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Eastern J Med: 21 (2)
Volume: 21  Issue: 2 - 2016
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LETTER TO EDITOR
1.The relationship between mean platelet volume and sex hormones; Methodological drawbacks
Ercan Varol
doi: 10.5505/ejm.2016.33971  Pages 54 - 55
Abstract | Full Text PDF

REVIEW ARTICLE
2.Obesity –“An excuse or a blame”
Pooja K Joshi, Rinkey A Chawla, Dhruti H Mistry, Meonis A Pithawala
doi: 10.5505/ejm.2016.55591  Pages 56 - 63
On a global scale, obesity has reached epidemic proportions and is a major contributor to the global burden of chronic disease and disability. At the moment, more than one billion adults worldwide are overweight and at least 300 million of them are clinically obese. Obesity is a rising worldwide problem affecting both the developed countries as well as the developing nations. Obesity is common but complex and multifactorial disorder with higher heritability. Obesity results because of body fat accumulated over a time because of chronic energy imbalance that is calories consumed exceed calories expended. There are many genetic and environmental factors that influence this balance. Obesity is an important public health problem because it increases the risk of developing diabetes, hypertension, heart disease and some type of cancers. The present article reviews role of genes that are identified in causing obesity.

ORIGINAL ARTICLE
3.Prevalence of chloroquine resistant Plasmodium falciparum malaria in pregnant females attending North Indian hospital
Haris Manzoor Khan, Samia Kirmani, Parvez Anwar Khan, Urfi İslam
doi: 10.5505/ejm.2016.93377  Pages 64 - 68
Chloroquine resistance was first reported in South-east Asia and South America region and has now spread to the vast majority of malaria endemic countries. P. falciparum malaria is a cause of high morbidity and mortality in general population as well as in antenatal females. 1. To evaluate the accuracy of different diagnostic tests for diagnosis of malaria in pregnancy. 2. To determine the level of chloroquine resistance in P. falciparum isolates from pregnant females. The study was conducted in Department of Microbiology and Obstetrics and Gynaecology of Jawaharlal Nehru Medical College and Hospital. A total of 156 pregnant females were included in the study. Diagnosis of malaria was done by blood smear examination or antigen detection assay or by Quantitative Buffey Coat assay. P. faciparum was cultured in RPMI 1640 medium and in-vitro drug sensitivity was done by microtest-II WHO sensitivity plates against chloroquine. P. falciparum culture was positive in 66 pregnant females. 28 isolates were found to be resistant to chloroquine. The effective concentration of chloroquine EC 50 was found to be 6.6, EC90 34.3, EC95 45.4, EC99 52.1 nmol/l. High level of chloroquine resistance in pregnant females can lead to serious complications in antenatal patients and their fetuses.

4.Color Distribution of The Gingiva Created by Color Schema Maker Software
Burak Ak, Barış Kaki
doi: 10.5505/ejm.2016.32032  Pages 69 - 74
INTRODUCTION: The aim of this study is to create a true gingival shade guide using schema maker software.
METHODS: 128 patients gingiva colors were recorded by a standardised photograph machine under standart light and distance conditions. The recorded images were analysed by Gimp software to extract RGB values by using color pick tool. RGB values were converted to CIE L*a*b* values. L* values were clustered by ward method. The avarage CIE L*a*b* values calculated. Gingiva images were layered by Gimp software and evaluated by Wenovo pictures to colors software v1.0.
RESULTS: According to this study, 3 clusters using CIE L values and 9 subclusters with using CIE a*b* values have calculated by hierarchical and k means clustering methods. 256 colors that can be used for gingiva color determination has been calculated by Wenovo color schema maker software.
DISCUSSION AND CONCLUSION: With the limits of this study, colors of the gingiva were evaluated for only white race and patients who admitted to our university.Wenovo schema maker software calculated more colors than statistical method that can be used for color determination of the gingiva. Further studies are needed to create more reliable color gingiva shade guide with a large number of patients and different races and places.

5.“The Efficacy Of Combined Low-Doses Of Propranolol And Flunarizine In Episodic Migraine”
Chandan Raybarman
doi: 10.5505/ejm.2016.03511  Pages 75 - 78
INTRODUCTION: This retrospective review is to evaluate the efficacy of a fixed combination of low doses of long - acting propranolol and flunarizine, when flunarizine mono therapy is ineffective in migraine
METHODS: Thirty- five patients (ages 21-57 years; average 36.5 years; male-female ratio, 1: 4) compatible with the diagnosis of migraine without aura received an initial single evening dose of flunarizine of 10 mg for a period of 8 weeks and none of them showed change of migraine attacks per month. These patients were divided into two treatment groups - Group A received a fixed combination of 20mg. long acting propranolol and 5mg. flunarizine and group B received a fixed combination of 40mg. long acting propranolol and 10mg. flunarizine for a period of 8 weeks, without a "drug-free" period of observation. The patients were assessed at the end of 8 weeks period for differences in attack frequency, duration and intensity compared to the baseline as well as in both the treatment groups.
RESULTS: Both groups showed significant reduction in the mean (±SD) of monthly migraine frequency, headache intensity, and headache duration (Wilcoxon Signed Rank test, significant at p≤ 0.01) when compared to baseline parameters. However, there was no significant difference in frequency, duration and severity for both doses groups when compared. There was no adverse effect observed.
DISCUSSION AND CONCLUSION: This study suggests that the fixed dose combination of 20 mg propranolol and 5 mg flunarizine could be a new treatment initiative, especially for patients in whom flunarizine mono therapy is ineffective in migraine prophylaxis

