Thursday, 31 August 2017

Diet and Oral health


We take a good care of our teeth and gum. We brush daily, floss regularly and clean the tongue to maintain a perfect oral hygiene. From using a right toothbrush to trusting only fluoride-rich toothpaste, we leave nothing to be desired in the quest to maintaining our dental health. All this however sometimes proves insufficient and we fail to get the kind of dental health we yearn. Why so? Well, it has a lot to do with what we eat! Yes, foods have a huge role to play in the way our teeth and gums maintain their health.

Diet has a major role in our oral health. Balance in the diet apart from strengthening the hard and soft tissues in the oral cavity it also helps in maintaining the proper masticatory function. We know acidic foods are harmful; we can’t afford eating fruits rich in citric acids and we have to cut down the intake of coffee, tea etc. But the question is, what should we eat? We should eat only what dentists ask us to. We should eat what adds value to our dental health. Researches have shown that Poor oral hygiene and change of diet lead to an increase in oral plaque and gingival inflammation. The inter-individual comparison indicated a shift in bacterial composition.

The important role of sociobehavioural and environmental factors in oral health and disease has been shown in a large number of socioepidemiological surveys. In addition to poor living conditions, the major risk factors relate to unhealthy lifestyles (i.e. poor diet, nutrition and oral hygiene and use of tobacco and alcohol), and limited availability and accessibility of oral health services. This article deals with the diet and nutritional aspects of Oral health.

Eating too much of acidic foods or drinks causes a lot of damage to our teeth. This weakens the enamel and leads to tooth decay in a gradual manner. We should thus start a diet rich in minerals. Including foods rich in calcium and phosphorous which gives the teeth its share of nutrients and keeps them stronger. So, eat more of cheese, milk, yogurt egg, fish etc.

Hard and crunchy foods with water help your teeth a lot. Such foods not only help in the production of saliva in the mouth but also help cleaning the tooth in a natural manner. This is how harmful foods and bacteria are kept out of the way. So, start having a diet rich in foods such as carrots, apples, and celery Lack of vitamin D can cause a lot of health problems. In fact, this vitamin is needed to keep your teeth healthy and stronger. So, start taking this vitamin and you know that the sunlight is the biggest source of that. Eat more of fish, egg, yolks as well.

Wednesday, 30 August 2017

Cutaneous Vasculitis as A First Sign of Isolated Peptoniphilus Spp in Urinary Tract Infection: A Case Report

Cutaneous vasculitis (CV) is a disease that may occur as a primary pro¬cess or be secondary to a wide and het¬erogeneous group of disorders, including drug reactions, infections, connective tissue diseases, autoimmune disorders and malignancies. There are several different cutaneous manifestations, including palpable purpura, urticarial papules and plaques, nodules, ulcers, and livedo reticularis. Skin biopsy is the gold standard for the diagnosis of CV. However, the presence of a leukocytoclastic vasculitis is not sufficient to establish the specific underlying aetiology. Herein, we summarize a case report of a 15-year-old woman affected with non-pruriginous skin lesions, predominantly in the lower limbs (up to thighs), without fever or signs of systemic or localized infection. The hysthopatological study of skin lesions showed orthokeratotic epidermis with underlying dermis with vascular changes with slight proliferation of capillaries, small vessels lesions, endothelial cell swelling, deposits of eosinophilic fibrin bands, and fibrinoid degradation. Neutrophil polymorphonuclear predominant inflammatory infiltrate around vessels with endothelial damage and nuclear dust (leukocytoclastia). In addition, an urine cultura showed a Peptoniphilus spp infection. With the diagnosis of of CV caused by a Peptoniphilus spp isolated in an urinary tract infection, the patient was treated with corticosteroids and amoxicilin. After 1 week, all the skins lesions were resolved.

nancies. Clinically, it is mainly characterised by palpable purpura, involving usually the lower extremities with histopathologic findings that have in common vascular inflammation and blood vessel damage. Skin biopsy is the gold standard for the diagnosis of CV. However, the presence of a leukocytoclastic vasculitis is not sufficient to establish the specific underlying aetiology. Current pharmacological treatment of primary CV is mainly based on corti¬costeroids, while, immunosuppressive agents can be added in the most severe cases. However, when CV is secondary to an underlying bacterial infection, this treatment may lead to a deleterious effects in patients. Herein, we describe a case of CV secondary to a urinary tract infection produced by Peptoniphilus spp with a short review of the literature. For our knowledge, this is the first case reported of CV caused by a Peptoniphilus spp isolated in an urinary tract infection. 

A previously healthy 15-year-old woman with no prior significant medical history was admitted in our Emergency Department affected with non-pruriginous skin lesions, predominantly in the lower limbs (up to thighs), without fever or signs of systemic or localized infection. No apparent possibility of insect bite. Requesting any abnormalities in the previous weeks, the patient referred a respiratory tract infection treated symptomatically 1 week ago. Attending to the physical examination, cardiopulmonary as well as abdominal explorations were anodyne. Any disturbs were observed at oropharyngeal level. The patient presented edemas in distal region of lower extremities without fovea. At skin level in lower extremities, macular and purpuric lesions of different sizes were observed. These lesions were not erasable to the digital pressure. The smallest lesions were petechiae like, while the largest lesions were confluent up to 4-5 cm in their largest diameter (Figure 1 and 2). On left forearm, the patient showed 2-3 petechiae lesions on extensor face. On right hand, 2 millimetric petechiae on the dorsal side were also observed. 

Tuesday, 29 August 2017

Vaccination 101: Make Sure Kids Are Up to Date


As the new school year starts, ensure your tyke is up and coming on all immunizations. "Schools are an awesome situation for spreading microorganisms and infections since understudies are in swarmed classrooms, sharing things and in closeness to each other," said Zachary Klase. He's a right hand educator of natural sciences at University of the Sciences in Philadelphia. 

"A main consideration adding to numerous viral episodes is being in a situation where you are near others, for example, going to a similar class, playing on similar games group or living in a habitation lobby," he included a college news discharge. Inoculations ensure against maladies like meningitis, lockjaw, measles diphtheria, pertussis (whooping hack), polio, mumps, rubella and hepatitis B. 

