Mitochondrial Function in the Formation of Sexual Constitution of Men| Chapter 11 | Current Topics in Medicine and Medical Research Vol. 10

 A brief description of mitochondrial functions and factors contributing to the development of mitochondrial dysfunction is given in the article. In the prenatal phase and early ontogenesis, the sexual constitution of an individual is established. The effect of mitochondrial function on sexual constitution formation is indicated by reasoned evidence.

Author (s) Details

A. M. Ashurmetov
Department of Medical, Administration of the President of the Republic of Uzbekistan, Central Clinical Hospital, Tashkent, Uzbekistan.

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An Overview of Schwannomas –ATypical Presentation and Challenges | Chapter 16 | Current Topics in Medicine and Medical Research Vol. 10

 Introduction: Schwanomma and neurofibroma are neurogenic tumors. In the head and neck, they occur sometimes. Nevertheless, their existence on the vagus is unusual. In order to order imaging for pelvic lesions that present atypically, a high index of suspicion is required. Discussion: Schwanommas are T1 hypointense and T2 hyperintense heterogeneously on MRI. The histopathological appearance is characteristic of the Schwanomma with Antoni type A and type B. Conclusion: Schwanommas are benign tumors that are slow-growing and that are separable from the parent nerve. After resection, recurrence is rare. Schwannomas originating from the vagus nerve cause bradycardia, and during surgical excision, the anesthetist must be attentive. Constipation can occur with pelvic schwannoma. For their issues and unusual presentations, we present our cases.

Author (s) Details

Dr. R. Vijai
Saveetha Medical College and Hospital, Chennai, India.

J. Ruban Kumar
Saveetha Medical College and Hospital, Chennai, India.

R. Arihanth
Saveetha Medical College and Hospital, Chennai, India.

Manoj Prabu
Saveetha Medical College and Hospital, Chennai, India.

Narayanasami Bharath
Saveetha Medical College and Hospital, Chennai, India.

Khalilur Rahman
Saveetha Medical College and Hospital, Chennai, India.

Arcot Rekha
Saveetha Medical College and Hospital, Chennai, India.

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Update on Ketamine Infusion Therapy for Sustained Opioid Cessation for Chronic Pain and for Depression | Chapter 9 | Current Topics in Medicine and Medical Research Vol. 10

 Objectives: Opioid abuse and opioid use disorders (OUD) continue to threaten the veteran population of America with chronic opioid use estimates of over 28 percent for non-cancer pain . Long-term opioid cessation is the primary consequence of the original analysis using ketamine-assisted opioid detoxification, whereas secondary results are evaluations of opioid withdrawal, pain relief, and side effects of ketamine. The composite outcomes to date are also checked in this update. Design: Preliminary retrospective analysis requiring a systematic examination of a database that has been collected prospectively. Setting: Veterans Affairs Medical Center in Nashville, Tennessee; report from Franklin, TN, private practice clinic. Subjects: 41 veterans with chronic non-cancer pain and chronic opioids who underwent opioid detoxification aided by ketamine; update contains 114 patient results. Methods: The authors analyzed a real-time data set of forty-one patients who met the criteria for inclusion. Data collected over a 28-month period April 2016-July 2018) was reviewed by the authors. Following detoxification and the initial ketamine infusion sequence, patients were tracked for up to 12 months after infusion at regular intervals, extending this monitoring duration to October 2018 to ensure that all patients had at least 3 months of follow-up results. 

Results: Long after therapy, most veterans stayed opioid-free: 83%, 75%, and 58% at one, three, and six months, respectively (p=0.0001). Seventy-six percent of patients reported either no or moderate severity of opioid withdrawal. At one and three months, median pain declines were 50 percent and 40 percent respectively. The frequency of alarming side effects of ketamine was poor.

Conclusion: Overall, this update offers new proof that the use of a standardized procedure for ketamine infusion combined with rapid detoxification of opioids is quite successful, results in a high rate of sustained reduction of opioids, reduces chronic pain, minimizes withdrawal of opioids using purely non-opioid analgesics, and reduces depressive symptoms. A randomized controlled trial may be used in future research, but blinding patients and clinicians could be difficult. Opioid detoxification aided by ketamine tends to be a safe and efficient method for targeting opioid addiction and has the potential to decrease opioid consumption, deaths associated with overdose, and chronic pain.


Author (s) Details

Randall J. Malchow
VA Tennessee Valley Healthcare System, USA and AMG Ketamine and Wellness Center, USA.

