The role of radiation treatment in the management of inflammatory musculoskeletal conditions: a revisit

Inflammatory musculoskeletal conditions are a common group of diseases among the elderly, worldwide. They are characterized by articular degenerative changes accompanied with often debilitating pain. Treatments often involve life-long analgesic therapy or joint replacement in extreme cases. The aim of this current review is to look at the role of radiation treatment with the hope of further study into the effectiveness of radiation treatment in reducing pain, eliminate or reduce the need for life-long analgesic therapy and thereby avoiding the analgesics’ side effects. Extensive literature search was done on PubMed and other available data base and the findings are presented and discussed. Literature showed that many countries in Europe, especially Germany use radiation routinely for the treatment of many degenerative disorders including osteoarthritis with good results and few side effects. A pilot study is therefore recommended with a view to establish the effectiveness or otherwise of this treatment method in patients.

Correlation Between Tsh And Body Mass Index In Male And Female Patients With Subclinical Hypothyroidism

Hypothyroidism is a syndrome resulting from thyroid hormone deficiency or rarely inefficacy. It is a common endocrinological problem affecting especially women and the elderly. Thyroid hormones play an important role in synthesis, metabolism and mobilization of lipids. One of the most important symptoms of hypothyroidism is weight gain or inability to lose weight. The rapid increase in the prevalence of obesity in the past 20 to 30 years emphasizes the important role of lifestyle and environmental factors, because genetic changes could not have occurred so rapidly. Obesity is a complicated process that depends on signals of satiety and hunger, genetics, endocrine abnormalities, and other factors. Our study purposes to investigate the relationship between BMI and thyroid function in patients of subclinical hypothyroidism. Objective of this study is to correlate thyroid stimulating hormones (TSH) and body mass index (BMI) in male and female patients with subclinical hypothyroidism. This cross sectional study included 42 Subclinical hypothyroid patients, both males and females between 20-45 years of age and without a history of alcohol or tobacco consumption, history of any cardiovascular disorders or diabetes mellitus and any drug history like corticosteroids, beta blockers. and TSH test estimated by VITROS 5600 integrated analyzer and correlated with body mass index. The results showed a positive Correlation analysis in subclinical Hypothyroid males between BMI and TSH, (r= 0.47), which was found to be statistically significant (p=0.02*) in case of subclinical Hypothyroid females the results indicated positive correlation between BMI and TSH (r= 0.58) which was found to be statistically significant (p=0.005*). A strong positive correlation between Body Mass Index (BMI) and Thyroid stimulating hormones (TSH).

A Review On Reactive Oxygen And Nitrogen Species

Generally Reactive oxygen species (ROS) and Reactive nitrogen species (RNS) consist of free radicals and hasty species in these two groups and breakdown yield of lipids proteins, nucleic acids and carbohydrates. Free radicals (FR) contain one or more unpaired electrons and could be positively or negatively charged or neutral in nature. Superoxide anion (O-.2), free hydroxyl radical (OH.-) and nitric oxide (NO·) are important free radicals in human body and produce numerous additional free radicals mostly from unsaturated fatty acids. Physiologically they can be defined as overactive disjointed atoms or molecules which are capable of upsetting and fragmenting other molecules. Free hydroxyl is the mainly reactive neutral free radical with half life of about 10-9 second. It is capable of insulting fragmenting and mutating any cellular molecule with forceful passion. Superoxide anion (O-.2) in human body arises from metabolic reactions, irradiation and leakage from electron transport chain. Superoxide is often referred as primary ROS as most of other ROS and RNS arise from it and are therefore termed as secondary ROS and RNS. These free radicals are produced in cellular membrane mitochondria, nucleus, lysosomes, peroxisomes, endoplasmic reticulum and cytoplasm. Redox-sensitive proteins with important cellular functions are confined to signalling microdomains in cardiovascular cells and are not readily available for quantification. A popular approach is the measurement of stable by-products modified under conditions of oxidative strain that have entered the circulation. However, these may not accurately reflect redox stress at the cell/tissue height. Many of these modifications are “functionally silent”. Functional importance of the oxidative modifications enhances their validity as a proposed biological marker of cardiovascular disease, and is the strength of the redox cysteine modifications such as glutathionylation. We assess selected biomarkers of oxidative stress that show promise in cardiovascular medicine, as well as new methodologies for high-throughput measurement in research and clinical settings. Although associated with disease severity, supplementary studies are necessary to examine the usefulness of the most promise oxidative biomarkers to forecast prognosis or rejoinder to treatment.