6.Evaluation of patients with idiopathic portal hypertension: could tissue transglutaminase antibodies predict the celiac disease ?
Fikret Gören, Ahmet Cumhur Dülger
doi: 10.5505/ejm.2016.03521  Pages 79 - 83
INTRODUCTION: Idiopathic portal hypertension(IPH) traditionally has been described as a diagnosis of exclusion in patients who have presinusoidal portal hypertension. Gut- derived serologic markers in IPH are an increasing focus of attention, but there are only a few published studies on serological markers of celiac disease in patients with IPH and the results are contradictory. Furthermore, the role of tissue transglutaminase (TTG) antibodies have not yet been identified.
METHODS: This study determined what proportion of IPH patients had a seropositivity of TTG antibodies and evaluated the role of TTG antibodies in IPH. Demographics and clinical data, TTG antibodies, hematologic and biochemical parameters and radiologic studies were retrospectively reviewed in all IPH patients attending our hospital.
RESULTS: 10 clinically and biopsy-proven IPH patients (8 women and 2 men) were identified, all of them were diagnosed between 2009 and 2011. IgA and G antibodies to tissue transglutaminase were evaluated in all patients. 5 patients had a positive TTG IgA, 3 patients had a positive TTG IgG and 2 of them had negative autoantibodies. No patient was IgA deficient. 6 patients were eligible for duoenal biopsy and non of them had biopsy-proven celiac disease(CD).
DISCUSSION AND CONCLUSION: Although the data are limited, this study suggests that seropositivity for TTG antibodies could be positive in IPH. But there was no relation between positive serologic results and CD.

7.Evaluation of maternal thyroid autoimmune status in gestational trophoblastic disorders
Erbil Karaman, Orkun Çetin, Numan Çim, Ali Kolusarı, Seyithan Güler, Recep Yıldızhan, İsmet Alkış, Hanım Güler Şahin
doi: 10.5505/ejm.2016.46855  Pages 84 - 87
INTRODUCTION: To investigate the maternal autoimmune status of patients with molar pregnancies
METHODS: The study was conducted at Yuzuncu Yıl University, Department of Obstetrics and Gynecology between January 2012 and June 2016. The medical records patients who were diagnosed and followed for complete and partial molar pregnancies were reviewed retrospectively. The data of patients who were studied for maternal thyroid auto-antibodies including Anti-Thyroid peroxidase(TPO) and Anti-Tyroglobulin(Tg) were included in the study.
RESULTS: The mean maternal age of complete molar pregnancies were significantly higher than partial molar pregnancies (p: 0.010). There was no significant difference in terms of beta-HCG, TSH and free T4 values between two groups (p: 0.815, p: 0.204 and 0.072, respectively). None of the patients were anti- TPO positive in the study. There was no significant difference in anti-thyroglobulin positivity between two groups (p: 0.950).
DISCUSSION AND CONCLUSION: Maternal thyroid autoantibody status did not showed any difference in partial and complete molar pregnancies. Thyroid dysfunction seen in molar pregnancies seems to be due to the stimulation of follicular cell receptors with HCG rather than auto-antibodies against thyroid gland.

8.In Stored Human Blood, The Inhibitor Effect of Tannic Acid and Caffeic Acid on Lipid Peroxidation and Oxidative DNA Damage
Zübeyir Huyut, Mehmet Ramazan Şekeroğlu, Ragıp Balahoroğlu, Hamit Hakan Alp, Erdem Çokluk
doi: 10.5505/ejm.2016.76476  Pages 88 - 93
INTRODUCTION: Stored bloods, are exposed to a number of negative changes called as "storage lesions" morphological, biochemical and functional, to begin the first phase of the storage. In this study, we investigated the effects of caffeic and tannic acid in lipid peroxidation and oxidative DNA damage in stored blood.
METHODS: The blood was taken from 10 healthy male individuals to the blood bag containing CPD. Each donor's blood was separated into three groups. The first group was used as the control group with nothing added to the blood. A total of 30 µg/mL caffeic acid and 15 µg/mL tannic acid was added to the second and third group, respectively. Malondialdehyde, ubiquinone-10 and 8-hydroxy-2 deoxyguanosine levels were determined at baseline and on the 7th, 14th, 21st and 28th day, by high pressure liquid chromatography.
RESULTS: The MDA and 8-OHdG levels of control and tannic acid groups were increased on the 21st and 28th days (p<0.001), whereas in caffeic acid group was preserved (p>0.05). Also, CoQ10 levels increased in the control group time dependently (p<0.001), but preserved in the other two groups (p>0.05). In addition, CoQ10 and 8-OHdG levels of tannic and especially caffeic acid groups was lower than the control group in the inter-group comparison, in perods of progressing time (p<0.05).
DISCUSSION AND CONCLUSION: These results showed that oxidative stress was increased in the stored blood, but adding tannic and caffeic acid into the stored blood can be attenuate the effects of oxidation.

