Vascular Endothelial Growth Factor Study of Placenta in Preeclampsia | Chapter 15 | Emerging Research in Medical Sciences Vol. 3

Preeclampsia is defined as new onset hypertension and albuminuria in previously normotensive pregnant women after 20 weeks of pregnancy. There is no cure; management is reliant on a structured antenatal surveillance programme and antihypertensives. Recent advances in immune histochemistry study of placenta have elucidated an increased Vascular Endothelial Growth Factor (VEGF) expression in various placental bed disorders like recurrent pregnancy loss, preeclampsia, fetal growth restriction, preterm and abruption placenta. Increased release of VEGF family proteins has been attributed to atherosis and placental hypoxia. However, some studies have found normal VEGF concentrations in placenta in these disorders of feto-maternal interphase. This chapter aims to analyse the VEGF expression in placental biopsy from preeclampsia and normotensive pregnancies.

VEGF density is more in the placentas from preeclampsia pregnancies as compared to placenta from a normal pregnancy. The mean weight of placenta is smaller in preeclampsia group. Additionally, the fetal capillaries are also small in diameter and lumen was collapsed. The pulsatility index of uterine artery supplying the placenta is also higher in preeclampsia pregnancies. The high velocity blood flow can mechanically damage the tender fetal villi floating in the intervillous space. This damage collapses the fetal capillaries as evidenced by the smaller diameter of fetal capillaries in the placental biopsy.

Placental hypoxia in cases of preeclampsia is a potent stimulus for VEGF expression. Nevertheless, the increased VEGF expression should be seen in the light of collapsed fetal vessels in a small placenta.

Author(s) Details

Dr. Jayavelan Ramkumar
Department of Cardiothoracic Vascular Surgery, Sri Ramachandra Medical College, Sri Ramachandra University, Chennai, India.

Benjamin M. Sagayaraj [Head of the Department]
Department of Pediatrics, Saveetha Medical College, Saveetha University, Chennai-602105, India.

Dr. Nidhi Sharma
Department of Obstetrics and Gynaecology, Saveetha Medical College, Saveetha University, Chennai-602105, India.

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Early Breastfeeding Initiation (EBFI) | Chapter 14 | Emerging Research in Medical Sciences Vol. 3

The objective of the paper was to describe the concept Early Breastfeeding Initiation (EBFI). Early breastfeeding initiation (EBFI) is recommended within the first hour following giving birth as a simple strategy in enhancing neonatal health and survival. Despite the clear definition by [WHO] on EBFI, some variations still exists across board on what exactly EBFI initiation is. The variations have compounded negatively on neonatal outcomes hence the need to describe EBFI by assigning measurable attributes for standardization of operations in maternity units. A literature review of 39 articles was conducted between the years 1999 to 2016 in a period of two weeks from the 1^st to the 15^th of July 2016. The following search engines were used: Cochrane data base, Journal of human Lactation, Pub – med and MEDLINE. EBFI has been inconsistently described within the same health profession. Taking into cognizant the attributes of EBFI and applying them in the maternity units has a potential of averting neonatal deaths by a significant percentage.

Author(s) Details

Gladys Mugadza (RGN, SCM, BSc, MSc, DPhil Fellow)
Department of Nursing Science, University of Zimbabwe, Zimbabwe.

Mathilda Zvinavashe (PhD. RN. Associate Professor)
Department of Nursing Science, University of Zimbabwe, Zimbabwe.

Felicity Zvanyadza Gumbo (MBchB, MMed(Paeds) PhD)
Department of Pediatrics, University of Zimbabwe, Zimbabwe.

Babill Stray-Pedersen
University of Oslo, Norway.

Clara Haruzivishe (PhD Midwifery/MCH, Med, Bsc Nurs.)
Department of Nursing Science, University of Zimbabwe, Zimbabwe.

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Complementary Medicine, Breast Cancer, and Pain | Chapter 13 | Emerging Research in Medical Sciences Vol. 3

Aims: The purpose here was to investigate for the first time effects following five-weeks of a complementary medicine intervention or mindfulness-based intervention (MBSR) in cancer patients with chronic pain. Specifically, psychological inflexibility in pain, pain self-efficacy, and expressive suppression were investigated for the first time in breast cancer patients with cancer-related pain.

Study Design: One group pre-post intervention design.

Place and Duration of Study: Lubbock, Tx medical center, spring 2010.

