Evaluation of Novel Cost-effective Technique for Speedy Resolution of Infantile Umbilical Hernia: Ammannaya’s Technique | Chapter 18 | Innovations in Medicine and Medical Research Vol. 2

Umbilical hernia in the infant is common and resolves in majority of the cases by 6 years of age. Observation till this age and surgery in the event of persistence are the widely followed management strategies. Trusses, taping and adhesive strapping have been tried to achieve speedy resolution with variable success and a significant incidence of skin complications. We present a novel, simple, easily reproducible, and highly cost-effective technique to achieve complete resolution of infantile umbilical hernia in a span of 8 weeks, with no skin complications. 


Author(s) Details

Dr. Ganesh Kumar K. Ammannaya
Department of Cardiovascular & Thoracic Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India.

Ninada Sripad
Department of Microbiology, Goa Medical College, Goa, India.

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Fluoroquinolone Resistance in Relation to Phylogenetic Background and Iron Uptake Associated Virulence Profile among Urinary Escherichia coli Isolates from HIV and Non-HIV Patients | Chapter 9 | Innovations in Medicine and Medical Research Vol.2

Introduction: Urinary tract infection is a major cause of morbidity among HIV patients and is more often underestimated in developing countries. Urinary Escherichia coli isolated from HIV and non-HIV patients in South India were analyzed to determine the virulence profile and phylogenetic distribution and their correlation with fluoroquinolone (FQ) resistance. Methods: This study aimed to assess the difference in the incidence of iron uptake associated virulence genes among urinary E. coli isolated from HIV (n= 76) and non-HIV antenatal patients (n=42). We compared the incidence of virulence associated genes (VAGs) among the E. coli isolates in relation to FQ resistance, phylogeny and host immunocompromise.  Results: fyuA was higher among the isolates from HIV than from non-HIV patients (P=0.00024).              E. coli isolates from HIV, non-HIV patients primarily belonged to the phylogroups D and B2 respectively. Q and FQ resistance were higher among isolates from HIV patients compared to nonHIV patients (P=0.000414, P<0.0001 respectively). PhylogroupB2 strains were predominant among the FQ susceptible than FQ-resistant strains (P=0.000652). fyuA and iutA was higher among the Qresistant isolates than their susceptible counterparts (P<0.0001; P=0.000132). FQ resistant isolates harboured fyuA, iutA than the susceptible isolates (P=0.0063; P=0.000478). Hly+ phenotype was significantly associated with FQ-susceptible isolates (P=0.003253).  Discussion: Our results establish the relative predominance of non-hemolytic, fyuA+, Q, FQ resistant E. coli isolates primarily of phylogroup-D among the HIV patients and there by suggests that non-B2 strains with lower virulence but with increased antibiotic resistance establish infection in HIV patients.

Author(s) Details

Dr. Kesavaram Padmavathy
Department of Microbiology, Research Laboratory for Oral and Systemic Health, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, India and Department of Microbiology, Dr. ALM PGIBMS, University of Madras, Chennai, India.

Dr. Krishnan Padma
Department of Microbiology, Dr. ALM PGIBMS, University of Madras, Chennai, India.

Dr. Sikhamani Rajasekaran
Government Hospital of Thoracic Medicine, Chennai, India.

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Investigation of Concealed Homicide and Establishment of Positive Identification: A Critical Study | Chapter 8 | Innovations in Medicine and Medical Research Vol. 2

To conceal a crime to be detected by the investigating agencies like police and doctor is the prime moto for the criminals. These concealed homicides are very difficult to investigate by the investigating officers starting from confirmation of alleged accused to the collection of positive evidences in favour of the case to prove beyond doubt in the court of law. More difficulties arise when they try to destroy the evidences by concealing dead body of offence, by throwing the body in the unapproachable area or making difficult to identify by relatives or investigation officers by burning or mutilating the deceased by the accused. A case is discussed here, having similar observations that the accused tried to concealed the crime by burning the dead body on the outskirt of the city. Various aspects in this case like cause of death, establishment of positive identification etc. are discussed in this paper. 

