Epsom salts was inadvertently discovered in Epson spring in England and used as magnesium salt in 1697. It is simply the magnesium sulphate, a commonly used ingredient in beauty and wellness kiosks for soothing joints, muscles and mind. Richard Martin Willstatter working on plant pigments begged a Nobel Prize in 1915 for his discovery of chlorophyll containing magnesium. The magnesium holds the centre position in chlorophyll in a manner as iron in hemoglobin.
It is well known that depression is more common in women than in men with more prescriptions for antidepressants, hospital admissions for depression and suicide attempts. However another aspect to be considered is that depression is different in women than men because women have depressive episodes at times of hormonal shift which is a physiological phenomenon not encountered in men. This is why hormone therapy is so important.
“Pharmacodynamics of cannabinoids “(i.e. a set of biological effects elicited in the living organism by interaction with its biochemical and biophysical functions up to the cellular level) is studied for a long time during both, physiological and pathological conditions. Cannabinoids received their names according to their natural occurrence as constituents of Cannabis sativa L. (marijuana).
The nutritional compositions of sorghum stem sheath-Spondias mombin extract were evaluated. The enriched stem sheath extract were obtained by mixing sorghum stem sheath and Spondias mombin (iyeye) extract in varied proportions at 100:0; 0:100; 95:5; 90:10 and 85:15. The five samples were subjected to analysis: proximate, mineral, vitamin C, antinutrient composition. Data obtained were analysed using descriptive and inferential statistics. The result showed that observable increases were noticed in proximate, vitamin C and mineral composition from 5% inclusion of Spondias mombin extract in sorghum stem sheath drinks. The anti-nutrient compositions: tannin, oxalate and saponin, ranged from (0.144 to 0.442, 0.303 to 0.385, 0.070 to 0.198) mg/100 ml, respectively for sorghum stem sheath- Spondias mombin extract which were within consumable safe limits. The study concluded that nutritious enriched drinks could be produced from sorghum stem sheath and Spondias mombin extract at ambient temperature.
Chronic venous leg ulcers (VLU), especially long-lasting non-healing ulcers, are among the risk factors for squamous cell carcinoma (SCC) with particularly aggressive behaviour. We present a case of a 71-year-old female patient with a relevant personal history of multiple SCC and basal cell carcinoma (BCC) excision and chronic venous insufficiency showing for about three years a ulcerated lesion located on the anteromedial distal third of the left leg non-responsive to specific treatment, which subsequently increased their size and merged. Biopsy sample was taken. Histopathology revealed a G2 SCC in all biopsy samples. After the staging, a left inguino-femoral lymphadenectomy and the excision were done. The treatment of bone exposure with a soleus muscle flap in the upper half of the defect and skin graft for all the defect and a specific oncologic treatment were proposed as possible curative solutions. Patients with chronic venous leg ulcers and clinically suspicious lesions should be evaluated for malignant transformation of the venous lesion. When diagnosed, malignancy complicating a chronic venous leg ulcer requires a resolute treatment as it may be fatal.
The paper reviews enclosure asphyxia as a cause of death of three Nigerian children aged three years, five years and seven years respectively, who were found dead and locked in the boot of a Mercedes Benz 200E Sedan car a day after they were declared missing. The first two were siblings of the same parent whose fathers actually owned the car, while the older child was a neighbour kid all of whom were well known to each other as friends and playmates. They had gone missing for a few hours prior to being seen playing together. Search parties were raised and they were never found until the following day when they were found dead in the boot of the car parked a few meters away from the house under a tree. Incidentally the same car was driven round the neighbourhood for 3 hours during the search the previous day with no inkling that they were in the boot of the car. Autopsy was ordered by the coroner to determine the cause of death.
Background: Azithromycin (AZM) is a macrolide antibiotic with distinct pharmacokinetic properties and is increasingly used as maintenance treatment in patients with bronchiectasis in order to reduce infectious exacerbations and improve pulmonary symptoms. The exact mechanism of action is not known and the relation between azithromycin dose level, local and systemic drug levels and clinical effect however, has not been extensively studied yet.
Objectives: To explore the relation between AZM serum and sputum concentrations, clinical effect parameters and side effects.
Methods: Azithromycin concentrations were measured in serum and sputum samples of bronchiectasis patients receiving one year of AZM treatment (250mg OD) enrolled in the Bronchiectasis and Azithromycin Treatment (BAT) trial, a double blind, randomised placebo-controlled trial. Results were correlated with data on AZM dose level, exacerbation frequency, lung function (forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), quality of life and symptoms collected within the same year.
