incidence

Determination of antibiotics susceptibility profile of Shigella species isolated from children with acute diarrhea

Published on: 15th December, 2020

OCLC Number/Unique Identifier: 8870458574

Diarrheal diseases continue to be the major cause of morbidity and mortality among children under 5 years. This study aimed to isolate, identify and determining the prevalence, antimicrobial susceptibility profile of Shigella sp associated with acute diarrhea among children in Kano, Northern Nigeria. A cross sectional study was conducted among children less than 5 years diagnosed with acute diarrhea and admitted to paediatric ward of Murtala Muhammad Specialist Hospital Kano. Stool samples from a total of 37 (20 male and 17 female) subjects were used to isolate and identified the pathogen. Antimicrobial susceptibility test was conducted using disc diffusion method. The result showed 12 out of 37 samples were positive for Shigella sp which accounted for 32.4%. Higher incidence of Shigella sp was found among subjects of age between 2 – 3 years. The isolates were 100% resistant to Ampicillin. High resistance was also observed in Amoxicillin (83.33%), Chloramphenicol (58.33%) and Tetracycline (25%). The isolates are 100% sensitive to ciprofloxacin, 66.7% to Levofloxacin and Gentamicin each and 58.33% to Erythromycin. Three (3) isolates were resistance to Ampicillin and Amoxicillin, 5 isolates were resistance to Ampicillin, Chloramphenicol and Amoxicillin while 2 isolates were resistance to Ampicillin, Chloramphenicol, Tetracycline and Amoxicillin. It is concluded that Shigella sp is one of the etiological agent of diarrhea in children. Ciprofloxacin, levofloxacin and Gentamicin are drugs of choice for treating diarrhea caused by Shigella sp.
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Incidence of hepatitis B and hepatitis C in Pediatric ward in 2ed March teaching hospital, Sebha: South of Libya

Published on: 28th April, 2021

OCLC Number/Unique Identifier: 9028067583

Objective: to determine the incidence of HBV and HCV in pediatric ward. Sitting: 2ed March teaching hospital, sebha Libya. Materials and Methods: this was a prospective hospital base study of pediatric cases admitted to 2ed March teaching hospital during a period from March 2018 to February 2019. Pediatric cases were studied for the incidence of HBsAg and HCV Ab by ELISA, Rapid technique. The positive result was confirmed with line immuno-assay. Results: the study showed positive HBsAg in 12 patients and HCV in 2 cases out 25 cases represented with acute hepatitis from a total of 1763 pediatric cases were submitted in this study, with incidence rate of 0.68% and 0.11% respectively. Conclusion: the incidence of HBV and HCV are low in Sebha, therefore active program need to be applied to control the spread of infection among the population.
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The Risk Factors for Ankle Sprain in Cadets at a Male Military School in Iran: A Retrospective Case-control Study

Published on: 23rd March, 2017

OCLC Number/Unique Identifier: 7286429204

Introduction: Ankle sprain is a widespread impairment in sport groups; this impairment leads to an absence from the workplace. The ankle sprains incidence rates are induced by height, weight, BMI, physical fitness, level of match, classification of sport, and personal exposure to sport. Methods: A longitudinal case-control study was executed to verify the outcome of risk factors for ankle sprain at a Military Male School between 2012 and 2013 of 4987 people at risk for ankle sprain, a total of 234 cadets sustained new ankle sprains during the study, 432 non-injured cadets randomly selected as the control group. Results: Regarding to the total people at risk in our study the incidence rate was approximately 5/1000 ankle sprain-years. Cadets with ankle sprains had higher weight, BMI and higher scores in Army Physical Fitness test than the control group. Ankle sprain occurred most commonly during athletics (51.4%). Ankle sprain incidence rate did not significantly vary from different athletic competitions after controlling for athlete-exposure. Soccer and Ball Games had the highest ankle sprain incidence rate. Conclusion: Higher weight, increased BMI, greater physical conditioning and athlete exposure to selected sports were all risk factors for ankle sprain.
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Occipital lobe ependymal cyst with unusual presentation