Author(s)Details

Mohammed Iliyas Sheikh
Professor and Head,Forensic Medicine and Toxicology, Surat Municipal Institute of Medical Education and Research (SMIMER), Opposite Bombay Market, Umarwada, Surat – 395010 Gujarat, India.

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Study on Human Vaccines for Oncogenic Viruses and Perspectives for Tumor Antigens Induced by Virus | Chapter 7 | Innovations in Medicine and Medical Research Vol.2

The Variola major, the virus that causes the smallpox, lethal virus in the 30% of the cases, was eraticated in 1979 in the human species, thanks to a capillary vaccination on global scale. Recently the Word Health Organization (WHO) declared that India and Southeast Asia are polio-free, really a great achivement since the vaccine for polio, an infectious desease that can cause paralysis, was certificated safe and useful only 60 years ago. The vaccine for the virus, responsible for hepatitis B infection HBV, is able to prevent 50% of all liver cancers. Human Papilloma Virus (HPV) have been correlated with the cervical cancer (genotypes 16 and 18 particularly oncogenic in humans): the USA Food and Drug Administration (FDA) in 2006 released the first vaccine against HPV. Finally, the ability of the immune system to recognize a tumor-associated antigen enables the development of a vaccine approach for therapeutic application and represents a main target of this field of research. Long years of research were required for busting new systems to fight cancer. Research is going to obtain the complete sequence by proteomics approaches, in order to achieve adequate antigen preparations that might be used to generate assays for a specific anticancer vaccine. 

Author(s) Details


Giulio Tarro
Beaumont Bonelli Foundation for Cancer Research, Naples, Italy and Committee on Biotechnologies and Virus Sphere, World Academy of Biomedical Technologies, UNESCO, Paris, France.

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From Sequence of Tumor Liberated Protein (TLP) to Potential Targets for Diagnosis and Therapy: Advanced Study | Chapter 6 | Innovations in Medicine and Medical Research Vol.2

A preliminary analysis of immunoprecipitation followed by Western Blotting (WB) shows corin and TLP precipitate at the same level (approximately 50 KDa) and are recognized by the same antibodies. In parallel the tests of immunoprecipitation were improved by the use of cell extracts derived from lung cancer cells A549 and NCI-H23 with the aim of obtaining a precipitate containing only the TLP. In fact the partial amino acid sequence of TLP shows a high homology with the sequence of human corin (only one amino acid is different) and is present in lung cancer under different isoforms. It is known that human corin is expressed mostly outside the cells and the protein extract derived from the extracellular medium and from the cells transfected with the plasmid, which over expresses corin, shows several bands analysed on SDS-PAGE that are equivalent to the bands (about 50-100 KDa) observed in the WB analysed by anti-TLP.

Author (s) Details

Giulio Tarro
Beaumont Bonelli Foundation for Cancer Research, Naples, Italy and Committee on Biotechnologies and VirusSphere, World Academy of Biomedical Technologies, UNESCO, Paris, France.

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Evaluation of In vitro Antioxidant and Diuretic Potential of Ethanol Extract of Gongronema latifolium Leaves on Wistar Albino Rats | Chapter 5 | Innovations in Medicine and Medical Research Vol.2

Medicinal herbs are the significant source Diuretics, phytochemicals and antioxidants. Gongronema latifolium had been widely used for its reported biological activities in indigenous system of medicine. The diuretics, phytochemicals and antioxidant properties were evaluated considering their possible contribution to improve the use of herbal products in treatment of diseases. The phytochemical properties such as Tannins, Alkaloids, saponin, steroids, flavonoids, glycosides and terpenoid were observed to be present after the qualitative analysis on the plant extract. The antioxidant activity was determined using nitric oxide, lipid peroxidation and 2,2-diphenyl-1-picrylhydrazyl free radical scavenging activities. The plant extract showed 93.18% inhibition in nitric oxide at highest (200 µg/ml) used. This is higher when compared to DPPH and lipid peroxidation extract which are 90.652 and 90.99 mg respectively. The percentage inhibition of the plant extract showed low inhibition concentration as against 50% (IC50). Seven groups of two rats each was used for diuretic study. Ethanol leaf extract was administered intra-peritoneally to the rats at doses of 25, 50, 100, 200 and 400 mg/kg body weight respectively. Furosemide (40 mg/kg) was used as positive control. This was evaluated by measuring the urine volume and urinary electrolyte excretion. The extracts produced a significant increase in urine volume at 200 and 400 mg/kg (1.50 and 1.90) respectively and enhanced urinary excretion of sodium, chloride, potassium and bicarbonate (p<0.05). The result obtained showed that Gongronema latifolium has potential and significant phytochemical, antioxidant and diuretic properties.

