Showing papers in "British journal of medicine and medical research in 2015"
TL;DR: The diversity of phytochemicals present in plants and dietary components provide drug leads for the development of novel therapeutic agents and amelioration of diseases by botanical therapeutics.
Abstract: Free radicals pose serious threat to tissues and vital organs, especially membrane lipids, proteins and nucleic acids of cells. Overproduction of reactive oxygen/ nitrogen species (ROS/RNS) and other related radicals lead to oxidative stress which has been implicated in aging and a number of diseases. Free radicals react with biomolecules and cause lipid peroxidation, loss of enzyme activity, mutation and carcinogenesis. A number of degenerative diseases including cardiovascular disease, diabetes, and adverse hepatic conditions have been attributed to accumulation of free radicals. Diseases resulting from radical overload might also lead to different types of cancers. However free radicals at low or moderate levels are vital to human health. ROS and RNS produced in a well regulated manner help maintain homeostasis at the cellular level in the normal healthy tissues and play an important role as signaling molecules. Cellular antioxidant enzyme systems including superoxide dismutase, catalase, glutathione peroxidases/reductase, peroxiredoxins along with non enzymatic antioxidants viz., tocopherols, vitamin C and glutathione etc., apart from several dietary components protect cells and organisms from the lethal effects of excessive ROS production. Natural products of plant origin have been used in traditional medicine for the treatment Review Article Kumar and Pandey; BJMMR, 7(6): 438-457, 2015; Article no.BJMMR.2015.351 439 of diseases resulting from radical overload. The diversity of phytochemicals such as polyphenols, flavonoids, carotenes and saponins etc. present in plants and dietary components provide drug leads for the development of novel therapeutic agents. This review deals with the components of free radical biology, their adverse consequences in humans and amelioration of diseases by botanical therapeutics.
79 citations
TL;DR: This new disease has the potential to be a highly disruptive discovery involving changes in fundamental health care policy, and the understanding of the role of immune function in the exacerbation of a range of common medical conditions is understood.
Abstract: Background: The National Health Service (NHS) in the UK has been beset by unprecedented growth in emergency admissions to hospital which are specifically medical in nature, while surgical and trauma admissions are only showing the level of low growth expected from demographic change, or what is called the ageing population. There has never been an adequate explanation for this dichotomy. An Infectious Basis: The proposed infectious basis rests upon the observation that growth in medical admissions occurs in spurts which occur approximately five years apart, albeit three years between spurts have also been observed during the 1990’s. It is these spurts which are driving the long-term growth, rather than the relatively minor growth which occurs in the interval between the spurts. These periods of high growth are characterized by spikes in all-cause mortality, and typically result in a 15% increases in admissions to the medical group of specialties. However much higher growth is seen for particular conditions/diagnoses which appear to have a common Review Article Jones; BJMMR, 6(8): 735-770, 2015; Article no.BJMMR.2015.251 736 immune function basis via infection, inflammation and autoimmunity. These outbreaks can be seen across Europe, and the last three outbreaks commenced around Mar-02, Mar-05 and Mar-10 with subsequent spread over the next two years. The middle of these three outbreaks had the lowest increase in deaths and medical admissions. Implications: There is now an overwhelming body of evidence pointing to a recurring series of infectious-like events. In the UK, the 2012/2013 outbreak led to 45,000 extra deaths while across the 27 EU countries, each outbreak appears to result in somewhere in excess of 467,000 deaths. In Europe, the outbreaks tend to occur earlier in Denmark, Romania, Bulgaria and Slovakia, while they tend to occur later in the UK, Belgium, Greece and Slovenia. Emphasis now needs to switch toward clinical studies which screen the population for changes in the levels of specific IgM and IgG antibodies against a range of potential candidate organisms, and post mortem examination of the tissues of persons who die from a particular range of conditions such as neurological disorders including dementia and Alzheimer’s; respiratory and gastrointestinal tract diseases, and cardio/vascular conditions. Conclusion: This new disease has the potential to be a highly disruptive discovery involving changes in fundamental health care policy, and our understanding of the role of immune function in the exacerbation of a range of common medical conditions.
65 citations
TL;DR: The existence of a new type of infectious outbreak, with relatively slow spread, has been confirmed and is part of a longer time-series of outbreaks.
