This paper described the pathophysiology of suicide deaths from paraquat poisoning which occurred in patients who died in fewer than 24 hours after ingesting paraquat. These deaths were referred to as hyperacute paraquat poisoning deaths. Thrombotic microangiopathy was the predominant pathological finding in all these cases and was evident in the brain, lung, heart, kidneys and in all organs and tissues examined. Of note, diffuse alveolar capillary thrombosis occurred, causing damage to alveolar walls, including those in subpleural locations, resulting in focal visceral pleural rupture leading to pneumothorax and pneumomediastinum in these cases, thus giving rise to yet another mechanism of pneumothorax and pneumomediastinum in paraquat toxicity. Thrombotic microangiopathy is the major pathological mechanism that underlies paraquat poisoning and has not hitherto been reported.
{"title":"Paraquat-induced Thrombotic Microangiopathy: The Pathophysiology in Hyperacute Paraquat Poisoning Deaths","authors":"H. Daisley, A. Rampersad, O. Acco, D. Meyers","doi":"10.7727/WIMJ.2018.141","DOIUrl":"https://doi.org/10.7727/WIMJ.2018.141","url":null,"abstract":"This paper described the pathophysiology of suicide deaths from paraquat poisoning which occurred in patients who died in fewer than 24 hours after ingesting paraquat. These deaths were referred to as hyperacute paraquat poisoning deaths. Thrombotic microangiopathy was the predominant pathological finding in all these cases and was evident in the brain, lung, heart, kidneys and in all organs and tissues examined. Of note, diffuse alveolar capillary thrombosis occurred, causing damage to alveolar walls, including those in subpleural locations, resulting in focal visceral pleural rupture leading to pneumothorax and pneumomediastinum in these cases, thus giving rise to yet another mechanism of pneumothorax and pneumomediastinum in paraquat toxicity. Thrombotic microangiopathy is the major pathological mechanism that underlies paraquat poisoning and has not hitherto been reported.","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2018-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48419830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Stemming the Brain Drain from the Caribbean Postgraduate Medical Education at The University of the West Indies Reform and Expansion of the Faculty of Medicine","authors":"M. Ragbeer","doi":"10.7727/wimj.2018.127","DOIUrl":"https://doi.org/10.7727/wimj.2018.127","url":null,"abstract":"","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2018-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42937563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. O’Sullivan, T. Campbell, A. Darby, N. Mourillon, J. Campbell, T. Melbourne, V. Green, Jackson
Objective: To report demographic and self-reported clinical characteristics associated with persistent and severe arthralgia 8–12 months post-chikungunya virus (CHIKV) infection. Methods: A cross-sectional study of 306 adults who self-reported CHIKV infection was conducted. Subjects were consecutively enrolled at public primary healthcare centres in urban and rural areas in Jamaica. Adults with arthralgic conditions were compared with those who reported no arthralgia. Binary logistic regression models were used to determine demographic and self-reported clinical factors associated with severe arthralgia and persistent arthralgia. Results: Most subjects (70.3%) reported arthralgia after CHIKV outbreak (age: 47.6 ± 18.5 years). Medical consultation (36.2%) and laboratory confirmation (1.4%) were low. The prevalence of persistent and severe arthralgia in the previous month was 30.3% and 27.5%, respectively. Severe arthralgia was associated with the female gender (odds ratio (OR): 2.44; 95% confidence level (CI): 1.08, 5.52) and pre-existing arthritis (OR: 3.78; 95% CI: 1.23, 11.62). Females showed a greater likelihood of persistent arthralgia (OR: 2.18; 95% CI: 1.09, 4.39). Conclusion: Self-perceived arthralgia was an important feature 8–12 months post-CHIKV infection and has implications for the recognition and management of arthritis/rheumatic conditions.
