Download the Free Unbound MEDLINE PubMed App to your smartphone or tablet.
Available for iPhone, iPad, iPod touch, and Android.
Med Princ Pract [journal]
- Allopurinol as a Preventive Contrivance after Acute Ischemic Stroke in Patients with a High Level of Serum Uric Acid: A Randomized, Controlled Trial. [JOURNAL ARTICLE]
- Med Princ Pract 2013 Nov 27.
Objectives: To assess the clinical relevance (functional outcome) of a 3-month allopurinol regimen in patients with high serum uric acid (SUA) levels and acute ischemic stroke without considering the changes in SUA levels. Materials and Methods: In a randomized, double-blind, controlled study, 70 patients (45 females, 25 males) with acute ischemic stroke who had elevated levels of SUA were included. They were divided in two 35-patient groups to investigate the effect of 3 months of an allopurinol (200 mg/day) regimen versus placebo on their functional outcome, which was evaluated using a modified Rankin scale. Results: The overall mean age was 68.9 ± 11.33 years (range 27-89). The final favorable functional status (mRS = 0-2) was 23 (65.7%) and 14 (40.0%) in the treated and placebo groups, respectively, which was strongly associated with allopurinol consumption (OR = 4.646, p = 0.014) and age ≤70 years (OR = 0.139, p = 0.005) in patients with ischemic stroke after adjusting for confounders. There was no significant difference in death between allopurinol-treated cases (3; 8.6%) and placebo-treated ones (6; 17.2%; p = 0.278). Conclusion: Allopurinol treatment was well tolerated and improved the 3-month functional status of patients with acute ischemic stroke who had high levels of SUA without considering the decreasing effect of allopurinol on SUA. © 2013 S. Karger AG, Basel.
- Metformin-Induced Hemolytic Anemia. [JOURNAL ARTICLE]
- Med Princ Pract 2013 Nov 27.
Objective: To report a rare side effect of metformin, an oral antidiabetic drug that is used for the treatment of type 2 diabetes mellitus. Clinical Presentation and Intervention: A 17-year-old boy was hospitalized for receiving acute lymphoblastic leukemia treatment that was composed of vincristine, L-asparaginase, daunorubicin, and prednisone. Hyperglycemia was determined without any clinical sign and metformin was started for steroid-induced insulin resistance. On the second day of metformin treatment, the patient's hemoglobin level decreased, and a direct Coombs test was positive for immunoglobulin G but negative for complement. An indirect Coombs test was negative. The glucose-6-phosphate dehydrogenase level was within the normal range. Drug-induced hemolytic anemia was suspected and metformin was discontinued. The jaundice gradually disappeared and there was no requirement for red blood cell transfusions. Conclusion: This case showed that physicians should be aware of the potential side effect of metformin although it is infrequent. © 2013 S. Karger AG, Basel.
- Cardiomyopathies: The Value of Cardiac Magnetic Resonance Imaging. [LETTER]
- Med Princ Pract 2013 Nov 21.
- Gastric Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue and Signet Ring Cell Carcinoma, Synchronous Collision Tumour of the Stomach: A Case Report. [JOURNAL ARTICLE]
- Med Princ Pract 2013 Nov 12.
Objective: To report a rare case of synchronous marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) signet ring cell carcinoma occurring as a collision tumour in the stomach. Clinical Presentation and Intervention: A 53-year-old man was diagnosed initially with signet ring cell carcinoma of the stomach. The microscopy of the subsequent total gastrectomy revealed a collision tumour of MALT lymphoma and signet ring cell carcinoma associated with Helicobacter pylori gastritis. Conclusion: This case highlighted the importance of a careful evaluation of the accompanying lymphoid population in the biopsy samples of gastric adenocarcinoma and underlined the need for multiple endoscopic biopsies to detect these rare synchronous tumours. © 2013 S. Karger AG, Basel.
