Genetic Basis of Type 2 Diabetes Via the Gene Coding for Angiotensin-converting Enzyme | Chapter 7 | Advancement and New Understanding in Medical Science Vol. 2

Back Ground: Diabetes is a metabolic disease most often associated with complications when the biological parameters are uncontrolled, so management of diabetes remains a challenge in Africa. The increasement of this disease is associated with the ageing population, economic development, increasing urbanization, a less healthy diet and decreased physical activity.

Objective: The aim of this study was to find a relationship between the polymorphism of the gene encoding for angiotensin converting enzyme (ACE) and type 2 diabetes (T2D) in Gabonese subjects.

Method and Materials: This study was carried out in the laboratory of the Research Unit of the University of Health Sciences. The study population consisted of 225 subjects. This panel was composed of 88 controls (normoglycemic and non-hypertensive and not having a family history of diabetes) and 137 type 2 diabetic individuals. The genotypic analysis of the ACE gene of the different subjects was carried out by the technique of Polymerase Chain Reaction (PCR). Categorical and continuous variables were compared between diabetic patients and controls using the Chi-square test (X2) for categorical and the ANOVA test for continuous.

Results: The distribution of DD, ID, and II genotypes in controls and diabetics was 63.6%, 33%; 3.4% respectively and 65.7%; 31.4%; 2.9%. In addition, the allelic distribution showed that the alleles I and D in the controls and the diabetic subjects had proportions of 19.9%; 80.1% vs. 18.6%; 81.4% respectively. The genotypic and allelic differences between the two groups were not significant (p = 0.78).

Discussion and Conclusion: Therefore the allele D would not be the factor involving the I/D polymorphism in the occurrence of type 2 diabetes (T2D) in the Gabonese population. Plasma ACE activity in diabetic patients, as well as analysis of other genes may be related to the onset of the disease in order to highlight a genetic relationship linked to the occurrence of the pathology which can lead to better management of the patients and especially a new clinical approach for an effective diagnosis of diabetics.

Author(s) Details:

Ndong Atome Guy Roger,
Laboratory of Research in Biochemistry (LAREBIO), University of Sciences and Technology of Masuku, Franceville, Gabon.

Ovono Abessolo Felix,
Department of Chemistry and Biochemistry, University of Health Sciences (USS) Libreville, Gabon.

Mbang Bengone Aude Synthia,
Laboratory of Research in Biochemistry (LAREBIO), University of Sciences and Technology of Masuku, Franceville, Gabon and Department of Chemistry and Biochemistry, University of Health Sciences (USS) Libreville, Gabon.

Ollomo Benjamin,
Department of Chemistry and Biochemistry, University of Health Sciences (USS) Libreville, Gabon.

Yacka Laurianne,
Department of Chemistry and Biochemistry, University of Health Sciences (USS) Libreville, Gabon.

Lebibi Jacques,
Laboratory of Research in Biochemistry (LAREBIO), University of Sciences and Technology of Masuku, Franceville, Gabon and Chemistry Unit, Faculty of Science and Technology, University of Sciences and Technology of Masuku, Franceville, Gabon.

Ngou-Milama Edouard,
Department of Chemistry and Biochemistry, University of Health Sciences (USS) Libreville, Gabon.

Please see the link here: https://stm.bookpi.org/ANUMS-V2/article/view/13093

Audit of Caesarean Section for Non-Progress of Labor: A Clinical Findings | Chapter 6 | Advancement and New Understanding in Medical Science Vol. 2

Background: There is alarming increase in the number of caesarean section in the recent past years and many of the indications are due to non-progress of labor. Identification of non-progress of labour is crucial so that its proper evaluation and management can result in favourable outcome. Non-progress of labour can result in fatal outcome for mother and baby. This chapter evaluate various parameters and associated factors responsible for non-progress of labor and to study the neonatal outcome.

Methods: Retrospective case record analysis of the obstetric outcome in 42 patients who underwent caesarean section for non-progress of labour was undertaken at PCMS for the period of one year from June 2013-June 2014. Factors like age, parity, gestational age, duration of prolonged labor, maternal and neonatal outcome was analyzed.

