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Obstructive Sleep Apneas, Cervical Osteophytosis and Sudden Death: A Paradigmatic Case and a Brief Overview of the Literature

Abstract:

Obstructive sleep apnea (OSA) syndrome is a common disease characterized by partial or complete collapse of the upper airway during sleep secondary to functional or anatomical factors. The gold standard method for OSA diagnosis is an overnight polysomnogram demonstrating repetitive obstructive apneas and hypopneas during sleep. OSA syndrome is associated with cardiovascular diseases, stroke and rarely with sudden death. OSA and cervical spine osteophytes share some common risk factors, and their coexistence may cause mechanic respiratory obstruction with a severe sleep apnea. We present a brief overview on this syndrome, its links to the cervical spine pathology and their combined effect on a patient presenting with neurological signs who suddenly died before an effective treatment was possible to perform. This case highlights how a rapid deterioration of the functional balance may be possible even when a clinical condition has been present, known and unchanged fo...

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Acute Onset Symptomatic Polycythaemia Vera

Abstract:

A case of acute symptomatic polycythaemia vera is presented with diagnostic work‑up, risk stratification, and acute management considerations. The discussion highlights thrombotic risk and cytoreductive strategies.

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Parents’/Carers’ Expectations and Perceptions of Structured Aquatic Taught Baby Programmes: An Online Survey

Abstract:

Although structured taught aquatic baby programmes (STABPs) are one of the earliest forms of physical activity, the possible impacts of structured taught aquatic baby programmes are unknown. This study aims to understand the perceived impact that attending STABPs has on parents/carers, their baby/child and their family. An online survey was completed by 2854 parents/carers. It was advertised via numerous online advertisements. Of the respondents, 89% had attended STABPs. ‘Attendees’ were significantly older and were less likely to live in a more deprived area compared to ‘non-attendees’. STABPs are perceived to be beneficial in terms of water safety, confidence, benefits to parent-child relationships and interaction with other children but cost affects attendance. The evidence-base regarding the benefits of STABPs should be established to further understand their impact on parents/carers and babies. Further research should focus on understanding barriers t...

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Massive Splenic Rupture – An Unusual Presentation

Abstract:

A case report of massive splenic rupture with atypical presentation. It covers diagnostic work‑up, stabilization, and operative decision‑making.

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A study on the association of ACE i/D gene polymorphism, Obesity, Blood pressure and susceptibility of type 2 diabetes mellitus among the Kurmis of West Bengal, India.

Abstract:

Earlier studies reported significant association of obesity, hypertension and Type2 Diabetes Mellitus (T2DM). Genetic and many disease-associated alleles have been identified through GWAS and applied to T2DM and indicated roles of renin-angiotensin system (RAS) in insulin signaling pathway and insulin resistance has been well documented. Angiotensin converting enzyme (ACE) gene catalyzes the conversion of angiotensin I to angiotensin II and also inactive the vasodilatation and hence renin-angiotensin system (RAS) in insulin signaling pathway and insulin resistance has been reported. To best of the knowledge we are reporting for the first time regarding association of ACE gene polymorphism with body composition, physiological and metabolic variables among any endogamous ethnic group (Kurmis) from of West Bengal, Eastern India. To achieve the purpose, total 197 (male 99 and female 98) randomly selected apparently healthy unrelated adult individuals of Kurmi populati...

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Mucosa-Muscular Signaling for Bile-Induced Esophageal Dysmotility. An Experimental Study in Ex-Vivoguinea-Pig Isolated Esophagi

Abstract:

Background/Aims:

Esophageal motor abnormalities are frequently found in patients with gastroesophageal reflux disease. The effect of bile in esophageal dysmotility is probably secondary to mucosal signaling to the muscular layer and not a transmural process. This study aims to identify the mucosa-muscular signaling path by receptors blockage in an experimental study.

Methods:

Fifteenguinea pig esophagi were isolated and ex-vivo esophageal contractility was assessed with force transducers. The esophagi were incubated in 100 µM ursodeoxycholic acid for 1 hour and 5 sequential contractions induced by 40 mM KCl spaced by 5 minutes were measured. After 30 minutes, esophagi specimens were incubated in 3 different smooth-muscle contraction antagonists: atropine (1µM) in 5, suramin (1µM) in 5 and genis...

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Metabolic Acidosis and Cardiovascular Disease in Patients on Peritoneal Dialysis

Abstract:

Backgroud:

Metabolic acidosis, a common condition particularly in end stage renal disease patients, results in malnutrition and inflammation. In this study, we focused on the importance of metabolic acidosis on manifestations of cardiovascular disease in patients on peritoneal dialysis.

Methods:

We studied 20 patients on continuous ambulatory peritoneal dialysis (CAPD), 15 males and 5 females, on mean age 61.6 ±11.3 years old. Metabolic acidosis was determined by serum bicarbonate concentrations less than 22mmol/L, which were measured in gas machine. Dialysis adequacy was defined by total Kt/V/week for urea including peritoneal Kt/V for urea and residual GFR (ml/min/1.73m2). High sensitivity C-reactive protein (hsCRP) was measured using enzyme linked immunoabsorbed assay (ΕLISA). The concentrations of ...

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Reduction in Estimated Glomerular Filtration Rate in Patients with Elevated Blood Urea Nitrogen but Normal for any Other Markers of Kidney Damage

Abstract:

Background:

It is unclear whether patients who present with elevated blood urea nitrogen (BUN), but are normal for other markers of kidney damage, are prone to develop chronic kidney disease (CKD). This study therefore investigated estimated glomerular filtration rate (eGFR), a marker of CKD, in these patients.

Methods:

Patients with elevated BUN but normal for other markers of kidney damage who were followed-up for ≥48 months in our outpatient clinics were retrospectively evaluated. BUN, eGFR, and serum creatinine concentrations in the patient group were compared with findings in an age- and sex-matched control group.

Results:

At baseline, BUN concentration was significantly higher in the patient than that in the control g...

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Cytomegalovirus Esophagitis: Two Patients with Different Features

Abstract:

Two cases of CMV esophagitis presenting with distinct clinical and endoscopic features are presented. Diagnostic clues, histopathology, and antiviral therapy considerations are highlighted, emphasizing vigilance in immunocompromised hosts.

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Review: Non-Invasive Continuous Blood Glucose Measurement Techniques

Abstract:

Diabetes is a metabolic disorder that results in human body due to insulin deficiency, insulin resistance or both. In the management of diabetes, glucose monitoring technology has been used for the last three decades. The aim of this review article is to describe concise and organized information about different techniques of non-invasive continuous blood glucose monitoring. Many research groups have been working to develop wearable sensors for continuous blood glucose monitoring, but at present, there are to our knowledge no commercially successful non-invasive glucose monitors on the market. To achieve an acceptable sensor system, a glucose sensor should have accuracy better than 15mg/dl (0.8 mmol/l). In future development, continuous glucose sensor systems may become predictable, selective, reliable and acceptable for patient use.

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