A Review On Antioxidants And Oxidative Stress In Type-2 Diabetes Mellitus

Strikingly the developments in both therapeutic and nutritional circuits have punctuated with some success and some spectacular failures in treating Type- 2 Diabetes mellitus (T2-DM). It is advocated that antioxidants should be given only if pre-existing deficiency is present. Selection of antioxidant is another important aspect. Type-2 Diabetes mellitus (T2-DM) is measured to be one of the most frequent chronic diseases global. There is a increasing scientific and public awareness in connecting oxidative stress with a variety of pathological conditions including Type-2 Diabetes mellitus (T-2DM), cardio vascular diseases (CVD), coronary artery diseases with Type-2 Diabetes mellitus (CADT2-DM) as well as other human diseases. Pre- existing experimental and clinical studies report that oxidative stress plays a major role in the pathogenesis and development of complications in T2-DM. Conversely, the exact mechanism by which oxidative stress could contribute to and accelerate the development of complications in T2-DM is only to some extent known and remains to be clarified. On the one hand, hyperglycemia induces free radicals; on the other hand, it impairs the endogenous antioxidant defense system in patients with diabetes. Endogenous antioxidant defense mechanisms include both enzymatic and non-enzymatic pathways. Common antioxidants include the vitamins A, C, and E, glutathione (GSH), and the enzymes superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and glutathione reductase (GRx). This review describes role of oxidative stress in micro and macro vascular complications of T2-DM. Lastly but most importantly the impact of OS is not obligatory but facultative. As such only those diabetic patients will be benefited by antioxidant therapies that have impelling punch of pro-oxidants.

Prevalence of prediabetes in secondary school students in Port Harcourt, Nigeria

This study aimed to assess the prevalence of prediabetes using impaired fasting glucose (IFG) in secondary school students aged 10 to 19 years in Port Harcourt; Nigeria; and to determine associated risk factors. Fasting blood glucose (FBG); blood pressure (BP); and body mass index (BMI) was measured. All students who had a FBG of 5.6 - 6.9mmol/l were asked to undergo an oral glucose tolerance test (OGTT). A total of 880 students were studied. The prevalence of IFG using the International Society for Paediatric and Adolescent Diabetes (ISPAD) criteria was 17% and prevalence was comparatively higher in subjects who were obese; had systolic prehypertension or diastolic hypertension; as well as a family history of diabetes. There was; however; no statistical association between the BMI percentile categories; BP category; sex and age category; or family history of diabetes and occurrence of IFG. The prevalence of IFG was 4% using the World Health Organization (WHO) criteria. Only one child had diabetes. Sixty-six (42%) students who had IFG had an OGTT; of which 10(15%) had IGT. We conclude that prediabetes is common in this population; and screening should be considered; at least in those with obesity or a family history in diabetes

Topical Anaesthesia for Pain Relief during High Dose Rate Brachytherapy for Carcinoma of the Cervix

Purpose: To determine the clinical efficacy of a local anaesthetic spray of 10 xylocaine in reducing pain and discomfort in patients undergoing high dose rate (HDR) brachytherapy. Patients and Method: Ninety two consenting patients diagnosed with cervical cancer and planned for HDR as part of their treatment were enrolled for the study. Each patient had three sessions of brachytherapy following the standard procedures. In the first session all the patients had brachytherapy in the usual manner with conscious Sedation with parenteral diazepam and pentazocine. For the second and third sessions; they had treatment sessions using conscious sedation and 10 xylocaine spray and a control session using conscious sedation and a placebo spray with 0.9 normal saline (NS) respectively. Visual Analogue Scale (VAS) was used in assessing pain during each of the procedure. Results: Only 80 patients completed the study. Their age ranged from 28-70 years with a median age of 54 years. The pre-treatment VAS median scores in the treatment and the control sessions were similar at 0.275 and 0.200. However; the post-procedure median VAS scores were increased to 6.3 in the control group and 3.2 in the xylocaine-treated group (P 0.0001). The haemodynamic status including the blood pressure (BP) and pulse rates (PR) were similar pre and post procedure in both groups. Conclusion: Topical xylocaine spray is efficacious in reducing pain and discomfort in HDR Brachytherapy without any appreciable adverse effect

Evaluation of Serum and Salivary IgG in Head and Neck Squamous Cell Carcinoma.