Published on: 19th September, 2019

OCLC Number/Unique Identifier: 8286553600

Intraparenchymal cysts without communication to the ventricles or the subarachnoid space are named ependymal or epithelial cysts. The estimated ratio of their incidence compared with arachnoid cysts is 1:10. Neurologic deficit can occur when the cyst exerts mass effect on its surroundings. We report a case of cerebral ependymal cyst in a 75-year-old lady who presented with history of headache, vomiting and left incomplete homonymous hemianopsia. Neuroimaging studies showed a large right occipital cyst. She underwent the neurosurgical procedure of marsupialization. Histologic findings and the immunophenotype was consistent with a diagnosis of ependymal cyst. The patient made an excellent recovery after the procedure.
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Micronutrient deficiency, a novel nutritional risk factor for insulin resistance and Syndrom X

Published on: 30th November, 2018

OCLC Number/Unique Identifier: 8465489491

Emerging evidence indicates that micronutrient deficiency could play a significant role in the pathogenesis and progression of many chronic diseases including diabetes mellitus, hypertension, obesity, dyslipidemia, hyperuricemia, kidney disease, cancer, anemia and other cardio-metabolic and neurodegenerative diseases through the induction of Insulin resistance (IR). However, there are still gaps in our scientific knowledge regarding the links between micronutrient deficiencies, IR, and cardio metabolic disorders. This review provides current information on recent advances and a global perspective regarding the relationship between micronutrient deficiency, IR, and cardio metabolic disorders. Empirical evidence indicates that deficiencies in either micronutrients associated with insulin activity (such as Chromium, manganese, magnesium, and iron) or antioxidant enzyme cofactors (such as vitamin A, copper, zinc, and manganese) could impact several physiological processes leading to a cascade of metabolic and biochemical derangements such as B-cell apoptosis, loss of islet cell mass, defective tyrosine kinase activity, oxidative stress, pancreatic β-cell dysfunction, reduction in lean body mass, defective insulin signaling mechanism, elevated protein kinase C activity, and excess intracellular calcium. Collaboratively, these states of metabolic malfunctioning are associated with IR, which triggers the onset of many cardio metabolic diseases. Undoubtedly, the prevention of micronutrient deficiency may indeed ameliorate the incidence of IR and cardio-metabolic disorders in those at risk and in the general population.
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Possible links between consumption of A1 “like” milk And Type 1 Diabetes (T1D)

Published on: 27th June, 2019

OCLC Number/Unique Identifier: 8172451193

During the last three decades, there has been an interesting debate on the intake of A1 ‘like” milk and incidence of type 1 diabetes (T1D) in genetically predisposed individuals. The epidemiological, ecological and case-control studies have concrete pieces of evidences in favor of the hypothesis that is further supported by animal trials in mice and rat and in vitro trials on cell lines. But on the other hand, European Food Safety Authority reported that there isn’t sufficient data to draw a final recommendation at this stage in terms of contradictory results, lack of cause-effect relationship and being a mere suggestive evidence [1]. However, the report itself states that these studies are strong enough to formulate a concrete hypothesis and further research is needed to confirm the same. Keeping in view the published data in favor of the hypothesis and the counter-arguments, it is suggested that further research with well-designed animal and in vitro trials with intact proteins and peptides is needed to fully confirm the hypothesis. Until the issue is fully resolved, it’s the personal choice of the individuals at risk to T1D (genetically predisposed) to either remove A1 “like” or increase the A2 “like” milk from their diet. 
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Primary Cutaneous Lymphomas and Interferon Treatment

Published on: 9th January, 2017

OCLC Number/Unique Identifier: 7355942281

Primary cutaneous lymphomas (PCLs) are the second most common group of extranodal non-Hodgkin lymphomas (NHL) with an estimated annual incidence of 1/100.000. Interferons (IFNs) are used in mono or combination therapy for cutaneous lymphomas especially for cutaneous T-cell lymphomas (CTCL) for years. IFN-α is the most widely-used type for cutaneous lymphomas. IFN-α has been shown to be a highly active agent in CTCL with response rates ranging from 40% to 80%. In this review, the current information about PCLs and IFNs treatment is summarized.
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Neutrophil to Lymphocyte Ratio (NLR) in Peripheral Blood: A Novel and Simple Prognostic Predictor of Non-small Cell Lung Cancer (NSCLC)

