International Journal of Medical Science and Clinical invention <p><strong>International Journal of Medical Science and Clinical invention</strong>&nbsp;is an international, peer-reviewed journal that welcomes original research articles and reviews on&nbsp;current advances in Medical sciences,&nbsp;preclinical&nbsp;and&nbsp;clinical medicine, and&nbsp;related disciplines.</p> <p>The Journal’s primary aim is to make every effort to contribute to progress in medical sciences. The strive is to bridge laboratory and clinical settings with cutting edge research findings and new developments.</p> <p><em>International Journal of Medical Science and Clinical invention&nbsp;</em>&nbsp;publishes articles which bring novel insights into&nbsp;diagnostic and molecular imaging, offering essential prior knowledge for diagnosis and treatment indispensable in all areas of medical sciences. It also publishes articles on&nbsp;<strong>Clinical</strong>&nbsp;pathological sciences&nbsp;giving foundation knowledge on the overall study of human diseases. Through its publications&nbsp;<em>International Journal of Medical Science and Clinical invention</em>&nbsp;also stresses the importance of&nbsp;Medical sciences&nbsp;as a rapidly and ever expanding area of research on drug design, development, action and evaluation contributing significantly to a variety of scientific disciplines.</p> en-US (Valley International) (Pawan lohar) Fri, 01 Feb 2019 15:28:30 +0000 OJS 60 Clinical and microbiological periodontal aspects of treatment HIV patients <p><strong>Objective: </strong>This study aims to review the literature on periodontal disease and its clinical and microbiological peculiarities in patients with HIV<strong>. </strong></p> <p><strong>Material and methods: </strong>A search was made from 2007 to 2018 of the scientific literature to evaluate the clinical and microbiological aspects of therapy periodontal in HIV patients.</p> <p><strong>Results:</strong> The studies shows periodontal status may predict the progression of HIV to Aids and periodontal treatment may be not complete effective in HIV- associated with oral manifestations. In respect to HIV infection, it is also associated with dysregulation of oral microbiota which may compromise the oral mucosal immunity of HIV-infected.&nbsp; Thus, the highly active antiretroviral therapy (HAART) regimens contributed to reduce plasma load of the virus and improvement the results of periodontal treatment in patients that has CD4 control.</p> <p><strong>Conclusion: </strong>The studies revealed periodontal status may predict the progression of HIV to Aids and periodontal treatment may be not complete effective in HIV- associated with oral manifestations. Further studies are needed to understand the complete dynamics of microbiomes and to establish new management of periodontal aspects.</p> Nathale Cruz Batista, Juliane Maria da Silva Rodrigues, Camila Possal de Paula, Vinicius Chaves Pedrosa, Gabriela Alessandra da Cruz Galhardo Cam, Raissa Martins Mendes ##submission.copyrightStatement## Fri, 01 Feb 2019 00:00:00 +0000 Sarpogrelate and atorvastatin synergistically ameliorate hyperlipidemia-induced aortic damage in LDL receptor deficient (LDL-R⁻/⁻) mice <p>Hyperlipidemia is a major risk factor for blood vessel damage, which can lead to cardiovascular diseases. Statins are the first-line treatment for hyperlipidemia and atherosclerosis. However, most patients receiving statins do not reach the low-density lipoprotein-cholesterol (LDL-c) goal. Sarpogrelate (SP) has been shown to reduce blood lipids and oxidative stress. Therefore, this study investigated the effects of SP plus atorvastatin compared to atorvastatin alone on aortic damage in LDL-R<sup>⁻/⁻</sup> mice with hyperlipidemia. Male LDL-R<sup>⁻/⁻</sup> mice were randomly divided into four groups: normal diet-fed mice (control group), high-cholesterol diet-fed mice (H group), high-cholesterol diet-fed mice treated with atorvastatin (HA group), and high-cholesterol diet-fed mice treated with atorvastatin + SP (HAS group). Total cholesterol (TC) and LDL-c levels were lower in the HA and HAS groups. SP plus atorvastatin was more effective in reducing TC and LDL-c levels, compared