{"title":"Chikungunya Virus Infection-associated Arthralgia in Adult Jamaicans Post-outbreak","authors":"O. O’Sullivan, T. Campbell, A. Darby, N. Mourillon, J. Campbell, T. Melbourne, V. Green, Jackson","doi":"10.7727/wimj.2018.090","DOIUrl":"https://doi.org/10.7727/wimj.2018.090","url":null,"abstract":"Objective: To report demographic and self-reported clinical characteristics associated with persistent and severe arthralgia 8–12 months post-chikungunya virus (CHIKV) infection. Methods: A cross-sectional study of 306 adults who self-reported CHIKV infection was conducted. Subjects were consecutively enrolled at public primary healthcare centres in urban and rural areas in Jamaica. Adults with arthralgic conditions were compared with those who reported no arthralgia. Binary logistic regression models were used to determine demographic and self-reported clinical factors associated with severe arthralgia and persistent arthralgia. Results: Most subjects (70.3%) reported arthralgia after CHIKV outbreak (age: 47.6 ± 18.5 years). Medical consultation (36.2%) and laboratory confirmation (1.4%) were low. The prevalence of persistent and severe arthralgia in the previous month was 30.3% and 27.5%, respectively. Severe arthralgia was associated with the female gender (odds ratio (OR): 2.44; 95% confidence level (CI): 1.08, 5.52) and pre-existing arthritis (OR: 3.78; 95% CI: 1.23, 11.62). Females showed a greater likelihood of persistent arthralgia (OR: 2.18; 95% CI: 1.09, 4.39). Conclusion: Self-perceived arthralgia was an important feature 8–12 months post-CHIKV infection and has implications for the recognition and management of arthritis/rheumatic conditions.","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2018-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41601515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mj Ramdass, S. Balliram, A. Cadan, N. Bhaggan, B. Mohammed, R. Singh, J. Maharaj, A. Boodram
{"title":"Prevalence of Methicillin-resistant Staphylococcus aureus in the Surgical Wards ofthe Port-of-Spain General Hospital, Trinidad and Tobago","authors":"Mj Ramdass, S. Balliram, A. Cadan, N. Bhaggan, B. Mohammed, R. Singh, J. Maharaj, A. Boodram","doi":"10.7727/wimj.2016.311","DOIUrl":"https://doi.org/10.7727/wimj.2016.311","url":null,"abstract":"","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":"1 1","pages":"57-59"},"PeriodicalIF":0.1,"publicationDate":"2018-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43600133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hasan Küçükkolbaşı, S. Kucukkolbasi, H. Ayyildiz, R. Dursun, H. Kara
OBJECTIVE This study aimed to determine a possible correlation between oral mucosal disease and salivary concentrations of the antimicrobial peptides human beta-defensin-1 (hbetaD-1) and human beta-defensin-2 (hbetaD-2). METHOD The present work focussed on the establishment of a reversed phase-high performance liquid chromatography (RP-HPLC) procedure to quantify human beta-defensins (hbetaD-1 and hbetaD-2) in saliva samples of patients with oral diseases such as lichen planus (n = 10), Behcet (n = 10) and recurrent apthous stomatitis (n = 10). RESULTS Linear calibration range for hbetaD-1 and hbetaD-2 defensins was 1.67-200 microg mL-1 and 3.13 -100 PG mL-1 with R2 values of 0.9998 and 0.996, correspondingly. The concentration of beta-defensins in saliva was determined by comparing the peak areas of eluted hbetaD-1 and hbetaD-2 with that of their standards. The variation of the amount of beta-defensins was evaluated by comparisons of the results obtained from the patients with oral mucosal diseases before and after treatments and the control subjects. The limit of detection (LOD) and limit of quantification (LOQ) were found to be 1.62 microg mL-Sand 5.39 microg mL-1 for hbetaD-1 and 0.94 mig mL-1 and 3.13 microg mL-1 for hbetalD-2, respectively. CONCLUSION The salivary beta-defensin concentration was significantly higher in patients with oral mucosal diseases than in healthy volunteers; furthermore, in patients with oral mucosal diseases, the concentration was significantly higher before treatment than after treatment.