Every one of the 50 states require government funded school youngsters to be immunized unless they have a waiver, and schools and colleges have immunization rules, particularly for the individuals who live in dormitories. 

Antibodies are commonly made utilizing an inactivated germ or a little piece of dynamic microscopic organisms or infection, to enable the body to build up an invulnerable response if the genuine article tags along. They're accessible at drug stores and wellbeing facilities notwithstanding specialists' workplaces, and certain wellbeing focuses give antibodies to allowed to poor people and those without protection.

Thursday, 24 August 2017

Diagnostic Challenge of Renal Angiomyolomas


Renal angiomyolipomas (AML) are benign neoplasms, arising from perivascular epithelioid cells. They are very rare tumors and are strongly associated with tuberous sclerosis. Their incidence in the general population is very low, approximately 0.3-2.4%, and were described as first time in 1880 by Bourneville and Brissard. Most patients with renal AML are asymptomatic. The dreaded complication is spontaneous retroperitoneal hemorrhage. Due to that, prophylactic surgery is recommended to prevent hemorrhage in patients with tumor size larger than 8 cm in diameter. Here we describe a young woman who presented with severe abdominal pain and was found to have underlying renal angiomyolipoma complicated with active hemorrhage.

A 21-year-old woman presented with sudden onset right flank and right lower quadrant abdominal pain that began when she woke up that morning. She described the pain as sharp, knife like, non-radiating, 7/10 in intensity, aggravated by minimal movement and relieved by lying still, associated with nausea and 1 episode of non-bloody vomiting. She also reported an episode of syncope earlier that day, when she lost consciousness for few seconds. She denied hitting her head, seizure like activity or post syncopal confusion. Patient denied abdominal injury, recent illness, foreign travel, fever, chills, change in bowel or bladder habits and vaginal discharge. She had no significant past medical or surgical history. She was not taking any medications. She was never married or pregnant. Her menstrual cycles were irregular. Last menstrual period was 20 days prior to admission. She reported being sexually active and used condoms for protection. She denied any significant family history. On physical examination, patient was afebrile and vitally stable. She had severe tenderness to palpation in the right upper and lower abdomen and right flank. Normoactive bowel sounds were present. Attending to blood tests, complete blood count and comprehensive metabolic panel were within normal limits except for a normochromic normocytic anemia with hemoglobin of 11.6 g/dl and minimal leukocytosis (WBC 11.1 u/kL). Urine analysis and urine pregnancy test were negative. Chest x ray was unremarkable. CT scan of abdomen and pelvis with contrast (Figure I) was obtained, which revealed a 17.5 x 13.8 x 13.1 cm retroperitoneal mass arising from the right kidney.

The mass was composed of fatty and soft tissue components along with blood products. A differential diagnosis of ruptured angiomyolipoma and malignant tumors such as liposarcoma were considered. Considering patient’s young age, acuity of symptom onset and the fact that the mass arised from the kidney, the diagnosis of renal angiomyolipoma was determined to be more likely. The patient had no stigmata of tuberous sclerosis on physical examination. Initially, we decided to proceed with conservative management but within a time span of 12 hours, patient’s hemoglobin decreased to 9.5 g/dl. Interventional radiologist was consulted for the management of ongoing bleeding. Emergency arteriogram with super selective embolization of AML with alcohol and coil was performed through the lower pole of right renal artery. A CT guided biopsy of right renal lesion was also performed. Histological examination confirmed our diagnosis of renal angiomyolipoma. The patient was monitored in Intensive care unit for few more days and was subsequently discharged as she improved. She is planned to undergo elective resection of angiomyolipoma at a future date. 

Wednesday, 23 August 2017

Caregiving Needs Double as End of Life Nears


Dependence on parental figures duplicates as individuals close passing, and half of those guardians - regularly unpaid relatives - report having no time for themselves, another investigation demonstrates. The examination utilized a broadly illustrative specimen of around 2,400 more established grown-ups in the United States. The investigation creators found that parental figures gave almost double the quantity of hours of assistance every week to passing on people than to those not toward the finish of life. "We were absolutely mindful when managing end-of-life mind that families are generally included, yet we couldn't evaluate that before this [research]," said examine creator Dr. Katherine Ornstein. She's a partner educator of geriatrics and palliative prescription at the Icahn School of Medicine at Mount Sinai in New York City. 

More than 34 million Americans gave unpaid care to a grown-up matured 50 or more seasoned in the previous a year, as per 2015 figures from the National Alliance for Caregiving and AARP. Most guardians are female. Ornstein and her group drew from two broadly illustrative overviews in which parental figures in the United States revealed their encounters nurturing biting the dust grown-ups over age 65. The specialists stood out this information from that of different parental figures giving progressing care. More seasoned grown-ups were delegated being toward the finish of life on the off chance that they kicked the bucket inside a year of the overviews' fruition. 

The examination found that withering grown-ups had a normal of 2.5 guardians helping them. Those close to the finish of life got 61 hours of assistance for every week contrasted with 35 hours of assistance for each week for more established grown-ups who weren't toward the finish of life. More than 33% of the finish of-life guardians detailed physical trouble identified with their obligations. Simply finished half revealed having no time for themselves. These figures were 21 percent and 40 percent, individually, for different guardians. About nine of every 10 guardians are unpaid, as indicated by the examination. For end-of-life parental figures who were companions, almost 66% announced accepting no assistance from family or companions. "What we see now is, all things considered, there are 2.5 individuals helping somebody toward the finish of life. You can suppose they don't have that, it's significantly more troublesome," Ornstein said. "At the point when life partners are filling in as guardians, the greater part are detailing doing only it and have the [most challenging] results." 

Barbara Coombs Lee is leader of Compassion and Choices, a Washington, D.C.- based backing association for patients' rights and end-of-life issues. She called attention to that the parental figures reviewed in the new investigation didn't really know early that the individual they were administering to was toward the finish of life.