Abstract: Aims: In 2003, 2008 and 2012, deaths in the UK showed unexpected and unexplained large increases similar in magnitude to the larger influenza epidemics seen before 2000. However there were no unusual levels of influenza to explain these spikes. This study aims to investigate the spread of a presumed infectious agent across England and Wales during the 2012 event, and to establish a longer time-series for these outbreaks. Study Design: Longitudinal study of deaths. Place and Duration of Study: Deaths for residents of Local Authority (LA) and regional areas in England and Wales from January 2009 to July 2014. Analysis of monthly deaths from January 1951 to December 2012 for the whole of England & Wales, to detect events prior to 2012. Analysis of calendar year deaths between 1963 and 2013. Methodology: Running twelve month totals are used to detect the onset of a step-like increase in deaths which endures for twelve to eighteen months before abating. Results: These events can be traced back to the early 1950’s where they were intertwined with influenza epidemics. Moderately slow infectious-like spread across the UK occurs over a two year Original Research Article Rodney P. Jones; BJMMR, 5(11): 1361-1380, 2015; Article no.BJMMR.2015.154 1362 period. The last event which peaked in 2012 and 2013 led to a minimum estimate of 42,000 excess deaths, although 60,000 deaths are a more likely estimate. An additional event in 2010, which affects around 30% of LAs, appears linked with the swine flu epidemic and leads to underestimation of deaths in these locations for the 2012 event. The magnitude of the increase associated with the 2012 event decreased with increasing LA size, an effect which is due to the modifiable areal unit problem (MAUP). These events are always linked to large increases in emergency medical activity and emergency department attendances. The increase in deaths at local authority level is highly variable ranging from +5% to +30%, and this variability leads to large differentials in the cost pressures experienced by the local health services. In particular, 90% of LAs in London experienced the lowest percentage increase from the 2012 event. As a general rule it was observed that local authorities experiencing a low percentage increase in death for the 2012 outbreak, had experienced a high percentage increase following the 2008 outbreak and vice versa. This implies that the events are linked to the same agent. Conclusion: The existence of a new type of infectious outbreak, with relatively slow spread, has been confirmed and is part of a longer time-series of outbreaks. Large numbers of deaths appear to be associated with each event, although the 2012/2013 event appears to have led to the highest number of deaths in any of these outbreaks since 1950. Urgent action is required since the next outbreak is due around 2016 to 2018.
36 citations
TL;DR: It is suggested that all the above point to an outbreak of a previously uncharacterized type of infectious agent, and there are profound implications regarding the use of standard five year age bands for the standardization of medical admission rates.
Abstract: Aims: This study aims to investigate the small area spread of a presumed infectious agent, and to determine which factors determined the point of initiation, speed of the spread and the resulting increase in emergency medical admissions. Study Design: Analysis of a monthly time series of medical admissions using small area population aggregates of around 7,000 population contained within the census spatial unit called a Mid Super Output Area (MSOA). Place and Duration of Study: Emergency medical group admissions for residents of the six unitary authority locations in Berkshire, southern England between January 2008 and March 2013. Methodology: A running twelve month total of admissions was used to determine the point of Original Research Article Jones and Beauchant; BJMMR, 6(1): 126-148, 2015; Article no.BJMMR.2015.190 127 initiation and the extent of a step-like increase in medical admissions. Results: Analysis shows evidence for spatial spread initiating around June 2011 through to March 2013. At onset, medical admissions increase and stay high for 12 to 18 months before beginning to abate. This spread commenced earlier among mainly Asian small areas (clustered from July 2011 onward) and later (clustered around March 2012) in predominantly affluent white areas. The observed percentage increase in admissions within the unitary authority areas varied from 25% to 51% (median value), however the average increase was highest as the geographic area became smaller, and this is suggested to arise from the aggregation of smaller social networks where the point of initiation of infectious spread occurs over time. The percentage increase in admissions displayed high single-year-of-age specificity suggestive of the immune phenomena called antigenic original sin, and is therefore suggestive of a different strain of an agent with previous outbreaks. The increase in emergency admissions showed a month-of-year pattern which appeared to follow the seasonal pattern of vitamin D levels in the blood. The presence of nursing homes, deprivation and ethnicity also has an effect on the average increase in admissions. Conclusion: It is suggested that all the above point to an outbreak of a previously uncharacterized type of infectious agent. There are profound implications regarding the use of standard five year age bands for the standardization of medical admission rates.
33 citations
TL;DR: For the first time it was quantitatively shown that BPH begins from the excessive proliferation of the glandular epithelium and that the Zn redistribution in the histological structures of prostate tissue is a pathogenetic factor of the disease.
Abstract: Aims: To clarify the changes in morphometric parameters and contents of zinc (Zn) and in the relationship between these characteristics in normal and hyperplastic human prostates, a quantitative morphometry and energy-dispersive X-ray fluorescence analysis was performed. Methodology: Samples of the human prostate of mass under 30 g were obtained from randomly selected autopsy specimens of 35 men (European-Caucasian aged 40-87 years) who died mainly from trauma. All prostate glands were divided into two portions, each with an anterior-posterior cross-section: one tissue portion was reviewed by an anatomical pathologist while the other was used for the Zn mass fraction measurement. After preliminary histological investigation the subjects were divided into a control group (n=24) and a benign prostatic hyperplasia (BPH) group (n=11). The mean percent volume of the stroma (S), glandular epithelium (E), glandular lumen (L) and glandular component (GC=E+L) were determined, and the mean ratios of percent volumes (S/E, S/GC, and E/L) were calculated for each prostate specimen. Results: Increases in E (33.6% vs 26.7%) and GC (52.3% vs 44.4%) and also a decrease in S Original Research Article Zaichick and Zaichick; BJMMR, 8(8): 692-706, 2015; Article no.BJMMR.2015.495 693 (47.7% vs 55.6%), S/E ratio (1.53 vs 2.31) and S/GC ratio (0.97 vs 1.40) were observed, when values for Zn mass fraction in the earliest stage of BPH were compared with normality. A significant positive correlation between Zn and L (r = 0.65, P0.001) and between Zn and GC (r = 0.45, P0.05) and also a negative correlation between Zn and S (r = 0.45, P0.05), between Zn and E/L ratio (r = 0.63, P0.001), and between Zn and S/GC ratio (r = 0.42, P0.05) was seen in histologically normal prostate tissue. A negative correlation between Zn and S and a positive correlation between Zn and L disappeared in the earliest stage of hyperplastic change. It means that a homeostatic control of Zn level in the histological structures of prostate tissue was partially destroyed. Conclusion: For the first time it was quantitatively shown that BPH begins from the excessive proliferation of the glandular epithelium and that the Zn redistribution in the histological structures of prostate tissue is a pathogenetic factor of the disease.