Results: In our study mean age of the women who underwent caesarean section for non-progress of labor was 25 years±2.26. When the duration of labor was analyzed, maximum cases i.e. 60% non-progress of labor is seen in active phase, 30% cases had prolonged latent phase of labor, arrest of descent was observed in 10% of cases. There were 14 babies who were shifted to NICU, out of them 10 babies had Apgar score <7. Average baby weight was 2689grams±446.60. Increase in the baby weight might be one of the factors associated with non- progress of labour in second stage, However, in the present study mean weight was 2.8 kg.

Conclusions: Maximum cases 60% were in active phase, 10% with non-progress in second stage of labor. Out of total cases, 33% of newborns had NICU admission, out of them 16% had poor Apgar score but rate of NICU admission due to non-progress of labor remained same. Hence early decision making in caesarean section will help in preventing neonatal complication. There was no neonatal mortality observed in the study. Increased clinical skill and a good documentation of the progress of labour in birth records are of great importance to identify and classify prolonged labour, careful management of interventions is crucial to keep normal births normal and avoid mistreatment.

Author(s) Details:

Tripti Singh Kathuria,
Department of Obstetrics & Gynecology, Peoples Medical College and Research Centre, Bhopal, Madhya Pradesh, India.

Rekha Sapkal,
Department of Obstetrics & Gynecology, Peoples Medical College and Research Centre, Bhopal, Madhya Pradesh, India.

Please see the link here: https://stm.bookpi.org/ANUMS-V2/article/view/13092

Pleuroparenchymal Mucormycosis: A Rare Case Presentation | Chapter 5 | Advancement and New Understanding in Medical Science Vol. 2

We present a case of non-resolving pneumonia, later identified as pleuropulmonary mucormycosis in a patient with uncontrolled Diabetes Mellitus. Mucormycosis is a rare, but emerging, life-threatening, rapidly progressive, angioinvasive fungal infection that usually occurs in immunocompromised patients. We present a case of a 46 years old male with cough and scanty expectoration for two months, fever for one month and right sided chest pain for 7 days and shortness of breath for 3 days. Pleuroparenchymal mucormycosis is relatively rare disease and maintaining a high level of suspicion is important in right clinical setting with pleuropulmonary involvement that fails to respond to antibacterial agents because early recognition of this diagnosis, along with aggressive management, is critical to effective therapy and patient survival. The study highlights the importance of the early diagnosis, treatment, and consideration of fungal infection before making a clinical diagnosis of pulmonary tuberculosis in immunocompromised patients so that timely intervention can be done for the management of pulmonary fungal infections.

Author(s) Details:

Yadav Prashant,
Department of Respiratory Medicine, U P University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.

Kumar Adesh,
Department of Respiratory Medicine, U P University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.

Gupta Kumar Ashish,
Department of Respiratory Medicine, U P University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.

Please see the link here: https://stm.bookpi.org/ANUMS-V2/article/view/13091

Ocular Alterations in Severe COVID-19 Patients with Invasive Mechanical Ventilation and Prolonged Pronation | Chapter 4 | Advancement and New Understanding in Medical Science Vol. 2

This work was designed to investigate ocular alterations in patients affected by severe COVID-19 who required invasive mechanical ventilation and prolonged pronation to optimize lung ventilation areas.

Conjunctivitis seems to be the initial or only symptom of this pathology, other alterations in the ocular surface are chemosis, epiphora and ocular secretions. In the COVID-19 pandemic, the use of intensive care units, prolonged pronation, and invasive mechanical ventilation in the management of complicated patients increased greatly. The study design was descriptive, prospective, and cross-sectional, it was carried out in the Intensive Care Unit of the Specialties Hospital of the XXI Century National Medical Center, Mexican Institute of Social Security during the months of March and May 2021. All patients over 18 years of age, of both sexes with a positive test polymerase chain reaction (PCR) for COVID-19, who had the diagnosis of severe pneumonia associated with SARS-CoV-2 who were under invasive mechanical ventilation and who had more than 16 hours of pronation.

The mean age of the patients was 60 years. 68.9% had comorbidities. The most frequent findings in adnexa were blepharoedema and chemosis. In the ocular fundus, several alterations including cotton-wool lesions, intraretinal hemorrhages and arteriolar vasoconstriction were observed. The effect of the hours of pronation on the frequency of retinal alterations was statistically significant the group of patients without changes against those who had more than two retinal alterations. Having more than 145 hours of pronation increases the risk of having more than two retinal alterations. Intraocular pressure increased in pronation by 61 % with P < 0.05. In COVID-19 pneumonia that causes a critical state, it has been seen that there is a proinflammatory and thrombotic state and tissue ischemia due to decreased oxygen distribution, which is related to the development of multi-organ failure and this in turn.