Tuesday, 22 August 2017

End-of-life Decision-Making in Neonatology: The Role of Nurses and Parents


Scientific and technical advances applied to the field of neonatology have led to the development of improved intensive care treatments for newborns at risk of increasingly complicated health problems, such as congenital malformations, hypoxic-ischemic events and, in particular, extreme prematurity. Therefore, the resuscitation of preterm infants of under 24 weeks gestation age (GA) is no longer considered exceptional in developed countries. The increase in our ability to intervene has equaled improved survival rates for these children, however the incidence of serious sequelae has not significantly decreased. In 2012, the Spanish Society of Neonatology (SENeo) published its recommendations on decision-making at the end of life in neonatology, establishing categories of patients susceptible to limitation of therapeutic effort (LTE). These categories in-clude: 1. Children born at the limit of viability (gestational age <24 weeks GA). 2. Congenital anomalies incompatible with life. 3. Children with diseases that do not respond to intensive care and who will, therefore, most likely die in a short term. 4. Children who may survive with permanent dependence on invasive life support. This categorization contrasts with the survival and sequelae data of preterm babies available at that time. In the Epicure 2 trial, conducted in England on a cohort of 952 preterm babies less than 26 weeks GA in 2006, an increase in survival in all age groups was observed, compared with the cohort of the first phase this study, collected in 1995. Thus, survival is exceptional below 23 weeks GA and survivors suffer from the most serious side effects. Between 23 and 24 weeks GA, 10% of those admitted to intensive care survived with moderate or severe disability at 6 years of age. In the 1995 cohort, survival preterm babies between 24 and 25 weeks GA receiving intensive care represented 34%, and half of the survivors had moderate or severe disabilities. In the cohort of 2006, the survival of this group increased by 12%, with no evidence of changes in morbidity. Over 25 weeks GA there has been a significant increase in survival, from 54% to 67%, among the groups studied between 1995 and 2006. The figures for survival and morbidity among different age groups does not allow for the detection of qualitative differences, and thus, gestational age becomes a criterion for establishing one of the assumptions of LTE.

A recent study published by the SEN1500 group on behalf of the Spanish Society of Neonatology (SENeo) has revealed the incidence of serious sequelae in the population of preterm infants in Spain over recent years. According to the results of this population-based study, the survival rate without major morbidity, which includes major brain damage (MBD), bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC) and early or late onset sepsis, is 2.6% at 24 weeks GA, 5.1% at 25 weeks GA and 9.6% in babies born at 26 weeks GA. If we consider only the MBD, BPD and/or ROP, the survival without sequelae is 9.5%, 19% and 29.9% for 24, 25 and 26 weeks GA, respectively. These results show that the chances of healthy survival below 25 weeks of gestation is very low [4]. Thus we find discrepancies between the available evidence and the recommendations on the limit of viability concept.

End-of-life decision-making in the newborn population who are within the limits of viability is highly complex, with medical, ethical, social and cultural implications that impact the balance between survival and quality of life. The changing parental role in neonatal units over the final years presents a challenge to professionals who seek to include them in ethical and end-of-life decisions. Moreover, the role of the different professionals involved in patient care remains unclear, especially the role of the nurse, who is the professional who spends the most time with both the child and family. In this sense, the SENeo has issued a statement regarding the role of parents: “Parents are generally the best ‘lawyers’ of their children and in most cases wish to actively participate in end-oflife decisions, however they need information that is accurate, comprehensive, honest and understandable”. Concerning the role of the nurse, this institution states: “the importance of the participation of the nurse who is responsible for the patient in the process of deliberation and decision-making is vital, as nurses contribute towards a better understanding of the parents’ values of parents as well as the circumstances and the social and family and social context”. Because of this incoherence in the definition of the limits of viability and the indefiniteness of the different roles of the stake holders, we sought to explore the perceptions of the nursing staff in the neonatal intensive care unit (NICU) of the University Hospital La Paz in Madrid, Spain, on the process of end-oflife decision-making, focusing on aspects related to both the role of nurse and the role of parents.

Monday, 21 August 2017

Zika May Not Last in Semen as Long as Thought


Zika infection won't not stay in the semen of some contaminated men insofar as beforehand thought, a little report recommends. The scientists said Zika may just be available in semen for about a month. Past research had proposed that Zika infection can be found in semen for whatever length of time that 188 days after the beginning of indications. The new investigation included 12 men in French Guiana who had Zika infection. Four of the men never had any noticeable Zika in their semen. One discharged Zika infection in his semen for no less than three days. What's more, seven had Zika-bound semen for no less than a month, the analysts announced. The greatest length of perceptible Zika in semen in the examination was 45 days. "These information propose that not all men who are symptomatically tainted with Zika infection will have Zika infection RNA noticeable in semen," Dr. Franck de Laval, of the Military Center for Epidemiology and Public Health in Marseille, France, and associates composed. The outcomes additionally demonstrated that Zika replicates in the balls or semen-creating organs, since the measure of Zika in semen was essentially not the same as the Zika stack found in the men's blood. "More information are expected to better illuminate general wellbeing proposals," the examination creators recommended. Zika infection is regularly transmitted by means of mosquito nibble. Be that as it may, the infection likewise can be sexually transmitted, as indicated by the U.S. Communities for Disease Control and Prevention. 

The CDC prescribes that men conceivably presented to Zika utilize condoms or avoid sex for no less than a half year, to keep a Zika-contaminated pregnancy bringing about neurological birth absconds. It's impossible the CDC proposals will change in light of these discoveries, an irresistible infection master said. Dr. Daniel Caplivski is chief of the Travel Medicine Program and partner educator for the division of irresistible maladies at the Icahn School of Medicine at Mount Sinai in New York City. "Shockingly, the central suggestions of general wellbeing specialists with respect to deferring pregnancy after Zika infection disease or introduction are probably not going to change, given the level of instability that remaining parts from different examinations in which the hereditary material of the infection was perceptible for longer timeframes," Caplivski said. Furthermore, notwithstanding these discoveries, individuals should in any case take after the CDC's Zika rules for safe sex, wellbeing specialists said. As indicated by Dr. Amesh Adalja, a senior connect with the Johns Hopkins Center for Health Security, in Baltimore, "Since it is vague which men will have longer diligence, it is essential for Zika-tainted/presented men to rehearse safe sexual practices for a half year present disease on stay away from transmission of the infection." 

