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Showing posts from July, 2019

New Insights into Gastric Pressure Activity | Chapter 13 | New Insights into Disease and Pathogen Research Vol. 1

Diseases in the gastric cavity are, to some extent, related to with gastric motility. Using a telemetric device, which is composed of a capsule robot, an in-vitro pocket data recorder, an ultrasonic locating unit, and an in-vitro data processing computer, to obtain gastric physiological digestive or interdigestive pressure activity is a good way to get the pattern of gastric motility. This chapter of the book first presents such a telemetric device. Then, general data processing and analysis method, as well as reasonable interpretation on how to generate such gastric pressure activity are given. Such general process for processing pressure recordings includes removal of abnormal values, five-three-Hanning (53H) weighted average smoothing and estimation of pressure activity fluctuation frequency. Finally, an analysis method for detecting quadratic phase coupling (QPC) behavior of human gastric interdigestive pressure activity is proposed. They are the Fourier transforms of the diagonal…

Family Risk of Metabolic Disorder; A Parameter for Timely Screening of Vascular Endothelial Health | Chapter 12 | New Insights into Disease and Pathogen Research Vol. 1

Aim: To study the correlation of vascular endothelial health with family risk of metabolic disorders, in healthy overweight, obese and non obese subjects.
Study Design: A case-control (pilot) study.
Place and Duration of Study: The study was conducted in Cardiovascular Physiology lab, Department of Physiology, K.G.M.U
Methods: Cases and controls comprisedfrom January 2009 to February 2010. of 30 overweight / obese healthysubjects (BMI >= 25 kg/m2 and/or WHR (female>0.85; male>1) and 30 non-obese healthy subjects respectively (BMI< 25 kg/m2 and/or WHR (female<0.85; male<1) excluding subjects with secondary cause of abnormal blood flow. Vascular endothelial health was assessed via reactive hyperemic response measured via impedance plethysmography in the subject’s forearm. Fasting plasma glucose and serum lipid profile was also done.
Results: On comparison of biochemical variables, lipid derangement was recorded in both the groups. Significant difference in VLDL (control…

Ethical Dilemmas in Orthodontics | Chapter 11 | New Insights into Disease and Pathogen Research Vol. 1

Introduction: Doctors and dentists possess special training and expertise which patients and their families do not. This special knowledge and skillset, which has the potential to benefit as well as harm patients, places on the medical or dental professional the moral obligation to act in the interests of the patient.
Aim: To present a clinical case as an example of an ethical dilemma that orthodontists may face when advocating for the best interests of a child.
Case Presentation: A five-year-old girl attended my private orthodontic clinic with a main complaint of lower anterior teeth overlapping her upper anterior teeth. She was in the primary dentition stage. There was a conflict between the orthodontist’s interests of the child and the need to respect parental autonomy. Her mother had doubts and misgivings about the effectiveness of orthodontic treatment and was reluctant to have her daughter begin treatment at this age.
Discussion: Factually, there are ethical problems continuously …

Fetuin A: A Newer Marker for Pre Diabetes | Chapter 10 | New Insights into Disease and Pathogen Research Vol. 1

Objective: To evaluate the role of Fetuin A levels in predicting glycemic outcome in individuals with impaired fasting glucose.
Research Design and Methods: A total of 742 young individuals were recruited for the study out of which 177 had impaired fasting glucose, 468 had normoglycemia and 97 individuals with diabetes. These individuals were offsprings of diabetics (either mother or father or both) and were siblings amongst themselves belonging to age group of 18-35 years. Various biochemical investigations such as fasting plasma glucose, glycosylated Hb, serum insulin, C-peptide and Fetuin A were carried out. People with impaired fasting glucose were followed and analyzed according to glycemic outcome and quartile of Fetuin A level.
Results: A total of 66 individuals with prediabetes reverted back to normal, 28 progressed to diabetes and 83 remained with prediabetes over a mean±S.D follow up of 24±4.1 months. People in the highest quartile of fetuin A had the highest Insulin, Insuli…

Metabolic Syndrome in Postmenopause: eNOS, p22 phox, CETP and ESR1 Gene Polymorphisms Related to Endocrine-Metabolic Changes | Chapter 09 | New Insights into Disease and Pathogen Research Vol. 1