Published on: 30th March, 2017

OCLC Number/Unique Identifier: 7355938332

Lung cancer is the leading cause of cancer-related deaths worldwide, and almost accounts for 20% of these deaths, however, the cure rate is less than 10% [1]. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all cases of lung cancer [1], but fewer than 15% of individuals diagnosed with NSCLC can survive for more than 5 years, which poses a great threat to the patient’s life and health [2]. Recently, the incidence of lung cancer keeps dynamically growing, but more than 75% of patients at diagnosis has appeared local development or metastasis, missing the best period of surgery. Moreover, despite surgical treatment is the optimal choice for early-stage NSCLC patients, 30%-40% of patients with NSCLC develop tumor recurrence in a short time. Therefore, improving the prognosis of patients with lung cancer and predicting the long-term survival of patients is of particular importance [3]. At present, tumor and node metastasis (TNM) staging system, clinicopathological characteristics, visceral pleural invasion and marginal status are used to predict the disease progression and overall survival of NSCLC patients. There is no index which is stable, effective, reliable and less harmful to assess prognosis, predict recurrence risk and overall survival.
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Minimally invasive gracilis muscle transposition: Initial report

Published on: 23rd April, 2020

OCLC Number/Unique Identifier: 8861740961

Rectourethral fistula (RUF) is a divesting complication after prostate cancer treatment. The RUF incidence after radical prostatectomy is about 0.5% to 2%, [1,2]. Radiotherapy, criotherapy and high intensity focused ultrasound are other more severe causes [3,4]. Repair of RUF is a challenging surgical procedure. There are some possible approaches but transperineal is the most utilized. In cases of complex fistulas interposition of muscle flaps between the rectum and urethra is highly recommended. Gracilis muscle transposition (GMT) is the preferred, due to excellent mobility and vascularization for perineal reconstruction [5,6]. Dissection of the gracilis muscle is done using one, 2 or 3 large incisions in the medial border of the thigh. The aim of this report is present a new minimally invasive access to obtain a pediculate flap of gracilis muscle to interposition between bladder and rectum to treat RUF.
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3D software reconstruction for planning robotic assisted radical nephrectomy with level III caval thrombus

Published on: 30th April, 2020

OCLC Number/Unique Identifier: 8861737634

Inferior vena cava (IVC) involvement by intraluminal extension of tumor is infrequent, occuring in 4% to 10% of patients with renal cell carcinoma (RCC) [1-5]. Based on the cephalic extension of the thrombus, Mayo [6] described a classification of inferior vena cava thrombi in 4 categories, which has implications on surgical complexity, estimated blood loss (EBL) and peri-operative complications, but not cancer-specific survival [2,7]. Level III IVC thrombus is classified as being located in the retro-hepatic IVC below the diaphragm. Total resection of this tumor is the best chance of cure when no distant metastases are present [4,8]. Actually, open radical nephrectomy with concomitant thrombectomy is still the standard treatment. This procedure is technically challenging and involves a large incision and prolonged convalescence [9]. Recently, the feasibility of robotic IVC thrombectomy has been demonstrated, with potential lower EBL and shorter hospitalization and convalescence [7,10-14]. This surgery requires thorough knowledge of surgical anatomy, detailed pre-operative preparation and meticulous robotic technique [7]. The key point in the surgical management is the correct assessment of the extension of the endocaval thrombus, what is mainly based on radiological examinations [8]. Although Ultrasonography (US) and computerized tomography (CT) are useful in demonstrating the extent of the thrombus, CT is not always accurate in delineating the superior margin of the tumor in the IVC. More precisely, magnetic resonance imaging (MRI) can demonstrate a tumor thrombus and its extension, besides signs of wall invasion, being extremely useful to surgical procedure planning [8,15]. Vena cavography is not additive to US, CT, and MRI, and it increases the risk of contrast-associated renal injury [4,8]. However, new modern image technologies has emerged to help surgical planning, as three-dimensional visualization technique (3DVT) based on routine CT or MRI processed image data [16-20]. Recently, a comparative study showed advantage of 3DVT in management of complex renal tumor during laparoscopic partial nephrectomy [20]. This modality is able to demonstrate anatomy relations, allowing the surgeon to observe the relationship between targeted tumor and peripheral structure before surgery and perform virtual manipulation. This kind of preoperative accurate assessment can enhance surgeons confidence of surgical procedure and decrease surgical risk and incidence of complications [20]. There is no report in the literature of the use of this type of technology in cases of IVC tumor thrombus. We present the use of 3D holographic interactive reconstruction in a single case of robotic radical nephrectomy with level III IVC thrombectomy.
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Why? It is the question that I ask myself every day, every hour, every second...