32 citations
TL;DR: Smokeless tobacco use is a global epidemic affecting 121 countries and countries, especially developing countries, should formulate strategies specific to SLT control.
Abstract: Background: In 2010, a study estimated the number of smokeless tobacco (SLT) users in 70 countries at 302.4 million. These countries represented 70% of the global population. We aimed to update this information and widen the scope to estimate the global prevalence of SLT use by including a larger number of countries. Methods: Data on the prevalence of current SLT use in 121 countries were obtained from various sources. Country-wise and gender-wise breakdown of the adult population in these countries was derived from the UN World Population for 2015. To translate prevalence rates into an estimate of the number of adult SLT users, we multiplied the adult male and female SLT prevalence rates by the corresponding male and female adult population in the respective countries. We then added the Short Research Article Sinha et al.; BJMMR, 9(6): 1-20, 2015; Article no.BJMMR.16285 2 estimated number of male and female SLT users to get an overall estimate of SLT use. Results: There were 352 million SLT users (351.9 million) in 121 countries. Of these, 67% were men (232.7 million) and 33% were women (119.2 million). Nearly 95% (333.1 million) of global SLT users lived in developing countries and only 5% (918.8 million) lived in developed countries; 82.7% of global SLT users lived in the World Health Organization (WHO) South-East Asia Region. Globally, 90.4% of SLT users live in 11 countries of the world: India (237.4 million, 67.5%), Bangladesh (30.9 million), Myanmar (12.6 million), Pakistan (10.1 million), USA (9.6 million), China (4.1 million), Indonesia (3.2 million), Nepal (2.7 million), Madagascar (2.6 million), Germany and Uzbekistan (2.4 million each). Conclusion: Smokeless tobacco use is a global epidemic affecting 121 countries. All 180 countries that have ratified the WHO Framework Convention on Tobacco Control (WHO FCTC) are obliged to monitor SLT use. Parties to the Convention should collect information periodically using standard protocols for national and international comparability. To prevent health and economic losses attributable to SLT use, countries, especially developing countries, should formulate strategies specific to SLT control.
30 citations
TL;DR: To determine the prevalence of depression, anxiety and stress (by DASS scoring system) among purposive sample of medical students in Islamabad, Pakistan, a cross - sectional survey was conducted.
Abstract: Objective: To determine the prevalence of depression, anxiety and stress (by DASS scoring system) among purposive sample of medical students in Islamabad, Pakistan. Study Design: Cross - sectional survey (June, 2014 to November, 2014) Sampling Technique : Purposive sampling (non - probability) Methods: The questionnaire used in this study consisted of three components: A socio demographic questionnaire that required each student to pro vide their age, gender and year of study, as well as marks obtained as mean % scoring i n the professional examinations and DASS scale (the Depression, Anxiety, and Stress Scale). Procedure: Sixty - six medical students were the participants who were attendin g private and public medical universities in Pakistan. Following the granting of ethical approval from the university and medical college to conduct the study, medical students from first year to fifth year were contacted
29 citations
TL;DR: A new type of infectious event is strongly implicated which appears to exert its clinical effects via some form of immune impairment and lead to a persistent infection in a very large acute hospital in Reading.
Abstract: Aims: To study the effect of a large infectious-like event on admissions to, and bed occupancy in, a very large acute hospital in Reading (western Berkshire) England, observed to commence in the early part of 2012. These changes occurred in parallel with infectious-like spread of an agent leading to increased medical admissions across the whole of Berkshire. Study Design: Longitudinal study of hospital admissions, bed occupancy and deaths. Place and Duration of Study: Admissions and deaths at the Royal Berkshire Hospital NHS Foundation Trust (England) between April 2008 and September 2013. Methodology: A running 12 month total of admissions, deaths and occupied beds was constructed from aggregated hospital admission and discharge data. Trends were analysed by admission type, discharge destination, specialty, International Classification of Diseases (ICD-10) primary diagnosis and Healthcare Resource Group (HRG) v4 chapter. Results: Admissions, deaths and occupied beds all showed a simultaneous step-like increase around March to June of 2012, which led to considerable operational pressure and a marked reduction in elective overnight surgery due to reduced bed availability. The increase in in-hospital Original Research Article Jones; BJMMR, 6(1): 56-76, 2015; Article no.BJMMR.2015.184 57 deaths exhibited a curious time cascade which was specific for various diagnoses. Deaths first increased for those with cancers or intestinal conditions in January 2012, followed by hepatic, diabetic and asthma in February 2012, then a time series of other conditions, through to arthritis and arthrosis conditions in July 2012. All of these occurred at a time when deaths across the whole of the UK showed a large and unexpected increase. Conclusion: A new type of infectious event is strongly implicated which appears to exert its clinical effects via some form of immune impairment. The agent leads to a persistent infection. The immune modifying virus, cytomegalovirus, which (in other studies) is associated with a 20% higher odds ratio for all-cause mortality, has been circumstantially implicated, however, this requires confirmation.