CASE REPORT
9.Broca’s aphasia as a consequence of electric shock – A case study
Noorain Alam, Raj Kumar
doi: 10.5505/ejm.2016.09990  Pages 94 - 97
The electric shock (ES) occurs upon contact of a human body part with any source of electricity that causes a sufficient current through the skin, muscles and hair. Broca's aphasia is a type of nonfluent aphasia, so called because speech production is halting and effortful. Current literature contains relatively little about the present state of knowledge concerning the neurological effects of electrical injury to man. A 50 year old case reported C U Shah Medical College and Hospital, Surendranagar with complaint of electric shock in his right hand. He lost consciousness and when he regained consciousness he had right sided hemiparesis and had lost speech ability. The CT scan (fig 1) finding showed infracts in left frontal lobe. The patient was assessed with the first part of the Western Aphasia Battery (WAB) (Kertesz, 1974). His spontaneous speech, repetition, naming are severely affected while auditory comprehension was relatively better. He was diagnosed with Broca’s aphasia. The pathology of Aphasia due to electrical shock involves blood vessel damages. Electrical shock can result in many neurological complications and Aphasias are one of them. We need to assess all these possibilities while working with the persons who have suffered electrical shock.

10.Solitary transverse colon metastasis: A rare case of uterine cervical cancer recurrence
Tatsuya Fukami, Hiroshi Tsujioka, Sakiko Matsuoka, Sumire Sorano, Atsushi Tohyama, Hiroko Yamamoto, Sumie Nakamura, Maki Goto, Ryoei Matsuoka, Fuyuki Eguchi
doi: 10.5505/ejm.2016.40522  Pages 98 - 100
A 44-years-old, Japanese woman underwent radical hysterectomy, preoperative chemotherapy and postoperative radiotherapy for uterine cervical cancer. She complained an abdominal palpable mass. The resection of transverse colon was performed. The postoperative pathological diagnosis was metastasis of uterine cancer without peritoneal dissemination. There have been few reports of metastatic colon cancer and most of them were gastric or lung cancer. We report a rare case of squamous cell carcinoma of uterine cervix metastatic to transverse colon.

11.Primitive neuroectodermal tumor (PNET) of nasal cavity
Roopesh Sankaran, Syed Zaifullah bin Syed Hamzah, Ramesh Kumar, Balwant Singh Gendeh
doi: 10.5505/ejm.2016.69937  Pages 101 - 104
This is case where an elderly woman referred to our clinic with history of recurrent epistaxis from right nostril for one year duration associated with persistent right nasal blockage, hyposmia, loss of weight and loss of appetite. On examination noted polypoidal mass at right sphenoethmoidal recess with evidence of previous surgery. Patient underwent endoscopic removal of the mass and histopathologic examination was reported as malignant small round blue cells tumors from right olfactory cleft and right ethmoidal air cells. Based on immunohistochemical examination, it was consistent with primitive neuroectodermal tumour (PNET).

12.Hyperlipidemia in infant case of acute monoblastic leukemia
İbrahim Ece, Murat Dogan, Sinan Akbayram, Nesrin Ceylan, Nihat Demir, Kaan Demirören
doi: 10.5505/ejm.2016.84829  Pages 105 - 106
Severe hyperlipidemia is a rare presentation usually associated with acute myeloid leukemia. 2-month-old girl complaining of discomfort. Her skin and conjunctivae were pale, abdominal distention and 5 cm hepatosplenomegaly were determined. Blood count revealed anemia (10 g/dL) and thrombocytopenia (41x109/L). Total leukocyte count was 24x109/L, and on blood smear, 58% blast and 42% lymphocytes were seen. Bone marrow aspirate revealed diffuse infiltration with blast cells consistent with acute monoblastic leukemia. Her plasma had a milky appearance. In the laboratory examination, triglyceride level was 1428 mg/dl, cholesterol level was 1291 mg/dl. This case report illustrate that the hematological malignancies may present with severe hypertriglyceridemia.



 
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