to atorvastatin alone. Morphological and immunohistochemical analyses showed that lipid deposition and macrophage infiltration were significantly suppressed in the HAS group, compared to those in the HA group. CD36 expression was lower in aotra tissues of mice in the HA and HAS groups than in the H group. Furthermore, macrophages and pro-inflammatory cytokine levels were lower in the HA and HAS groups than in the H group. There were significant differences in macrophages, pro-inflammatory cytokine and CD36 levels between HA and HAS groups. Therefore, SP plus atorvastatin might be more effective in ameliorating hyperlipidemia-induced aortic damage in LDL-R<sup>⁻/⁻</sup> mice, compared to atorvastatin alone.</p> Zhipeng Zhang, Fan Yang, Rongmei Na, Hongyang Liu, Zuowei Pei ##submission.copyrightStatement## Sun, 03 Feb 2019 17:27:02 +0000 Improved brain function in an adult case of Intellectual Disability with Autism Spectrum Disorder following Cell Therapy <p>Intellectual disabilities (ID) are neurodevelopmental disorders characterized by deficits in intellectual functioning and adaptive behavior which includes conceptual, social and practical skills. 1 out of 4 individuals with ID have co-existing autism spectrum disorder (ASD). Recently, cell therapy has shown great potential in management of ID with ASD due to their ability to address the underlying pathophysiology via immunomodulation and synaptogenesis. We administered autologous bone marrow mononuclear cells intrathecally in a 20-year-old male patient diagnosed as ID with ASD. Over 3 years follow up, there were no adverse events and along with symptomatic improvements, IQ scores improved from 46 to 56 and scores on ISAA improved from 134 to 70. Comparative positron emission tomography–computed tomography brain showed improved metabolism in bilateral frontal, temporal cortices and cerebellum. Autologous bone marrow mononuclear cell therapy may be effective to improve quality of life in individuals of ID with ASD even in adulthood</p> Dr. Alok Sharma, Dr. Nandini Gokulchandran, Ritu Varghese, Dr. Hemangi Sane, Dr. Vishal Ganar, Pooja Kulkarni, Samson Nivins, Dr. Prerna Badhe ##submission.copyrightStatement## Tue, 05 Feb 2019 11:47:18 +0000 Shared decision making in 21st century health care – best practices <p>Shared decision making is an interactive and collaborative process between patients and health care providers that is used to establish and execute health care decisions. This process is characterized by several features of the patient-provider interaction including eliciting and acknowledging patients’ preferences for participation; providing choices as to how the decision-making process will proceed; and mutually respecting and adhering to the ultimate choices established by patients. Shared decision making takes place based on the premise that patients have a right of self-determination. An expectation also exists that patient involvement in shared decision-making can increase the likelihood of treatment adherence by patients, improved health care outcomes, and decreased health care expenditures. This notwithstanding, the altruistic and beneficial practice of shared decision making is potentially fraught with challenges including a perceived excessive time commitment to the process with incomplete adherence by providers. In addition, contextualizing this process can represent a challenging task for providers. Finally, the touted benefits of shared decision making, including patient satisfaction with decision (SWD), improved patient outcomes, and decreased health care expenditures must be scientifically scrutinized to justify the best practices designation and widespread implementation of SDM.</p> L. Michelle Leyd, Eric R. Carlson ##submission.copyrightStatement## Tue, 05 Feb 2019 11:56:29 +0000 The Effect of antibiotic stewardship targeted against vancomycin and carbapenems on antibiotic usage in PICU <p><strong>Introduction</strong>: Inappropriate and excessive usage of antibiotics has led to an ever-expanding drug resistance phenomenon, such that some bacterial diseases have recently become untreatable. Antibiotic stewardship (ABS) programs are important for rationalizing the administration of antibiotics in hospitals, and studies have proven their effects on reducing costs and microbial resistance.