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Sickle - Cell Disease 镰状细胞病
Pub Date : 2020-09-30 DOI: 10.47363/jmhc/2021(3)162
S. Phadnis
Sickle cell disease is a common inherited, multisystem, monogenic disorder of red blood cells (erythrocytes) caused due to polymorphic changes in hemoglobin. The most commonly known condition; Sickle cell anemia wherein there aren’t enough healthy RBCs to carry adequate oxygen throughout the body is considered to be a common form if Sickle-cell disease. Other type of Sickle cell disease is Hemoglobin SC disease (HbSC) caused due to inheritance of beta s and beta c alleles. The third type of such disease is HbS thalassemia caused due to beta-thalassemia mutation in the beta-globin gene leading to Sickle hemoglobin (HbS). Polymerization of HbS due to presence of fetal hemoglobin in the erythrocytes that in turn reduces the concentration of HbS which becomes the prominent determinant to check the severity of the disease. Reduced concentrations of HbS also reduce hemolysis that prevents acute vaso- occlusion. This pain is caused as the irregular shaped RBCs and WBCs get entrapped in the small blood vessels causing vascular obstruction and tissue ischemia. HbS polymerization can also lead to hemolytic anemia which is a state where in rate of RBC destruction is faster than formation; such patients are likely to develop vasculopathy. During the process of hemolysis, hemoglobin is released into plasma that inhibits endothelial nitric oxide signaling causing endothelial cell dysfunction. Hemolysis is also associated with formation of erythrocyte microvesicles that acts as a activator of tissue factor. Malaria is considered to cause HbS. Sickle cell disease is found to be highest in the African continent mostly affecting the new borns. The cause of deaths is hug in Africa due to poor diagnostic facilities. Measures taken against H influenzae and S pneumoniae that is profoundly detected in African children with Sickle cell disease can help reduce the disease proximity. Implementation of early life screening can thereby be effective in this case.
镰状细胞病是一种常见的遗传性、多系统、单基因的红细胞疾病,由血红蛋白的多态性改变引起。最常见的情况;镰状细胞性贫血是一种常见的镰状细胞病,其中没有足够的健康红细胞在全身携带足够的氧气。镰状细胞病的另一种类型是血红蛋白SC病(HbSC),由β s和β c等位基因遗传引起。这种疾病的第三种类型是HbS地中海贫血,是由于-珠蛋白基因中的-地中海贫血突变导致镰状血红蛋白(HbS)而引起的。由于红细胞中胎儿血红蛋白的存在,HbS的聚合反过来降低了HbS的浓度,这成为检查疾病严重程度的重要决定因素。HbS浓度的降低还能减少溶血,从而防止急性血管闭塞。这种疼痛是由于不规则形状的红细胞和白细胞被困在小血管中,引起血管阻塞和组织缺血。HbS聚合也会导致溶血性贫血这是一种红细胞破坏速度快于形成速度的状态;这样的病人很可能发展成血管病变。在溶血过程中,血红蛋白被释放到血浆中,抑制内皮一氧化氮信号,导致内皮细胞功能障碍。溶血还与红细胞微泡的形成有关,红细胞微泡是组织因子的激活剂。疟疾被认为是导致HbS的原因。镰状细胞病在非洲大陆发病率最高,主要影响新生儿。在非洲,由于诊断设施差,死亡原因很严重。针对在患有镰状细胞病的非洲儿童中广泛发现的流感嗜血杆菌和肺炎链球菌采取的措施有助于减少疾病的接近性。因此,在这种情况下,实施早期生命筛查是有效的。
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引用次数: 0
Eicosapentaenoic Acid Based Therapies: Fish Facts and Stories 二十碳五烯酸治疗:鱼类的事实和故事
Pub Date : 2020-09-30 DOI: 10.47363/jmhc/2021(3)161
A. Kuchkuntla, Sri Harsha Patllola
The significant hypo-lipidemic, anti-thrombotic and anti-inflammatory features of EPA created extensive interest in preventive cardiology from the early 90s, since then several clinical studies were conducted to study the mechanisms and benefits of fish oil use. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are essential FAs therefore, they must be provided in diet or in the form of supplements. The supplements are low dose combinations of EPA and DHA have no significant benefits in terms of CVD prevention in clinical trials. However, a high dose Ethyl ester formulation of EPA has shown a 25% reduction of major adverse coronary events in the secondary prevention. Cardio-protective potential of EPA is attributed to its triglyceride lowering effect, reduction in inflammatory markers, improving coronary plaque stability, anti-platelet effect and improvements of over-all metabolic profile. We intend to provide preventive and therapeutic potentials of EPA in CVD, mechanisms of cardio protection, available evidence and future trails.
