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   2013| August  | Volume 5 | Issue 8  
    Online since August 30, 2013

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The emerging role of outdoor and indoor air pollution in cardiovascular disease
Jacinta C Uzoigwe, Thavaleak Prum, Eric Bresnahan, Mahdi Garelnabi
August 2013, 5(8):445-453
DOI:10.4103/1947-2714.117290  PMID:24083218
Outdoor and indoor air pollution poses a significant cardiovascular risk, and has been associated with atherosclerosis, the main underlying pathology in many cardiovascular diseases. Although, it is well known that exposure to air pollution causes pulmonary disease, recent studies have shown that cardiovascular health consequences of air pollution generally equal or exceed those due to pulmonary diseases. The objective of this article is to evaluate the current evidence on the emerging role of environmental air pollutions in cardiovascular disease, with specific focus on the types of air pollutants and mechanisms of air pollution-induced cardiotoxicity. Published literature on pollution was systematically reviewed and cited in this article. It is hoped that this review will provide a better understanding of the harmful cardiovascular effects induced by air pollution exposure. This will help to bring a better understanding on the possible preventive health measures and will also serve regulatory agencies and researchers. In addition, elucidating the biological mechanisms underlying the link between air pollution and cardiovascular disease is an essential target in developing novel pharmacological strategies aimed at decreasing adverse effects of air pollution on cardiovascular system.
  11,264 1,192 61
Spontaneous pneumomediastinum: Time for consensus
Sonu Sahni, Sameer Verma, Jinette Grullon, Anthony Esquire, Purvesh Patel, Arunabh Talwar
August 2013, 5(8):460-464
DOI:10.4103/1947-2714.117296  PMID:24083220
Pneumomediastinum (PM) is defined as the presence of free air in the mediastinal cavity. It is often regarded as a revealing sign of a more serious medical condition. PM is broken down into two categories, one, with an instigating event, referred to as secondary PM. The other is when free air is discovered in the mediastinal cavity without a clear etiology, referred to as spontaneous pneumomediastinum (SPM). Often misdiagnosed due to the vague nature of presenting symptoms, SPM must be part of the differential diagnosis of a chest pain patient to expedite discovery and if necessary, management. A MedLine/PubMED search was performed identifying all relevant articles with "SPM" in the title. Six case series were reviewed to determine what clinical scenario constitutes a possible case of SPM. Results showed that almost all patients with SPM exhibited some chest pain, but Hamman's crunch was present in only one-fifth of patients. Patients with certain pre-existing pulmonary diseases showed a greater propensity for the presence of free air in the mediastinal cavity. SPM must be diagnosed and managed promptly due to rare, but serious complications and any chest pain with an unknown etiology should contain SPM in the differential diagnosis.
  8,744 1,287 87
Treatment of allergic rhinitis with probiotics: An alternative approach
Gui Yang, Zhi-Qiang Liu, Ping-Chang Yang
August 2013, 5(8):465-468
DOI:10.4103/1947-2714.117299  PMID:24083221
Allergic rhinitis is a skewed immune reaction to common antigens in the nasal mucosa; current therapy is not satisfactory and can cause a variety of complications. In recent decades, the incidence of allergic rhinitis is increasing every year. Published studies indicate that probiotics are beneficial in treating allergic rhinitis. This review aims to help in understanding the role of probiotics in the treatment of allergic rhinitis. We referred to the PubMed database as data source. This review focuses on the following aspects: The types of probiotics using in the treatment of allergic rhinitis, approaches of administration, its safety, mechanisms of action, treating results, and the perspectives to improve effectiveness of probiotics in the treatment of allergic rhinitis. This review reports the recent findings regarding the role of probiotics in the treatment of allergic rhinitis. Probiotics are a useful therapeutic remedy in the treatment of allergic rhinitis, but its underlying mechanisms remain to be further investigated.