27 citations
TL;DR: Buprenorphine is more effective than bupropion in the treatment of methamphetamine craving, and this case-study of an Iranian patient could represent the most innovative information.
Abstract: Background: Methamphetamine dependency and abuse is a growing problem in the world. Objective: To compare efficacy of buprenorphine and bupropion in the treatment of methamphetamine craving in a single case. Results: Buprenorphine is more effective than bupropion in the treatment of methamphetamine craving. Discussion: This case indicates although both buprenorphine and bupropion could be beneficial in treating methamphetamine dependency and withdrawal craving, however, buprenorphine is much more effective than bupropion. Conclusion: To our knowledge there is not any report on buprenorphine use in the treatment of methamphetamine craving in Iran and other countries as well, therefore this case-study of an Iranian patient could represent the most innovative information. Case Study Ahmadi; BJMMR, 10(2): 1-4, 2015; Article no.BJMMR.19334 2
26 citations
TL;DR: 2 Department of Epidemiology and Geriatric Medicine, Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales, Australia.
Abstract: Social Determinants of Health (SDH) Research Center, Babol University of Medical Sciences, Babol, Iran. Department of Community Medicine, Social Determinants of Health (SDH) Research Centre, Babol University of Medical Sciences, Babol, Iran. 3 Department of Epidemiology and Geriatric Medicine, Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, New South Wales, Australia. 4 Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran.
26 citations
TL;DR: Doctor-nurse conflict is associated with a combination of socio-economic and interpersonal-intergroup factors and hospital management must understand the interplay of these factors and recognize its role in the handling of such conflicts.
Abstract: Background: Conflict within the health team is a recognized problem known to hinder quality health care service delivery. In order to achieve the objective for which a hospital is set up, interactions between all members within a medical team must be conducted in such a way that conflicts are minimized as much as possible. Aims: To examine conflict issues between doctors and nurses and to determine the causes and modes of expression of such conflicts in Nigerian hospitals. Methods: A cross-sectional study with quantitative and qualitative approaches was carried out in 2 tertiary hospitals in Ekiti State, Nigeria. Data was collected over 4 weeks in April 2005. Pre-tested semi-structured questionnaires were self-administered to 323 participants (Response Original Research Article Olajide et al.; BJMMR, 9(10): 1-12, 2015; Article no.BJMMR.15839 2 rate=96.4%) recruited. Focused group discussions (FGDs) were conducted with three groups each of doctors and nurses in the selected hospitals. Data were analyzed using frequencies, percentages and logistic regression. Results: Majority of our respondents were females (81.7%); below 40 years (53.0%); married (75.9%); nurses (84.5%) and with less than 15 years of professional experience (50.3%). Odds of conflicts were significantly higher with limited opportunities for staff interaction (OR=1.8, CI=1.12.9); desire for power (autonomy) by doctors (OR=3.2, CI=1.9-5.2) and desire for more influence by nurses (OR=12.5, CI=4.8-41.3). Chances of expressing conflicts were significantly higher as strikes (OR=2.1; 1.3-3.5) but less with physical assaults (OR=0.1, CI=0.03-0.41). Conclusion: Doctor-nurse conflict is associated with a combination of socio-economic and interpersonal-intergroup factors. Hospital management must understand the interplay of these factors and recognize its role in the handling of such conflicts. Doctors and nurses must also acquire the understanding of team building and group dynamics through training.
TL;DR: An immune/infectious basis for increasing admission rates appears most likely and may provide insight into why the rates for admission of certain medical diagnoses are increasing far faster than due to demographic change.
Abstract: Aims: To study the trends in admission for diseases of the appendix and to attempt to present a potential basis for the observed (complex) age-dependent trends and etiologies. Study Design: Longitudinal study of admissions relating to the appendix with analysis by age and gender. Place and Duration of Study: Admissions for diseases affecting the appendix for the residents of England over the period 2000/01 to 2012/13. Methodology: Retrospective application of age-standardized admission rates based on 2012/13 as the base year to determine what proportion of the increase in admissions is due to demography or to non-demographic forces. Synthesis of available literature covering diseases of the appendix to propose possible causes for the increase in admissions. Results: Based on admissions in 2012/13 diseases of the appendix cost the NHS in England around £107 million per annum (roughly £2 per head of population per annum). Admission rates peak at age 17 but have been increasing over the past 14 years in adults but not children. The rate of increase escalates with age and is more rapid in females. The trend for females shows far higher volatility than that for males and both show some degree of cyclic behavior. Depending on age, Original Research Article Jones; BJMMR, 5(5): 579-603, 2015, Article no.BJMMR.2015.063 580 demographic change can only explain between 20% and 40% of the long-term increase. Social and health service factors are unlikely to explain this gap. Conclusion: An immune/infectious basis for increasing admission rates appears most likely. A possible role for the immune modulating herpes virus, cytomegalovirus (CMV), is discussed in the context of a potential linkage between infection with multiple agents (called the infectious burden) and the development of multiple morbidity. Both of which increase with age and are amenable to manipulation by CMV. The suggested mechanism may also provide insight into why the rates for admission of certain medical diagnoses are increasing far faster than due to demographic change.
TL;DR: Myrmecodia pendans can be used as herbal remedies and moreover, the water boiling extraction can be employed as a simple manner for community herbal medicine without any toxic effect on cells.