Published on: 22nd March, 2021

OCLC Number/Unique Identifier: 9031334722

It is the dart that penetrates deep into my soul, every time I see with my own eyes how the incidence of cancer has grown in recent years. I am a pathologist. I am dedicated to diagnosing the disease from the cellular and tissue point of view. The answer to the question that haunts me may seem easy, simple, but I am not satisfied with knowing that advances in technology make it possible to diagnose a greater number of entities, many of them in early stages [1]. Of course, this statement is true. However, in recent years we have verified a greater number of cases with aggressive phenotypes, a fact that makes us ask ourselves certain questions. The first one is: Why? We know that cancer is a multifactorial disease in which genetics and different environmental factors participate. Are we witnessing the concurrence of factors that facilitate the greatest degree of neoplasms? Are habits the cause of this paradigm shift? On the table for debate is the therapeutic success of new strategies, of new drugs, of new algorithms, but the morphology is also changing. This change is exacerbated in the times of pandemic that we have lived through [2]. Pathologists attend a number of cancer diagnoses that have grown exponentially, as has the histological grade, not the staging, of it. And the initial question remains in the air, why? The fear of going to the hospital, the fear of self-exploration, the diversion of media attention to topics that arouse greater interest ... may be having a harmful effect on the health of patients [3]. I do not tell anything new, at least nothing that cannot be assumed by analyzing what happens every day in this new world, a world that will soon have to face, if not already, a cut in resources, research and other parameters that will negatively influence the answers to the eternal question: Why? In the era of personalized medicine, the same one that has reached or is close to reaching great milestones in the survival of once-deadly diseases, the microscope shows a parallel reality and allows, at least, to be pessimistic, or at least realistic: suffering…
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Tinnitus: Diagnosis and treatment options

Published on: 31st August, 2017

OCLC Number/Unique Identifier: 7317598632

Tinnitus-derived from the Latin “tinnire” meaning “to ring” is a perceived ringing, buzzing, or hissing in the ear(s) or around the head-which has multiple etiologies and is sometimes idiopathic. As of 2009 in the United States, approximately 50 million Americans were affected for six months or greater, while a United Kingdom study in 2000 reported a 10% prevalence in the adult population [1]. Tinnitus may vary widely with regard to pitch, loudness, description of sound, special localization, and temporal pattern [2]. Most often, tinnitus is associated with other aural symptoms, such as hearing loss and hyperacusis [3]. Tinnitus may result in sleep disturbances, work impairments, and distress. The severity varies within this cohort of chronic sufferers, with some unable to fulfill daily activities. Though tinnitus is more likely to affect adults and the incidence increases with age, children can experience tinnitus as well [4]. Males are more likely to suffer as are individuals who smoke [5]. 
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Kikuchi’s disease in a young Scandinavian woman

Published on: 20th September, 2017

OCLC Number/Unique Identifier: 7317601184

A 21 year-old woman presented with cervical lymphadenopathy and night sweats. Initially, lymphoma was suspected and one of the enlarged lymph nodes was excised in order to make a diagnosis. Histopathological examination revealed Kikuchi’s disease, which is usually a benign syndrome with spontaneous resolution. The disease is very rare, particularly in Caucasian populations. A higher incidence is seen in patients of Asian descent. The patient had persistent swelling of cervical lymph nodes over several months and further lymph nodes were removed as malignant transformation was suspected. However examinations showed only Kikuchi’s disease. There was given no specific treatment. Follow-up appointments were performed biannually and the patient is currently awaiting removal of yet another swollen lymph node on suspicion of relapse of her Kikuchi’s disease.
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Burden of hearing loss in Subsaharan Africa: Snapshot from an ENT clinic in Nigeria