Ladies' wellbeing pro Dr. Jill Rabin said the little size of the investigation warrants a bigger development. "The uplifting news is it might last a shorter period in men than recorded beforehand, yet we need a bigger example measure and take after individuals for a more drawn out timeframe," Rabin said. "Since we don't have enough information and we don't have enough individuals, we can't generally say what is the day and age should have been free of disease," she included. Zika causes neurological birth surrenders, most regularly microcephaly, a condition in which an infant's cerebrum and skull are immature, Rabin said. She's co-head of the division of mobile care with Women's Health Programs-PCAP Services at Northwell Health in New Hyde Park, N.Y. There's likewise worry that Zika-uncovered infants apparently conceived sound will create learning incapacities or issues with hearing or sight further down the road, Rabin noted. "Ladies of conceptive age would prefer not to have an infant conceived with Zika," she said. "You need to take after the most dire outcome imaginable, and the most dire outcome imaginable is it could last up to a half year. Why might you take a risk with your infant?"

Friday, 18 August 2017

The Cardiovascular Protective Effects of Erythropoietin Stimulating Agents

Erythropoietin (EPO) is a member of the class I family of cytokines with a strong ability to stimulate erythropoiesis. The endogenous EPO is mainly synthesized and secreted by the kidney, and the recombinant EPO is utilized in patients suffering from different kinds of anemia. EPO influences erythropoiesis by binding to its specific receptor which is expressed on the surface of immature erythroblasts. However, several studies have demonstrated that EPO and EPO receptors are not only expressed in erythroblasts but also in a number of cell types including those within the cardiovascular and nervous system, suggesting that the effects of EPO extend beyond regulation of erythropoiesis. There are different kinds of EPO, namely, epoetin alfa, epoetin beta, and epoetin gamma, which are analogues of recombinant human EPO (rhEPO) derived from a cloned human erythropoietin gene. All of them have the same 165 amino acid sequence with a molecular weight of 30,400 daltons and have the same pharmacological actions as native EPO. The normal serum concentrations of EPO for individuals with normal hematocrit range from 4-27 mU/mL. However, in certain conditions of anemia and hypoxia, EPO levels can be increased 100-1000 times the normal serum EPO concentration. Moreover, the subcutaneous administration of a single 600 U/ kg dose of epoetin alfa to healthy volunteers produced a peak serum concentration of over 1000 mU/mL after 24 hours.

A second generation drug, namely, darbepoetin has a threefold longer circulating half-life than rhEPO. It was shown that darbepoetin alfa is 3.6-fold more potent than rhEPO in increasing the hematocrit when each is administered thrice weekly, but when the administration frequency is reduced to once weekly, darbepoetin alfa is approximately 13-fold higher in vivo potency than rhEPO. A third-generation EPO-related molecule called continuous EPO receptor activator (CERA) has been manufac tured. The elimination half-life of CERA in humans is considerably increased to about 130 hours maintaining a stable control of hemoglobin levels with a monthly interval dose. The tissue protective effects of EPO, beyond the hematopoietic system, is mediated by activation of homodimeric EPO receptor, but is also believed to be mediated by its actions on the heterotrimeric complex consisting of EPO receptor and the β-common receptor. Nitric oxide (NO) is a potent vasodilator formed in endothelial cells, and plays a key role in control of the cardiovascular system. It was shown that EPO can exert non-erythropoietic effects in vascular endothelium and is increasingly regarded as a potent tissue protective cytokine. Several studies demonstrated that EPO decreases tissue damage by inhibition of apoptosis and reduction of inflammatory cytokines. In-vitro treatment with low dose of rhEPO increased endothelial nitric oxide synthase (eNOS) protein expression in cultured endothelial cells. On the other hand, incubation of human coronary artery endothelial cells with high dose of rhEPO for 24 hours inhibited eNOS expression and NO production suggesting that high dose of EPO may have detrimental effects on endothelial function. EPO has a vast variety of cardiovascular effects. It exerts its effects on cardiac as well as the vascular tissues since EPO receptors are expressed in cardiomyocytes, vascular endothelial cells and smooth muscle cells. The clinical dosage required to observe EPO-induced tissue protection is much higher than that required for hematopoietic effects. There is robust experimental evidence of beneficial effects with the use of EPO in the cardiovascular system. However, all the plausible mechanisms should be tested in clinical situations to properly evaluate clinical outcomes. There are some adverse events data described in clinical trials in patients with heart failure, kidney disease, myocardial infarction, and stroke. The adverse side effects associated with EPO therapy were due to its pleiotropic effects mainly in the cardiovascular system including hypertension, thrombosis and augmented tumor angiogenesis. Single-center studies have shown that EPO therapy of anemia in patients with heart failure was associated with improvement in exercise capacity, improved cardiac and renal function and reduced use of diuretics. Other trials evaluated the safety and efficacy of darbepoetin alfa at a dosage of 0.75μg/kg once every 2 weeks in symptomatic heart failure patients. It was demonstrated that the incidence of adverse events in these trials was similar between placeboand darbepoetin alfa-treated patients. However, the significant increase in hemoglobin shown with darbepoetin alfa therapy correlated well with improved health-related quality of life. 