EPA具有显著的降血脂、抗血栓和抗炎作用,自90年代初以来,人们对预防心脏病学产生了广泛的兴趣,此后进行了几项临床研究来研究鱼油的使用机制和益处。二十碳五烯酸(EPA)和二十二碳六烯酸(DHA)是必需的脂肪酸,因此必须在饮食中或以补充剂的形式提供。这些补充剂是EPA和DHA的低剂量组合,在临床试验中对预防心血管疾病没有显著益处。然而,EPA的高剂量乙酯制剂显示,在二级预防中,主要冠状动脉不良事件减少了25%。EPA的心脏保护潜力归因于其降低甘油三酯的作用、减少炎症标志物、改善冠状动脉斑块稳定性、抗血小板作用和改善整体代谢状况。我们打算提供EPA在心血管疾病中的预防和治疗潜力、心脏保护机制、现有证据和未来的研究。
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引用次数: 0
Effect of Motor Skill Training on Balance and Hand – Eye Coordination in Children with Attention Deficit Hyperactivity Disorder (ADHD) 运动技能训练对注意力缺陷多动障碍(ADHD)儿童平衡和手眼协调的影响
Pub Date : 2020-09-30 DOI: 10.47363/jmhc/2021(3)164
A. R
Background: ADHD or Attention Deficit Hyperactive disorder is one of the most common condition affecting children. It is a neuro behavioural disorder affecting boys more than girls with a ratio of 3:1 and it affects almost 3 to 6 percentage of school children. There are limited number of studies on motor skill training to improve attention, balance and hand eye coordination. Methodology: Quasi Experimental, Convenient sampling, sample size was 30. The Participants for the study were selected based on the inclusion and exclusion criteria and experimental group followed 6 weeks of motor skill training exercise along with conventional physiotherapy. Conclusion: The results of this study showed post-test values of paediatric balance scale, nine-hole peg board test and gross motor functional measure of experimental and control group has a p value < 0.05 which is statistically significant. The study concludes that, motor skill training on attention deficit hyperactivity disorder shows significant improvement in balance and hand eye coordination.