Published on: 31st December, 2019

OCLC Number/Unique Identifier: 8512989994

Background: Disabling hearing loss is a prevalent public health issue, with significant impact on patients’ communication. The disability associated with hearing loss depends on the severity of the hearing loss. There are limited rehabilitative measures in resource challenged environment. This study assesses the incidence, the factors for hearing impairment and the management outcome. Methods: A descriptive three-year chart review of patients managed for hearing loss in a tertiary health center in a developing country. The data collected include demographic data, clinical presentation and risk factors for hearing loss, audiometric reports, rehabilitative measures and management outcome. Results: The patients with ear symptoms managed within the study period were 1350, of whom 498 (36.8%) had hearing loss of varying degrees. These included 145 (29.1%) males and 353 (70.9%) females with male to female ratio of 1:2.4. The age ranged from 8 to 80 years (median age of 35.7). Disabling hearing loss in the better-hearing ear occurred in 216 (43.4%) of cases. Increasing age and chronic supportive otitis media were associated with disabling hearing loss. The hearing thresholds improved with hearing aids and ear surgical procedures; nonetheless the patients’ rehabilitation was impaired by limited resources. Conclusion: There is poor rehabilitation of people with hearing loss, though management outcome is commendable in a few of them. Health education will reduce the risk factors for disabling hearing loss and improved rehabilitative measures are needed for these individuals.
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Retinopathy of prematurity - Intersibling divergence of risk factors among twins

Published on: 19th February, 2020

Retinopathy of prematurity (ROP) is a consequence of an arrest in normal retinal neural and vascular development, which determines the aberrant retinal regeneration [1,2]. ROP is a disease process mostly reported in preterm neonates ranging from mild, transient changes in the retina with regression to severe progressive vasoproliferation, scarring, detachment of retina and blindness and it is common blinding disease in children and a major cause of vision loss among preterm infants [3]. Today it is well known that oxygen therapy is not the single causative factor, but many other risk factors play a causative role in the pathogenesis of ROP [4,5]. The risk factors for ROP include oxygen administration, hypoxia, hypercapnia, blood transfusion exchange transfusion, apnea,sepsis and total parenteral nutrition. The incidence of ROP has been reported to be similar in multiple and singleton births [6-8]. Twin studies show that from 70% to 80% of the susceptibility to ROP is conditioned by genetic factors [9,10]. Hence this study is to find out the incidence of ROP in twins in a tertiary care centre in a developing country. It also attempts to identify the difference in risk factors among twins which predispose to ROP in Neonatal Intensive Care Unit.
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Two different patterns and outcome of neodymium YAG capsulotomy

Published on: 25th February, 2020

OCLC Number/Unique Identifier: 8553878059

Visual impairment is a global health problem. Cataract is responsible for 50% of blindness worldwide [1]. Posterior capsular opacification is the most common late complication of cataract surgery as a result of proliferation of residual lens epithelial cells overall 25% of patients undergoing extra-capsular cataract surgery develops visually significant PCO within 5 years of the operation [2]. Nd: YAG laser provides the advantage of cutting the posterior lens capsule, thereby avoiding and minimizing infection, wound leaks, and other complication of intraocular surgery. Thus Nd:YAG laser capsulotomy is noninvasive, effective and relatively safe technique [3]. However, this procedure is associated with complications such as- postoperative increased intraocular pressure (IOP), cystoid macular edema (CME), disruption of the anterior vitreous surface, uveitis, lens subluxation, increased incidence of retinal detachment and pitting of the IOL [4]. Laser shots can be applied in several patterns such as “Cruciate or Cross pattern”, “Can opener”, inverted “U-Method” and in a “Circular pattern”. Many authors promote the use of a cruciate pattern in the Centre of the visual axis, with the clinician starting off on both axes away from the Centre to avoid pitting the lens centrally [5]. This study mainly aims to analyze the effect of various forms of PCO capsulotomy openings on visual function after Nd: YAG capsulotomy.
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Changes in intraocular pressure after ND-yag laser posterior capsulotomy

