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Jun 2024 DOI 10.14302/issn.2474-7785.jarh-24-5141
Efforts to mitigate or prevent painful disabling osteoarthritis have been pursued for more than a century with limited success. This current overview briefly summarizes how selected beliefs and behaviors, including coping and stress management approaches are potential mediators or moderators of osteoarthritis pain and its overall common adverse prognosis and outcome. Published data housed predominantly in PUBMED, PUBMED CENTRAL, SCIENCE DIRECT, and GOOGLE SCHOLAR sites and pertaining to selected aspects of the literature of current interest, cumulative results reported as of May 30, 2024, show a modest to strong rationale exists for considering the abovementioned factors in efforts to reduce pain and enable daily functions. Accordingly this line of research should be continued, and translated clinically without undue delay, especially in the face of increases in the aging population and osteoarthritis prevalence and undue suffering.
Aug 2021 DOI 10.14302/issn.2474-7785.jarh-21-3935
Background Anxiety and depression are key barriers to healthy aging and greatly heighten the risk for many negative health issues that seriously impact life quality. Aim This mini review examines the potential of low level laser treatments or photobiomodulation therapy for ameliorating severe anxiety and depression in older adults. Methods and Procedures Articles that adressed the current topic of interest extracted from PUBMED and Google Scholar were carefully and presented in narrative form. Results Photobiomodulation therapy appears to be a safe efficacious modality for ameliorating various degrees of anxiety and depression and for improving cognition, and is supported by several well established mechanisms of action at the molecular, cellular, and tissue levels. Conclusion More research to examine who might benefit most from this form of therapy, and in what respect in this area of growing global concern and few intervention options is strongly warranted.
Jun 2026 DOI 10.14302/issn.2766-8681.jcsr-26-6296
Background Acute diarrhea is the major cause of health public problem among paediatric patients in Tanzania. And in Low income countries (LICs), studies have shown, Acute watery Diarrhea (AWD) is the cause of morbidity and mortality which can be prevented by immediate identification and treatment of complications. Methods A prospective cohort study was done between December 2021 and April 2022 to determine the risks, complications, management strategies and predictors of mortality among paediatric patients ≤12 years of age with severe diarrhea. We excluded those who arrived in cardiac arrest at the Emergency Medicine Department (EMD) of Muhimbili National Hospital (MNH). Proportion was used to summarize the counts and frequency of participants who were at risk of complications and management strategies given and for predictors of outcomes. A Modified Poisson log linear model with a robust estimation test was used to test for significant associations between predictors and outcomes. Multivariate logistic regression was used to adjust for confounders. Results A total 6,570 paediatric patients presented to EMD during study period, and we recruited 144 (2.2%). The median age was 1 (IQR 0.7-2.0) years and most were male 86 (59.7%). Among the study participants with diarrhea, 120 (83.3%) had dehydration, acidosis 60 (42.3%), hypoglycemia 8 (5.6%), hypokalemia 76 (53.1%), and Acute renal failure 11 (7.6%). Those patients with complications received appropriate management, including IV crystalloid solution given to 131 (90.97%), and correction of acidosis 60 (42.3%), hypoglycemia correction with IV dextrose 10% 6 (4.2%), and hypokalemia and infections were corrected with IV potassium chloride 52 (36.1%) and IV antibiotic treatment 84 (58.3%) respectively. Conclusion Pediatric patients under 2 years of age are at high risk of severe diarrhea with dehydration as compared to other ages. Early referral and availability of point care tests are essential in early recognition of accompanied complications.
Jan 2026 DOI 10.14302/issn.2470-0436.jos-25-5905
Purpose To report a rare case of Mooren’s ulcer in a healthy young male without systemic autoimmune disease, and to highlight the effectiveness of conjunctival resection as therapy for cases unresponsive to medical management. Case report A 34-year-old immunocompetent male presented with progressive peripheral corneal ulceration in the left eye. Extensive systemic and infectious evaluations, including rheumatologic, immunologic, and microbiological testing, were unremarkable. Human leukocyte antigen genotyping was DR17(03)-negative and DQ2-positive. Rheumatological evaluation yielded no definitive systemic diagnosis. Despite immunosuppressive therapy with adjuvant medications, the epithelial defect and stromal inflammation persisted. The patient underwent conjunctival resection, resulting in marked reduction in inflammation, rapid re-epithelialization, and structural stabilization of the cornea. Histopathology of excised conjunctiva showed nonspecific inflammation without granulomatous changes, vasculitis, or neoplastic features. During follow-up, patient remained in remission with visual acuity preserved at 6/6 bilaterally and no recurrence. Conclusion Mooren’s ulcer is rare but vision-threatening. Early recognition, comprehensive evaluation, and timely surgical intervention can be vision-saving. This case highlights the role of a multidisciplinary approach and supports conjunctival resection as a useful adjunct in refractory disease. Long-term follow-up is essential.