Methodology: Sample: The sample consisted of 46 participants with 36 women in stage II (78%) and 10 (22%) in stage III with a mean age of 55 years. The MBSR intervention was held in a hospital counseling center for 1.5 hours/week for eight-weeks, with preliminary data collected at five weeks (reported here), at the end of the full program three weeks later, and three months post the 8-week program. Preliminary data here were collected on standardized instruments before (pre) and after (post) the five-week point of the eight-week MBSR program to evaluate intervention effects on the following: Psychological inflexibility in pain, pain self-efficacy, emotional regulation of suppressive expression, and pain intensity.

Results: Psychological inflexibility in pain scores prior to the program (M=60.05, SD=14.22) decreased significantly by the end of five-weeks of the program (M=57.68, SD=13.46) (t=3.76, P = 0.01); Pain self-efficacy prior to the program (M=20.61, SD=11.47) increased significantly by the end of the five-week period of the mindfulness intervention (M=22.47, SD=10.63) (t=3.11, P < 0.05); Emotional regulation strategy of suppression before the program (M=22.77, SD=7.75) dropped significantly by the end of the five-week mark (M=19.63, SD=8.43) (t=3.68, P = 0.01); lastly, pain intensity prior to the beginning of the intervention (M=33.67, SD=8.48) did not change significantly by the end of the five-week mark (M=32.86, SD=8.20) (P > .05).

Conclusion: These findings after five weeks of the intervention should be interpreted cautiously, for replication and future research need to be conducted at this time period. The results, however, provide data in the neglected area of cancer patients with cancer related pain and the possibility of effective yet shortened mindfulness interventions.

Author(s) Details

A. M. Tacon
Texas Tech University, Lubbock, TX, USA.

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Neuroleptic Malignant Syndrome: Looked at from the Diagnostic and Therapeutic Perspectives in a General Hospital Setting | Chapter 12 | Emerging Research in Medical Sciences Vol. 3

Neuroleptic malignant syndrome is a rare life-threatening condition, usually induced by typical and atypical antipsychotics. A middle-aged woman with bipolar disorder and acute back pain due to multiple falls was admitted to the trauma ward of a general hospital. After 3 days, she suddenly developed signs and symptoms of neuroleptic malignant syndrome possibly caused by injectable haloperidol given intramuscularly as “pro re nata” (as the medication needed), although the additional role of olanzapine could not be ruled out. A 3-day delayed diagnosis of neuroleptic malignant syndrome led to serious complications, which could be prevented by its prompt management contingent on its early diagnosis, even in the absence of certain diagnostic criteria. Although she improved substantially with treatment interventions and continued to have dialysis, she died later due to renal complications. The mental health professionals must avoid administering antipsychotic medications as needed among such vulnerable psychiatric patients admitted to general hospitals across the board.

Author(s) Details

Naseem Akhtar Qureshi
National Center for Promotion of Mental Health, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.

Abdulhameed Abdullah Al-Habeeb
National Center for Promotion of Mental Health, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.

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Up Scaling Mental Health and Psychosocial Services in a Disaster Context: Lessons Learnt from the Philippine Region Hardest Hit by Typhoon Haiyan | Chapter 11 | Emerging Research in Medical Sciences Vol. 3

In the aftermath of typhoon Haiyan which struck Philippines in 2013, the World Health Organization Philippines in collaboration with the Philippine government acted to improve access to mental healthcare in affected regions. Eastern Visayas with population 4, 3 million had merely four psychiatrists and seven generalists providing mental health care. It was selected as a model region for integration of mental health care into primary and secondary care. This study was carried out to evaluate the intervention’s success in strengthening mental health services in Eastern Visayas with particular regard to availability, accessibility and affordability of these services. Between June 2014 and March 2015, 1038 community workers were trained in psychosocial care and support and 290 non-specialized healthcare providers received training on assessment and management of mental health conditions including on-the-job supervision. By the end of the March 2015, 155 of 159 or 97.5% of primary healthcare units, 21 of 24 District Hospitals (87, 5%) and all eight provincial hospitals had a doctor and a nurse trained in assessment and management of mental health conditions. The supervised sessions in each locale benefited 50 to 200 patients per location. Regional Medical Centre added a 10 bed inpatient unit for the mentally ill. All provincial hospitals developed the capacity to admit 2 to 4 patients for acute psychiatric care and additional capacity was established in at least 6 district hospitals. In addition, services were enhanced to include access to and use of psychotropic medicines, cross-sectoral collaboration and a clinical referral pathway from the community to the tertiary level. This study demonstrates the feasibility of an intervention in a resource poor context, post-disaster, to improve access to mental healthcare care services over a relatively short period of time. The remote follow-up of this intervention three years later showed that the intervention was also to a great extent sustainable.