背景:多动症或注意力缺陷多动障碍是影响儿童最常见的疾病之一。这是一种影响男孩多于女孩的神经行为障碍,比例为3:1,影响了近3%至6%的在校儿童。关于提高注意力、平衡和手眼协调的运动技能训练的研究数量有限。方法:准实验,取样方便,样本量为30。根据纳入和排除标准选择研究参与者,实验组进行了6周的运动技能训练和常规理疗。结论:本研究结果显示,实验组和对照组的儿童平衡量表、九孔钉板试验和大体运动功能测量的测试后值均为p值<0.05,具有统计学意义。研究得出的结论是,注意力缺陷多动障碍的运动技能训练在平衡和手眼协调方面有显著改善。
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引用次数: 0
Dietary Fat and Energy Content of Steeped, Germinated and Unprocessed Maize Grains Meant For Complementary Feeding In Nigeria 尼日利亚用于辅食的浸泡、发芽和未加工玉米籽粒的日粮脂肪和能量含量
Pub Date : 2020-09-30 DOI: 10.47363/jmhc/2021(3)159
E. Adeyeye
Household technologies such as fermentation, soaking, roasting and malting are traditionally used in many societies with the assumption that they can contribute to improving the safety and quality of complementary foods. To observe the dietary lipid quality, unprocessed, steeped and germinated maize grains were used to evaluate their effect on the enhancement of fatty acids, phospholipids and phytosterols. Maize samples were denoted as B1 (unprocessed) B2 (sprouted) and B3 (steeped) maize. In crude fat, B2 was enhanced by 0.47g/100g (9.23%). Calculated fatty acids had values (g/100g) of:B1(3.66) B3(3.63). Highest levels of these fatty acids were observed as follows: SFA(B2, 27.2%), MUFA(B1,34.7%) and PUFA(B1,47.0%); but B3 was more concentrated in MUFA and PUFA than B2 but less than B1.Both oleic and linoleic fatty acids slightly increased during steeping stage of malting but later declined during germination phase particularly oleic acid. Total energy density (kcal/100g) concentration in the samples with the percentage linoleic acid had these values: B1(32.9, 43.7%), B2(36.0, 37.2%) and B3(32.7, 41.9%). Total phytosterol (mg/100g) values were low: B1(52.3), B2(43.7) and B3(45.1) with sitosterol predominating in all: 33.5 > 28.8 < 29.6 respectively. In phospholipids, values were generally higher than the phytosterols as we have total values (mg/100g) of: B1(74.4); B2(71.3) and B3(62.0) with phosphatidylinositol predominating in all samples: 25.5 > 25.1 > 22.4 respectively. Raw maize sample had highest concentration of phospholipids, phytosterols, MUFA and PUFA. The declines in B2 and B3 in the above parameters suggested that lipids were used for biochemical processes. However, B3 was better concentrated than B2 in phytosterols, MUFA, PUFA, linoleic and oleic acids. This showed germination reduced fat content due to hydrolysis and utilization of fat as an energy source in germination. Observations had depicted the contribution of maize to presence of high level phosphatidylinositol and sitosterol to the infant. It also contributed to information on discrepancies on the effect of fermentation/ germination on cereal lipids in literature. Either steeped or sprouted maize is good as complementary food.
发酵、浸泡、烘烤和麦芽酿造等家庭技术传统上在许多社会中使用,人们认为这些技术有助于提高辅食的安全和质量。为观察饲料脂质,采用未加工、浸泡和发芽的玉米籽粒,考察其对脂肪酸、磷脂和植物甾醇的增强作用。玉米样品分别表示为B1(未加工)B2(发芽)和B3(浸泡)玉米。粗脂肪中B2含量提高0.47g/100g(9.23%)。计算的脂肪酸值(g/100g)为:B1(3.66) B3(3.63)。这些脂肪酸的最高水平为:SFA(B2, 27.2%)、MUFA(B1,34.7%)和PUFA(B1,47.0%);但B3中MUFA和PUFA的浓度高于B2,而低于B1。油酸和亚油酸脂肪酸在浸泡期均略有增加,但在萌发期有所下降,尤其是油酸。亚油酸百分比样品的总能量密度(kcal/100g)浓度分别为:B1(32.9, 43.7%)、B2(36.0, 37.2%)和B3(32.7, 41.9%)。总植物甾醇(mg/100g)值较低:B1(52.3)、B2(43.7)和B3(45.1),其中谷甾醇占主导地位,分别为33.5、28.8和29.6。磷脂的值通常高于植物甾醇,因为我们有总值(mg/100g): B1(74.4);B2(71.3)和B3(62.0)在所有样品中以磷脂酰肌醇为主:分别为25.5 > 25.1 > 22.4。玉米原料样品中磷脂、植物甾醇、多聚脂肪酸和多聚脂肪酸含量最高。上述参数中B2和B3的下降表明脂质被用于生化过程。B3对植物甾醇、多聚脂肪酸、多聚脂肪酸、亚油酸和油酸的富集效果优于B2。这表明萌发过程中脂肪的水解和作为能量来源的利用降低了脂肪含量。观察描述了玉米对婴儿体内高水平磷脂酰肌醇和谷甾醇的贡献。这也有助于文献中关于发酵/萌发对谷物脂质影响的差异信息。浸泡或发芽的玉米都是很好的辅食。