The results from pre-clinical studies attribute multiple mechanisms of protection by EPO against myocardial disorders besides anemia treatment. Treatment with EPO may decrease apoptosis of myocytes, induce neovascularization by promoting myocardial angiogenesis increasing collateral vessels, reduce collagen deposition in ischemic myocardium, as well as, improve left ventricular function. However, large clinical trials did not demonstrate those benefits. Similarly, trials in patients with anemia and heart failure did not demonstrate improved clinical outcomes and raise concerns about increased complications [25, 26]. It is highly possible that EPO may have failed in these clinical trials because of the employment of insufficient dose. Preclinical studies have frequently used doses in the range of 1,000 to 5,000 IU/kg, while just a dose of 300 IU/ kg were utilized in many large clinical trials. Although this lower dose is adequate for the EPO receptors in the erythroblasts, the EPO receptors found on multiple cell types responsible for cardiovascular protection are different. However, the explanation may not be that simple. There is a complex interplay between vascular abnormalities and inflammatory mediators. There are several different cell types involved, and, within each individual cell, there are complex interactions among multiple signaling pathways. On the other hand, the use of higher doses of EPO in those large clinical trials might have had developed adverse effects such as thrombosis and hypertension. 

Thursday, 17 August 2017

Evaluating the Meaning of the Information Message and Speech-Mental Activity of a Person


We would like to offer to the attention of the readers a scientific report as a statement of the author’s hypothesis, which is experimentally tested, but requires an additional verification. The report addresses the trends outlined in the course of the scientific research on identification of regular patterns that describe the influence of information on people. The content of this scientific report relates to the field of interdisciplinary scientific research at the junction of the information theory and cognitive psychology. The article describes the criteria for evaluating the meaning of an information message and a speechmental activity of a person. Subject to an appropriate follow-on development, the results obtained can be applied in cognitive psychology, psychiatry and in the domain of artificial intellect.

We continue publishing the findings of the scientific research on the topic of information influence on people. This scientific report addresses the findings of the research, the beginning of which was described in our article. In this research we tried to identify the criteria for evaluating the meaning of an information message and speech-mental activity of a person. While the work has been performed, healthy people have been involved as test subjects. But, it would be useful and interesting to conduct a series of experiments under clinical conditions, because in terms of emotions, a healthy individual and a person suffering from a mental disorder can perceive the meaning of the same information message in dissimilar ways. The sphere of our scientific interest includes the elements of information theory and cognitive psychology. Characterizing cognitive psychology as a new scientific trend in psychology, W. Naisser noted in his book that tracing the movement of the information flow within the “system” (i.e. in the brain) is a toppriority objective in this new field of knowledge. The goal set by one of the founders of cognitive psychology is identical to the goal of our scientific work. 

This implies that the object of our study is cognitive psychology, which we research using the method of information theory. A person conveys or receives information in the process of speech-mental activity. This is a conscious or unconscious intellectual activity of a person, in which information is used in the form of speech. For presentation of information, an alphabet of the relevant natural language is used. One of the derivatives of the speech-mental activity of a person is a textual information message (text), to which a person attaches some meaning. A textual information message with a sense attached to it is the subject of our research. The speech-mental activity plays an important role in the process of interaction between people. One of the reasons why conflicts occur between people could be a misinterpreted information message. In other words, misinterpretation of the sense of the information message. This question is also relevant in psychiatry for evaluation of the speech-mental activity of a person in a disturbed state of mind (delirium).

Wednesday, 16 August 2017

Could Newborn Heart Stem Cells Jump-Start Old Hearts?


Undifferentiated cells from youthful hearts may inhale new life into maturing ones, look into in rats proposes. In the investigation, an exceptional kind of undeveloped cells was taken from the hearts of infant rats and infused into the hearts of old rats, normal age 22 months. Different rats from a similar age assemble were given saline shots. 

Standard heart work was measured in every one of the rats, utilizing echocardiograms, treadmill stretch tests and blood investigation. The gathering of more seasoned rats experienced an extra round of testing one month subsequent to getting the undifferentiated cells from the hearts of the youthful rats. The old rats who were given foundational microorganisms demonstrated better heart work, a 20 percent expansion in practice limit and, strangely, an enhanced capacity to regrow hair. 

"Our past lab studies and human clinical trials have indicated guarantee in treating heart disappointment utilizing cardiovascular [heart] immature microorganism implantations," said co-essential examiner Dr. Eduardo Marban, executive of the Cedars-Sinai Medical Center Heart Institute in Los Angeles. "Presently we find that these specific undeveloped cells could end up reversing issues related with maturing of the heart," he said in an organization news discharge. 

"The way the cells work to invert maturing is interesting," Marban included. "They emit modest vesicles that are packed with flagging particles, for example, RNA and proteins. The vesicles from youthful cells seem to contain all the required directions to get back to former days."

Monday, 14 August 2017

Prevalence and Contributing Factors of Insomnia among Elderly of Pashupati Old Aged Home (Briddhashram)

Insomnia is one of the major and unsolved problems in older people. The prevalence of insomnia increases steadily with age and is often a persistent problem, particularly in older adults and are often mistaken as a normal part of ageing. Studies investigating insomnia among elderly people living in geriatric homes, especially in Nepal, are rare. The objective of this study was to determine the prevalence and contributing factors of insomnia among elderly people of Social Welfare Centre Briddhashram (Old aged home), Pashupati, Kathmandu. A descriptive cross-sectional study design was conducted among 148 elderly people of 60-94 years of age, following simple random sampling technique. The tools used were semi-structured questionnaire, Athens Insomnia Scale (AIS) and Geriatric Depression Scale (GDS). The data was collected by using semistructured interview schedule and was analyzed by using SPSS version 17.0. This study highlights that around three-fifth (61.5%) of the respondents had insomnia associated with different factors such as age, suffering from increased number of physical symptoms, irregular sleep, etc. Three-fourth (75%) of the respondents complained of pain; followed by weakness of extremities (65.5%). Depression, perceived poor health status as compared to one year ago and use of drugs for long term illness were also found to be contributing factors of insomnia. Insomnia is common among elderly population.