May 2025 DOI 10.14302/issn.2694-2283.jsem-25-5529
Background Septic arthritis is a potentially limb or life-threatening joint infection that requires prompt recognition and intervention to reduce morbidity and mortality. While intra-articular joint injections are commonly performed for osteoarthritis and other arthropathies, they carry a rare but significant risk of iatrogenic infection, particularly when performed in the presence of unrecognized joint or periarticular infection. Case Presentation We report a case of a 52-year-old female with a history of traumatic brain injury and chronic right knee pain who developed severe knee swelling, pain, and systemic symptoms following an intra-articular corticosteroid injection performed without ultrasound evaluation/guidance. Post-procedure, she presented with fever, elevated inflammatory markers, and purulent knee effusion. Operative washout revealed a purulent tract extending from the knee joint capsule to the lateral thigh. Cultures from joint aspiration and intraoperative samples grew Streptococcus dysgalactiae. Blood cultures were negative. The patient reported frequent cat scratches to the affected knee and described an unusual sensation of the injection needle tracking laterally during the joint injection. She was treated with surgical drainage and a four-week course of amoxicillin, with full clinical recovery. Discussion This case highlights an unusual presentation of septic arthritis with extra-capsular extension likely due to iatrogenic needle tracking during joint injection. The causative organism, S. dysgalactiae, is an uncommon pathogen in septic arthritis, and the presumed source was contiguous spread from untreated cellulitis, possibly related to cat scratches/bites. The absence of predisposing comorbidities and negative blood cultures further support a local rather than hematogenous source. The case emphasizes the importance of thorough clinical evaluation and consideration of infection prior to joint injections, as well as the potential benefits of ultrasound guidance to minimize procedural complications. Conclusion Careful history, physical examination, and appropriate imaging are essential prior to joint interventions to avoid iatrogenic complications. This case illustrates the rare but serious risk of extra-capsular extension of septic arthritis following intra-articular injection and emphasizes the need for vigilance in identifying underlying infection before proceeding with invasive procedures.
Dec 2023 DOI 10.14302/issn.2693-1176.ijgh-23-4854
A potential treatment for Alzheimer's disease is vagus nerve therapy, which has been made possible by considerable advances in neuroscience. An essential component of the autonomic nervous system, the vagus nerve regulates memory, inflammation, and cognition. Researchers hope to delay the progression of Alzheimer's disease and improve cognitive function by implanting a vagus nerve stimulator (VNS). Alzheimer's patients have higher heart rate variability, according to an ECG study, which may be advantageous. To completely grasp its mechanics and long-term effectiveness, more research is necessary.
Aug 2023 DOI 10.14302/issn.2474-7785.jarh-23-4730
Background Osteoarthritis and depression are both key barriers to healthy aging and greatly heighten the risk for many negative health issues that seriously impact life quality. When combined what are the implications? Aim This mini review examines 2023 data pertaining to osteoarthritis and depression and older adults and a possible theoretical framework of stress that may direct our approaches in the future. Methods and Procedures Articles published between January 1 and August 15 2023 that addressed the current topic of interest and that were extracted from PUBMED, PubMed Central, Science Direct, and Google Scholar were carefully read and their key points arepresented in narrative form. Results As in the past, very few tangible theory-based prospective analyses that employ valid measures of depression and examine any association of any form of osteoarthritis longitudinally and in a consistent manner prevail. Several reports use the same or similar large cohort to draw upon, and find various degrees of clinical implications, but this may not embrace the need for more inclusivity, sampling strategies, control and diversity issues, as well as embracing the role of cognitions positive and negative. Conclusion Without efforts to develop sound research designs of diverse and carefully differentiated osteoarthritis substantive samples it is impossible to delineate the origin or implications of the osteoarthritis-depression linkage reported currently or arrive at a deep understanding of its relevance, to life quality and public health costs. What is needed to protect against or minimize either or both these clinically related disabling correlates in the aged population warrants timely study.
