Recent Articles

Methadone, a long-acting opioid agonist, binds to and occupies mu-opioid receptors, preventing withdrawal symptoms for 24 hours or longer, reduces craving for opioids, and, by maintaining high levels of opioid tolerance, reduces the euphoric effects of subsequent illicit opioid use. As a controlled substance with potential for abuse, methadone use is regulated in the US and other countries.

In Papua New Guinea (PNG), under-five mortality rate still remains high (69 per 1,000 live birth), and infectious diseases contribute to 38% of deaths among under-five children, possibly due to not only low immunization coverage but also undernutrition.

Guillain-Barr´e syndrome (GBS) usually presents with lower motor neuron (LMN) symmetrical weakness, areflexia, and hypotonia. GBS has rarely been reported with up going plantars’ response. We report a case of GBS with up going plantars during the course of the disease.

Bariatric surgery (BS) is a potential cause for malabsorption resulting in nutritional deficiency-related neuropathies and myelopathy.

Terbinafine hydrochloride (TH) is first line drug against treatment of onychomycosis; which is the commonest fungal infection of nail plate. However, strong barrier property of nail plate restricts the effective topical treatment of onychomycosis. In this study, TH loaded solid lipid nanoparticles (SLNs) were prepared and subsequently incorporated into a gel system. SLNs were prepared by high pressure homogenization (HPH) technique using glyceryl monosterate (GMS), compritol 888ATO and a co-processed lipid. They were evaluated for particle size, polydispersity index, zeta potential, % entrapment efficiency (%EE), % drug loading (%DL), drug content and in-vitro drug release. Optimized SLNs were incorporated into chitosan gel and further evaluated for in-vitro drug release and ex-vivo antifungal study.

A total of 150 patients categorized into 100 cases (urolithiasis-positive) with urinary stone disease, aged from 5 to 18 years, and met the characteristics of idiopathic urolithiasis in children as well as 50 controls (urolithiasis-negative) that had relatively similar demographic criteria except for idiopathic urolithiasis.

The Congenital Rubella Syndrome is a multisystemic disease and CNS involvement occurs in the form of microcephaly, mental/motor disabilities, leptomeningitis, encephalitis, vascular damage and retardation of myelination. We report a case of gross non-communicating hydrocephalus in a neonate of Congenital Rubella Syndrome which is a rare presentation.

The recent resurgence of interest in m6A has been spurred by some intriguing findings detailing the effects and dynamics of this epigenetic modification. The m6A modification is a highly reactive and fluid modification which can respond rapidly to a broad variety of stimuli, and translate these signals into cellular activity. The little information that has been established on its functional capacity has opened up many new avenues of research and has tremendous implications for several fields of study.

During the 19th Century, there was a difficult choice concerning whether a pancreatic cancer is primary or secondary. However, in this paper, it is shown that some views were decidedly in favor of attack from other primaries. Indeed, the evidence of spread to the pancreas included either concise or coalescent lesions.

Here we describe the case of a 35 year old male, with a harmonic phenotype, who sought medical assistance to assess the etiology of his infertility. As a result of clinical examination, karyotyping, FISH and molecular studies, we obtained the following karyotype: mos 45,X[18]/46,XY,idic(Y)q(11.2)[82]. Furthermore, the Y chromosome was characterized by the absence of the regions AZF2 (former AZFb, within the 11.22 band, and AZFc, within the 11.23 band), whereas the region AZF1 was conserved. Male infertility can be caused by several genetic alterations.

The first patient was a 77 year old man who had been on abiraterone for 12 months before his phosphorous was checked. At that point, it was 0.6 mg/dl, which is severely decreased. A full work up for hypophosphatemia showed normal parathyroid hormone and 25-hydroxyvitamin D. A urine study showed inappropriate excretion of phosphorous along with aminoaciduria and normoglycemic glucosuria.

Nanotechnology manipulates and creates matter to formulate nanometer scale materials and objects. It is an interdisciplinary field that involves a wide range of scientific and engineering disciplines, and has societal implications.

Coccidioidomycosis involving the larynx is a rare occurrence which seems to present with non-specific upper airway symptoms. The diagnosis is made by tissue biopsy and the treatment is usually fluconazole for 6-12 months depending on the clinical presentation. In unusual presentations of laryngeal problems clinicians should consider Coccidioidomycosis, especially in endemic regions.

A seventy five year male presented with acute onset right foot pain and swelling. Plain imaging revealed a lytic area in the medial and middle cuneiform bones of the right foot. Background history of resected pancreatic cancer and current presentation were consistent early diffuse disease recurrence of a pancreatic primary tumour. The presenting feature in this case was of symptomatic acrometastases, that is, metastases to the feet.

Complex Vescico-vaginal Fistulas (VVF) are a common cause of morbidity especially in elderly patients. These can be one of the most troublesome complications of obstetric trauma and pelvic surgery and usually occur due to previous operative interventions and/or as a result of chronic diseases. These are difficult to repair because of the poor or almost no supporting tissue left at the perineum as a result of the previous insults.

Appendicitis is a rare pregnancy associated surgical emergency, with appendectomy as the most frequent non obstetrical surgical procedure performed in pregnancy. Diagnostic delay increases maternal and fetal morbidity and mortality thereby highlighting the need for a prompt diagnosis and surgery. Two cases of appendicitis with pregnancy are being reported with abdominal pain as common presenting feature.

Large osteomas of the fronto-ethmoidal cavities are very rare benign tumors. Headache and ocular signs are the most common symptoms. Imaging allows the diagnosis. Treatment of ethmoid sinus osteoma is surgical. One case with orbital extension is reported and discussed. A 30 years-old male; complaining of swelling of themedial angle of the right eye. Computed tomography showed a right ethmoidal process with orbital extension. The tumor was removed through an external ethmoidectomy.

Infection with Salmonella spp can result in a variety of presentations such as enteric fever, septicemia, gastroenteritis, and septic arthritis. The common organisms seen in septic arthritis are Staphylococcus aureus and Streptococci which accounts for about 67% and 20% respectively. Salmonella spp however is less commonly seen in septic arthritis and it is usually associated with immunosuppression conditions and underlying chronic debilitating diseases such as malignancy, hemoglobinopathy, diabetes mellitus, and HIV.

A major part of nutrition research consists of the investigation of how food components affect the biochemical and physiologicalprocesses within the body. The rationale is that this mechanistic research will lead to a fuller understanding of disease etiology thereby generating information of practical value for the treatment and prevention of disease.

We report a case of a teenager with scoliosis and pectus excavatum who developed intraoperative refractory hypotension associated with prone position during posterior surgical correction of scoliosis. In this case, it was more difficult for the anesthetists to figure out the reason leading to severe hypotension when a surgery was partially completed, because there might be many confounding factors during surgery. Furthermore, TEE was difficult to be considered to be first diagnosis choice when patient have already underwent posterior spinal fusion surgery, compared to the cases previous reported that the surgery still did not begin.