</p> <p><strong>Method</strong>: The present study was conducted in the form of a clinical trial in which the effect of ABS targeted against vancomycin and carbapenems usage was evaluated in terms of the length of hospital stay and mortality in the PICU of Dr. Sheikh Children’s Hospital, Mashhad, Iran. This strategy implemented was reviewing the physicians’ prescriptions and providing feedback.</p> <p><strong>Results</strong>: In the PICU of Dr. Sheikh Children’s Hospital, vancomycin and carbapenems were inappropriately prescribed by the attending physicians in 78 and 48 % of cases, respectively. The mean number of days of both vancomycin and carbapenems usage decreased significantly in the intervention group in which the ABS program was implemented. However, no significant differences were observed between the two groups in the mean length of hospitalization and mortality.</p> <p><strong>Conclusions</strong>: Overall, it was concluded that pediatricians at Dr. Sheikh Children’s Hospital highly accepted and strongly implemented the ABS program. Our findings demonstrated that the program yielded favorable results that were similar to those of advanced hospitals. ABS programs are thus recommended for implementation in other hospitals.</p> Farzaneh Mohammadi, Gholamreza Khademi, Monavar Afzalaghaee ##submission.copyrightStatement## Wed, 06 Feb 2019 16:42:54 +0000 The Relapse rate in patients with actinic keratosis treated with diclofenac sodium 3% gel <p>Actinic keratosis (AKs) are dysplastic lesions limited to epidermal keratinocytes and are considered squamous cell carcinomas in situ. AKs affect individuals who have had chronic exposure to sunlight, particularly those with skin types 1 or 2 on the Fitzpatrick phototype scale. In this clinical trial topical therapy with diclofenac gel was demonstrated to be safe and effective overall for the treatment of actinic keratosis. A resolution of at least 50% of lesions was observed in 78% of patients with a high level of satisfaction in 85% of cases.</p> Janowska Agata, Dini Valentina, Oranges Teresa, Colombo Giorgio, Bruno Giacomo, Di Matteo Sergio, Romanelli Marco ##submission.copyrightStatement## Wed, 06 Feb 2019 16:59:13 +0000 Can a Multi-modal Communication Program Enhance Empathy and Doctor-Patient Social Interactions?; Results of a Pilot Training Study of Russian Medical Students <p>Communication is a vital element of basic professional competency within medicine. However, some medical schools may not typically offer structured developmental skills training to medical students. A multi-modal doctor communications enhancement-training program was therefore organized at a medical university in Russia. A total of 83 students ages 18-19 participated. Pre-course communication ability levels were measured at 21.7% low, 69.8% medium, and 7% high level. Post course outcome measurements demonstrated 1.2% low, 51.8% medium, and 47% high communication levels.</p> <p>Outcome: It was concluded in this pilot study that a formalized multi-modal communications development program in conjunction with performance feedback, could significantly enhance essential patient communication skills in Russian medical students.</p> Zakharova EA, Inklebarger J, Bogomolova ES, Roberts A ##submission.copyrightStatement## Mon, 11 Feb 2019 04:47:34 +0000 Factors Related To Contraceptive Selection of Iud On Mothers Who Are Family Planning Acceptors In Pantoloan Community Health Center Areas Palu City <p>A large population is a problem, the results of the population census show that the population in Indonesia reached 237.641.326 people with a Population Growth Rate of 1,49 percent. One of the efforts to implement the family planning program listed in the Medium-Term Development Plan is to increase the use of long-term contraceptive methods, one of which is the IUD. The use of IUDs at the Pantoloan Community Health Center was the lowest in 12 Community Health Center in Palu. From the data of the last 3 years, there have been fluctuations of 17 acceptors in 2013, 34 acceptors in 2014 and 30 acceptors in 2015. The purpose