The ocular alterations in patients with COVID-19 under invasive mechanical ventilation and prolonged pronation range from the ocular adnexa to the alterations in the fundus of the eye.

The relevance of this study lies in the fact that the patients were examined during the most severe period of the disease, where more systemic ischemic alterations could have manifested. These results suggest the need to implement a protocol for the primary and secondary prevention of ocular complications in patients with COVID-19, but which may be useful for patients who must remain in prolonged pronation for other medical indications.

Author(s) Details:

Zaira Lizette Jiménez Díaz,
Ophthalmology Service, Specialties Hospital, XXI Century National Medical Center, Mexican Institute of Social Security, Mexico City, Mexico.

Julio Alejandro Blanco D´Mendieta,
Ophthalmology Service, Specialties Hospital, XXI Century National Medical Center, Mexican Institute of Social Security, Mexico City, Mexico.

Arturo Carrasco Quiroz,
Ophthalmology Service, Specialties Hospital, XXI Century National Medical Center, Mexican Institute of Social Security, Mexico City, Mexico.

Lizbeth Karina Blanco D´Mendieta,
Ophthalmology Service, Specialties Hospital, XXI Century National Medical Center, Mexican Institute of Social Security, Mexico City, Mexico.

José D. Méndez,
Medical Research Unit in Metabolic Diseases, Cardiology Hospital, XXI Century National Medical Center, Mexican Institute of Social Security, Mexico City, Mexico.

Please see the link here: https://stm.bookpi.org/ANUMS-V2/article/view/13090

The Effect of Chronic Toxoplasmosis on Serum Testosterone Levels in Men | Chapter 3 | Advancement and New Understanding in Medical Science Vol. 2

Toxoplasma gondii is an obligate intracellular infects both humans and animals. T. gondii parasitize in different organs even in testes and it was isolated from semen. The level of testosterone in the serum was evaluated for men with chronic toxoplasmosis.

One hundred twenty-one blood samples were collected from apparently healthy men with different age groups they were attending the teaching hospital in Al-Diwaniyah province. Three milliliters of blood drawn from each man, and then sera were separated by centrifugation. Anti-Toxoplasma IgG antibody was detected. Same numbers of positive and negative sera were included in cases and control groups respectively, and then the quantitative determination of testosterone was analyzed in the serum of both groups.

Thirty eight (31.4%) out of 121 examined serum samples were given positive results for T. gondii IgG antibodies. The results indicated a high rate of infection among males in different age groups, especially in the 30-44 years group. The testosterone levels appeared that the hormone concentration was relatively higher in the case group than in the control group at ages 15-29 years with significant differences (P<0.05). People who live in cities compared to rural residents and those who keep cats compared to others recorded a higher rate (39. 14% and 35.71 % respectively) of anti-T. gondii IgG.

We conclude from the current study that the rate of infection with T. gondii is high among men and increases during the active period of maturity and is affected by some risk factors such as type of housing and ownership of cats and has an impact on their testosterone levels.

Author(s) Details:

Noaman N. A'aiz,
Department of Veterinary Microbiology, College of Veterinary Medicine, University of Al-Qadisiyah, Iraq.

Masar J. J. Al-Kurdy,
Department of Nursing Techniques, Technical Institute in Al-Diwaniyah, AL-Furat AL-Awsat Technical University, Iraq.

Thanaa I. Jawad,
Department of Nursing Techniques, Technical Institute in Al-Diwaniyah, AL-Furat AL-Awsat Technical University, Iraq.

Please see the link here: https://stm.bookpi.org/ANUMS-V2/article/view/13089

Urotensin II Levels is Associated with Insulin Resistance in Patients with Gestational Diabetes Mellitus | Chapter 2 | Advancement and New Understanding in Medical Science Vol. 2

Background: Gestational diabetes mellitus is glucose intolerance of varying degrees with onset or first detection during pregnancy, it can cause long and short-term morbidities in both the mother and the child, such as shoulder dystocia, preeclampsia, and high blood pressure. The most powerful endogenous vasoconstrictor peptide, urotensin II, and its receptor are involved in the etiology of gestational diabetes mellitus. The considerable decline in insulin sensitivity that occurs late in pregnancy reveals the lower insulin sensitivity that occurs before pregnancy.