Published on: 20th May, 2020

OCLC Number/Unique Identifier: 8605488676

The Nd-Yag L has been developed in Europe since the mid-1970s [10]. Today Nd-Yag LPC has become an established procedure for after cataract. Before the Nd-Yag L came into use, the capsulotomy was done by performing a small puncture with a needle knife or 27 gauge needle, either at the time of original operation or as a secondary procedure through the limbus in aphakic or through pars plana in pseudophakic. The Nd-Yag L preferred because it is non-invasive and infection cannot occur. The most important complication is a transient rise in IOP 1-3 hrs of Nd-Yag LPC [1]. Occasionally the pressure rise is high and can cause serious damage to the optic nerve, so that the IOP should be monitored and appropriate measures should be taken if necessary. Only if we can minimize its frequency or, better still, avoid it, altogether, can we accept Nd-Yag L as a safe procedure in our effort to restore vision. In otherwise normal eyes, a mild elevation of IOP is of no consequence because it usually resolves within 24 hour especially when the patient receives anti-glaucoma drugs before and after laser application. However in eyes with pre-existing glaucoma, the incidence of IOP elevation is higher and its duration is longer than in otherwise normal eyes. Some glaucomatous eyes may therefore require additional glaucoma therapy for several weeks following Nd-Yag LPC [3]. So monitoring is particularly important in the cases of glaucoma with optic nerve damage and field loss as these eyes are susceptible to small pressure rises for even a short period. A single rise to 40mmHg for a few hours can cause irreversible damage to the damaged optic nerve and lead to permanent visual loss or even blindness [1]. The purpose of this study is to evaluate the changes in IOP at 1hour,24hour and 1 week after Nd-Yag LPC.
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Adrenal insufficiency in Bilateral Adrenal Metastasis implemented SBRT

Published on: 14th February, 2018

OCLC Number/Unique Identifier: 7347067597

Today, there is a considerable increase in localizing adrenal bulks with the bringing radiologic diagnosis methods having high technology into use and improvement in diagnostic tests. Adrenal glands are vital tissues for the organism due to the hormones they secrete. Death is a natural result in the absence of adrenal cortex. Adrenal bulks can be seen with different clinical, laboratory and radiological data. These bulks are often benign and rarely malign. They can be functional or non-functional. Major treatment methods used fort he treatment of adrenal gland primary tumors or metastases are surgery, arterial embolisation, chemical ablation, radiofrequency ablation and radiotherapy [1-4]. Adrenal glands are one of the metastatic fields. In wide autopsy series, adrenal metastasis has been determined between the rates of 13-17% [5]. While unilateral metastasis is common, bilateral metastasis’ rate of incidence is between 4-20%. It has been stated that lung (35%), gastric (14%), esophageal (12%) and hepatobiliary (10%) primary carcinomas adrenal metastasis are prevalent most frequently [2]. Curative treatments are tested on patients having cancer with oligo metastasis limited with adrenal gland and primary source is under control because of the expectation of long-term survival, and the surgery is the first choice. These bulks can be treated with open and laparoscopic surrenalectomy in a curative way. It was reported in studies that overall survival was longer in resection of clinically isolated adrenal metastases when compared with nonsurgical therapy (including RFA, external beam radiotherapy, arterial embolization, radioembolization, chemical ablation, and cryoablation) [1,2,5,7]. Lo et al., found one-year survival as 73% and two-year survival as 40% in their study conducted on 52 patients having curative resection for solitary adrenal metastasis [3]. Tanvetyanon et al., demonstrated 5-year survival rates of 25% following resection of isolated synchronous adrenal metastases and reported 26% after resection of metachronous adrenal metastases in their study conducted on NSCLC patients developing solitary adrenal metastasis [4]. Conducted studies revealed that the rate of complication was 9-20% in patients having adrenalectomy for solitary adrenal metastasis [2-4,7]. In recent years, the use of radiotherapy, which is a treatment modality as effective as surgical resection, has become prevalent for the management of oligometastases. Today, three different modalities have been tested in the radiotherapy treatment of adrenal gland metastases. In the first one, total 50 Gy treatment dose with 3D-CRT as daily 2 Gy fraction dose is given [8]. The second one is IMRT implementations for adrenal gland metastases but it isn’t thought as suitable according to Practice Guidelines for Neuroendocrine Tumors published by NCCN in 2010. The third radiotherapy modality is stereotactic body radiotherapy (SBRT). SBRT implementations have started to be preferred today since they are completed in a few fractions in addition to that they show close results to surgery for primary tumors and metastases. Holy et al., implemented SBRT to patients having 13 solitary adrenal metastases with NSCLC at 5 fractions and between 20 and 40 Gy total doses. They found disease-free survival as median 12 months, overall survival as median 23 months and local control rate as 77% [9]. In SBRT implementations for different cancer types determined 30 adrenal metastases, Chawla et al., reported the rates of one-year survival, local control and distant metastasis as 44%, 55% and 13% respectively [10]. In Casamassima et al.,’s study on this issue, the rate of two-year local control was found as 90% [11]. Second degree toxicity was seen in none of the above mentioned studies according to the RTOG toxicity classification. Wardak et al., reported that the patient having lung cancer that they implemented SBRT for bilateral adrenal metastases developed adrenal insufficiency depending on SBRT [6]. Ippolito et al., Reported that adrenal insuffiency may be due to both the tumor and the local treatment [12]. Incidence of symptomatic adrenal insufficiency were reported 4% [2,13]. Casamassima et al and Onishi et al studies, two grade 2 adrenal insuffiencies were reported [11,14]. Consequently, when all these data were evaluated, it is seen that SBRT use has gradually become prevalent for patients not suitable for surgery because of comorbid disease, for patients having oligometastatic cancer that are not suitable for surgery since it has vital risk to resect or that refuse surgery. However, it hasn’t been clear yet that local control will be provided with how many total doses and which fraction schema. There is no agreement on the examination of the adrenal hormone axes because of the short length of life. Besides, it should be kept in mind that adrenal insufficiency can develop in patients implemented SBRT because of bilateral adrenal metastasis developing as synchronous or metachronous. The hormone levels of these patients need to be followed. More researches should be done to lighten this matter.  
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Effectiveness of Soft Tissue Mobilisation as an adjunct to the Conventional Therapy in patients with Ankylosing Spondylitis

