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KETOGENIC DIET AND ITS ROLE IN ELIMINATING MEDICINAL TREATMENT IN VARIOUS DISEASES
Get PDFVery-low-carbohydrate diets or ketogenic diets have been used 1920s to treat Epilepsy. Ultimately it finished medication. They have become widely known as one of the most common methods for obesity treatment. Now work over the last few years their therapeutic potential in many conditions, such as diabetes, polycystic ovary syndrome, acne, neurological diseases, cancer and the amelioration of respiratory and cardiovascular disease risk factors have been of help. The possibility that modifying food intake can be useful for reducing or eliminating medicinal treatment, which are often lifelong with significant side effects. It calls for serious investigation. Meaning of physiological ketosis in the light of this evidence is considered possible mechanisms for the therapeutic actions of the ketogenic diet on different diseases. There are still some well understood ideas about ketogenic diets, which may remove superfluous thinking. It could prove to be a boon later
COMPARATIVE STUDY OF SUBLAY OVER ONLAY MESH FIXATION IN INCISIONAL HERNIA OF ANTERIOR ABDOMINAL WALL
Get PDFBackground: Ventral hernia after abdominal surgery is a common complication. Several techniques for the repair of hernia of anterior abdominal wall have been described from time to time and it is a great challenge for a surgeon. The mesh placement by sublay technique authorized by Rives and Stoppa in Europe has been reported to be effective with low recurrence rate. Objective: The objective of this study was to evaluate the efficacy of sublay technique over the onlay mesh fixation in hernia of anterior abdominal wall. Methodology: This prospective study was conducted over a period of two years from January 2014 to December 2015. A total of 50 patients with hernia of anterior abdominal wall were included in this study. The patients were divided as group I (onlay mesh fixation) and group II (sublay mesh fixation). Data collected in data collection sheet regarding demographic data, severity of symptoms and post operative complains of patients which were then analyzed. Result: Total 50 patients were included in our study. Age ranged from 21-60 years. Male were 17(34%) and female were 33(66%). Post-operative complication was seroma 26 (52%), wound infection 18(36%) and no wound dehiscence in sublay mesh fixation. The 22(88%) patients in group II stay less than 5 days in hospital. While 19(76%) patients of group I was discharged from hospital >5th postoperative day. Conclusion: Sublay mesh repair in ventral hernia was found to be a better and effective technique with minimal complication rate
A YEAR REVIEW OF SUSPECTED DEATHS IN CUSTODY/DETENTION IN CALABAR, NIGERIA
Get PDFAims/Objectives: To determine the immediate/remote cause/manner of deaths of individual following custody/detention.
Materials & Method: A cross sectional of autopsy done within the period of a year (January 2015-Jan 2016) was evaluated and specifically two cases fall into this category to be analysed.
Results: The case A showed multiple subcutaneous haematoma (soft tissue injuries) and skeletal injuries(occipital fractures) The subcutaneous injuries was seen all over the body on de-fleshing of the epidermal layer of the skin; as the skeletal injuries seen only at the occipital region with subgleal, subarachnoid and interventricular haemorrhages. The case B though there was no obvious physical injuries but seen was massive interstitial pneumonia in both lungs.
Conclusion: The both died due to multiple soft tissue and skeletal injuries with massivesubarachnoid haemorrhage as per case A and case B due to bilateral interstitial pneumonia
VARIABILITY OF PHENYTOIN INDUCED GUM HYPERPLASIA IN PATIENTS OF EPILEPSY IN A TERTIARY CARE: THERAPEUTIC DRUG MONITORING OF PHENYTOIN NEEDS VERSATILE AND SPECIFIC METHODOLOGY
Get PDFPhenytoin is still used as the first choice in epilepsy. It is a well studied drug and due to its ADRs and side effects, TDM is a well defined technique, used in tertiary care centers. It optimizes dosage regimens in patients on phenytoin as it has a narrow therapeutic window. Its use needs vigilance as it has many drug-drug interactions, CNS side effects and gum hyperplasia. Serum drug concentrations guides us that the therapeutic levels be maintained during the course of treatment. Its therapeutic range is 10-20 micrograms/ml. Study was carried in tertiary centre where Neurology department is well established. A total of 1450 patients were enrolled in the study in 5 years period. Patients of (21-30 )years of age group attend maximally, maximum gum hyperplasia was in this age group who were in therapeutic range of phenytoin and patients in the study were taking equal doses in equal intervals of time. Patients had variable response in gumhyperplasia and it was a retrospective study. Serum concentration was estimated by EMIT System. Out of 1450 patients, only 190 (13.1%) patients developed gum hyperplasia in heterogeneous population viz therapeutic, subtherapeutic or toxic groups. Therapeutic drug monitoring of phenytoin is carried out to ensure effective and safe levels. 