Jennifer W. Baker
VA Tennessee Valley Healthcare System, USA

Ashley P. Yost,
VA Tennessee Valley Healthcare System, USA.
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Factors Underlying Stigmatization of Epilepsy: Case Study of Abasuba and Ameru Communities, Kenya | Chapter 8 | Current Topics in Medicine and Medical Research Vol. 10

 Objectives: To recognize factors that underlie the stigmatization of people with epilepsy (PWE) in the communities of Abasuba and Ameru, Kenya. Study Design: In this study, cross sectional design was used. Place of research: The study was performed in the sub-districts of Abothuguchi, Miriegameru and Nkuene in the sub-districts of Meru Central and Central, Gwasi and Mbita in the sub-districts of Suba in Kenya. Methodology: It was a cross-sectional, descriptive analysis. A updated participatory rapid evaluation approach that included the use of questionnaires, interview schedules and centered group discussions was used. Interviews were performed with family leaders, medical workers, community-based group executives, patients, parents, administrators, teachers, faith healers and herbalists. Performance: The results of the analysis show an essential statistical association between negative

Epilepsy of fear (~2 = 43.69354, df=1, p<0.05). The fear of epilepsy depends on knowledge of it almost 2 = 7.41663, df=1, p=0.00646). Except among the female respondents in the Meru Central District, occupation was not found to affect fear (almost 2 = 6.19763, df=2, p=0.04510). There was however, no important association between epilepsy apprehension and education level ( ⁇ 2 = 0.15773, df=2, p=0.092436). The idea that epilepsy resulting from a curse or witchcraft is transferable and infectious was profoundly ingrained in the culture of the two groups and that they are treated by society with resentment that results in alienation and social stigma.

Author (s) Details

Tiberry D. O. Nyakwana,
Department of Clinical Medicine, School of Medicine, Jomo Kenyatta University of Agriculture and Technology, 62000-00200, Nairobi, Kenya.

Dr. Jemimah A. Simbauni,
Department of Zoological Sciences, Kenyatta University, P.O.Box 43844-00100, Nairobi, Kenya.

James O. Jowi
Clinical Neurology, Maseno University, P.O.Box 19280 Code 40123, Kisumu, Kenya.

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Saussurea costus: A Source of Anticancer Bioactives | Chapter 7 | Current Topics in Medicine and Medical Research Vol. 10

 Cancer is the world's second largest cause of death and is responsible for an estimated 9.6 million fatalities in 2018. Plant-derived products or extracts are used to treat various illnesses or diseases in folk/traditional medicine. The anticancer function of Saussurea costus and its mode of intervention have been investigated in human breast, colon, and liver cancer cells. The bio-actives developed by S. Extensively extracted costus leaves were investigated for cytotoxic activity against breast (MCF-7), liver (HepG2), and colon (HCT116) cancer cell lines in five solvents of different polarities. The highest cytotoxicity and hence the greatest anticancer effect on all the cancer cell lines studied were the secondary metabolites extracted in hexane, methanol, ethyl acetate and chloroform solvents, while butanol was comparatively less involved. Further investigations showed that the extract arrested the cells and induced apoptosis in the G1 step of the cell cycle. Elevated pro-apoptotic protein expression and decreased anti-apoptotic protein expression indicated that the intrinsic (mitochondrial) pathway was involved in mediating cancer cell apoptosis upon S treatment. Extract Costus. Such outcomes indicate that the S. Cost extract is the potential source of the secondary metabolites that could be used to treat various breast, colon, and liver cancers as an anti-cancer agent. However for future research on these active ingredients, more assessments, active compound isolation, in vitro and in vivo evaluations are recommended.

Author (s) Details

Dr. Mushtaq A. Mir,
College of Applied Medical Sciences, King Khalid University, P.O.Box 3665, Abha 61421, Saudi Arabia

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Reporting a Case on Good Response of Lupus Hepatitis to Mycophenolate Mofetil and Belimumab as of Lupus Exanthema to Rituximab | Chapter 15 | Current Topics in Medicine and Medical Research Vol. 9

 We face several patients with multiple forms of systemic lupus erythematosus (SLE) in clinical practise. They are generally managed to inhibit systemic inflammatory processes with immunosuppressive drugs. Corticosteroids are often first-choice medications because they work promptly, which in emergencies such as lupus nephritis or serious neuropsychiatric disorders can be helpful. 15 years ago, a 66-year-old male patient was treated mainly for cutaneous lupus erythematosus. Local corticosteroids and the following systemic immunosuppressants were administered: methylprednisolone (MP), chloroquine (removed due to retinal bleeding), cyclosporine A and azathioprine (removed due to non-response). Methotrexate and golimumab were introduced due to polyarthralgia. In spite of a strong response, due to the production of hepatitis confirmed by liver biopsy, both drugs had to be stopped (virus serological tests were negative). A marked decrease in liver enzymes could be observed early after the start of combination therapy with 1 g mycophenolate mofetil (MMF) per day orally and 10 mg/kg belimumab intravenously at weeks 0, 2, 4, followed every 4 weeks. Hydroxychloroquine (HCQ) has been added due to insufficient lupus exanthema response.

