revealed hemorrhagic spots at the septum with bulging at the lateral wall of the nose and intact mucosa. The radiological examinations with biopsy were consistent with lymphangioma of the left orbit. Orbital Lymphangiomas are rare and it is not reported to present with recurrent epistaxis
Comparison of Pre and Post-Operative Hearing Results in Patients Undergone Modified Inlay Butterfly Cartilage Perichondrium Myringoplasty
No full textObjective: The perichondrium cartilage graft has its advantage not only on hearing outcome but also in graft uptake rate. So, the main aims are to compare the pre and post-operative hearing results and to observe the graft uptake rate.Materials and methodology: This is a prospective, longitudinal and analytical study conducted in the department of otorhinolaryngology in Kathmandu university hospital from 1st January 2011 to 1st June 2012. There were 34 patients who underwent modified inlay butterfly cartilage perichondrium myringoplasty using tragal cartilage perichondrium in ≥13 years patients and with the diagnosis of Chronic otitis media (mucosal- inactive) with central perforation of >50% and those requiring revision surgeries for failed myringoplasties were included. The pre and post-operative PTA (pure tone audiogram) was performed and evaluated. The post-operative hearing was assessed in terms of average ABG (air bone gap) and size of ABG closure.Results: Among 34 patients, the 30 (88.2%) patients had graft uptaken. Other 4 patients had residual perforation because of infection. The post operative ABG was smaller than the pre operative ABG. (36.57+/-12.13dB and 26.41+/-8.47dB respectively) The mean ABG closure was 10.15+/-10.23dB. The ABG closure was smaller than 10dB in 15 (50%) patients.Conclusion: There was statistically significant improvement in postoperative ABG with ABG closure within 10dB in 50% of patients. So, it is useful to perform the procedure in subtotal to total perforation with good outcome
Clinical and Therapeutic Aspects of Vertigo
No full textAbstract: Dizziness is a symptom frequently encountered in clinical practice, especially during emergency department visits and primary care visits. We can classify dizziness in one of four categories: vertigo, presyncope, disequilibrium and lightheadedness. Vertigo is the most common cause of dizziness and very often represents a diagnostic challenge for the clinician. Although appropriate clinical approach and history taking, the final diagnosis is unidentified in about 20 percent of the patients complaining of dizziness. The aim of this review is to provide an update on the main differential diagnoses of dizziness, with particular attention to the different otologic, vestibular and neurologic causes of vertigo, covering epidemiology, pathophysiology, clinical presentation, and therapy. We will discuss in detail the most common causes of vertigo, such as benign paroxysmal positional vertigo, labyrinthitis, Meniere's syndrome, vestibular neuritis, vestibular migraine and brainstem lesions. Special emphasis will be placed on the usefulness of diagnostic tests such as the Dix-Hallpike maneuver, the head impulse test and the electronystagmography. We will underline the need to perform a complete physical and neurological examination in order to correctly choose the appropriate diagnostic tests. Finally, we will review the different treatments currently available. It is extremely important to prescribe a proper treatment for dizziness, because this can dramatically improve the quality of life of these patients
Scenario of Pediatric Dermatoses in Rural Population of Central India
No full textIntroduction: Skin diseases in the pediatric population are common all over the world including rural and urban areas. The prevalence of pediatric dermatoses is higher in rural areas as compared to urban areas in relation to poor socio-economic status, poor personal hygiene, overcrowded, families lack of general awareness, lack of education, sanitation and specialized health facilities.Aim: To study the proportion of different skin conditions presenting in pediatric age groups.Material & Methods: This study was conducted in tertiary care center, Acharya Vinoba Bhave Rural Hospital. 710 patients were enrolled below the age group of 14 years and were divided in to 3 groups < 1 year, 1-4 years and 5-14 years.Results: Out of 710 patients 46.3% infection and infestation, 18.6% dermatitis and eczema, 8.7% and 8.3% dermatoses of skin appendages and miscellaneous dermatoses found respectively. Nutritional dermatoses was found in 5.9%, nevus 3.8%, papulosquamousdermatoses 3.6%, pigmentary dermatoses 2.67% and both bullous and keratinization each of 0.98% patients.Discussion: In our study most common dermatoses was infection and infestation which mainly occur due to low socioeconomic status, dietary habits, climatic exposure, lack of health awareness and poverty. Bacterial infections were most common in all the age group. The viral wart were common in 6-14 years of age group due to more exposure and enhanced outdoor activities.Conclusion: Our study brings into light the presentation of rural pediatric dermatology patients were commonly of dermatoses like infections, infestations, dermatitis and nutritional disorders
Correlates of Resilience in Adolescents and Adults
No full textWe sought to examine several positive and negative correlates of resilience (i.e., affect, gratitude, perceived stress, subjective happiness, mastery, and emotional reactivity) in a community sample of adolescents and adults and to determine whether these correlates of resilience differed between the groups. Seventy-nine community residents of an Upper Midwest community (48 adolescents aged 12-18 years and 31 adults aged 34-84 years) completed 8 validated self-report questionnaires, totaling 96 items, over an 8-week period. Bivariate analyses showed several moderate to large associations of the variables with resilience and several appeared to show differences in the magnitude of the associations by age group. Hierarchical regression models examining all psychosocial predictors of resilience showed that only positive affect and negative affect predicted unique variance in resilience. In addition, evaluation of hierarchical models showed evidence of interaction between age and positive affect, gratitude, and subjective happiness in predicting resilience. Associations between gratitude, positive affect, and happiness with resilience were consistently stronger for adults as compared to adolescents. These data provide preliminary evidence on potential differences to consider regarding psychosocial correlates of resilience in adolescents and adults and have implications for intervention and resilience promotion
Rate-Control vs Rhythm-Control for Atrial Fibrillation: A Controversy Reluctant to Die in the Era of Dronedarone?
No full textAlthough restoring atrial fibrillation to sinus rhythm seems beneficial in patients with non-permanent AF, clinical trials have not observed any convincing benefit of a rhythm-control strategy compared with a rate-control strategy. This may be related with the adverse effects associated with antiarrhythmic drugs that may offset any beneficial effect of this approach.Dronedarone has been recently approved for the treatment of patients with paroxysmal or persistent atrial fibrillation and is the only antiarrhythmic agent that has shown a benefit in the reduction of the incidence of hospitalization due to cardiovascular events or death compared with placebo.As AFFIRM is the most relevant clinical trial that has suggested that rhythm and rate control rates strategies are similar, and ATHENA the most important study analyzing the effects of dronedarone in patients with atrial fibrillation, the results of both studies have been compared