Aims: To evaluate salivary and serum IgG levels in patients with head and neck squamous cell carcinoma (HNSCC) and healthy control subjects and to assess the effect of treatment on IgG levels. Study Design: A cross sectional study. Place and Duration of Study: Department of Oral Pathology and Department of Radiotherapy, University College Hospital, Ibadan, Nigeria between January 2010 and December 2010. Methodology: Seventy eight subjects comprising 30 patients with untreated HNSCC, 18 patients with HNSCC receiving treatment and 30 healthy, age and gender-matched individuals were included. Serum and salivary samples from the participants were analysed for total IgG using ELISA technique. Results: The mean serum IgG in untreated and treated HNSCC patients was significantly lower compared with healthy controls (P=.001), while mean salivary IgG was significantly elevated (P=.001) in untreated HNSCC patients compared with treated and healthy controls. There was no significant correlation between serum and salivary IgG levels. Conclusion: In patients with head and neck squamous cell carcinoma, serum IgG was reduced while salivary IgG was elevated compared with healthy controls. Our finding suggests differential roles of immunoglobulin G in serum and saliva of patients with head and neck squamous cell carcinoma. Hence, salivary IgG may be a useful biomarker in patients with head and neck squamous cell carcinoma, while serum IgG levels may be useful in monitoring treatment in these individuals.

The Effects of Hospital Based Respiratory Physiotherapy an Intervention Study among COPD Patient in Al-Zawia City, Libya

Chronic obstructive pulmonary disease (COPD) is a one of the major cause of death and disability worldwide. This study aimed to compare the quality of life (QOL), Activity of Daily Living (ADL), Pulmonary Function Test (PFT) and general health symptoms pre and after hospital-based respiratory physiotherapy program among COPD patients. Pre and post intervention study was conducted between January and July 2010. A total of 54 subjects aged between 30 to 40 years old were recruited for this study using universal sampling method from Alzawia Teaching Hospital, Libya. Data collected were socio-demographic data, QOL (before and after the intervention) using the Short Form-36 (SF-36) questionnaire, ADL using the Barthel Index and the General Health Symptoms. The mean SF-36 score for QOL is 30.13 (SD = 8.06) and 63.46 (SD = 13.53) before and after the physiotherapy respectively (with the p <0.0001). Patients’ Activity of Daily Living mean scores are 70.18, (SD = 16.50) and mean = 88.89 (SD = 13.28) before and after program (p< 0.0001). The general medical condition mean score after respiratory physiotherapy is 3.72 as compared to 4.96 before the respiratory physiotherapy (p< 0.0001). Pulmonary Function Test shows improvement in actual/predicted FEV1 ratio in all 54 cases with mean improvement from 55.85 before to 81.67 after the pulmonary physiotherapy (with the p <0.0001). Hospital based respiratory physiotherapy program had significantly improved QOL, pulmonary function and activities of daily living among the subjects.

Antibacterial and phytochemical screening of the ethanolic leaf extract of azadirachta indica (neem) (meliaceae).

Azadirachta indica is a very useful traditional medicinal plant in the sub-continent and each part of the tree has some medicinal properties. The plant is native to Asia, but has now naturalized in West Africa and is widely cultivated in Nigeria as an ornamental as well as medicinal plant. This study aimed at screening the active components and the antibacterial effects of the ethanolic leaf extract of Azadirachta indica. Fresh leaves of the plant were collected, dried, homogenized and extracted using 95% Ethanol. The extract was used for the phytochemical screening and bacterial susceptibility testing using cup-plate method.The result obtained from this study showed the presence of tannins, saponins, flavonoids, alkaloids, glycosides, reducing sugars and terpenes in the ethanolic leaf extract. The antibacterial effect produced by the extract was dose-dependent at the tested doses (6.25 mg, 12.5 mg, 25 mg, 50 mg and 100 mg) on Escherichia coli (E. coli), Staphylococcus aureus (S. aureus) and Salmonella typhi (S. typhi). The minimum inhibitory concentration (MIC) for E. coli, S. aureus and S. typhi were 2.39 mg, 3.31 mg and 4.79 mg respectively. The effect produced by the ethanolic leaf extract at 100mg (18 mm) was statistically significantly higher than that of 1.5 mg ciprofloxacin (14 mm) on S. typhi (p<0.05). Azadirachta indica ethanolic leaf extract contains pharmacologically active constituents that may be responsible for its activity against S. aureus, E. coli and S. typhi. Therefore, the use of Neem plant in our community for treating diverse medical ailments especially infectious diseases is highly justified.