  7,027 1,426 26
Profile of hepatic involvement by dengue virus in dengue infected children
Amrita Roy, Debalina Sarkar, Sohini Chakraborty, Jasodhara Chaudhuri, Pramit Ghosh, Swapna Chakraborty
August 2013, 5(8):480-485
DOI:10.4103/1947-2714.117313  PMID:24083224
Background: The spectrum of liver dysfunction in children with dengue infection is wide and has been associated with disease severity. Aims: This study was undertaken to estimate the range of hepatic involvement in dengue infection in children. Materials and Methods: This study assessed the biochemical and clinical profile of hepatic involvement by dengue virus in 120 children with serologically positive dengue fever (DF), aged 2 months to 14 years. Results: All cases were grouped into DF without warning signs (Group 1), DF with warning signs (Group 2) and severe dengue (Group 3) according to revised World Health Organization 2009 criteria. The spectrum of hepatic manifestations included hepatomegaly (80.8%), hepatic tenderness (46.3%), jaundice (60%), raised aspartate transaminase (AST), alanine transaminase (ALT) and prolonged prothrombin time (41.7%) and reduced serum albumin (56%). Conclusions: Hepatic dysfunction was observed more in Groups 2 and 3. There was 84.4% and 93.75% ALT and AST elevation respectively in Group 2 and 94.5% and 95.9% ALT and AST elevation respectively in Group 3 and fulminant hepatic failure was observed in Group 3. Therefore in a child with fever, jaundice, hepatomegaly and altered liver function tests, the diagnosis of dengue infection should be strongly considered in areas where dengue infection is endemic.
  6,956 977 36
Severe vitamin D deficiency, myopathy, and rhabdomyolysis
Charles J Glueck, Brandon Conrad
August 2013, 5(8):494-495
DOI:10.4103/1947-2714.117325  PMID:24083227
  5,979 465 5
Cardiovascular repercussions of the pseudoexfoliation syndrome
Vasiliki Katsi, Antonios N Pavlidis, Manolis S Kallistratos, Athanasios Fitsios, Athanasios Bratsas, Dimitris Tousoulis, Christodoulos Stefanadis, Athanasios J Manolis, Ioannis Kallikazaros
August 2013, 5(8):454-459
DOI:10.4103/1947-2714.117294  PMID:24083219
Pseudoexfoliation syndrome is a primarily ophthalmological disorder caused by deposition of whitish-gray protein on the lens, iris, and multiple other eye tissues. There is increasing evidence over the previous years that pseudoexfoliation syndrome is a systemic disorder with various extraocular manifestations and has recently been linked to several cardiovascular disorders. The present article aims to summarize the current knowledge on cardiovascular implications of this well-described clinical entity.
  5,791 556 21
Limitations of 24-hour recall method: Micronutrient intake and the presence of the metabolic syndrome
Sunil Kumar Raina
August 2013, 5(8):498-498
DOI:10.4103/1947-2714.117329  PMID:24083229
  4,738 807 14
Manual khalifa therapy in patients with completely ruptured anterior cruciate ligament in the knee: First preliminary results from thermal imaging
Gerhard Litscher, Michael Ofner, Daniela Litscher
August 2013, 5(8):473-479
DOI:10.4103/1947-2714.117307  PMID:24083223
Background: This preliminary publication describes acute temperature effects after manual Khalifa therapy. Aims : The goal of this study was to describe temperature distribution and the effects on surface temperature of the knees and feet in patients with completely ruptured anterior cruciate ligament before and immediately after the manual therapy. Materials and Methods: Ten male patients were investigated with thermal imaging. An infrared camera operating at a wavelength range of 7.5-13 μm was used. Temperature was analyzed at three locations on both knees and in addition on both feet. Results: The study revealed that baseline temperature of the injured knee differed from that of the untreated control knee. After the therapy on the injured knee, the surface temperature was significantly increased on both knees (injured and control). There were no significant changes in the temperature of the feet. Conclusions: Further studies using continuous thermal image recording may help to explain the details concerning the temperature distribution.