Ageing is a natural phenomenon and an inevitable process. Every living being born, develops, grows old and dies. With the increase in age, people lose their creativity level, problem solving ability and learning skills as well as short-term memory. All the people of the world - be they rich or poor and learned or uneducated - have to pass through this cyclical process in their lives, irrespective of their present state of strength or merit or weakness. Sleep is a vital physiological process with important restorative functions. Sleep disorders and sleeping difficulties are among the most pervasive and poorly addresses problems of aging. Getting enough sleep can have a significant impact on daily function, alertness and overall quality of life. Insomnia or sleeplessness, is a sleep disorder in which there is an inability to fall asleep or to stay asleep as long as desired. This sleep disorder is often practically defined as a positive response to either of two questions: “Do you experience difficulty sleeping?” or “Do you have difficulty falling or staying asleep?”.

With age, several changes occur that can place one at risk for sleep disturbances including increased prevalence of medical condition, increased medications use, age related changes in various circadian rhythms, and environmental and life style changes. Insomnia is generally classified as primary or secondary to some underlying cause. Primary insomnia is usually not associated with a medical or psychiatric condition. Secondary insomnia occurs most frequently in the older adult with medical or psychiatric disorders. The causes of insomnia in the elderly are divided into four groups:  physical diseases or symptoms, such as long-term pain, bladder or prostate problems, joint diseases such as arthritis or bursitis, and gastroesophageal reflux;  environmental/behavioral factors; use of drugs, such as caffeine, alcohol, or prescription medications for chronic diseases; and mental diseases or symptoms, such as anxiety, depression, loss of personal identity, or perceived poor health status 

Thursday, 10 August 2017

Mathematical Analysis of Antibody Rhythms

The aim of this study is to develop biomathematical models with important physiological parameters involving immune response for antibody rhythms by using the circadian, infradian and ultradian rhythms of IgY antibody, which could be used in many aspects, for instance to explain the controversies concerning antibody concentration with biological reasons and biomathematical calculations, to optimize the antibody yield in large scale production. In general, this approach could be extended to construct computational models for other antibodies using their biological rhythms to describe their physiological and pathophysiological mechanisms. This approach would aid to utilize the engineered antibodies and their derivatives for various biomedical applications.

The immune system of all living things shows regularly recurring rhythmic variations in numerous frequencies, and the responses of the immune system to an antigen entry could vary in accordance to the chronobiological phenomena. These cyclic oscillations in living things occur for many essential biological processes in order to deal with environmental changes and challenges. Chronobiological phenomena are ubiquitous in living organisms; these periodic (cyclic) episodes are called as biological rhythms (a rhythm is a change that is repeated with a similar pattern). Most of the early reports on biological rhythms focused on circadian rhythms (roughly 24-hours cycle), which could be observed in chicken serum IgY, it has been depicted in mathematics by Forger and Kronauer in 2002 through “van der Pol oscillator”, written in the Lienard phase plane form:

This treats the state variables as some kind of “stuff”, the second of which is converted to the first, but whose creation is blocked or accelerated by light. In light of, this is not necessarily unrealistic; however it is only a first attempt at modeling changes in circadian rhythms [1]. The further investigations have imposed that, biological cycles having periods shorter or longer than circadian rhythm. For instance, cycles that have periods less than 20-hours are called ultradian rhythms, while cycles that have periods longer than 28-hours are called infradian rhythms. Collectively, these three rhythmic domains comprise a network or web of rhythmic oscillations that in many ways can be linked to the various chemical pathways that perform different functions and occur simultaneously within the same organelle or cell [2]. These cyclic oscillations in living things occur for many essential biological processes in order to deal with environmental changes and challenges. 

Wednesday, 9 August 2017

Stroke Rates Drop for U.S. Men, But Not Women


The general rate of strokes is declining in the United States, however has all the earmarks of being going down for the most part in men, another examination finds. "Our discoveries recommend that the abatements in rates of stroke after some time are basically determined by diminished stroke rates in men," said lead specialist Dr. Tracy Madsen. That makes specialists ask why American ladies aren't seeing similar advantages from stroke avoidance. "It might be that stroke counteractive action techniques are not as viable in ladies contrasted and men; for instance, future research ought to examine the likelihood that stroke chance variables like lifted circulatory strain, cholesterol and diabetes are more serious or are not controlled also in ladies," Madsen said. 

Madsen is a collaborator educator of crisis solution at the Warren Alpert Medical School of Brown University, in Rhode Island. "Stroke is an incapacitating yet preventable condition, and future endeavors should concentrate on stroke aversion in the two ladies and men, and also making sense of why rates of stroke in ladies did not diminish over this day and age," she included. For the investigation, Madsen and her partners gathered information on 1.3 million grown-ups living in southwest Ohio and northern Kentucky in the vicinity of 1993 and 2010. 

They took a gander at healing facility, center and coroners' records to recognize what number of individuals had a first stroke amid four one-year eras, dispersed around five years separated. Among more than 7,700 strokes, 57 percent were ladies, the analysts said. The rate of strokes among men went from 263 strokes for each 100,000 toward the begin of the investigation to 192 for each 100,000 toward the finish of the examination. 

For ladies, be that as it may, the rate went from 217 strokes for every 100,000 out of 1993 to 198 for each 100,000 of every 2010. This is not a factually critical decrease, the analysts said."By 2010, the rates of stroke were comparative amongst ladies and men, which is not quite the same as past information demonstrating that rates of stroke are commonly higher in men," Madsen said. "We likewise found that the declining rates of stroke in men are principally determined by an abatement in ischemic strokes, a particular kind of stroke caused by an absence of blood stream to the mind because of blocked veins or clusters," Madsen said. 

The rates for hemorrhagic stroke which is caused by seeping in the cerebrum, stayed stable for the two ladies and men, the examination found. The specialists additionally noticed that ladies were around four years more seasoned than men at the season of their stroke. Information from the U.S. Habitats for Disease Control and Prevention demonstrate that stroke has dropped to the fifth driving reason for death for men, however remains the fourth driving reason for death for ladies. A restriction of the investigation is that data on hazard factors for stroke that are interesting to or more typical in ladies -, for example, headache and the utilization of hormone substitution treatment - were not gathered, the scientists said.

