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   2016| January-March  | Volume 28 | Issue 1  
    Online since May 25, 2016

 
 
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REVIEW ARTICLE
The secret of neuroscience boom: Are there secret human experiments in Latin América?
David Salinas Flores
January-March 2016, 28(1):1-4
DOI:10.4103/1110-7782.182942  
About 6 years ago there sparked a phenomenon in science called the neuroscientific boom. Neurologists underpin this phenomenon to cost reduction techniques such as electroencephalograms and to improved noninvasive technology such as functional MRI. But the human brain, the most complex organ in the universe, has not yet been fully investigated with the existing noninvasive technologies. Thus, there is a suspicion that the real reason for this boom is a secret, forced, and illicit human experimentation in Latin America. Physicians should investigate, be alert, and report these potential unethical human experiments to prevent any further damage to the public health of the citizens of Latin societies.
  9,559 515 2
ORIGINAL ARTICLES
Seroprevalence and real-time PCR study of Epstein-Barr virus and the value of screening in pretransplant patients
Mervat Elansary, Hemmat E El Haddad, Usama A.A. Sharaf Eldin, Ahmed Hamdy, Mai M Sherif
January-March 2016, 28(1):9-15
DOI:10.4103/1110-7782.182947  
Objective This study was performed to estimate the prevalence of Epstein-Barr virus immunoglobulin M virus capsid antigen (EBV IgM VCA) among healthy blood donors and to confirm the real risk of transfusion transmission by detection of virus load using PCR quantification. Materials and methods A total of 860 apparently healthy Egyptian blood donors were enrolled and tested for EBV IgM VCA. Quantitative PCR was performed for reactive cases for EBV IgM VCA. Results An overall 38 patients were reactive for EBV IgM VCA, constituting 4.4% of the sample. Reactivity of Epstein-Barr virus did not differ significantly as regards sex distribution, blood grouping, Rh factor positivity, and hemoglobin level, but it was significantly higher among upper Egypt participants than among those from other regions (P = 0.006). There was a very high statistically significant positive correlation between the titer of EBV VCA IgM reactive cases and age in the studied group (P = 0.0001 and r = 0.6). PCR was negative for all of the reactive cases. Conclusion Routine screening for Epstein-Barr virus in blood bags is not economical. Screening is highly recommended only for immunocompromised and pretransplant patients. Viremia is not the role in individuals with EBV IgM positive sera, which in turn changes some concepts in organ transplantation.
  3,293 338 -
CASE REPORTS
Reversible cause of complete heart block: An unusual presentation of thyrotoxicosis
Nattusamy Loganathan, Somasundaram Maheswari, Kalliappan Tamilarasu, Gopalan Rajendiran
January-March 2016, 28(1):28-29
DOI:10.4103/1110-7782.182963  
Thyrotoxicosis is a clinical entity that is often very difficult to diagnose without biochemical confirmation, as its clinical features can be highly varied. It is more common in women, with a female to male ratio of up to 5 : 1 between the ages of 20 and 40. Thyroid hormone is important at a cellular level, affecting nearly every type of tissue in the body. Very rarely it can cause heart blocks. We report a case of complete heart block associated with thyrotoxicosis that reverted to sinus rhythm with medical management alone.
  3,281 190 -
ORIGINAL ARTICLES
Utility of fecal calprotectin as a discriminative biomarker between ulcerative colitis and irritable bowel syndrome and its ability to be used for the assessment of the remission stage of ulcerative colitis
Hossam M Elsaadany, Mohammed F Almaghraby, Awatif A Edrees, Yasser M Elsherbiny, Roobina K Kumar
January-March 2016, 28(1):21-27
DOI:10.4103/1110-7782.182956  
Background and aim Fecal calprotectin (FC) has been proposed in recent studies as a sensitive, specific biomarker for the diagnosis of ulcerative colitis (UC). Hence, the present study sought to investigate the efficacy of FC for the diagnosis and monitoring of UC, as well as to assess the correlation of FC with other disease activity indexes. Research design and methods The present study included 96 consecutive patients who presented with lower gastrointestinal complaints. Patients were classified into two groups: group I (which included patients with UC) and group II (which included patients with irritable bowel syndrome); then, according to the disease activity, group I was subdivided into the following: group Ia (which included patients with active UC) and group Ib (which included only those patients of group Ia who were in the remission stage of UC). For all patients, erythrocyte sedimentation rate and C-reactive protein were determined; moreover, all patients underwent quantitative determination of calprotectin in stool samples, abdominal ultrasonography, and complete colonoscopy with biopsies for the histopathological examination to assess the disease severity by using the UC activity index according to the Mayo endoscopic and Geboes histological scores. The diagnostic validity of FC levels in correlation with Mayo Disease Activity Index (MDAI) was then investigated. Results FC levels showed highly significant increase in patients with active UC compared with inactive UC and irritable bowel syndrome (524.17 ± 48.0 vs. 184.48 ± 3.33 and 47.17 ± 5.32 mg/kg, respectively, P < 0.001). FC level has 100% accuracy, sensitivity, specificity, positive predictive value, and negative predictive value in distinguishing UC patients from the control group at a cutoff value of 140 mg/kg, but at a cutoff value of 223 mg/kg FC level shows 93.4% accuracy, 89.8% sensitivity, 97% specificity, 97.4% positive predictive value, and 55% negative predictive value to distinguish the active phase from the remission phase of UC. In addition, there was a statistically significant proportional correlation between FC and the MDAI, but the correlation between FC and histological inflammatory activity statistically was more significant than with MDAI (r = 0.75, P < 0.001). Conclusion FC level is an accurate, noninvasive biomarker in clinical practice with high specificity and sensitivity for the diagnosis and monitoring of UC, as well as good marker for the evaluation of disease activity. Therefore, it can be used as a monitoring test to assess medical response and to predict clinical relapse of the disease.