Author(s) Details

Boris Budosan
Department of Public Mental Health, University of Zagreb, 10000 Zagreb, Croatia.

Katherine P. O’hanlon [MD, MPH]
Finger Lakes Health, Geneva, NY, USA.

John Mahoney
Centre for Global and Cultural Mental Health Melbourne, School of Population and Global Health, 207 Bouverie Street, The University of Melbourne Parkville, 3010 VIC, Australia.

Sabah Aziz
Depatrment of Public Health, Frontier Institute of Medical Sciences, 22010 Abbottabad, KPK, Pakistan.

Dr. Ratnasabapathipillai Kesavan
WHO Office, Avenue Mamba, P.O. Box 316, Monrovia, Liberia.

Dr. Kathryn Beluso
Capiz Emmanuel Hospital Inc., Roxas Avenue, Roxas City, Capiz, Philippines.

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A Literature Review of Physical Therapy for Pregnant Low Back Pain | Chapter 10 | Emerging Research in Medical Sciences Vol. 3

This study aims to review recently published clinical presentation on the effectiveness and impact of current therapy for low back pain (LBP) during pregnancy. This would help to build an information background and determine the necessity for future research on the development of an effective means for reducing pregnant low back pain.

Author(s) Details

M. Y. Li
Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.

C. W. Kan
Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.

A. S. W. Wong
Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.

Y. L. Kwok
Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.

J. Yip
Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.

S. P. Ng
The Hong Kong Community College, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.

T. H. T. Lao
Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.

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The Paradigm of Occupational Diseases Observed in Education Professionals in Brazil | Chapter 09 | Emerging Research in Medical Sciences Vol. 3

The magisterium has always been considered by law as a painful activity, which causes physical or psychological wear and tear on the organism, due to the repetition of psychological movements, pressures and tensions that affect the worker emotionally. Decree 53.831 / 64 framed the role of teacher as painful. This article aims to discuss the main occupational diseases verified in teachers in Brazil and as specific objectives to describe how the workload of teachers can contribute to the development of occupational diseases and to verify in the literature, prevention and safety measures that have been used and published. The results show that occupational diseases in teachers are common in the teaching environment, where the mental and emotional ones are among the majority for this class, later the diseases of the locomotive apparatus, which demonstrate that working long hours without valorization or adequate remuneration can generate health damages.

Author(s) Details

Karen Oliveira Gomes
Department of Physiotherapy, UNAMA – University of the Amazon, Brazil and Organizational and Work Psychology, Catholic University of Don Bosco, Pará, Brazil and Department of Psychology, UCDB – Catholic University of Don Bosco, Pará, Brazil.

Vitor Hugo Auzier Lima
Department of Biotechnology, UFPA – Federal University of Pará, Brazil and Department of Physiotherapy, UEPA – State University of Pará, Pará, Brazil.

Ysadora Maria Rodrigues Pinto
FAMAZ – Metropolitan Faculty of Amazon, Pará, Brazil.

Dhiego Lima Costa
Department of Biology, UFPA – Federal University of Pará, Pará, Brazil and Department of Pharmacy, UFPA – Federal University of Pará, Pará, Brazil and Department of Environmental Microbiology, UFPA – Federal University of Pará, Pará, Brazil.

Isaque Gemaque de Medeiros
Department of Chemistry, UFPA – Federal University of Pará, Brazil and Department of Chemistry, UNIUBE – University of Uberaba, Brazil.

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Peptide Based Tuberculosis Treatment: A Million Dollar Question | Chapter 08 | Emerging Research in Medical Sciences Vol. 3

Tuberculosis (TB) is a deadly tropical disease that is mainly caused by Mycobacterium tuberculosis. The pathogen is known to invade and replicate inside the host’s macrophage. Due to the emerging dilemma of multi-drug resistant TB and extensively-drug resistant TB, the exigency for finding new TB drugs is an obligation now. Among the propitious anti-tubercular agents studied in the past few decades, peptides from diversified sources have been substantiated to be persuasive with multiple advantages such as low immunogenicity, selective affinity to bacterial negatively charged cell envelopes and most importantly divergent mechanisms of action. This chapter highlights the role of prime peptides exploited from several other unplumbed sources as anti-tubercular agents.