of this study is to determine the relationship between knowledge, attitudes, husband’s support and attitudes of health officers on the contraceptive selection of IUD by mothers who are the family planning acceptors in the Pantoloan Community Health Center. The type of this research was a quantitative study with a Cross-Sectional approach. The total population was 649 and the sample was 106 people. Sampling technique used was a proportional stratified random sampling. Statistical analysis was performed using Chi-Square test and the variable that had a relationship with the contraceptive selection of IUD was the knowledge (ρ = 0,038), maternal attitude (ρ = 0,015), husband’s support (ρ = 0,010). Whereas the attitude of health officers (ρ = 0.443) had no relationship with the contraceptive selection of IUD. It was expected that the health officers and health cadres conducted many counseling to increase the knowledge.</p> Rosmala Nur, Harfiani Saputri, Abd. Rahman, Diah Ayu Hartini, Ummu Aiman, Sendhy Krisnasari, Rahma Dwi Larasati, Pitriani . ##submission.copyrightStatement## Wed, 13 Feb 2019 09:08:22 +0000 Genes Expression in Type 1 Diabetes: An Update <p>Type 1 Diabetes (T1D) is autoimmune disease with a sturdy genetic component, which, through interactions with particular environmental factors, causes disease onset. T1D usually reveals in early to mid-childhood through the autoimmune destruction of pancreatic cells resulting in a lack of insulin production. Traditionally, prior to genome-wide association studies (GWAS), six loci in the genome were fully established to be associated with T1D. The originations of genetic factors involved in T1D through GWAS present the first step in a long process leading to cure. Genes uncovered using this approach is indeed necessary to disease biology and will define the key molecular pathways leading to cure of T1D. However, such genome wide scans can lack coverage in certain regions where it is difficult to , thus, it is possible that other loci with practical effect sizes remain to be uncovered through whole genome sequencing approaches. In this review, we address recent expansions in the genetics of T1D and provide an update on the latest predisposition loci added to the list of genes involved in the of T1D</p> Dr. Kishore Kumar Soni, Dr. Sushil Singh ##submission.copyrightStatement## Thu, 14 Feb 2019 15:58:11 +0000 Magnitude and associated factors of Perioperative hypothermia in patients who underwent Elective surgery at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. <p><strong>Background : </strong>Body temperature is a vital sign and 37°C is the mean core body temperature of a healthy human. Core body temperature is normally tightly regulated and maintained within narrow range. Perioperative hypothermia is one of the major problems during surgery and anesthesia that can affect operated patients. <strong>Methods:</strong> Institutional based cross-sectional study was conducted. Patient interview, chart review and temperature measurement were employed for data collection. Temperature was measured using tympanic membrane thermometer. SPSS version 20 software was used for analysis. binary logistic regression was used to look at associations anda p-value of &lt;0.05 was considered statistically significant.</p> <p><strong>Result :</strong>The overall magnitude of preoperative, intra and post-operative hypothermia in this study was 16.2%, 53.2% and 31.3%, respectively. Age (AOR=7.15, 95% CI, 1.16, 43.99), coexisting illness (AOR, 3.32, 95% CI, 1.06; 10.36), preoperative hypothermia (AOR; 57; 95% CI; 7.1, 455.4), operation room temperature (AOR=1.91; 95 % CI, 1.04; 3.5) and crystalloid fluids administered (AOR; 2.3; 95% CI, 1.07, 4.9) were found to be factors associated with intraoperative hypothermia.</p> <p><strong>Conclusion and recommendation:</strong> The magnitude of perioperative hypothermia remains high. Measures should focus on improving room temperature and warming up fluids. Susceptible patients like the aged and those with coexisting disease should be given extra attention.</p> <p>&nbsp;</p> Mulualem S. Fekede, Wosenyeleh A. Sahile ##submission.copyrightStatement## Sun, 17 Feb 2019 18:15:58 +0000