{"title":"Evaluation of hβD-1 and hβD-2 levels in saliva of patients with oral mucosal diseases","authors":"Hasan Küçükkolbaşı, S. Kucukkolbasi, H. Ayyildiz, R. Dursun, H. Kara","doi":"10.7727/WIMJ.2012.315","DOIUrl":"https://doi.org/10.7727/WIMJ.2012.315","url":null,"abstract":"OBJECTIVE This study aimed to determine a possible correlation between oral mucosal disease and salivary concentrations of the antimicrobial peptides human beta-defensin-1 (hbetaD-1) and human beta-defensin-2 (hbetaD-2). METHOD The present work focussed on the establishment of a reversed phase-high performance liquid chromatography (RP-HPLC) procedure to quantify human beta-defensins (hbetaD-1 and hbetaD-2) in saliva samples of patients with oral diseases such as lichen planus (n = 10), Behcet (n = 10) and recurrent apthous stomatitis (n = 10). RESULTS Linear calibration range for hbetaD-1 and hbetaD-2 defensins was 1.67-200 microg mL-1 and 3.13 -100 PG mL-1 with R2 values of 0.9998 and 0.996, correspondingly. The concentration of beta-defensins in saliva was determined by comparing the peak areas of eluted hbetaD-1 and hbetaD-2 with that of their standards. The variation of the amount of beta-defensins was evaluated by comparisons of the results obtained from the patients with oral mucosal diseases before and after treatments and the control subjects. The limit of detection (LOD) and limit of quantification (LOQ) were found to be 1.62 microg mL-Sand 5.39 microg mL-1 for hbetaD-1 and 0.94 mig mL-1 and 3.13 microg mL-1 for hbetalD-2, respectively. CONCLUSION The salivary beta-defensin concentration was significantly higher in patients with oral mucosal diseases than in healthy volunteers; furthermore, in patients with oral mucosal diseases, the concentration was significantly higher before treatment than after treatment.","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":"62 1","pages":"230-238"},"PeriodicalIF":0.1,"publicationDate":"2018-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44816283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In an effort to balance and monitor blood pressure, any rise in blood pressure must be carefully monitored, studied, treated and controlled. Hypertension is a conglomeration of physiological, emotional and mental factors. The physiological condition is often aggravated by atherosclerosis and arteriosclerosis, drug abuse and obesity. Cigarettes, alcohol and caffeine are known contributory factors to hypertension. It is now known that mental and emotional hypertension is common in persons who live stressful lives amidst the hustle and bustle of their daily activities.
{"title":"Herbs that Ensure Good Health and Longevity.","authors":"J. Jainarinesingh","doi":"10.7727/WIMJ.2013.153","DOIUrl":"https://doi.org/10.7727/WIMJ.2013.153","url":null,"abstract":"In an effort to balance and monitor blood pressure, any rise in blood pressure must be carefully monitored, studied, treated and controlled. \u0000 \u0000Hypertension is a conglomeration of physiological, emotional and mental factors. The physiological condition is often aggravated by atherosclerosis and arteriosclerosis, drug abuse and obesity. Cigarettes, alcohol and caffeine are known contributory factors to hypertension. It is now known that mental and emotional hypertension is common in persons who live stressful lives amidst the hustle and bustle of their daily activities.","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":"63 1","pages":"90-91"},"PeriodicalIF":0.1,"publicationDate":"2018-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41474799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Chandramathi, K. Suresh, Z. B. Anita, U. Kuppusamy
Objective: Oxidative stress has been implicated in the pathophysiology of various life threatening diseases namely cancer, cardiovascular disease and diabetes. This study aims to compare the severity of oxidative damage in cancer and some factors that may influence the levels of urinary oxidative biomarkers. The factors were sample collection period, cancer stages and lifestyle disease conditions (which are known to be associated with oxidative stress) such as diabetes with and without hypertension. Methods: The effects of the above mentioned factors on the levels of urinary advanced oxidation protein product (AOPP) and other oxidative indices such as hydrogen peroxide (H2O2), malondialdehyde (MDA) and ferric-reducing antioxidant power (FRAP) were evaluated according to well-established methods. Results: The period of sample collection did not show any significant difference in the parameters tested. The levels of oxidative stress in breast and colorectal cancer patients that generally increased with the cancer stages showed that cancer progression correlates with high oxidative damage. Comparison between diabetes with and without hypertension did not give any significant difference in the parameters tested. Among all the four oxidative indices, the level of AOPP in breast, colorectal and other types of cancers were significantly higher compared to diabetes with or without hypertension. Conclusions: The oxidative damage to protein is significantly higher in cancer and may potentially serve as a non-invasive oxidative biomarker for this disease.