Apr 2023 DOI 10.14302/issn.2641-5518.jcci-23-4554
This report details sequential rare complications arising from a vascular stent infection. Clinical course, microbiology, and imaging are outlined, with emphasis on early recognition and multidisciplinary management. Lessons for device surveillance and antimicrobial stewardship are highlighted.
Oct 2021 DOI 10.14302/issn.2474-7785.jarh-21-3979
Background Aging, a state often associated with poor emotional health status greatly impedes life quality and independence for many. Aim This mini review examines the potential of the concept of positive psychology as an active approach to fostering successful or more successful, rather than suboptimal aging. Methods and Procedures Articles that addressed the current topic of interest and were located in the PUBMED, Medline, Web of Science, PsycINFO and Google Scholar electronic data bases were carefully sought and analyzed and presented in narrative form. Results Various forms of positive psychology appear to provide a safe efficacious evidence based approach for purposes of ameliorating various degrees of anxiety and depression and for improving cognition, life quality, and health well-being in diverse subgroups of older adults Conclusion More research to examine who might benefit most from this highly promising form of intervention, and in what respect appears to have considerable merit in light of the growing populations of older adults and few intervention options to help them to age optimally and as successfully as possible.
May 2021 DOI 10.14302/issn.2766-8681.jcsr-21-3783
Background Klippel-Feil Syndrome (KFS) is described as the clinical triad of short neck, low posterior hairline, and limitation of neck mobility. Objective Topresent our clinical experience with KFS patients who also had adjacent segment disease (ASD) and to propose a novel classification system for these patients. Methods This retrospective study was performed in the neurosurgery department of our tertiary care center. Data were gathered using the medical records of 22 KFS patients (10 males, 12 females) with ASD. Diagnosis was confirmed with imaging modalities including X-ray, computerized tomography, and magnetic resonance imaging. Clinical and radiological findings as well as therapeutic outcomes were noted. Results The average age of our series was 56.09 (range: 41 to 67) years. The operative technique was selected as for our novel “Yilmaz-Yucesoy Classification System”. Accordingly, one patient (4.54 %) received non-surgical treatment (Yilmaz-Yucesoy Grade 1), six cases (27.27 %) underwent anterior cervical arthroplasty, seven patients (31.81 %) underwent anterior cervical discectomy or corpectomy and fusion with cervical cage and plate (Yilmaz-Yucesoy Grade 3). Eight patients (36.36 %) with cervical spinal instability had anterior cervical discectomy or corpectomy and fusion with cervical cage and plate (Yilmaz-Yucesoy Grade 4). No mortality or remarkable complications were detected. Conclusion Appropriate and timely recognition and classification of patients with KFS and ASD based on our newly proposed “Yilmaz-Yucesoy Classification System” yielded promising treatment outcomes. However, further prospective, randomized, controlled trials are warranted on larger series to validate our preliminary results.
May 2020 DOI 10.14302/issn.2641-5518.jcci-20-3317
This case report describes facial nerve palsy due to Ramsay Hunt syndrome, highlighting otic vesicles, audiovestibular symptoms, and imaging considerations. Management with antivirals, corticosteroids, and supportive care is summarized. Early recognition can improve outcomes and limit sequelae.
Jan 2019 DOI 10.14302/issn.2474-7785.jarh-18-2458
Introduction Cognitive and physical (especially aerobic) training have been reported to enhance cognition in the elderly. The goal of this study was to compare the effectiveness of two types of training, namely combined cognitive-and-physical training and cognitive training alone, for cognition and in particular for executive function and working memory. Material and Method Healthy older adults (aged 65–86 years) were included in cognitive-and-physical - CAP (n=16) - or cognitive - COG (n=16) - training groups or in a passive control group – CONT (n=16). The training took place in 60-minute sessions conducted twice a week for 8 weeks. Cognitive functions were assessed before and immediately after the interventions and at a 1-month follow-up. Results In the short-term, the CAP and COG groups showed a transfer on updating, unlike the CONT group. In the long-term, although the gains achieved by both CAP and COG persisted, the benefit observed in the COG group was greater than that in the CAP group. Conclusion Our data suggest that there may be a complementarity between cognitive and physical training effects at the level of short-term transfer, given that physical training was able to boost cognitive training. Moreover, regarding transfer, physical training may help improve performance on untrained tasks. However, as far as the long-term persistence of the benefits of training is concerned, the results tend to indicate the superiority of cognitive training.
