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   Table of Contents - Current issue
July-September 2019
Volume 12 | Issue 3
Page Nos. 91-146

Online since Friday, August 23, 2019

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Physical medicine in cancer rehabilitation: A narrative review Highly accessed article p. 91
Richard Crevenna
Cancer rehabilitation improves functional status, quality of life, social participation and return to work of cancer survivors. This narrative review indicates the importance of physical medicine (PM) in cancer rehabilitation and describes the situation in a Middle European University Hospital Centre. Cancer rehabilitation includes information, psycho-oncology, nutrition and PM and it is an immanent team process. Rehabilitation goals can be restorative, supportive, preventive and sometimes palliative. The rehabilitation concept focuses on symptoms and sequelae of cancer and its treatment, enabling the patients to counteract these sequelae and side effects, to gain self-competence and to easier come back after cancer treatment. The field of PM and rehabilitation (R) is an essential part of cancer rehabilitation concerning the improvement of physical performance, quality of life, social participation and return to work. Physiatrists have competencies in diagnostics and therapy as well as of coordination of the rehabilitation team and are, therefore, important players in the concept of cancer rehabilitation. Cancer survivors benefit from cancer rehabilitation due to an improvement of physical performance, nutrition, mental stabilisation, quality of life and participation (social participation and workability). PM and R is an important part of it.
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Rehabilitation of peripheral nerve injuries p. 96
Othmar Schuhfried
Rehabilitation after peripheral nerve lesions involves several professional groups such as medical doctors, physiotherapists, occupational therapists and orthopaedic technicians. The therapy goal is not only to treat the immediate symptoms due to the nerve lesion but also to avoid secondary damage. Peripheral nerve lesions often lead to severe functional limitations that affect the quality of life and professional and social participation and require appropriately targeted intervention in this regard.
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Orthopaedic and traumatological rehabilitation p. 99
Christian Wiederer
The target of orthopaedic or traumatological rehabiliation has changed over the last years. Scores of pain or flexibility of joints are not longer the final aims. Now just best functional improvement in everyday activities is the most important goal of a successful rehabilitation. There are many conservative therapeutic methods for rehabilitation settings, especially including training therapy, water therapy and occupational therapy. This article describes the extern and intern evidence based knowledge about many important forms of therapies.
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Digital dentistry p. 102
Tim Peter, Deepthi Cherian
To date, there has been various softwares used in the field of dentistry as a whole be it in the case history, imaging and in clinical practice management (PM). This article classifies the different types of dental softwares and gives an overview of the different softwares available and used in dentistry across the world with a brief note on its history. We highlight the different dental softwares available for various imaging modalities, PM and easy diagnostics in the field of dentistry. It also gives an insight into the future with different kinds of dental softwares used in the field of dentistry.
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Role of imaging in Alzheimer's disease p. 106
Walaaeldin Elfaal
Alzheimer's disease (AD) is the most common cause of dementia and its prevalence is expected to increase in the coming years. Therefore, accurate diagnosis is crucial for patients. The emerging imaging techniques have provided important information for the clinical practice and management of the disease. Computed tomography, magnetic resonance imaging, positron emission tomography, single-photon emission computed tomography and in vivo amyloid imaging are currently available for clinical use.
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Contraction and intracellular calcium transport in epicardial and endocardial ventricular myocytes from streptozotocin-induced diabetic rat p. 111
Frank Christopher Howarth, Manal M A. Smail, Muhammad Anwar Qureshi, Anatoliy Shmygol, Jaipaul Singh, Lina Al Kury
Introduction: Diabetes mellitus (DM) is a global health problem. According to the International Diabetes Federation, 424.9 million people suffered from DM in 2017 and this number is expected to rise to 628.6 million by 2045. Although diabetes can affect every organ in the body, cardiovascular disease is a major cause of death and disability in people with diabetes. Diabetic patients frequently suffer from systolic and diastolic dysfunction. Within the ventricles, the electromechanical properties of cardiac myocytes vary transmurally. Aims and Objectives: The aim of this study was to investigate contraction and Ca2+ transport in epicardial (EPI) and endocardial (ENDO) myocytes from the left ventricle in the streptozotocin (STZ) – induced diabetic rat heart. Materials and Methods: Experiments were performed 5-6 months after STZ treatment. Ventricular myocytes were isolated by enzymic and mechanical dispersal techniques from EPI and ENDO regions of the left ventricle. Contraction and free intracellular Ca2+ concentration [Ca2+]i were measured by video edge detection and fluorescence photometry techniques, respectively. Results: Myocyte length and calculated surface area were smaller in EPI-STZ compared to EPI-CON. Time to peak (TPK) shortening was prolonged in EPI-STZ compared to EPI-CON and in ENDO-STZ compared to ENDO-CON myocytes. Time to half (THALF) relaxation of shortening was prolonged in EPI-STZ compared to EPI-CON. TPK Ca2+ transient was prolonged in EPI-STZ compared to EPI-CON, ENDO-STZ compared to ENDO-CON, ENDO-STZ compared to EPI-STZ and in ENDO-CON compared to EPI-CON myocytes. THALF decay of the Ca2+ transient was prolonged in ENDO-STZ compared to ENDO-CON. Fractional release of Ca2+ was increased in ENDO-STZ compared to ENDO-CON and in ENDO-STZ compared to EPI-STZ. Recovery of the Ca2+ transient was prolonged in ENDO-STZ compared to ENDO-CON. Conclusion: In conclusion the kinetics of contraction and Ca2+ transient and fractional release of Ca2+ from the sarcoplasmic reticulum are altered to different extents in EPI and ENDO myocytes from STZ-induced diabetic rat.