Diversidade genotípica de Helicobacter pylori: distribuiçäo de genótipos vacA, iceA e cagA e associaçäo com doenças gastroduodenais / vacA, iceA and cagA genotypes of Helicobacter pylori strains obtained rom patients with gstritis, duodenal ulcer and gastric carcinoma

A distribuiçao dos genótipos cagA, vacA e iceA foi avaliada, por meio de reaçao de polimerizaçao em cadeia, para detecçao dos diferentes alelos dos genes, em amostras de Helicobacter pylori isoladas de crianças e adultos com gastrite, úlcera péptica duodenal ou adenocarcinoma gástrico, encaminhadas para esclarecimento diagnóstico. Foi, também, investigada a associaçao entre diferentes genótipos e a distribuiçao dos mesmos de acordo com faixa etária e sexo. Observou-se predomínio de pacientes com monoinfecçao pela bactéria. A prevalência de infecçao mista variou conforme o marcador genético analisado, mas foi inferior às taxas relatadas, por outros autores, para pacientes tanto de países desenvolvidos como de países em desenvolvimento. Foi observada principalmente em crianças, o que pode estar relacionado às precárias condiçoes de higiene e saneamento da populaçao carente no Brasil. Predominância dos genótipos cagA positivo, s11m1 e iceA2 foi observada. Apenas a variante s1b foi detectada em amostras da bactéria isoladas de pacientes com monoinfecçao, refletindo, provavelmente, relaçoes históricas da populaçao brasileira com colonizadores portugueses. O genótipo cagA positivo mostrou-se fortemente associado com os alelos s1 e m1 do vacA, como observado em diferentes regioes do mundo ocidental. Os genótipos cagA positivo, s11m1 e iceA2 estavam associados com úlcera duodenal e carcinoma gástrico. Nao foi observada associaçao entre tamanho do amplicon de iceA2 e doença apresentada pelo paciente. A genotipagem de amostras da bactéria, no que se refere ao cagA e vacA, parece ser clinicamente relevante, inclusive no nosso meio, para predizer a evoluçao da infecçao. Entretanto, iceA2 nao deve ser considerado marcador molecular de patogenicidade, uma vez que os resultados obtidos em diferentes regioes do mundo sao contraditórios. A freqüência de amostras cagA positivas, bem como daquelas com genótipo s1/m1 e iceA2 aumentou com a idade, sugerindo que faixa etária pode ser importante na determinaçao da susceptibilidade à colonizaçao por amostras de...(au)

Prevalence, species differentiation, haemolytic activity, and antibiotic susceptibility of aeromonads in untreated well water

The use of untreated water for drinking and other activities have been associated with intestinal and extraintestinal infections in humans due to Aeromonas species. In the present study aeromonads were isolated from 48.7 percent of 1,000 water samples obtained from wells and other miscellaneous sources. Aeromonas species were detected in 45 percent of samples tested in spring, 34.5 percent in summer, 48 percent in autumn and 60 percent of samples tested in winter. Speciation of 382 strains resulted in 225 (59 percent) being A. hydrophila, 103 (27 percent) A. caviae, 42 (11 percent) A. sobria and 11 (3 percent) atypical aeromonads. Of 171 Aeromonas strains tested for their haemolytic activity, 53 percent, 49 percent, 40 percent and 37 percent were positive in this assay using human, horse, sheep and camel erythrocytes respectively. The results obtained indicate that potentially enteropathogenic Aeromonas species are commonly present in untreated drinking water obtained from wells in Libya (this may also apply to other neighbouring countries) which may pose a health problem to users of such water supplies. In addition, ceftriaxone and ciprofloxacin are suitable drugs that can be used in the treatment of Aeromonas-associated infections, particularly in the immunocompromised, resulting from contact with untreated sources of water