Author (s) Details

Dr. O. D. Omodamiro,
Pharmacology Unit, Department of Biochemistry, College of Natural Sciences, Michael Okpara University of Agriculture, Umudike, Abia State, Nigeria.

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Origin of the Viruses and Their Evolutionary History: Recent Advancement | Chapter 4 | Innovations in Medicine and Medical Research Vol.2

The human immunodeficiency virus (HIV) originated via a process of natural evolution, probably emerging from the primate SIV reservoir into the human population via hunting or other behavior involving contact with the blood of these animals. A particular subspecies of chimpanzee, the Pantroglodytes troglodytes, has been recognized as the most probable original source of human infection. Analysis of viral genetic sequences has allowed researchers to estimate that the native strain of HIV originated in 1931. In the West, sexual behavior patterns and injecting drug use subsequently began the epidemic. Polymerase Chain reaction (PCR), is a technique in molecular biology that amplifies a specific region of deoxyribonucleic acid (DNA), and has been useful in the molecular characterization of viruses. The Variola major, the virus that causes the smallpox, lethal virus in the 30% of the cases, was eradicated in 1979 in the human species, thanks to a capillary vaccination on global scale. It has now become a “historical footprint” in two known laboratories, one in the USA and another in Russia, leaving no obvious source for its often-theorized use as a bioterrorist weapon. Nevertheless, mass vaccination against smallpox continues to be a leading initiative in Western countries to guard against bioterrorist attack.

Author(s) Details

Giulio Tarro
Beaumont Bonelli Foundation for Cancer Research, Naples, Italy and Committee on Biotechnologies and Virus Sphere, World Academy of Biomedical Technologies, UNESCO, Paris, France.

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Comparative Study between Anthracycline Based Regimen and Taxane Based Regimen in Metastatic Gastric Cancer: General Perspectives | Chapter 3 | Innovations in Medicine and Medical Research Vol.2

Introduction: Taxanes and anthracyclin containing regimes are the most successful regimens in advanced gastric cancer with comparable results but with different toxicity profiles. Objective: To compare efficacy and toxicity of 2 regimens one containing anthrathycline (ECSF regimen) and other contain taxane (PCF regimen) as a first line therapy in advanced gastric cancer. Methods: Between May 2011 and Dec 2015, a total of 120 patients with locally advanced and metastatic gastric adenocarcinoma were included in the study, 60 patients received  ECSF (Epirubicin 50 mg/m2 iv  d1, Cisplatin 60 mg/m2 iv d1, 5-FU 1750 mg/m2/d “1 and 8” CIVI over 24 h, Folinic acid 200 mg /m2 day 1, 8 repeated every 3 weeks), while, another 60 patients received PCF (Paclitaxel 150 mg/m2 IV on day 1; Cisplatin 15 mg/m2 IV on days 1-5 and 5-FU 600mg/m2/day CIVI  d1-5 every 3 weeks) until disease progression or unacceptable toxicities. Results: ORR of ECSF was superior to PCF arm, 47% vs. 34% respectively p = 0.001. The toxicity profiles were less in ECSF arm than PCF arm especially in neutropenia and mucositis. Median PFS and OS were significantly higher in ECSF arm than PCF (6.9 vs. 4.9 months p= 0.022) and (11.1 vs.8.9 months p = 0.028) respectively. Conclusion: The use of anthracycline based regimen as first line therapy in advanced gastric cancer showed better outcome and acceptable toxicity when it compared with paclitaxel containing regimen.