A CASE OF PORPHIRIC NEUROPATHY ASSOCIATED WITH PERIPHERIAL, CENTRAL AND AUTONOMOUS NEUROPATHY
Get PDFAcute Intermittent Porphyria (AIP) is a disease associated with a partial deficiency of biosynthesis enzymes caused by genetic anomalies and is characterized by several functional disorders, which are mainly neurologic. Our case is a 19 years old woman, who has been initially admitted with stomach pain and anemia. A couple of days after her arrival, she developed certain neurologic disorders (epileptic seizures, autonomous and peripheral motor neuropathy) as well as other system involvements (hyponatremia caused by inappropriate ADH syndrome, an increase in liver enzymes etc.). All these findings and symptoms pointed to the possibility AIP. After implementing central venous catheter, she was treated with intravenous infusions of Haem arginate and antiepileptic, antihypertensive and antiarrhythmic medications as well. Her urinary excretion of δ-aminolevulinic acid (ALA) was markedly increased being (81,70 mg/l). When analyzed, HMBS genes were found to be a heterozygote. The neurologic involvement in AIP generally has a proximal motor neuropathic character. Since distal neuropathy is a rare finding in porphyric neuropathy, we report this case which presented with the additional association of autonomous neuropathy and central nerves system involvement
KNOWLEDGE ON PREVENTION AND MANAGEMENT OF UNCOMPLICATED MALARIA, AMONG RESIDENTS OF A RURAL COMMUNITY IN ENUGU STATE, SOUTHEAST NIGERIA
Get PDFProtozoan parasite, Plasmodium causes malaria. It is transmitted through the bite of Anopheles mosquito. Globally, about 3.2 billion people are at risk of getting infected with malaria. An estimated 214 million new cases of malaria, resulting in about 438,000 deaths were recorded in the year 2015, with the greatest burden being on the African continent. Malaria prevention remains a key approach towards tackling the public health challenge posed by malaria disease. Malaria case management is also key in malaria control/elimination strategy. Case management consists of early diagnosis and prompt treatment. The research was a cross-sectional study carried out among rural dwellers who presented for a medical outreach in January 2015, at Egede town, a rural community in Udi Local Government Area of Enugu State, Southeast Nigeria. The socio-demographic variables of the 296 respondents revealed that majority of the respondents were 50 years and above (76.7%), females (70.3%), married (83.1%), had no formal education (53.0%), and are farmers by profession (70.9%). Overall knowledge of respondents on prevention of malaria was 51.1%, while the knowledge on diagnosis and treatment was 24.5%. The first pillar of the WHO "Global technical strategy for malaria, 2016–2030", is to "Ensure universal access to malaria prevention, diagnosis, and treatment". Implementation of this pillar requires the creation of awareness about the recommended malaria prevention interventions, diagnostic testing, and correct treatment among people residing in various communities, especially in the rural areas
AN INVESTIGATION AND MANAGEMENT OF OUTBREAK OF HAND FOOT AND MOUTH DISEASE IN SOUTHERN INDIA
Get PDFIntroduction: Hand foot and mouth disease (HFMD) is a viral illness that mainly affects young children is mostly caused by Coxsackie A16 or Enterovirus 71. In India, HFMD outbreaks are uncommon. The authors report an outbreak of HFMD in Wellington, Dist Conoor (Tamilnadu) India recently.
Methods: Based on clinical parameters a case definition was adopted. Cases were recorded on structured case investigation forms. Laboratory diagnosis was done by using Enterovirus PCR in 5’non coding region and nucleotide sequencing of VP1.