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Complications of ureteroscopic stone lithotripsy: A multicentre local study p. 119
Murtadha Almusafer, Ali Mohammed Jawad Al-Tawri
Aims: The aim of the study was to evaluate semi-rigid retrograde ureteroscopic pneumatic stone lithotripsy complications and to compare between the stone-related factors associated with the occurrence of these complications. Settings and Design: The Study design was a prospective study. Subjects and Methods: Two hundred and fifty-one patients (143 male and 108 female) who underwent (266) ureteroscopic procedures for their ureteral stones in Basra Teaching Hospital and also in communication with the other local centres at the south of Iraq extending from January 2015 to August 2017. Full medical and surgical history, routine laboratory investigations and imaging study were done preoperatively. After taking informed consent, pre-operative antibiotic was given, procedure done under general or regional anaesthesia using (8 or 9.5) ureteroscopy (URS) and lithotripsy, double j stent inserted when indicated. Stone-free status was reached when all the stones were destructed and extracted while gravels and fragments <2 mm left for spontaneous passage. The patient was discharged home after 24 h unless complications occurred. Statistical Analysis Used: Descriptive statistics were done to measure the frequency of intra- and post-operative complications using SPSS version 21. Results: Stone-free status was achieved in 81.95%. Regarding intra-operative complications, perforation occurred in 10.1%, of them 8.6% were minor and 1.5% were major, mucosal abrasions occurred in 7.1%, false passage in 2.25%, stone retropulsion in 4.1% and intraoperative bleeding in 1.8%. Post-operative complication includes fever (6.4%) and ureteral obstruction (6%). Conclusions: Semi-rigid URS has gained wide acceptance worldwide and seems to be safe and efficient in managing ureteral stones with low rate of intra- and post-operative complications.
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Acute fatty liver of pregnancy p. 126
Saba Yehya AlSayari, Azza ElSayed, Zenab Yusuf Tambawala, Kinda Al Ani
Acute fatty liver of pregnancy (AFLP) is a rare and serious disorder occurring in the third trimester of pregnancy. It can cause both maternal and fetal morbidity and mortality. Its presentation can be confusing, and differential diagnosis of other liver pathology needs to be considered. Prompt and aggressive management is required to save maternal life. We present a case of AFLP at a tertiary care hospital in Dubai.
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Scrotal leiomyoma p. 129
Sikiru Adekola Adebayo, Ijeoma Nkemdilim Chibuzo, Augustine Oghenewyin Takure, Gabriel Olabiyi Ogun, Michael Chigoziem Nweke, Olayiwola Babatunde Shittu, E Oluwabunmi Olapade-Olaopa
Scrotal leiomyomata are rare benign tumours of the dartos muscle or subcutaneous tissues of the scrotum. We present a case of a 33-year-old male with a left hemiscrotal mass which was initially thought to be a sebaceous cyst, and later, a paratesticular tumour. Histology of the excised mass revealed a scrotal leiomyoma, an uncommon lesion.
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Tracheal amyloidosis presenting with hemoptysis p. 134
Madhu Priya, Ranjan Kumar Das, Srabani Mukherjee
Amyloidosis is a generic term for a heterogeneous group of disorders associated with deposition of protein in an abnormal fibrillar form. The diverse spectrum of amyloid-related diseases is now recognised to include Alzheimer's disease, Type II diabetes and transmissible spongiform encephalopathies. Amyloidosis can be hereditary or acquired, localised or systemic and potentially lethal or merely an incidental finding. Tracheal amyloidosis refers to the deposition of localised amyloid deposits in the trachea. Localised tracheal amyloidosis is a rare form of amyloidosis with only a few hundred cases reported so far. We report here a case of a 65-year-old male presenting with haemoptysis.
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Polyglandular autoimmune syndrome diagnosed previously as an isolated primary adrenal insufficiency p. 137
Abdulraheem Abdullah Bahishwan, Rasheed Mohammed Bamekhlah, Mohammed Rasheed Bamekhlah
A 32-year-old female patient diagnosed 3 years back as Addison's disease; she presented with vaginal candidiasis, oral thrush, fatigue and constipation, and the condition started since childhood and pre-puberty in succession. On examination, there were vitiligo and nail dystrophy. The investigations required done, which revealed hypoglycaemia, hypocalcaemia and hyperkalaemia; hormonal study gave a picture of primary adrenal and parathyroid insufficiency with euthyroidism. The patients finally proved to have mucosal candidiasis, primary hypoparathyroidism and Addison's disease with no thyroid abnormality. The case was diagnosed with autoimmune polyglandular syndrome (Type I).
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Hepatosplenomegaly in Rosai–Dorfman disease: A rare finding in a rare disease p. 140
Aamer Ubaid, Farishta Waheed, Awais Naeem
Rosai–Dorfman disease (RDD) is a rare, usually self-limiting disease caused by a histiocytic proliferation of unknown aetiology in the lymph nodes sinuses and extranodal tissue. The condition usually presents with massive lymphadenopathy involving multiple lymph node groups in the body but is not always confined to the lymph nodes – it can also involve extranodal tissues such as the skin, liver, spleen and central nervous system. We present the case of a 50-year-old female with RDD with hepatosplenomegaly initially misdiagnosed with tuberculosis.
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Be Healthy, be mobile: An initiative to improve the quality of life of diabetics in senegal p. 144
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
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Erratum: Principles of lung cancer screening – Low-dose computerized tomography p. 146

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