Results: 83 sputum samples from 31 patients and 151 serum samples from 43 patients were available for analysis. Mean AZM dose-level ranged from 18.8 to 39.8 mg/kg body weight/ week, generating mean AZM concentrations of 7.57 mg/L (SD 9.49) in sputum and 0.11 mg/L (SD 0.085) in serum. No correlation was found between side effects and AZM dose level, sputum- or serum concentrations. Significant correlation was found between AZM sputum concentration and CRP-level (r= -0.6).
Conclusion: High and stable AZM sputum levels were reached during long term treatment, as opposed to low AZM levels in serum. Apart from CRP-levels to AZM sputum concentration, no other outcome parameter showed significant correlation to AZM serum- or sputum levels. AZM dose- or exposure levels were not predictive for the occurrence of side effects.
The postpartum period is a phase during which various endocrine disorders may arise due to changes in the immune system. Postpartum thyroiditis and postpartum hypophysitis (lymphocytic hypophysitis) are two autoimmune diseases that typically occur independently but are rarely found together in the same patient.Postpartum thyroiditis usually starts with thyrotoxicosis and progresses to hypothyroidism, while postpartum hypophysitis can lead to adrenal insufficiency and dysfunction of other pituitary hormones.This case report discusses a female patient who presented with severe headaches, fatigue, and hypotension five months after childbirth. The patient was diagnosed with both postpartum thyroiditis and postpartum hypophysitis simultaneously, and dysfunction of both the thyroid and pituitary was detected. Hormone replacement therapies were administered, and the patient’s symptoms were brought under control.This case emphasizes the importance of carefully evaluating both thyroid and pituitary function during the postpartum period. Early diagnosis and appropriate treatment are crucial for preventing potential complications and improving long-term health outcomes.
Sanjeewani Fonseka*, B Subhani, V Alahakoon, CN Wijeyaratne, IB Gawarammana, NS Kalupahana, N Ratnatunga, S Rosairo and PVR Kumarasiri
Published on: 6th August, 2019
Background: Polycystic ovary disease (PCOD) is an endocrine disorder. It leads to menstrual disturbances, infertility, obesity and dermatological manifestations such as hirsutism and acne which leads to impaired health-related quality of life (QOL).
Aims: To evaluate the perceived health related QOL in patients with PCOD treated with ethinyl oestradiol (35µg)/cyproterone acetate (2 mg) (EE/CPA) and ethinyl oestradiol (20 µg)/ desogestrel (0.15mg) (EE/DES) alone and in combination with low-dose metformin.
Methods: A total of 117 patients with PCOD diagnosed according to Rotterdam Consensus Criteria 2003 with a hirsutism score of 8 or more according to modified Ferriman-Gallway Score (mFGS) were randomised to receive one of four drug combinations (arm A – EE/CPA, arm B- EE/DES, arm C- EE/CPA plus metformin, arm D- EE/DES plus metformin). The outcomes assessed were body mass index (BMI), hirsutism (using mFGS) and health-related QOL (Polycystic Ovary Syndrome Health- Related quality of life Questionnaire (PCOSQ) and a Visual Analog Scale (VAS) score) at baseline and 12 months after treatment.
Results: PCOSQ score in relation to the hirsutism, emotions, menstruation, obesity, infertility and VAS score in relation to hirsutism and obesity had improved at the end of 12 months (p< 0.001) in all treatment arms. There was no difference between treatment arms in all measured outcomes at baseline and at the end of 12 months.
Conclusion: Treatment with EE/CPA and EE/DES is associated with an improvement in perceived QOL in patients with PCOD. The addition of low-dose metformin did not have a significant benefit.
In homicide cases, knowledge about time of death is important as it directs police investigation towards the discovery of authorship, including or excluding suspects of a crime, and determining nature of death. In Brazil, entomological evidence is still neglected by official forensic organizations and for this reason cases using insects to estimate post-mortem interval (PMI) are still rare. Dipteran specimens collected and analyzed by the staff of Criminalistics Institute (CI) from São Paulo State, Brazil, made it possible to elucidate circumstances of the death, including suspects to the crime scene, in five occurrences involving discovery of cadavers. In all cases, blowflies were collected and were identified as belonging to species Chrysomya albiceps (Wiedemann, 1819), Chrysomya megacephala (Fabricius, 1794), Chrysomya putoria (Wiedemann, 1830), Hemilucilia semidiaphana Rondani, 1850 and Lucilia eximia (Wiedemann, 1819) (Diptera: Calliphoridae), while only in one case Sarcophagidae (Diptera) flies were also collected. PMI estimate was calculated taking into account laboratorial developmental rate data of mentioned species on the environmental temperature on which bodies and insects were exposed, along with comparisons to field research previously conducted in those areas. Based on larval age and behavior, the course of the investigation had changed, pointing to the crime author (case I), as well as the nature of the crime (cases I-III) and associated suspects to the criminal act (cases IV-V). Results show how promising is the use of entomological evidence during investigations of violent deaths.
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