Abstract: Aims: To find out the scientific base of the traditional plant Myrmecodia pendans as a new natural source for herbal remedies in aspect of its therapeutic compounds and cytotoxic effect on normal cells. Study Design: Experimental laboratory, in vitro study. Place and Duration of Study: Laboratorium Bio Core Faculty of Dentistry Trisakti University, Jakarta, Balai Penelitian Tanaman Rempah dan Obat (BALITRO), Bogor and Pusat Studi Satwa Primata, Bogor, between March to August 2014. Methodology: Several extraction methods of Myrmecodia pendans using maceration technique was done to evaluate their phytochemical contents and cytotoxic effects using (3-(4,5dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) tetrazolium (MTT) assay method. Results: The phytochemical test of both ethanol 70% extract and boiling water extraction produce active phenolic compounds, especially those of flavonoids. There is no cytotoxic effect of the Original Research Article Sudiono et al.; BJMMR, 8(3): 230-237, 2015; Article no.BJMMR.2015.443 231 ethanol 70% dried extract on fibroblast cells by MTT assay method. One way analysis of variance (ANOVA) test showed significant differences of % inhibition cells growth effect between M. pendans extracts and control group (p=0.00<0.05). Tukey’ high significant difference (HSD) test showed significant differences of % inhibition cells growth effect between each concentrations of 500; 250; 100; 50; 25; 12,5; 6,25; 3,125; 1,56 to 1.000 ppm and also between 1.000 ppm to control (p=0.00<0.05). Conclusion: Myrmecodia pendans can be used as herbal remedies and moreover, the water boiling extraction can be employed as a simple manner for community herbal medicine without any toxic effect on cells.
TL;DR: Size and shape of the frontal sinus varies among individuals, and frontal sinus is relatively larger in men than women.
Abstract: Aim: This study evaluated radiographic variations and measured dimensions of the non-pathologic frontal sinuses. Study Design: Retrospective. Place and Duration of Study: Orthodontics Department, Dental School, Shahid Beheshti University of Medical Sciences, 2003 to 2012. Methodology: Subjects older than 12 years with no sinus pathology were included. Borders of the frontal sinus were traced. Line drawings were scanned, and sinus dimensions were calculated by computer software by two examiners. In addition, asymmetry and shape of superior margin of sinus were evaluated. Gender differences were analyzed by independent sample t-test and chi square with a 0.05 level of significance. Results: A total of 66 subjects were included (40 female and 26 male). Height, width and area of the frontal sinus in the sagittal plane were 2.26 cm, 1.13 cm and 1.37 cm 2 , respectively. The corresponding numbers in the frontal plane were 2.79 cm, 5.00 cm and 7.04 cm, respectively. Original Research Article Tehranchi et al.; BJMMR, 8(5): 464-462, 2015; Article no.BJMMR.2015.467 455 Although all dimensions were larger in men than in women, it was not significant (P>0.05). Most of the cases had relatively symmetric frontal sinus. Conclusion: Size and shape of the frontal sinus varies among individuals. Frontal sinus is relatively larger in men than women.
TL;DR: This review finally explores the most recent advances in the field of nanotechnology for drug delivery in the brain, and gives meaningful examples of delivery systems developed including the micelles, liposomes, dendrimers, microcapsules and polymeric.
Abstract: The blood-brain barrier (BBB) is a neurobiological frontier that isolates brain tissues from the blood vascular system. Its main role is to protect the brain and the central nervous system from external fluctuations in hormones, nutrients and drugs, while allowing the passage of water and small lipophilic molecules. Diffusion across the BBB can occur through several biological mechanisms, but the most common one is simple diffusion, which mainly depends on the size, lipid solubility and concentration gradient of the molecule. Because of the highly dense network of capillary endothelium cells found in the BBB, most of the drugs are not able to cross this physiological barrier. Delivering therapeutic agents to the brain is thus a big challenge, which may prevent treatment of important neurological diseases. In order to overcome this difficulty, researchers have used nanotechnology to help the passage of drugs across the BBB. Nanotechnology has significantly contributed to the field of biotechnology by improving the strategies for drug delivery, and by providing novel carriers for safe and effective brain targeting. The aim of this review is to Review Article Fakhoury et al.; BJMMR, 6(6): 547-556, 2015; Article no.BJMMR.2015.232 548 discuss in more details the anatomical structure and the functions of the BBB, as well as its significance in neurological diseases. A closer look will be given at the transport mechanisms across the BBB. This review finally explores the most recent advances in the field of nanotechnology for drug delivery in the brain, and gives meaningful examples of delivery systems developed including the micelles, liposomes, dendrimers, microcapsules and polymeric
TL;DR: Self esteem is high among adolescents, though this is may be overemphasized as more research is needed in this area, and low self esteem was more common among the female respondents in all the age ranges.