Aim: The aim of the study is to see if there is a link between Urotensin II levels and insulin resistance in pregnant women with gestational diabetes.

Method: This is a case-control study, conducted in the obstetrics and gynecology department at Baghdad Teaching Hospital from the first of January 2019 to the end of December 2019. A sample of 80 pregnant women participated in the study fulfilling inclusion criteria. 40 of them were diagnosed with gestational diabetes mellitus by (2 hours 75 gm. Oral glucose tolerance test) and 40 women as a control group. The analysis was done by using the Statistical Package for Social Science (SPSS) program, version 23 for qualitative variables.

Results: The mean age of the gestational diabetes mellitus group was 29.8±6.9 years and control was 29.7±6.6 years with no significant differences. The study showed a highly significant increase in Insulin, fasting blood glucose, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), of the GDM group than that in the group without disease. A significant difference was found regarding high -  sensitivity C-reactive protein hs-CRP (p=0.004). The level of Urotensin II in subjects with gestational diabetes was (109±33.22) highly was higher than that in healthy subjects (78±22.6). There is a positive correlation between circulating Urotensin II levels with fasting insulin and HOMA-IR. While a negative correlation was found with fasting blood glucose.

Conclusion: The level of UII was found to be raised in gestational diabetes pregnant women. We also discovered that circulating levels of UII were greater in women with GDM than in controls. Insulin resistance was observed to be greater in pregnant women with GDM in comparison with controls.

Author(s) Details:

Najmah M. Meran,
Obstetrics and Gynecology Department, College of Medicine, University of Baghdad, Baghdad, Iraq.

Farah Abdul Salam Hussein,
Obstetrics and Gynecology Department, Baghdad Teaching Hospital, Baghdad, Iraq.

Please see the link here: https://stm.bookpi.org/ANUMS-V2/article/view/13088

Correlation Analysis of Serum Magnesium Levels with Renal Parameters in AKI Patients | Chapter 1 | Advancement and New Understanding in Medical Science Vol. 2

This chapter aimed to correlate serum magnesium levels with renal parameters in patients with Acute kidney injury (AKI) patients.

AKI is a prevalent condition with a range of causes and effects, including electrolyte imbalances that can manifest as hyperkalemia, hypocalcemia, or hypocalcemia depending on the stage. One of the most frequent electrolyte abnormalities seen in hospitalized patients, particularly in the critically ill, is hypomagnesemia. As a result, we made the decision to investigate the relationship between serum magnesium levels and AKI.

A total of 100 patients from those attending medicine OPD and getting admitted in medicine ward, Victoria &Bowring hospital, attached to Bangalore medical college and research institute, during the period of November 1st 2016 to august 30th 2018 was taken for the study. The decrease in magnesium <1.7 mg/L was defined as hypomagnesaemia. AKI was defined as per AKIN criteria. Day 1, day 3 and day 6 magnesium levels were measured.

Prevalence of hypomagnesemia was 53%, 30% and 36% on day 1, day 3 and day 6 respectively. Out of 120 cases, 20 cases were excluded out of which 4 were due to obstructive uropathy, 6 were suffering from multi-organ dysfunction syndrome and 10 were diabetic. 66patients recovered from AKI and 34 did not recover, all 34 patients were treated with haemodialysis. It was observed that there was a positive correlation between serum magnesium, and serum creatinine. Normomagnesemia and hypermagnesemia on day 1,3 and 6 were significantly associated with recovery of AKI (p=<0.001).

In AKI patients, hypomagnesemia was far more common, and recovery was correlated with normal magnesium and hypermagnesium levels on days 1, 3, and 6. Hypomagnesemia was linked to non recovery rather than improvement.

Author(s) Details:

Raveendra K. R.,
Department of Medicine, Bangalore Medical College and Research Institute, KR Road, Bangalore, Karnataka, India.

Avinash H. R.,
Department of Medicine, Bangalore Medical College and Research Institute, KR Road, Bangalore, Karnataka, India.

Nitish Ashok Gurav,
Department of Medicine, Bangalore Medical College and Research Institute, KR Road, Bangalore, Karnataka, India.

Please see the link here: https://stm.bookpi.org/ANUMS-V2/article/view/13087