Author (s) Details Abeer Ibrahim
Department of Medical Oncology and Hematological Malignancies, South Egypt Cancer Institute, Assiut University, Asyut, Egypt.

Mohamed A. Salem
Department of Surgical Oncology, South Egypt Cancer Institute, Assiut University, Asyut, Egypt. 

Dr. Ahmed Hefny
Department of Medical Oncology and Hematological Malignancies, South Egypt Cancer Institute, Assiut University, Asyut, Egypt.

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Research on Containment of Ebola – Steps to Prevent Spread of Emerging Infectious Diseases: The Nigeria Example | Chapter 2 | Innovations in Medicine and Medical Research Vol.2

Emerging infectious diseases are diseases whose incidence in humans have increased in the past decades or threaten to increase in the near future. The epidemiological and Laboratory techniques needed to detect, investigate and contain a deliberate outbreak are the same as those used for natural outbreaks. The threat to Nigeria posed by the arrival in Lagos of a patient acutely ill with Ebola was potentially enormous. Six response teams were deployed within the Emergency Operations Centre; 1) Epidemiology/ Surveillance, 2) Case Management/ Infection Control, 3) Social mobilization, 4) Laboratory Services, 5) Point of Entry and 6) Management / Coordination. The strategy group reviewed and approved all of the teams work and needed resources. Eleven patients with laboratory confirmed Ebola were admitted and discharged, an additional patient was diagnosed at convalescent stage while eight patients died. 

Author(s) Details


Dr. Y. J. Peter
Department of Medical Microbiology and Parasitology, College of Health Sciences, University of Abuja, Nigeria.

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Detailed Study on Pattern of Cancer Pain in Patients Admitted at a Tertiary Care Centre in Northern India- A Prospective Observational Study | Chapter 1 | Innovations in Medicine and Medical Research Vol.2

Aims: Pain being the commonest symptom in cancer, its prevalence and pattern needs to be studied. The aim of this study was to evaluate the prevalence and pattern of cancer pain in admitted patients. Study Design: Prospective observational study. Place and Duration of Study: This study was carried out at Cancer Research Institute, Swami Rama Himalayan University, Dehradun, India, between January 2018 and April 2018. Methodology: After institutional ethical clearance and written informed consent 393 patients were enrolled in the study. We prospectively evaluated patients admitted with diagnosis of cancer for presence, severity and pattern of pain, using clinical assessment and numerical pain scale at admission and at discharge. Chi-square test was used for categorical data and multivariate analysis was performed with multinominal regression and ANNOVA tests. Results: In 393 patients prevalence of pain, moderate-severe pain, neuropathic pain (NPP), mixed pain was 67%, 47.8%, 10.2% and 31.9% respectively. More than one pain site was present in 43% of patients. The median numerical pain score was 2 overall, 4 in patients with pain and 7 in patients with NPP or mixed pain. Prevalence of severe pain and NPP or mixed pain was highest in hepatobilliary, lung, head and neck and genitourinary cancers. As many as 42.97% (113/263) patients had more than one pain site. On multivariate analysis severity of pain was significantly associated with primary tumor site (P=0.002), NPP (P=0.000), number of metastatic sites (P=0.02) and number of pain sites (P=0.009); NPP with primary tumor site (P=0.000), number of pain sites (P=0.000) and severity of pain (P=0.014). The proportion of patients with moderate-severe pain reduced from 47.8% before admission to 10.7% at discharge with adequate analgesic management. Conclusion: The prevalence of cancer pain and moderate-severe pain is high in admitted patients. Various patient, disease and pain variables need to be considered for an adequate cancer pain assessment and management. Team approach with active participation of primary medical team, adjunct support from palliative care specialist is desirable for cancer pain management.

Author (s) Details

Anshika Arora,
Department of Surgery, Cancer Research Institute, Himalayan Institute of Medical Sciences, SRHU, Dehradun, Uttarakhand, India.

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