{"title":"Urinary Advanced Oxidation Protein Product: A Potential Oxidative Damage Marker for Cancer","authors":"S. Chandramathi, K. Suresh, Z. B. Anita, U. Kuppusamy","doi":"10.7727/WIMJ.2012.324","DOIUrl":"https://doi.org/10.7727/WIMJ.2012.324","url":null,"abstract":"Objective: Oxidative stress has been implicated in the pathophysiology of various life threatening diseases namely cancer, cardiovascular disease and diabetes. This study aims to compare the severity of oxidative damage in cancer and some factors that may influence the levels of urinary oxidative biomarkers. The factors were sample collection period, cancer stages and lifestyle disease conditions (which are known to be associated with oxidative stress) such as diabetes with and without hypertension. Methods: The effects of the above mentioned factors on the levels of urinary advanced oxidation protein product (AOPP) and other oxidative indices such as hydrogen peroxide (H2O2), malondialdehyde (MDA) and ferric-reducing antioxidant power (FRAP) were evaluated according to well-established methods. Results: The period of sample collection did not show any significant difference in the parameters tested. The levels of oxidative stress in breast and colorectal cancer patients that generally increased with the cancer stages showed that cancer progression correlates with high oxidative damage. Comparison between diabetes with and without hypertension did not give any significant difference in the parameters tested. Among all the four oxidative indices, the level of AOPP in breast, colorectal and other types of cancers were significantly higher compared to diabetes with or without hypertension. Conclusions: The oxidative damage to protein is significantly higher in cancer and may potentially serve as a non-invasive oxidative biomarker for this disease.","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2018-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46959683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Nagassar, N. Christian, R. Gorton, B. Willey, T. Mazzulli
{"title":"Agreement, Time and Cost Comparison for the Identification of Gram Negative Bacteria Isolates Using VITEK® 2 Compact, VITEK® 60, VITEK® Mass Spectrometry and API® 20E/NE","authors":"R. Nagassar, N. Christian, R. Gorton, B. Willey, T. Mazzulli","doi":"10.7727/WIMJ.2017.139","DOIUrl":"https://doi.org/10.7727/WIMJ.2017.139","url":null,"abstract":"","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2018-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49663316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. Urakçı, M. Kaplan, M. Kuçukoner, A. Dogan, Z. Oruç, Zincircioğlu Sb, E. Bodakçı, N. Akdeniz, A. Işıkdoğan
Leukemoid reaction is characterized by an elevation in neutrophil levels in peripheral blood and is defined as a total leukocyte number exceeding 50,000/mm 3 . An increase in mature neutrophils occurs in peripheral blood in Leukemoid reaction. A 70-year-old man was referred to us due to development of leukocytosis. His history revealed that the mass had begun beneath the armpit 2 months previously and had spread rapidly. At physical examination his general condition was poor, and he was conscious, oriented and cooperative. Yellow-colored, painful, ulcerated and necrotized masses with discharge, attached to the skin and approximately 16x13 cm in size were determined in the left axilla. A painful, ulcerated, hemorrhagic mass with discharge attached to the skin and appearing to begin beneath the ear lobe, 10x9 cm in size, was determined below the ear. White cell count was 100,000 mm 3 . Ninety percent segmented neutrophils, 6% non-segmented neutrophils, 1.1% lymphocytes, 2.3% monocytes, 0.2% basophils and 0.3% eosinophils were determined at peripheral smear. Leukocyte alkaline phosphatase score was high. Squamous cell carcinoma with paraneoplastic Leukemoid reaction is an exceedingly rare combination. This case report was intended to remind physicians of the condition.
{"title":"The Case of Squamous Cell Carcinoma Accompanied Leukemoid Reaction.","authors":"Z. Urakçı, M. Kaplan, M. Kuçukoner, A. Dogan, Z. Oruç, Zincircioğlu Sb, E. Bodakçı, N. Akdeniz, A. Işıkdoğan","doi":"10.7727/wimj.2015.137","DOIUrl":"https://doi.org/10.7727/wimj.2015.137","url":null,"abstract":"Leukemoid reaction is characterized by an elevation in neutrophil levels in peripheral blood and is defined as a total leukocyte number exceeding 50,000/mm 3 . An increase in mature neutrophils occurs in peripheral blood in Leukemoid reaction. A 70-year-old man was referred to us due to development of leukocytosis. His history revealed that the mass had begun beneath the armpit 2 months previously and had spread rapidly. At physical examination his general condition was poor, and he was conscious, oriented and cooperative. Yellow-colored, painful, ulcerated and necrotized masses with discharge, attached to the skin and approximately 16x13 cm in size were determined in the left axilla. A painful, ulcerated, hemorrhagic mass with discharge attached to the skin and appearing to begin beneath the ear lobe, 10x9 cm in size, was determined below the ear. White cell count was 100,000 mm 3 . Ninety percent segmented neutrophils, 6% non-segmented neutrophils, 1.1% lymphocytes, 2.3% monocytes, 0.2% basophils and 0.3% eosinophils were determined at peripheral smear. Leukocyte alkaline phosphatase score was high. Squamous cell carcinoma with paraneoplastic Leukemoid reaction is an exceedingly rare combination. This case report was intended to remind physicians of the condition.","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2018-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48622556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hearing Evaluation in Children with Type 1 Diabetes Mellitus","authors":"Sakat, K. Kılıç, A. Çayır","doi":"10.7727/WIMJ.2017.150","DOIUrl":"https://doi.org/10.7727/WIMJ.2017.150","url":null,"abstract":"","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2018-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44176951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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