Tuesday, 8 August 2017

Joint Injuries Which Can Go Unnoticed: Fibular Head Dislocation


Approximately 65% of the emergency cases are major and minor traumas. 35% of the unnoticed traumatic injuries are seen in the Emergency Departments. Unnoticed traumatic injuries adversely affects the patient’s prognosis, as well as tarnishing the reliability and reputation of the related clinician and institution. Dislocation of the Proximal Tibiofibular Joint (PTFJ) is among the injuries that can go unnoticed. While dislocation of the PTFJ is usually described with accompanying bone fractures in the literature, isolated dislocation of the PTFJ is very rare. This study aims to report an isolated PTFJ dislocation case presenting to our Emergency Department with the complaint of knee pain due to falling while walking.

A twenty eight year-old male patient presented to our Emergency Department with the complaint of knee pain due to a slip and fall accident on the accident. Physical examination revealed tenderness to palpation in the lateral aspect of the right knee. He was totally capable of passive movements of the joint; however, he felt increasing pain with the flexion of the knee and ankle. The patient could walk with support. His pulse palpations and neurological examination revealed normal results. Direct imaging suggested dislocation of the PTFJ (Figure 1). Then, computed tomography (CT) scan of the knee was performed. 

posterior radiograph of left lower extremity with normal findings; C. the lateral x-ray of right lower extremity demonstrate proximal tibiofibular joint dislocation; D. the lateral roentgenogram of left lower extremity with normal findings. CT scan revealed anterolateral dislocation (Figure 2). Closed reduction was performed in the sedated patient using the conventional method with the collaboration of an orthopedic consultant in the Emergency Department, and long leg cast was applied. The patient was hospitalized in the Orthopedics Inpatient Clinic for monitoring and treatment. Magnetic resonance imaging (MRI) scan of the knee was performed to evaluate the ligament structures on Day 2 of hospitalization. Injury of the tibiofibular ligament was detected (Figure 3). Due to the absence of problems in his monitoring and follow-up results, the patient was discharged with recommendations on Day 5 of hospitalization. 

Monday, 7 August 2017

Areas of Medico-Legal Unreliability in Personal Injury Cases


Combining clinical and medico-legal analysis of any one particular civil case being litigated is an innovative approach devised by the first author and his colleagues to address both clinical/psychological and medico-legal aspects of complex personal injury cases [1-3]. This unique analysis ensures a comprehensive approach to understanding the key medicolegal processes in psychological assessment. This paper develops this innovative process further and highlights the application of key medico-legal postulates and develops these in respect of dispute resolution and the use of the Joint Statement process, uniquely developed and practiced in the UK (England and Wales).

Mr. D was a 29 year old man driving alone on a busy arterial road in Cambridge. He was stationary in traffic at an intersection, waiting to turn right. A car approaching from behind collided with the rear of his car at approximately 60 mph. At the time he felt very shocked and although he was afraid he was severely injured, he did not believe he was going to die.This assessment identified the psychological symptoms of stress, mood disturbance, situational travel anxiety as a driver and passenger, social and work disruption. Diagnosis of a Specific Phobia and multi-factorial Pain Disorder (Physical and Psychological aspects) were made with DSM-IV codes of 300.29 and 307.89 given [4]. At time of assessment, 12 months later, despite some improvement, there were residual symptoms of depressive and recreational drug use to help manage ongoing pain. Psychometric test data was consistent with this.

Throughout this case, careful scrutiny was made covering clinical aspects (diagnosis, severity, treatment requirements and likely resolution of symptoms) and medico-legal aspects (causation, multi factorial history, range of opinion, prognosis and material contribution to onset and course of symptoms). The case process was run efficiently by both claimant and defendant teams and the result was that the claimant was recompensed for his injuries, physical and psychological, and the disruption to and time off work. Despite the adversarial process, the use of reassessment, alternative expert assessment and subsequent joint discussion allowed for a professional, logical and comprehensive understanding of the genesis, development and likely resolution of the symptoms and case of Mr. D. In particular, dispute resolution is key to most, if not all, civil cases involving personal injury. The system operating in England and Wales of utilising Joint Statements is unique to the UK and a key characteristic of the ‘therapeutic’ or ‘positive’ approach to understanding and resolving apparent or real differences in opinion in the civil courts.

Thursday, 3 August 2017

As Many as 1 in 3 Experience New or Worse Pain With Yoga


Many individuals attempt yoga wanting to mend damage, yet some breeze up with more a throbbing painfulness, another investigation finds. The examination, which studied many individuals doing yoga for over a year, found that 66% said that some current hurts enhanced in view of yoga - frequently, bring down back and neck torment. Many individuals attempt yoga wanting to recuperate damage, yet some breeze up with more a throbbing painfulness, another examination finds. The investigation, which reviewed many individuals doing yoga for over a year, found that 66% said that some current hurts enhanced in view of yoga - regularly, bring down back and torment. 

Furthermore, just about 11 percent said it caused new issues - most ordinarily, torment in the hand, wrist, elbow or shoulder. The investigation didn't dive into particular wounds, however rather got some information about general hurts in various body territories. So it's difficult to know how genuine the issues were, said Tom Swain, a scientist with the Center for Injury Sciences at the University of Alabama at Birmingham. "You don't need to maintain genuine damage to have torment. It could simply be sore muscles," said Swain, who wasn't associated with the investigation. 

In an examination distributed a year ago, Swain and his associates took a gander at genuine yoga-related wounds. They found that in the vicinity of 2001 and 2014, just about 30,000 Americans arrived in the crisis space for wounds credited to yoga - including sprained joints, genuine muscle strains and even cracks. Furthermore, the rate moved throughout the years, the investigation found. 

In any case, given how well known yoga is, the danger of winding up in the ER is very low, the analysts said. By 2014, the rate of ER-treated wounds remained at 17 for each 100,000 yoga specialists. "So despite the fact that there is some danger of damage," Swain stated, "that shouldn't dissuade individuals from taking an interest in yoga, in light of the fact that there are numerous potential advantages." Studies have attached yoga to wellbeing increases extending from bring down pulse, cholesterol and heart rate to changes in melancholy, nervousness and rest issues. Besides, in view of other research, yoga may not be any more dangerous than different types of activity, as per the specialists behind the momentum ponder.