Aims: To investigate the endocrine-metabolic changes in postmenopausal women with MetS and examine relationship with the polymorphisms of eNOS-G894T, p22(phox)-930 A/G, CETP TaqIB, ESR1 (PvuII and XbaI) genes.
Methods: 280 postmenopausal apparently healthy women aged between 60 and 80 years were classified into non-MetS (212) and MetS (68). Clinical, anthropometric and endocrine-metabolic parameters were measured. The single nucleotide polymorphisms were determined and tested for interacting with these parameters.
Results: The weight, waist circumference, blood pressure, WBC, triglycerides, LDL-C, TG/HDL-C ratio, apolipoprotein (apo)B, apoB/apoA-I ratio, fasting glucose, insulin, HOMA, uric acid,were higher and HDL-C was lower in MetS group thusfulfilled the criteria for the MetS. The significant higher levels of E2, T3, GHBP, PTH and lower levels of cortisol, SHBG, FSH, LH, IGFBP1, cortisol/DHEA ratio were also detected. Genetic association studies showed that presence of A allele p22…

Silent Myocardial Ischemia in Master Marathon Runner | Chapter 08 | New Insights into Disease and Pathogen Research Vol. 1

Silent myocardial ischemia is defined as objective documentation of myocardial ischemia in the absence of angina or anginal equivalents. Silent myocardial ischemia is quite different from silent coronary artery disease. The symptomatic angina is the tip of the ischemic iceberg and it is less frequent in athletesthan in non-athletes. Athletes change their perception of ischemic stimulus and increasing pain threshold from increased circulating endorphin levels.Silentmyocardialischemiaismoreprevalentthan angina in patients with coronary artery disease, and athletes are not immune to it. Inordertodiscoverearlystagesof malignant neoplasia (e.g. breast and colon cancer) in the asymptomaticstage andthuspreventreachingfinalstagesof thedisease, screening participation has been widely accepted. Vice versa,although atherosclerotic cardiovascular diseasecausesmoredeaths and disabilitiesthanallcausesofdeathcorrelatedtocancer, therearenopreciseguidelinesconcerningthescreeningof asymptomaticelements…

Aminoff Suffering Syndrome: A Challenge for Medical and Nursing Staff during End-of-Life Care: Open Letter and Proposals | Chapter 07 | New Insights into Disease and Pathogen Research Vol. 1

The diagnosis of Aminoff Suffering Syndrome in advanced dementia determined by measuring the suffering level of patients according to the Mini Suffering State Examination (MSSE) scale—facilitates acceleration and intensity of care by the nursing staff in order to prevent and relieve suffering. Relief of Suffering Units for patients with Aminoff Suffering Syndrome should be an integral part of any medical department or nursing home that specializes in caring for elderly people. Aminoff Suffering Syndrome at the end of life could, and should be diagnosed, prevented and diminished. The treatment of patients with Aminoff Suffering Syndrome at the end of life is a genuine challenge for medical and nursing personnel. Our proposals for further experimental studies at the end of life are the diagnosis of Aminoff Suffering Syndrome in dying patients with cancer, AIDS, cardiac, pulmonary, kidney, liver and other terminal diseases. We recommend that such studies should be performed at the St Chr…

Spotlight on Leucin-Rich Repeat Kinase 2 (LRRK2) G2019S Mutation and Parkinson's Disease in Egyptians | Chapter 06 | New Insights into Disease and Pathogen Research Vol. 1

Aim: Many causative genes and susceptibility loci have been identified to be associated with Parkinson's disease (PD) in different ethnic populations. One of these genes is the Leucin-rich repeat kinase 2 (LRRK2) gene. The G2019S substitution in that gene is the most common mutation identified to co-segregates with PD. One of the significant mutations in LRRK2 linked to PD is the G2019S which has been found associated with neuronal impairment and loss of dopaminergic neurons. Furthermore, new monoclonal antibody assay has been developed to quantify LRRK2 G2019S kinase pathway activity in Parkinson’s patients. This type of mutation has been investigated in the North part of Egypt (Alexandria and nearby region), which showed an incidence of 9.7% of heterozygous mutation in LRRK2 G2019S in a sample of Egyptians with sporadic PD. We investigated the same mutation in 69 Egyptian patients with sporadic PD and 96 ethnically matched controls who all were inhabitants of Upper Egypt to find…

Effect of Verbal & Pictorial Materials on Memory Retention among Undergraduate Students – An Interventional Study | Chapter 05 | New Insights into Disease and Pathogen Research Vol. 1