- Ambulatory Blood Pressure Parameters in Office Normotensive Obese and Non-Obese Children: Relationship with Insulin Resistance and Atherosclerotic Markers. [JOURNAL ARTICLE]
- Med Princ Pract 2013 Nov 12.
Objectives: To determine differences in ambulatory blood pressure (ABP) parameters between office normotensive obese and non-obese children and to evaluate correlations of ABP parameters with insulin resistance and the lipid profile. Subjects and Methods: Thirty-eight obese [body mass index (BMI) above the 95th percentile] and 38 non-obese children aged 9-17 years were recruited. All subjects who were normotensive during office visits and who underwent 24-hour ABP monitoring were evaluated. Insulin resistance and the lipid profile were also evaluated. Results: The mean daytime, night-time and 24-hour systolic blood pressure (SBP) and the daytime and 24-hour diastolic blood pressure (DBP) in normotensive obese children were significantly higher compared to the values in non-obese children (p < 0.05). There was no difference in the frequency of nocturnal non-dippers and nocturnal hypertension (night-time SBP at or above the 95th percentile) between the two groups (p > 0.05). Children with night-time SBP at or above the 95th percentile and non-dippers had higher atherosclerotic markers than children with night-time SBP below the 95th percentile and dippers (p < 0.05). In logistic regression analysis, the low-density lipoprotein cholesterol (LDL-C):high-density lipoprotein cholesterol (HDL-C) ratio and night-time SBP had significantly positive associations with being obese in adolescents (OR 6.54, 95% CI 1.15-37.07, p = 0.03, and OR 1.1, 95% CI 1.01-1.19, p = 0.02, respectively). Conclusion: Normotensive obese children had higher ABP parameters. A high LDL-C:HDL-C ratio and night-time SBP were associated with an increased risk of being obese. High LDL-C:HDL-C ratios and total cholesterol:HDL-C levels in children and adolescents may be risk factors for night-time hypertension. © 2013 S. Karger AG, Basel.
- The Protective Effect of Hesperidin on Methotrexate-Induced Intestinal Epithelial Damage in Rats: An Experimental Study. [JOURNAL ARTICLE]
- Med Princ Pract 2013 Nov 11.:45-52.
Objective: The purpose of this experimental study was to evaluate the efficacy of hesperidin (HES) in protecting against methotrexate (MTX)-induced intestinal damage using histopathological and immunohistochemical techniques. Materials and Methods: Seventy-eight male Wistar albino rats were divided into 4 groups that received (a) saline only (control group), n = 19; (b) HES only, n = 19; (c) MTX only, n = 19, and (d) MTX plus HES, n = 21. On the first day of the study, a single dose of MTX (20 mg/kg) was administered intraperitoneally to group 3 and 4 rats. The HES (200 mg/kg) was administered by gavage for 5 days. For the MTX plus HES group, HES (200 mg/kg) was administered by gavage for 5 days after MTX treatment. Rats were sacrificed on the 2nd, 4th and 6th day of the study. Tissue samples from the jejunum were taken for histopathological and immunohistochemical analysis. Results: On the 4th day, crypt injury in the MTX plus HES group (1.00 ± 0.00) was less than that in the MTX group (2.00 ± 0.89; p < 0.05). The small intestinal damage score was lower in the MTX plus HES group (6.33 ± 0.82) as compared to the MTX group (8.00 ± 2.37). Inducible nitric oxide synthase and interleukin-8 levels were lower in the MTX plus HES group (65 and 25%, respectively) as compared to the corresponding values of the MTX group (80 and 52.5%, respectively). On the 6th day, the Ki-67 proliferation index in the MTX group (45%) was lower than that in the MTX plus HES group (76.67%) and the control group (p < 0.05). The small intestinal damage score was high in the HES group on the 4th day due to increased cellular infiltration. On the 6th day, the Ki-67 proliferation index rose in parallel with the decrease in cellular infiltration and therefore histopathological scoring. The proliferation-enhancing effect of HES also appeared in healthy rats. Conclusion: HES seemed to have a protective effect against MTX-induced intestinal injury. © 2013 S. Karger AG, Basel.