Abstract: Background: Self esteem among adolescents is a neglected issue in pediatrics, especially in this part of the world. Females ages fourteen to seventeen seemed to have positive self-esteem and so do the males but self esteem is low at middle ages. Females tend to have a low self esteem than males Objectives: The objective of this study is to determine the pattern of self esteem among adolescents and associated factors. Original Research Article Chinawa et al.; BJMMR, 5(1): 98-106, 2015; Article no. BJMMR.2015.011 99 Methods: The study was carried out among adolescents attending secondary schools from two cities; (Enugu and Abakiliki located in south eastern part of Nigeria) within age range of 10-19 yr. A structured self administered questionnaire developed from self esteem scores was used for data collection. Pearson’s chi-square was used to test for relationship between categorical variables while student ttest was used to test significant relationship between continuous variables. Test of significance was set at p<0.5. Results: The self esteem questionnaire used was classified into two major questions with several sub questions. The first group is about self confidence, self fulfillment and self worth and confidence, the second group include depression, hopelessness, loneliness, and suicidal thoughts. We enrolled 507 adolescents in this study. The mean age of all participants was 16.3 (1.2) yr. Total mean self esteem score for all respondents is 15.77±2.769. Low self esteem was observed in 3.6% of the respondents with 4.3% of females and 2.5% of Males. Low self esteem is mostly seen in older adolescents aged 18-19 (44%) and rare among (adolescents less than 11 yr (0%). Low self esteem was more common among the female respondents in all the age ranges. Conclusion: Self esteem is high among adolescents, though this is may be overemphasized as more research is needed in this area.
TL;DR: Current practice of nurse leaders is not evidence-based, which can result in serious deficiencies in the quality and safety of nursing care, and nurse leaders must attempt to equip themselves with the attitudes and skills required to change in practice using EBP.
Abstract: Introduction Evidence-based practice (EBP) has been recognized as the gold standard for safe and high quality care. Nurse leaders have a strategic position in terms of initiating changes in clinical settings for successfully implementing EBP. Therefore, the factors that influence implementing EBP must be measured. Aims To examine nurse leaders' attitudes, self-efficacy, and training needs for implementing evidence-based practice. Place and duration of study Four teaching hospitals affiliated to Kerman University of Medical Sciences in the southeast of Iran from January to April 2014. Methods A cross-sectional study was conducted on 70 nurse leaders from four teaching hospitals. After using a modified forward/backward translation procedure to create a Persian version of "perceptions of nurses of evidence-based practice questionnaire", data were collected from the participants and analyzed using SPSS (version 20), descriptive statistics, Student's t-test, analysis of variance (ANOVA), and Pearson's correlation. Results Most (82.86%) of the participants had not attended any specific training course on the implementation of EBP and 80% had not been involved in any research activities. Nurse leaders' attitudes toward EBP were unfavorable (mean=2.55±0.88), their levels of self-efficacy in EBP skills were weak (mean=2.64±1.31), and their demand for training in all of the EBP areas was moderate (3.89±.97). Conclusion Current practice of nurse leaders is not evidence-based, which is worrisome and can result in serious deficiencies in the quality and safety of nursing care. Nurse leaders must attempt to equip themselves with the attitudes and skills required to change in practice using EBP.
TL;DR: The occurrence of single rooted mandibular first molars as well as supernumerary roots is very unlikely and the incidence of two distinct canals in mesial root is high, however distal roots mainly represented one canal.
Abstract: Aims: The root canals have complex morphology and vary widely among individuals variations. The objective of this research was to analyse the morphology of root canals and existence of extra canals in mandibular first molar in subpopulation of Al-Medina Al-Munawarah. Study Design: Experimental/Analytical. Place and Duration of Study: College of dentistry, Taibah University, Madinah Munawwarrah, Saudi Arabia, 2014. Methodology: This study was conducted using freshly extracted mandibular first molars (n=100). All teeth were examined for morphology of roots, root canals and apical foramen by Cone Beam Computed Tomography (CBCT). The root canals configuration was classified using Vertucci's classification. Results: All mandibular first molars (100%) had two distinct and clearly separated roots. There was a high probability of two canals (92.5%) in mesial root compared to the distal root that contain two canals only in 20% of teeth. There was no occurrence of more than two roots or more than two canals in any of the roots in the selected teeth. The majority of distal roots (80%) had single canal with type I canal configuration followed by type III (10%), type V (7.5%) and type II (2.5%). The mesial roots presented comparatively complex canals configuration. Type I canal configuration was Original Research Article Zafar and Alrahabi; BJMMR, 6(5): xxx-xxx, 2015; Article no.BJMMR.2015.228 515 observed in only 7.5% teeth. The incidence of C shaped canals was very low (2.5%). Conclusion: The occurrence of single rooted mandibular first molars as well as supernumerary roots is very unlikely. The incidence of two distinct canals in mesial root is high (>92%), however distal roots mainly represented one canal (80%).
TL;DR: This study conducted a cross-sectional study in which two hundred and eighty hypertensive patients participated to validate the Persian version of the Hill-Bone’s scale of “Compliance to High Blood Pressure Therapy.”
Abstract: Introduction: Hypertension is a global public health concern. Among the factors that contribute to this crisis, the poor control of hypertensive patients is a major concern. Patients’ lack of adherence to the medication regimen is often considered to be the main reason for this failure. Several medication-adherence scales were designed to measure the extent to which patients adhere to their medication and treatment regimens. Since these scales must be very reliable and have strong validity if they are to be used in clinics and research, this study was performed to test the reliability and validity of the Hill-Bone’s scale of “Compliance to High Blood Pressure Therapy.” Methods: After using a modified forward/backward translation procedure to create a Persian version of the Hill-Bone’s scale, we conducted a cross-sectional study in which two hundred and eighty hypertensive patients participated to validate the Persian version. Exploratory and Original Research Article
TL;DR: This paper is a comprehensive review of the effects of phytochemicals present in berry fruits on cancer and encompasses the occurrence and bioavailability of these compounds evidences for their effects on the various mechanisms by which may exert their effects.