Author(s) Details

Ameer Khusro
Department of Plant Biology and Biotechnology, Loyola College, Nungambakkam, Chennai-34, India.

Chirom Aarti
Department of Plant Biology and Biotechnology, Loyola College, Nungambakkam, Chennai-34, India.

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Association of Adiponectin and Leptin with Coronary Atherosclerosis Severity Indices in Metabolic Syndrome Patients | Chapter 07 | Emerging Research in Medical Sciences Vol. 3

Adipose tissue is considered as an active endocrine organ that releases a large number of adipokines modulating blood pressure, glucose and lipid metabolism, inflammation, and atherosclerosis. Atherosclerosis has been found linked with various traditional and novel risk actors. This chapter describe the updated review of published literature and present research findings describing the linkage of extent and severity of coronary atherosclerosis with two of the adipokines, adiponectin and leptin, as novel risk factors in metabolic syndrome (MetS) patients. A pilot, Case-control study was carried under Sadbhavna Medical and Heart Institute, Patiala and, Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, between January to December 2013. MetS patients (n=55) with age ≥18 years, undergoing angiography for diagnosis and/or interventional treatment of atherosclerosis and 25 matched control subjects were recruited. Evaluation of traditional and novel cardiovascular risk factors (adipose-derived hormones) and their association with angiographic-derived presence and degree of atherosclerosis indices (number of blocked vessels, severity index, and extent index) was carried out. Low serum adiponectin and high total cholesterol level were found as the independent predictors of atherosclerosis for number of blocked vessels. For extent and severity index, low adiponectin level was the only significant and independent predictor. Leptin and adiponectin/leptin (A/L) ratio could not prove as significant predictors (p≥0.05). Based on the results, it was concluded that Total cholesterol, adiponectin, leptin and A/L ratio might play a vital pathogenic role not only in the occurrence, but also in the severity, extent, number of vessels blocked complexity in MetS.

Author(s) Details

Kanchan Vohra
Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, Punjab, India.

Sikander Garg
Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, Punjab, India.

Sudhir Varma
Department of Cardiology, Sadbhavna Medical and Heart Institute, Patiala, Punjab, India.

Harpreet Singh Kalra
Department of Medicine, Sadbhavna Medical and Heart Institute, Patiala, Punjab, India.

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Gangrenous Gut in a Pregnant Woman: A Case Report | Chapter 06 | Emerging Research in Medical Sciences Vol. 3

Gangrene of the intestines is a rare complication in pregnancy. Intestinal obstruction and ischemic bowel diseases are common causes of gangrene of the intestines in pregnancy. Adhesion bands can cause intestinal obstruction while arterial occlusion, venous thrombosis, and vasculitis are some causes of ischemic bowel disease. We present a case of small intestinal gangrene in a 30-year-old woman in her third pregnancy, diagnosed during an emergency cesarean section with extensive gangrene of the ileum and jejunum caused by band formation at the illeo-caecal junction. This case, despite the unfortunate catastrophic outcome, highlights the subtle challenges of managing rare obstetric complication in resource-limited settings.

Author(s) Details

Verner Orish [MBBS, DTM, MPHIL, PhD]
Department of Microbiology and Immunology, School of Medicine, University of Health and Allied Sciences, Ho Volta Region, Ghana.

Emmanuel Coomson [MBBS]
Department of Family Medicine, Essam Government Hospital, Sekondi-Takoradi, Sekondi, Western Region, Ghana.

Dr. Seth Fanyi [MBBS]
Department of Obstetrics and Gynaecology, Jemima Crentsil Hospital, Sekondi-Takoradi, Sekondi, Western Region, Ghana.

Onyekachi Onyeabor [MD, MPH]
Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia, USA.

Adekunle Sanyaolu [PhD]
Federal Ministry of Health, Abuja, Nigeria.

Chuku Okorie [MBBS, MPH]
Essex County College, Newark, New Jersey, USA.

Afolabi Antonio [MBBS, MSc, MRCPI, FRCPC]
Department of Internal Medicine, Lloydminster Regional Hospital, Lloydminster, Saskatchewan, Canada.

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