  2,547 218 -
CASE REPORTS
Pulmonary embolism: 'the great masquerader' of pneumonia in a patient with progressive supranuclear palsy
Robin G Manappallil, Vinod Krishnan
January-March 2016, 28(1):30-32
DOI:10.4103/1110-7782.182965  
Patients with Parkinson's disease are at risk of developing aspiration pneumonia. Pulmonary embolism is a rare but life-threatening complication in such patients, but could the same be true in progressive supranuclear palsy, an atypical form of Parkinsonism? This case report aims at highlighting the development of unprovoked pulmonary embolism in a patient with progressive supranuclear palsy and also describes how pulmonary embolism can mimic pneumonia in such patients.
  2,245 187 -
ORIGINAL ARTICLES
Clinical cytohistopathological study of benign thyroid disease in Sidi Bel Abbes region, Western Algeria
Achwak F Bendouida, Nouria Harir, Mustapha Diaf, Lahcen Belhandouze, Feriel Sellam, Soraya Moulessehoul, Aicha Rih
January-March 2016, 28(1):5-8
DOI:10.4103/1110-7782.182944  
Background and objective Benign thyroid disease is the most common disorder of the endocrine system. Our study aimed to analyze the clinical and cytohistological diagnosis of benign thyroid disease in western Algeria (Sidi Bel Abbes region) as well as define the characteristics of this pathology. Patients and methods This was an epidemiological retrospective descriptive study of patients with benign thyroid disease, performed at the Department of Surgery, University Hospital Dr Hassani Abdelkader, in Sidi Bel Abbes, during the period of 10 years (from January 2004 to December 2013).The medical data were analyzed using the statistical package for the social sciences (SPSS, version 20.0). Results A total of 430 patients were recorded (33 men and 397 women). The average age of patients at diagnosis was 45.02 ± 13.41 years. Our survey demonstrated that 42.09% of the population had solitary nodular goiters, 27.44% had multinodular goiter, 21.63% of patients had binodular goiter, 5.35% had solitary nodule, and finally 3.49% were affected by goiter diseases. Fine-needle aspiration cytology analysis revealed that benign dystrophic lesion was present in most cases (25.93%), followed by hyperplasia (22.56%) and suspicion of malignancy (14.14%). Our results revealed that benign thyroid disease could be recurrent and hereditary. Histopathologically, colloid goiter, multinodular goiter, and vesicular adenoma were recorded in 23.75, 21.07, and 13.03%, respectively. Conclusion According to our results, benign thyroid disease in the region of Sidi Bel Abbes is a frequent health illness that is predominant in young women compared with young men of same age.
  1,886 234 -
Circulating serum anti-C1q antibody: Correlation with clinical and histopathological activity in patients with proliferative lupus nephritis
Amer A Abeed, Amel Katat, Iman E El-Gohary, Omar A Hamam
January-March 2016, 28(1):16-20
DOI:10.4103/1110-7782.182950  
Introduction In systemic lupus erythematosus (SLE) the prevalence of anti-C1q antibodies (Abs) varies from 30 to 50% and is associated with high clinical activity and, particularly, with renal involvement. Moreover, in the absence of anti-C1q auto-Abs, no lupus nephritis occurs, whereas at least 50% of patients with anti-C1q auto-Abs have or develop lupus nephritis. For lupus nephritis, anti-C1q Abs are as specific as high-avidity dsDNA Ab and capable of closing a diagnostic gap in some cases. Patients and methods The present study was conducted on 40 patients with SLE. Patients were classified into group I (20 patients with active proliferative lupus nephritis (LN)), group II (10 patients with inactive LN), and group III (10 patients without nephritis). Laboratory investigations were carried out, including complete blood picture, renal functions (blood urea, serum creatinine, and creatinine clearance), complete urine analysis and urine analysis for dysmorphic red blood cells (RBCs), measurement of 24 h urinary proteins, erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA), and anti-dsDNA, and measurement of serum anti-C1q. Renal biopsy was taken from all patients of group I. Results Anti-C1q Abs were significantly higher in group I than in other groups. There were statistically significant positive correlations between anti-C1q Ab level, anti-dsDNA, and percentage of dysmorphic RBCs in urine in group I. There was also a statistically significant positive correlation between anti-C1q Ab level and cellular crescents, leukocyte infiltration, and endocapillary cellularity in the activity index. Conclusion Anti-C1q Ab can be used as an indicator of renal activity in patients with lupus nephritis.
  1,682 154 -
QUESTIONS AND ANSWERS
Questions and guide to answers
Amany Abdel Maqsod Sholkamy
January-March 2016, 28(1):33-37
DOI:10.4103/1110-7782.182966  
  1,409 143 -
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