Abstract: An overwhelming body of research has now firmly established that the dietary intake of berry fruits has a positive and profound impact on human health, performance, and disease. Evidence suggests that edible small and soft-fleshed berry fruits may have beneficial effects against several types of human cancers. Studies show that the anticancer effects of berry bioactives reduce and repair damage resulting from oxidative stress and inflammation. In addition, also regulate carcinogen and xenobiotic metabolizing enzymes, various transcriptions and growth factors, inflammatory cytokines, and subcellular signaling pathways of cancer cell proliferation, apoptosis and tumor angiogenesis. Berry phytochemicals may also potentially sensitize tumor cells to chemotherapeutic agents by inhibiting pathways that lead to treatment resistance, and consumption may provide protection from therapy-associated toxicities. This paper is a comprehensive review of the effects of phytochemicals present in berry fruits on cancer and encompasses the occurrence and bioavailability of these compounds evidences for their effects on the various mechanisms by which may exert their effects. These include effects on cellular differentiation and apoptosis; effects on proteins and enzymes that are involved in these processes Review Article Castro and Teodoro; BJMMR, 6(8): 771-794, 2015; Article no.BJMMR.2015.252 772 at a molecular level, and other various effects through altered immune function and chemical metabolism.
TL;DR: In this article, the impact of war trauma on child mental health was investigated, and the mediating role of different coping strategies was discussed, where children living in families with low family monthly income reported more emotional problems.
Abstract: Aims: To investigate the impact of war trauma On child mental health; the mediating role of different coping strategies. Methods: The sample was selected randomly from the five localities of the Gaza Strip that had been exposed to war16 months earlier. Children completed the Gaza Traumatic Events Checklist20 items-War on Gaza, UCLA PTSD scale, Birleson Depression Scale, Child Revised Manifest Anxiety Scale, and Kidcope for children. Results: Children reported many traumatic events (mean = 4). One third (32.5%) had partial and 12.4% had full criteria of PTSD. Children living in families with low family monthly income reported more emotional problems. There was significant association between exposure to traumatic events and developing PTSD. The rates of significant anxiety and depressive symptoms were 20.5% and
TL;DR: Mohammadi et al. as mentioned in this paper used the VARK questionnaire to determine the learning styles of medical students during their basic science training at Mashhad University Medical School (MUMS).
Abstract: Background: An awareness of learning styles may help teachers modify their teaching methods to improve the educational outcomes of their students. Aim: The aim of this study was to determine the learning styles of medical students during their basic science training at Mashhad University Medical School (MUMS). Methods: The VARK (Visual, aural, read/write and kinesthetic learning styles) questionnaire was used to gather information on learning styles in 245 medical students during their basic science Original Research Article Mohammadi et al.; BJMMR, 7(4): 292-298, 2015; Article no.BJMMR.2015.335 293 training at MUMS in 2014. The questionnaire was previously assessed for its validity and reliability. Data were analyzed using SPSS software. Results: Overall, 245 students (115 male/130 female) with a mean age of 22.17 2 ± .27 years completed the questionnaire. Of these students 91.84% preferred a singlemodal learning style and 8.16% of students preferred a multi-modal learning style. Of the students with a preference for a single modal learning style, 20% (45 students) had a preference for visual, and 53.33% (100 students) for auditory learning styles respectively; 22.22% (50 students) of students were categorized as single read-write and 4.44% (10 students) were classified as having a kinesthetic learning style preference respectively. Among the multi-modal group, 25% (5 students) of students preferred a bimodal and 75% (15 students) preferred a quad-modal learning style. There was a significant association between learning styles with age and gender (P 0.05). Conclusions: The key finding of our study was that learning style is age and gender dependent. Different teaching methods may be appropriate for men and women.
TL;DR: This paper presents a poster presented at the 2016 International Congress of the American Academy of Pathology and Pathology presented in New York, where it was presented as well as at the National University of Medical Science, Rawalpindi, Pakistan.
Abstract: 1 Department of Basic Medical Sciences, University of Missouri–Kansas City, 2411 Holmes Street, Kansas City, MO 64108, USA. 2 Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology, National University of Medical Science, Rawalpindi, Pakistan. Division of Pharmacology and Toxicology, School of Pharmacy, University of Missouri-Kansas City, 2464 Charlotte Street, Kansas City, MO 64108, USA.
TL;DR: The electronic prescribing system, either standalone or embedded in the electronic health record, is a powerful tool in the hands of healthcare providers, as it reduces half of medication errors caused by handwritten prescribing.
Abstract: Background: The electronic prescribing system, either standalone or embedded in the electronic health record, is a powerful tool in the hands of healthcare providers, as it reduces half of medication errors caused by handwritten prescribing.
TL;DR: NAFLD is tremendously common among people with type 2 diabetes in Jazan region and the major associated factors were age, obesity, uric acid and elevated liver enzymes.