Since it was not possible to boost skin lesions after 9 months of administration of belimumab in conjunction with MMF and HCQ, biologic therapy was moved to another Bcell inhibitor, rituximab (1000 mg intravenously at weeks 0 and 2), which is considered to be used to treat patients with lupus. Surprisingly, a rapid and marked improvement in lupus exanthema was noted following the very first infusion. Since 2003, such a change has not been seen. An excellent response to MMF and belimumab may be confirmed by systemic lupus erythematosus (SLE)-associated hepatitis, as well as arthralgia. Rituximab has been shown to be more effective (in conjunction with MMF and HCQ) in treating SLE-associated skin lesions in our patients, despite the fact that these medicines are not yet approved for SLE therapy. Of course, only after treatment failure or intolerance of approved drugs can such medicines be added. We want to encourage doctors to collect data on the off-label use of immunosuppressants in connective tissue diseases in order to broaden the likelihood of care in patients that are not sensitive or difficult to respond to.

Author(s) Details

O. Psenak
Clinic of Internal Medicine III, Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology Paracelsus Medical University, Salzburg, Austria, Cancer Cluster Salzburg, Austria.

A. Studnicka-Benke
Clinic of Internal Medicine III, Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology Paracelsus Medical University, Salzburg, Austria, Cancer Cluster Salzburg, Austria.

H. Haufe
Department of Pathology, Paracelsus Medical University, Salzburg, Austria.

R. Greil

Clinic of Internal Medicine III, Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology Paracelsus Medical University, Salzburg, Austria, Cancer Cluster Salzburg, Austria.

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Advanced Study on Preparation, Physical-Chemical Characterization, and Cytocompatibility of Polymeric Calcium Phosphate Cements | Chapter 14 | Current Topics in Medicine and Medical Research Vol. 9

 

Background: Much attention has recently been paid to calcium phosphate cements (CPCs) because of their advantages in terms of in situ handling and forming capabilities compared to calcium phosphate bioceramics. Mechanical and in vitro biological physicochemical properties of novel polymeric calcium phosphate cement (CPC) formulations have been investigated.
Methods: to obtain Forms I, II and III CPCs, monocalcium phosphate, calcium oxide and synthetic hydroxyapatite were mixed either with modified polyacrylic acid, light activated polyalkenoic acid or with polymethyl vinyl ether maleic acid. CPCs were compared with zinc polycarboxylate cement (control) setting time, compressive and diametric strength. X-ray diffraction, scanning electron microscopy, and infrared spectroscopy were used to identify specimens. CPCs and control were tested for in vitro cytotoxicity.
Results: Hydroxyapatite, monetite, and brushite were seen by X-ray diffraction analysis. The presence of stretching peaks in the IR spectra of set cements confirmed the acid-base reaction. Rod-like crystals and platy crystals were disclosed by SEM. The cement setting time was 5-12 min. Compared with power, type III showed significantly higher strength values. High biocompatibility was achieved in type III.
Conclusions: In comparison to zinc polycarboxylate cement (control group), Type III CPC displayed acceptable setting time, substantially higher compressive, and diametral tensile strengths. For dental applications, Type III CPCs show promise.

Author(s) Details


Rania M. Khashaba
Department Oral Biology, Medical College of Georgia, Augusta, GA 30912-1129, USA., Department Orthopaedic Surgery, Section of Biomaterials, Medical College of Georgia, Augusta, GA 30912-1129, USA. and Department of Dental Materials, Misr International University (MIU), Cairo 11787, Egypt.

Mervet Moussa
Department of Oral Pathology, Cairo University, Cairo 11559, Egypt. and Department of Oral Pathology, Misr International University (MIU), Cairo 11787, Egypt.

Christopher Koch
Department Orthopaedic Surgery, Section of Biomaterials, Medical College of Georgia, Augusta, GA 30912-1129, USA.

Arthur R. Jurgensen
Savannah River National Laboratory, Savannah River Nuclear Solutions, Aiken, SC 29808, USA.

David M. Missimer
Savannah River National Laboratory, Savannah River Nuclear Solutions, Aiken, SC 29808, USA.

Ronny L. Rutherford
Savannah River National Laboratory, Savannah River Nuclear Solutions, Aiken, SC 29808, USA.

Norman B. Chutkan
Department Orthopaedic Surgery, Section of Biomaterials, Medical College of Georgia, Augusta, GA 30912-1129, USA.

James L. Borke

Department Oral Biology, Medical College of Georgia, Augusta, GA 30912-1129, USA and Department Orthopaedic Surgery, Section of Biomaterials, Medical College of Georgia, Augusta, GA 30912-1129, USA.

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