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引用次数: 0
Gene Therapy Shows Promise Against Sickle – Cell Disease 基因疗法显示对抗镰状细胞病的希望
Pub Date : 2020-09-30 DOI: 10.47363/jmhc/2021(3)163
S. Phadnis
Sickle Cell Disease (SCD) is a genetic blood disorder which is characterized by presence of abnormal hemoglobin (HbS) allele along with a second allele that can cause polymerization of such abnormal molecule. The state arises due to a genetic mutation that distorts red blood cells into sickle shaped. Sickle cells block red blood cells from passing through the blood vessels and prevent the supply of oxygen that results into severe complications like anemia, hypertension and organ failure
镰状细胞病(SCD)是一种遗传性血液疾病,其特征是存在异常血红蛋白(HbS)等位基因以及可引起这种异常分子聚合的第二等位基因。这种状态是由于基因突变使红细胞扭曲成镰刀状而产生的。镰状细胞阻止红细胞通过血管,阻止氧气的供应,从而导致贫血、高血压和器官衰竭等严重并发症
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引用次数: 0
How to Decrease the Cost of Healthcare 如何降低医疗成本
Pub Date : 2020-09-30 DOI: 10.47363/jmhc/2021(3)165
R. Yanushevsky
Healthcare is among the most important issues for Americans since the U.S. healthcase system is the most expensive in the world. Public spending, including governmental spending, social health insurance, and compulsory private insurance constitutes the largest source of healthcare spending. By analyzing the reasons of high healthcare costs the paper contributes to the ongoing policy debates how to improve the current healthcare system
医疗保健是美国人最重要的问题之一,因为美国的医疗系统是世界上最昂贵的。公共支出,包括政府支出、社会健康保险和强制性私人保险构成医疗保健支出的最大来源。通过分析高医疗成本的原因,本文有助于正在进行的政策辩论如何改善目前的医疗体系
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引用次数: 0
Fatal Multisystem inflammatory syndrome (MIS) in a young adult following a recent mild Covid-19 一名年轻成人近期轻度Covid-19感染后出现致命性多系统炎症综合征
Pub Date : 2020-09-30 DOI: 10.47363/jmhc/2021(3)158
Mahathi Gopalakrishnan
Corona virus disease (COVID19) has been evolving with different spectrum of illness over time. Recently, Multi system Inflammatory syndrome (MIS), a hyper inflammatory immune response has been observed after recovery from COVID, and is described in children. Here we present a young adult with Multi system inflammatory syndrome post an asymptomatic COVID infection with a rapidly worsening clinical course. Shock, gastrointestinal symptoms are described in most adults with multisystem inflammatory syndrome (MIS-A), while respiratory involvement is minimal, whereas the patient we are reporting here had severe respiratory involvement and fulminant course. As the case reports of MIS-A is being reported majority of cases are not diagnosed in time. Increased awareness about this condition is essential, as timely immunomodulatory therapy is therapeutically life saving
随着时间的推移,冠状病毒疾病(COVID19)一直在演变成不同的疾病谱。最近,在儿童中发现了多系统炎症综合征(MIS),这是一种新冠肺炎康复后的炎症免疫反应。在这里,我们介绍了一名患有多系统炎症综合征的年轻人,在无症状的新冠肺炎感染后,其临床病程迅速恶化。大多数患有多系统炎症综合征(MIS-A)的成年人都有休克和胃肠道症状,而呼吸道受累程度很低,而我们在这里报道的患者有严重的呼吸道受累和暴发性病程。由于MIS-A的病例报告正在报告中,大多数病例没有及时诊断。提高对这种情况的认识是至关重要的,因为及时的免疫调节治疗可以挽救生命
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引用次数: 1
The Genetic Basis of Hypertension 高血压的遗传基础
Pub Date : 2020-06-30 DOI: 10.47363/JMHC/2021(3)152
Michalopoulou Helena, Stamatis Foivos-Konstantinos