Results: 101 children with the clinical diagnosis of HFMD reported to the hospital within 17 days. The age ranged from 10 months to 11 yrs and 5 months. HFMD started with fever and common cold/ nasal discharge. Mouth sores were present in 69 (68.3%) children, multiple vesiculopapular rash with erythematous base were observed over hands and feet in 88 (87.1%) and 83 (82.17%) cases respectively. Of the 34 various types of samples collected, 18 were found to be positive for Coxsackie A16.
Conclusion: An epidemic of HFMD swept through Dist Conoor due to Coxsackie A16 which was controlled by adopting simple yet effective measures. Early diagnosis and awareness about this highly contagious disease can help prevent and contain an epidemic
CHRONIC NON-SPECIFIC ULCERS IN THE ORAL CAVITY CAN RESEMBLE DIABETIC FOOT ULCERS
Get PDFOral ulcers are one of the most common mucosal lesions seen in different locations in the oral cavity. Most of these ulcers will resolve within two weeks. However, chronic ulcers remain problematic in the way they are managed and investigated for possible etiological factors. Viral infections, gastrointestinal disorders, blood diseases, cancer treatment, local trauma, medications or a combination of more than one factor contribute to oral ulcerations. The terms idiopathic or non-specific oral ulcers are still used when no possible explanation could be found regards the causative factors of the ulcerations. We present a unique case of a completely healthy 45 year old female, where a chronic fistula related to a failed root canal treatment developed into a chronic non-specific ulcer over the period of thirty years. The chronic ulcer resembled a diabetic foot ulcer in both clinical and histopathological pictures. Associated teeth with poor prognosis were extracted. Muco-gingival corrective surgery to close the associated gingival defect as well as a ridge preservation surgery to compensate for the associated bone loss produced excellent healing of both soft and hard tissues
NEW INNOVATION IN ENDODONTIC THERAPY; ELECTRIC DISCHARGE MACHINING
Get PDFBackground: Nickel titanium rotary files have become popular because of their superelastic behaviour that makes them the best choice for shaping curved root canals.1 This is mainly because of the superelasticity of NiTi alloy, which provides increased flexibility and allows the instruments to effectively follow the original path of the root canal.2 Despite the advantages related to the superelasticity, fracture of NiTi files due to torsional overloading or flexural fatigue remains aconcern in clinical practice.3,4 Possible strategies to increase efficiency and safety of NiTi rotary files include an improvement in the manufacturing process, or the use of new alloys that provide superior mechanical properties.5 Recently, a series of proprietary thermomechanical processes have been used to optimize the microstructure of NiTi.6,7,8 A new HyFlex CM NiTi rotary files (Coltene Whaledent, Switzerland) with controlled shape memory were introduced. CM wire is obtained by thermally treating the NiTi wires to shift the austenite/ martensite transition temperature at about 50 °C so that a stable martensitic microstructure is allowed at the mouth temperature.9 This imparts to the files a high fatigue resistance and the possibility to be easily bent during use, recovering its original shape by heating above the transformation temperature.10 Recently, patented treatment is involved in the innovative manufacturing of new HyFlex EDM files (Coltene Whaledent, Switzerland). The main feature of these files is that they are manufactured via an electro discharge machining (EDM) process.11-15 The present research evaluated cutting efficacy of a new innovation Hyflex EDM rotary file system manufactured by Electric Discharge Machining
ASTASHINE CAPSULES: AN EXCELLENT CHOICE TO IMPROVE SPERM PARAMETER AND FERTILITY
Get PDFIn 2010, an estimated 48.5 million couples worldwide were infertile according to the World Health Organization (WHO). Infertility is defined as the inability of a sexually active, noncontracepting couple to achieve spontaneous pregnancy within one year. Other surveys have shown that 15% of couples do not achieve pregnancy within one year and seek medical treatment for infertility. Eventually close to 5% will remain unwillingly childless. One in eight couples encounters problems when attempting to conceive a first child and one in six when attempting to conceive a subsequent child.
Astaxanthin is most widely studied and talked about for enhancing endurance, sports recovery, and to support heart, brain and eye health. Recently, clinical trials have been conducted to learn the relationship between astaxanthin and sperm health. Several studies shown that the antioxidant astaxanthin, is supportive of sperm health and in particular sperm motility