Aims: To compare the effectiveness of pictorial against verbal materials in memory retention among medical students.
Study Design: Crossover randomized controlled trial.
Place and Duration of Study: This study was conducted in Melaka-Manipal Medical College, Muar, Johor, Malaysia in April 2016.
Methodology: 38 right-handed medical students of Melaka-Manipal Medical College were volunteers and participants were divided into two groups equally via simple random sampling. One group of participants were to recall pictures shown first followed by words while the other group of participants were to recall words first followed by pictures. All the pictures and words shown were of everyday objects. Data were analysed using Epi Info version 7.
Results: There was a significant difference of memory retention between pictures and words (P-value =; p < 0.05) and of memory accuracy (P-value; p < 0.05). For memory retention, both groups were found to have higher scores for pictures than words as b…

Neurocysticercosis and Psycho-social Trauma | Chapter 04 | New Insights into Disease and Pathogen Research Vol. 1

This chapter describes a patient with neurocysticercosis who presented with psychotic features. He came to Cairns, Queensland, Australia as a refugee following his experiences of civil unrest in Rwanda. A review of the current literature on neurocysticercosis is described including an introduction, clinical presentation of neurocysticercosis, diagnosis, treatment, case presentation, clinical course, Axis 1-IV diagnoses and discussion highlighting psychosocial trauma. A history of the genocide he survived in Rwanda in 1994 is summarised along with a discussion of traumatic or dissociative psychosis that was included in his differential diagnosis. The patient was admitted through the Emergency Department where he was assessed and treated in a medical ward with the involvement of the Psychiatric Liaison Team and Infectious Disease Team. CT and MRI of the brain confirmed the diagnosis of neurocysticercosis. Medical treatment was administered for neurocysticercosis and community psychiatri…

The Role of Chromogenic Replica System for Isolation & Identification of Uropathogens in the Era of Molecular Diagnostics | Chapter 03 | New Insights into Disease and Pathogen Research Vol. 1

Multidrug resistance in uropathogens is a serious problem in a health care set up. To deal with that, rapid identification of the etiological agent from clinical urine sample is utmost important. Use of replica disc for presumptive identification of uropathogens is an easy to perform, cost effective and rapid method, which can be, adopted in the microbiology laboratories as a primary screening method.
Author(s) Details
Dr. Seema Bose Department of Microbiology, Hind Institute of Medical Sciences, Safedabad, Lucknow, India.
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Delirious Mania: Recognition and Successful Treatment with Donepezil in the Context of Historical and Contemporary Investigations of Delirium and Delirious Mania | Chapter 02 | New Insights into Disease and Pathogen Research Vol. 1

Aims: Presentation of a case of severe delirious mania with resolution of delirium after treatment with donepezil.
Presentation of Case: KA was a 44 y/o Australian female with a history of bipolar affective disorder with psychotic manic episodes. Two weeks prior to her psychiatric admission she was admitted to a medical ward after an overdose (OD) of acetaminophen. On review, it appeared that this OD may have been the beginning of an unrecognized delirious mania. The patient was sent home and returned 2 weeks later for a prolonged psychiatric admission with multiple medical comorbidities. Psychiatric management and medical care were provided in intensive settings and despite adequate treatment and improvement in mood symptoms, her delirium did not resolve. Immediately upon institution of donepezil, her delirium resolved. After a period of stability, donepezil was stopped. Her delirium returned and donepezil was reinstituted with resolution of normal cognitive function.
Discussion: The D…

Molecular Basis of Pathogenesis of Diabetes Mellitus Type 2- a New Perspective | Chapter 01 | New Insights into Disease and Pathogen Research Vol. 1

Decreased insulin secretion due to beta cell dysfunction of the pancreas and defective utilization of insulin due to insulin resistance / Hyperinsulinemia are two important issues in the pathogenesis of DM2. There are many explanations in the literature to account for these two observed phenomena and their interrelationship. DM2 is believed to occur due to a complex interplay of environmental and Behavioural factors in genetically predisposed persons. Among the theories explaining the pathogenesis of DM2, the viscera- Portal hypothesis, the Ectopic fat hypothesis and the adipose tissue as an endocrinal gland are prominent. Besides, the role played by oxidative stress, metabolic stress, mitochondrial dysfunction, endoplasmic reticulum stress, etc. are also advanced. It is felt that basic to and at the core of all the observed facts, is the shift of energy metabolism from normal glycolysis to B- oxidation of fats. Hence, how B - oxidation prevails over glycolysis is the fundamental issu…