  4,539 676 8
Diagnosis of persistent left superior vena cava draining directly into the left atrium
Raghav Gupta, Anthony Pearson
August 2013, 5(8):496-497
DOI:10.4103/1947-2714.117328  PMID:24083228
  3,778 585 5
Central nervous system and Cryptococcus neoformans
Veronica A Gaona-Flores
August 2013, 5(8):492-493
DOI:10.4103/1947-2714.117321  PMID:24083226
  3,360 444 1
Cryptococcal meningoencephalitis in human immunodeficiency virus/acquired immunodeficiency syndrome in douala, cameroon: A cross sectional study
Henry Namme Luma, Elvis Temfack, Marie Patrice Halle, Benjamin Clet Nguenkam Tchaleu, Yacouba Njankouo Mapoure, Sinata Koulla-Shiro
August 2013, 5(8):486-491
DOI:10.4103/1947-2714.117318  PMID:24083225
Background: Cryptococcal meningoencephalitis (CM) kills about half a million human immunodeficiency virus (HIV) patients per year, mostly in Africa. Aim: The aim of this study was to determine the prevalence, clinical presentation and in-hospital outcome of CM among HIV-infected patients in Douala. Materials and Methods: A cross-sectional clinical note review of 672 HIV-1 patients' files admitted from January 1 st 2004 to December 31 st 2009 at the Internal Medicine unit of the Douala General Hospital, Cameroon was performed. Only patients diagnosed of CM by microscopy of Indian ink stained cerebrospinal fluid (CSF) were studied. Results: The prevalence of CM in the study was 11.2%. Mean age of patients was 36.9 ΁ 12.7 years. Median cluster of differentiation 4 (CD4) cell count was 23 cells/μL, (interquartile range [IQR]: 10-61) and 62.7% of CD4 cell counts were <50 cells/μL. The most prevalent symptom was headache in 97.3% of patients. In CSF, median proteins was 0.9 g/L (IQR: 0.6-1); median glucose 0.2 g/L (IQR: 0.1-0.3) and median leucocyte count 54 cells/μL (IQR: 34-76) mostly of mixed cellularity. The case fatality rate was 52% and low CD4 cell count was strongly associated with death, odd ratio 4.6 (95% confidence interval: 2.6-8.0, P < 0.001). Conclusion: The high case fatality of CM in Douala warrants adequate diagnostic measures and optimization of standardized treatment to reduce mortality.
  3,228 452 7
Perspectives of medical interns regarding female feticide and declining sex ratio in India
Shubhada Avachat, Pritish Raut, Mrinal Zambare, Dilipkumar Gund, Rutuja Pundkar
August 2013, 5(8):469-472
DOI:10.4103/1947-2714.117302  PMID:24083222
Background: Female feticide, skewed sex ratio, and its attendant social evils have grave ethical undertones for medical professionals and our commitment to save lives. A concerted effort by all is essential against female feticide. Aim: This study was to assess the knowledge of female feticide, declining sex ratio, and corrective measures among medical interns. Materials and Methods: A cross-sectional study was conducted among 79 medical interns. Data werecollected with the help of predesigned structured questionnaire. Chi-square tests, Kruskal-Wallis tests, and Z tests were used to test the significance level. Results: Knowledge of current sex ratio was significantly better among female interns than male interns. Majority of interns opined that creating awareness is an effective measure to combat declining sex ratio and only 33 interns had correct knowledge regarding all measures. Only 37.9% of interns knew all the legal indications for use of prenatal diagnostic techniques. However, 81% of interns were aware of punishments mentioned for violation of the Act. Mean score of knowledge was 22.06 among males and 24.4 among females. Conclusion: The findings in our study underline the need to sensitize doctors regardingevery aspect of Pre-Conception and Prenatal Diagnostic Techniques Act and selective sex determination.
  2,929 320 -