Published on: 5th January, 2018

OCLC Number/Unique Identifier: 7869163621

Introduction: The HRMT (Human Resting Myofasial Tone) factor plays an important role to initiate the trigger the inflammation at the disease site in Ankylosing spondylitis (AS) as in all spondyloarthropathies. The incidence of fibromyalgia is higher in AS and a limiting factor to undergo the exercise program. Aim of the study: To know the effectiveness of soft tissue mobilisation in patients with Ankylosing Spondylitis when it used as an adjuncts to the conventional exercises. Methodology: 40 subjects were randomly assigned in to experimental and conventional group. Experimental group (n=20) received conventional exercises along with soft tissue mobilisation and the conventional group (n=20) received only conventional exercises (flexibility exercises, aerobic exercise and breathing exercise) for a period of 4 weeks, 5days/week. Results: The result of the study showed that both the conventional and experimental groups improved significantly in stiffness, pain and physical function aspects after treatment. However the experimental group had a greater change as compared to conventional group. Conclusion: The study demonstrates that soft tissue mobilisation has an effect when it used before the conventional exercise in patients with ankylosing spondylitis.
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Dietary and Lifestyles assessment among Obese Women in Gaza City, Palestine

Published on: 4th December, 2018

OCLC Number/Unique Identifier: 7943259697

Background: The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. Aim: To clarify and figure out food habits and different lifestyle pattern among a sample of Palestinian women attending the nutrition center in the Gaza Strip. Methods: A cross-sectional study involved 116 women were randomly chosen by purposive census sampling. They aged 25 to 60 years with a diagnosis of obesity. The data collected by interview questionnaire that included social factors, lifestyle habits, and health/disease history. Results: Age group variable has distributed significantly (p=0.024), (31.0%) of morbid obese were ≥35 years group compared to (13.5%) of morbid obese amongst the younger group. The higher intakes of legumes (OR: 2.134, P=0.003), nuts (OR: 3.917, P=0.019), eggs (OR: 6.840, P=0.009), fast foods (OR: 4.461, P=0.005), and soda drinks (OR: 2.230, P=0.004) were the risk factors linked to the increased risk of morbid obesity. Moreover, the higher intakes of legumes (OR: 8.439, P=0.011), eggs (OR: 6.900, P=0.041), chips (OR: 5.049, P=0.012), sugar (OR: 2.068, P=0.011), and fast foods (OR: 3.029, P=0.025) are risk factors of chronic diseases. Conclusion: The study identified several lifestyle factors and improper dietary habits associated with obesity among women in Gaza city. There is a great need to change these habits to avoid the increased risk of obesity. Gene-environment interaction can explain the high incidence of obesity. A national plan of action to overcome obesity is urgently needed to reduce its economic and health burden
Cite this ArticleCrossMarkPublonsHarvard Library HOLLISGrowKudosResearchGateBase SearchOAI PMHAcademic MicrosoftScilitSemantic ScholarUniversite de ParisUW LibrariesSJSU King LibrarySJSU King LibraryNUS LibraryMcGillDET KGL BIBLiOTEKJCU DiscoveryUniversidad De LimaWorldCatVU on WorldCat
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