Abstract: Backgrounds: Non-alcoholic fatty liver disease (NAFLD) has become one of the major health problems world widely, especially among communities with sedentary lifestyle. The main objectives of this study were to know the prevalence of NAFLD among Saudi patients with T2DM in Jazan region and to determine the most important associated factors. Materials and Methods: A cross sectional study targeted 230 type 2 diabetic patients, who attended Diabetic Center at Jazan General Hospital. All participants were screened for NAFLD Original Research Article Elmakki et al.; BJMMR, 5(7): 872-879, 2015; Article no.BJMMR.2015.094 873 using abdominal ultrasonography in addition to clinical and laboratory workup. Descriptive statistics, Chi square/Fisher exact test and logistic regression were utilized for data analysis. Results: The prevalence of fatty liver in the present study was 47.8% (95% CI 41.1–54.6), with no significant difference between males 49.1% (95% CI 40.0–58.3) and females 46.3% (95% CI 36.656.3). The prevalence of NAFLD was found to be 52.9% among patients who their ages range between 40-59 years. Factors associated with NAFLD were found to be age, uric acid, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) (p-value<0.05 for all). Conclusion: NAFLD is tremendously common among people with type 2 diabetes in Jazan region and the major associated factors were age, obesity, uric acid and elevated liver enzymes. There was no positive correlation between the presence of fatty liver and duration of DM or the degree of glycemic control.
TL;DR: Evidence is discussed showing that the chain of disulfide exchange can be inhibited by a small redox molecule – sodium selenite and it is suggested that this inexpensive and readily available food supplement can be an ultimate inhibitor of Ebola and other enveloped viral infections.
Abstract: It is known that the virulence of Ebola and other RNA enveloped viruses involves in the first step their attachment to host cell membranes. Following this initial step the virus enters the target cell cytoplasm by forming hydrophobic spikes that make holes in the membrane lipid bilayer. Formation of such spikes is catalyzed by the reduced form of viral protein disulfide isomerase (PDIred) thus initiating chain of disulfide exchange reactions. Consequen tly, hydrophobic protein epitopes become exposed, which in the absence of proper chaperones form hydrophobic ‘spikes’ capable of penetrating the host cell membranes. In this communication evidence is discussed showing that the chain of disulfide exchange e vents can be inhibited by a small redox molecule – sodium selenite. It is suggested that this inexpensive and readily available food supplement can be an ultimate inhibitor of Ebola and other enveloped viral infections.
TL;DR: The present study focused on nail metal analysis, a biological material similar to hair, which located a high metal burden in Punjabi cancer patients and their live-in relatives, suggesting that an excessive metal exposure is a factor in the pathogenesis of cancer.
Abstract: The cancer prevalence in the Malwa region of Punjab (1089/million/year) is much higher than the national average cancer prevalence in India (800/million/year). In our previous study on hair metal analysis, we located a high metal burden in Punjabi cancer patients and their live-in relatives, suggesting that an excessive metal exposure is a factor in the pathogenesis of cancer. The present study focused on nail metal analysis, a biological material similar to hair. Previously, we had used
TL;DR: Wang et al. as discussed by the authors conducted a longitudinal study on 186 pregnant women attending health centers of Quchan city for receiving routine prenatal care to evaluate the anxiety status of pregnant women in the third trimester of pregnancy and fear of childbirth and related factors.
Abstract: Aims: The present study has been conducted with the aim of evaluating the anxiety status of pregnant women in the third trimester of pregnancy and fear of childbirth and related factors.
Methodology: This longitudinal study was conducted in 2014 on 186 pregnant women attending health centers of Quchan city for receiving routine prenatal care. Demographic questionnaire, Glomberk questionnaire for the fear of birth and marital satisfaction-right (Grimes) and Spielberg State and Trait questionnaire were used on 3 occasions in the third quarter for data collection. Data were analyzed using the statistical package SPSS (version 20), analysis of variance test, T-test and one -way analysis of variance (ANOVA). P value of less than 0.05 was considered significant.
Results: According to the results, 47.2% of mothers suffered from moderate and severe anxiety and 43.5% suffered from covert moderate and severe anxiety. Average anxiety in pregnant women in the third round was more than the first and second round and this difference was statistically significant (F=10.33, P<0.002). In addition, there was a statistically significant correlation between age, educating level, employment status, abortion record, marital satisfaction and fear of childbirth (P<0.05), but there was no statistically significant correlation between factors such as number and type of delivery (P<0.05).
Conclusion: The results further indicated that maternal anxiety and trait increases with pregnancy age. Therefore, health care providers’ awareness of changes to mental health status of pregnant women is very important for the formulation of appropriate policies and measures to promote mental health during pregnancy.
TL;DR: This study determines the essential oil composition of Artemisia herba-alba grown wild in south Jordan and test their activity against clinical isolate antibiotics resistant bacteria and screening for essential oil activity was carried out.
Abstract: Background: There is a high variability in chemical composition of essential oil from Artemisia herba-alba grown in different countries and different localities in the same country. This has led to the characterization of many oil-dependent chemotypes assigned to the plant. Only one report was published on the essential oil composition of Artemisia herba-alba grown in Jordan. Aim: The current study aims to determines the essential oil composition of Artemisia herba-alba grown wild in south Jordan and test their activity against clinical isolate antibiotics resistant bacteria. Methodology: The essential oils were isolated by hydrodistillation and analysed by Gas Chromatography-Mass Spectrometry (GC-MS). The screening for essential oil activity was carried out using disc diffusion method on methicillin-resistant Staphylococcus aureus , methicillin-sensitive