Hypertension (HTN) is one of the major risk factors for almost all cardiovascular diseases including coronary artery disease, stroke, heart failure and renal failure. Nonetheless , blood pressure (BP) regulation is insufficient due to its multifactorial nature involving interactions among genetic, environmental, mechanistic and neuroendocrine factors. Essential hypertension is the most frequent diagnosis indicating that a monocausal etiology has not been identified. The identification of causal genetic determinants has been unfulfilling. Analyses of rare monogenic syndromes of HTN focusing on renal sodium handling and steroid hormone metabolism have proved the well-defined genetic frame of hypertension though they do not affect the normal distribution of BP in the general population. Genome-wide association studies (GWAS) have revealed genetic variants that are associated with BP with small effect size which cumulatively explain to a very small extend the variability of BP. New large-scale studies in the genomic arena will clarify the polygenic determinants of BP and open a perspective on translation of the progression in BP genetics to clinical use
高血压(HTN)是几乎所有心血管疾病的主要危险因素之一,包括冠状动脉疾病、中风、心力衰竭和肾衰竭。然而,由于其多因素的性质,涉及遗传、环境、机械和神经内分泌等因素的相互作用,血压调节不足。原发性高血压是最常见的诊断,表明单原因病因尚未确定。因果遗传决定因素的鉴定一直没有实现。对肾钠处理和类固醇激素代谢的罕见HTN单基因综合征的分析证明了高血压的明确遗传框架,尽管它们不影响血压在普通人群中的正态分布。全基因组关联研究(GWAS)揭示了与BP相关的遗传变异,其效应大小很小,累积起来只能在很小的范围内解释BP的变异性。新的基因组领域的大规模研究将阐明BP的多基因决定因素,并为BP遗传学的进展转化为临床应用开辟前景
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引用次数: 0
Physicochemical Properties of Selected Local Medicinal Soups Consumed in Southwest Nigeria 尼日利亚西南部某些地方药汤的理化性质
Pub Date : 2020-06-30 DOI: 10.47363/jmhc/2021(3)147
Buraimoh Samuel Osaretin, Adeniyi Adejoke Deborah
Cottonseed (Gossypium herbaceum), bitter leaf (Vernonia) amydalina), cashew leaf (Anacardium occidentale), Piper nigrum (black pepper) and scent leaf (Ocimumgratissimum) are major ingredients used in preparation of the local soups namely; ‘koroowu soup’, ‘black soup’, ‘cashew leaf soup’ and ‘ewe luje soup’ consumed in certain parts of Nigeria. The ingredients for the soups were sorted according to the local preparations, separately blended into a paste and were either cooked or uncooked. The pastes were subjected to physicochemical (proximate, pH, total titratable acidity, mineral, phytochemical, antioxidant) and antimicrobial assays. The results showed that the cooked and uncooked pastes from these soups had pH ranged from 4.38-5.89, total titratable acidity (TTA) (0.05%-0.37%), moisture (9.30%-24.75%) and ash content (3.41%-7.17%). However, it was observed that the soup pastes were high in protein (10.39%-12.64%), fibre (13.82%-20.48%) and fat (21.11%-34.47%). The mineral content of the soups revealed that calcium ranged from 1.24ppm8.74 ppm, zinc (1.3 ppm-1.65 ppm), potassium (4.04 ppm-20.94 ppm) and sodium content (14.27 ppm-67.00 ppm). The phytochemical composition of the pastes showed that saponin (4.59mg/g-62.91 mg/g) was the highest, followed by phytate (15.24 mg/g-61.39 mg/g), alkaloid (0mg/g-27.84 mg/g), tannin (2.39 mg/g-6.57 mg/g), oxalate (0.72 mg/g-2.12 mg/g). The soup samples were found to exhibit free radical scavenging property (DPPH) of 30.0%-100%, 2,2’-azino-bis(3-methylbenzothiazoline-6-sulphonic acid) (ABTS) scavenging ability (70.0-100%), and ferric reducing power (2.73 mg/g-20 mg/g). However, the aqueous extract from the soup pastes could not inhibit the growth of microorganism tested. Further studies should be carried out to identify the bioactive compounds responsible for the antioxidant activities recorded from the soup pastes.