Wednesday, 2 August 2017

Burden of Atrial Fibrillation in Patients with Spontaneous Intracerebral Hemorrhage in Florence District over the Years


Atrial fibrillation (AF) is the most commonly found arrhythmia in clinical practice, and represents a public healthcare problem worldwide. Its incidence and prevalence increase steadily with age. Prevention of AF-related cardio embolism, and especially of embolic strokes, which represent about one third of all ischemic strokes, is one of the main goals of AF treatment. Oral anticoagulation, both with direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs), represents the treatment of choice for preventing cardio embolism. Therefore, in the last decades many efforts have been made to increase physician’s confidence in the appropriate management of AF. Due to high acute mortality and severe neurological disability, spontaneous intracerebral hemorrhage (ICH) represents the most devastating stroke subtype. The 30-day mortality rate approaches 40%, and seems to have remained unchanged over the last 30 years. In the acute phase, few specific treatments, such anti-hypertensive drugs and reversal therapy in coagulopathy-associated ICH, are available only for selected patients, and their benefits are questionable. Literature evidence about the real burden of AF in patients with spontaneous ICH is lacking. Therefore, the aim of our study was to provide answer to this issue.

We reviewed the International Classification of Diseases, 9th revision, Clinical Modification (ICD-9th CM) database referred to patients discharged from the six Hospitals of Florence district (Careggi Hospital, Santa Maria Nuova Hospital, Santa Maria Annunziata Hospital, San Giovanni di Dio Hospital, Figline Valdarno Hospital and Borgo San Lorenzo Hospital), Tuscany, Italy in a 15-year period (2001-2015). Code 431 (spontaneous ICH) was searched as primary or secondary diagnosis, and then matched with code 427.31 (AF) in one of the other discharge diagnoses. The endpoints of this research were the number of cases of spontaneous ICH and AF, and the number of deaths occurred every year in patients with spontaneous ICH associated or not with AF. The burden of AF in patients with spontaneous ICH, and in-hospital mortality were reported as percentage of diagnoses.

Overall, 7452 patients were discharged with ICH as primary or secondary diagnosis. Of them, 3695 (49.5%) were females. 4363 patients (59.1%) were 75-years old and older, whereas 1678 (22.5%) were 65-75 years old, and 1411 (18.4%) under the age of 65 years. Six hundred and ninety-three patients (9.2%) had AF. The burden of AF increased with age (1.5% in patients under the age of 65 years, 6.4% in patients aged 65- 75 years, and 12.8% in those older than 75 years), and over the years (5.6% in 2001, 8.9% in 2008, and 11.4% in 2015) (Figure 1), irrespective of age. In-hospital mortality decreased over the years both in patients with and without AF (Figure 2). However, in patients with AF-related ICH, in-hospital mortality was significantly higher than in those without AF (29.4% vs 23.3%, p=0.04). 

Tuesday, 1 August 2017

An Adult Case of Congenital Bronchoesophageal Fistula


Although bronchoesophageal fistula (BEF) is well-known as a congenital disease, it is rarely seen in adults. Most common causes of acquired BEF in adult are malignancy, infection, trauma, and inflammation. We experienced a case of acquired and idiopathic BEF in an adult, therefore described our rare case and review of manuscripts associated with BEF.A 47-year-old man was admitted to our emergency department with complaints of fever, cough, and dysphagia with liquid ingestion. Information from the hospital from which he was transported indicated that esophageal tissue biopsy disclosed no evidence of malignancy, cytomegalovirus (CMV), or herpes simplex virus. Tuberculosis was not identified by interferon-gamma release assays test and polymerase chain reaction from the sputum. Findings from his general examination on arrival were as follows; heart rate 95 beats per minutes, blood pressure 97/66 mmHg, respiratory rate 16 breaths per minute, oxygen saturation 100% with 2L oxygen, body temperature 36.60 C, Glasgow Coma Scale score E4V5M6. Laboratory examination results were as follows: white blood cells 8700/μ, hemoglobin 10.4g/dl, C-reactive protein 14.3mg/dl.

 Anti-human immunodeficiency virus (HIV) test was negative. His chest radiography showed an abnormal shadow in the left lower field, suggesting pneumonia (Figure 1A). Chest computed tomography revealed a fistula running from the middle esophagus to the left lower bronchus, with pneumonia and atelectasis in the left lower lobe (Figure 1B). Contrast radiography of the upper gastrointestinal tract showed a barium outline of the esophagus, fistulous tract, and the left lower lobe bronchus (Figure 1C). To detect the cause of the fistula, gastrointestinal fiberscopy (GIF) was performed. Multiple longitudinal ulcers and fistulas were recognized (Figure 1D). No malignant or inflammatory tissues were recognized from BEF is well-known as a congenital disease and is thought to have been first reported by Negus in 1929. Frequent causes of acquired BEF include malignancy; on the other hand, benign causes such as tuberculosis, inflammatory conditions like Crohn’s disease, and traumatic factors have been found to be responsible for only 5-6% of cases.

 BEF is divided into fourtypes along with Braimbridge and Keith’s classification of BEF in 1965: type I, esophageal diverticulum with a large ostium and fistula at its tip; type II, a short tract running directly from the esophagus to the trachea or bronchus; type III, a fistulous tract connecting the esophagus with a cyst in the lobe, which also communicates with the bronchus; and type IV, a fistula that leads into a sequestrated lobe or segment. Common complaints are recurrent bouts of cough, hemoptysis, dysphagia, and fever. Esophageal cancer is the major cause of BEF in adults. BEF develops in 5% to 15% of patients with esophageal cancer, leading to life-threatening complications. Treatment and adequate management of BEF is challenging. Kimura et al. reported a patient with advanced esophageal cancer with tracheobronchial fistula treated with esophageal bypass surgery. Fukuhara et al. reported four cases of esophagobronchial fistula treated with stenting [5]. BEF caused by esophageal cancer is a sign of poor prognosis. Palliative treatment and quality of life are the main concerns for these patients.