- Integrating a Primary Oral Health Care Approach in the Dental Curriculum: A Tanzanian Experience. [JOURNAL ARTICLE]
- Med Princ Pract 2013 Nov 13.
This paper is based on a conference presentation made during the inauguration of the Faculty of Dentistry, Kuwait University, as a World Health Organization Collaborating Centre for Primary Oral Health Care (POHC) on November 27-28, 2012. The aim of this paper is to review how the POHC approach has been integrated into the dental curriculum, sharing the Tanzanian experience as a case presentation from a developing country. The burden of oral diseases worldwide is high, and the current oral health workforce is inadequate to meet the challenges. Curative oral health care is very costly and not accessible to the poor and minorities. To tackle the problem, the POHC approach rooted in primary health care that emphasizes equity, community involvement, prevention, appropriate technology and a multi-sectorial approach was developed and has been operating for more than 3 decades now. Execution of a comprehensive POHC requires a trained oral health workforce mix with essential competencies. For this case study, a literature search was done using the search engines subscribed to by the library of Muhimbili University of Health and Allied Sciences, including PubMed, Cochrane, ScienceDirect and Scopus, Wiley-Blackwell Interscience, Sage and the Health InterNetwork Access to Research Initiative (HINARI) that gives access to Scirus and Google Scholar. Challenges are discussed with an emphasis more on addressing the common risk factors and determinants of oral health. Integration of the POHC approach in the dental curriculum for training a competent workforce is crucial in attaining better oral health. Resources are still a major challenge, and the impact of the POHC approach in the curriculum is yet to be evaluated. © 2013 S. Karger AG, Basel.
- A Case of Pigmented Fungiform Papillae of the Tongue in a Middle Eastern Woman. [JOURNAL ARTICLE]
- Med Princ Pract 2013 Nov 12.
Objective: To report a case of pigmented fungiform papillae on the tongue. Clinical Presentation and Intervention: A 29-year-old female presented with patchy pigmented areas on her tongue of 2 years' duration. Examination of the tongue showed pigmentation confined to the fungiform papillae on the dorsum of the tongue. She was healthy and was not taking any medications and hence a diagnosis of pigmented fungiform papillae was considered. The patient was reassured of the benign nature of this condition and no treatment was given. However, a 6-month follow-up was suggested. Conclusion: Clinicians should be aware of this benign variant of lingual pigmentation to avoid confusion with pathological conditions and also to avoid unnecessary investigative procedures. © 2013 S. Karger AG, Basel.
- [Faculty Seminar Series: A Window into Research Potentials and Productivity.] [JOURNAL ARTICLE]
- Med Princ Pract 2013 Nov 13.:1-2.
- Histological Evaluation to Study the Effects of Dental Amalgam and Composite Restoration on Human Dental Pulp: An in vivo Study. [JOURNAL ARTICLE]
- Med Princ Pract 2013 Nov 8.:40-44.
Objective: To study and compare the effects of dental amalgam and composite restorations on human dental pulp. Materials and Methods: One hundred sound premolars scheduled for orthodontic extraction were divided equally into two groups: group A, teeth restored with silver amalgam, and group B, teeth restored with composite resin. Each group was equally subdivided into two subgroups [extracted after 24 h (A-1 and B-1) or 7 days (A-2 and B-2)], and the histological changes in the pulp related to the two different materials at the two different intervals were studied. Results: It was found that after 24 h, the inflammatory response of the pulp in teeth restored with amalgam and composite was similar (p = 1.00). However, after 7 days, the severity of the inflammatory response of the pulp in teeth restored with amalgam was less compared to that in teeth restored with composite (p = 0.045). Conclusion: This study confirmed that amalgam continues to be the mechanically as well as biologically more competent restorative material. Composite could be a promising restorative material to satisfy esthetic needs for a considerable period of time. However, its biological acceptance is still in doubt. © 2013 S. Karger AG, Basel.