棉籽(Gossypium herbaceum)、苦叶(Vernonia)、腰果叶(Anacardium occidentale)、黑胡椒(Piper nigrum)和香叶(Ocimumgratissimum)是制作当地汤的主要原料,即;“koroowu汤”、“黑汤”、“腰果叶汤”和“ewe luje汤”在尼日利亚某些地区消费。汤的原料根据当地的准备进行分类,分别混合成糊状,要么煮熟,要么生。对膏体进行了理化(近似、pH、总可滴定酸度、矿物质、植物化学、抗氧化)和抗菌测定。结果表明:熟浆和生浆的pH值为4.38 ~ 5.89,总可滴定酸度(TTA)为0.05% ~ 0.37%,水分(9.30% ~ 24.75%),灰分(3.41% ~ 7.17%)。结果表明,肉汤的蛋白质含量(10.39 ~ 12.64%)、纤维含量(13.82% ~ 20.48%)和脂肪含量(21.11% ~ 34.47%)较高。这些汤的矿物质含量显示,钙(1.24ppm - 8.74 ppm)、锌(1.3 ppm-1.65 ppm)、钾(4.04 ppm-20.94 ppm)和钠(14.27 ppm-67.00 ppm)的含量不等。植物化学成分以皂苷(4.59mg/g-62.91 mg/g)最高,其次为植酸(15.24 mg/g-61.39 mg/g)、生物碱(0mg/g-27.84 mg/g)、单宁(2.39 mg/g-6.57 mg/g)、草酸(0.72 mg/g-2.12 mg/g)。结果表明,该汤样品具有30.0% ~ 100%的自由基清除能力(DPPH), 2,2′-氮基-双(3-甲基苯并噻唑-6-磺酸)(ABTS)清除能力(70.0% ~ 100%)和2.73 mg/g- g- mg/g的铁还原能力。而汤膏的水提物对被试微生物的生长没有抑制作用。进一步的研究应该进行,以确定从汤膏记录的抗氧化活性负责的生物活性化合物。
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引用次数: 0
Prospective Studies are Required to Assess the Prevalence/Incidence of Neuro-Covid 需要前瞻性研究来评估神经新冠病毒的患病率/发病率
Pub Date : 2020-06-30 DOI: 10.47363/jmhc/2021(3)153
J. Finsterer, F. Scorza
Letter to the Editor With interest we read the article by Khedr et al. about a retrospective cohort study of 117 patients with neuro-COVID collected during a three months period in Upper Egypt [1]. It was found that stroke was the most frequent central nervous system (CNS) manifestation of neuro-COVID in this cohort and that anosmia/ageusia was the most frequent peripheral nervous system (PNS) manifestation of neuro-COVID [1]. The study is appealing but raises the following comments and concerns.
致编辑的信我们饶有兴趣地阅读了Khedr等人的文章。该文章涉及对上埃及三个月内收集的117名神经性新冠肺炎患者的回顾性队列研究[1]。研究发现,在该队列中,中风是神经性新冠肺炎最常见的中枢神经系统(CNS)表现,嗅觉缺失/老年痴呆是神经性COVID最常见的外周神经系统(PNS)表现[1]。这项研究很有吸引力,但提出了以下评论和担忧。
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引用次数: 0
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Journal of medicine and healthcare
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