Nov 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2291
In The Gambia like all nations, drug abuse is seen as a social and health problem that has many serious implications for the physical, social, psychological and intellectual development of the victims more especially, the children. Therefore, it continues to be a concern to families, community leaders, educators, social workers, health care professionals, academics, government and its development partners. Though there are some studies on drug abuse, there is none on children and drug abuse focusing on the street children the most vulnerable category. Street children are hypothesized to be more at risk of any epidemic including drug abuse. This study sought to determine the risk and prevalence of drug abuse among street children focusing on those in the car parks. The research was focused on six critical areas: level of knowledge of drug abuse, perception towards it, level of knowledge of the causes of it in the community and among street children, level of knowledge of negative impacts of it, level of knowledge of the preventive methods; and level of knowledge of the support services and treatments needed by victims. A structured questionnaire was used to collect the data from thirty five participants (i.e. one driver and six casual apprentices from each of the five car parks) were interviewed. The data was presented and analyzed using tables and percentage. The findings revealed among other things, that there is high level of awareness of drug abuse but the feelings towards it are mixed. Like other children, street children are abusing drugs mainly due to peer influence with the ultimate objective of getting high to relief stress, group recognition, desire to be trusted by peers, etc. Similarly, participants are highly aware of the negative impacts encompassing fighting, stealing, mental illness, etc. To finance the behavior, victims are engaged in all types of dangerous antisocial behavior including romantic ones exposing them to a range of diseases including STIs and HIV/AIDS. Marijuana is the most commonly abused drug. Though in the minority, some have started experimenting cocaine/coke, hashish; and heroin. While participants have good knowledge of the critical methods to fight drug abuse, the support services needed by victims, victims are mostly reluctant to seek the services not only because they are hard to find but fear societal stigmatization, exclusion and discrimination and professionals’ maltreatments.
Feb 2018 DOI 10.14302/issn.3066-8042.jac-17-1843
Children and youth with ADHD are a vulnerable group susceptible to adversity in wide-ranging life domains. However, many children and youth, irrespective of having ADHD become successful both academically andinterpersonally, and improve their cognition. This group can be considered as being “resilient”, that is, adapting to the adversity they may face in a positive manner. The overarching goal of this paper is to highlight domains at the academic, interpersonal and cognition levels that are indicative of resiliency among children and youth with ADHD. The secondary goal is to highlight interventions that result in promoting resiliency among this group at these levels. It is necessary for future interventions to be designed and implemented with developing the resiliency of children and youth with ADHD in mind. To achieve this, research needs to begin to identify the strengths of children and youth with ADHD to provide insight into how their strengths can compensate for their weaknesses, and to promote their resiliency leading to success academically, interpersonally and cognitively.
Feb 2018
The possibility of tailoring treatment on specific characteristics of patients – i.e. personalized medicine – has received attention in the field of rheumatic diseases since biological DMARDs targeting a unique pathway have become available. However the idea of personalized rheumatology has advanced slowly, at different paces in different disease groups, and it is only now surfacing in the recommendations for assessment and treatment of rheumatoid arthritis (RA). Many of the difficulties encountered stem from the recognition that many rheumatic diseases are not a single entity but encompass different subsets identified on the basis of genetic traits, cellular and molecular characterization both in blood and in tissues, laboratory markers and clinical manifestations (most notably in SLE). These differences suggest a multiplicity of pathogenetic triggers, whose various combination results in slightly or very diverse presentations. Developments in companion diagnostics and the identification of distinct subsets within complex syndromes are going to allow the definition of predictive biomarkers able to reduce poor treatment outcome, thus ensuring that we are treating “the right patient with the right drug”.
Aug 2017 DOI 10.14302/issn.2638-4469.japb-17-1563
GAGA-binding proteins in plants are encoded by the BARLEY B-RECOMBINANT / BASIC PENTACYSTEINE (BBR/BPC) family, which can be spilt into several groups on the basis of sequence divergence. The proteins of the different groups share an evolutionary conserved BASIC PENTACYSTEINE (BPC) domain at their very C-terminus that is important for DNA binding. Hallmark of this domain are five Cysteines at defined positions and spacing, which are considered to form a zinc-finger like structure that is involved in GAGA-motif recognition. Here, we report the formation of stabile homodimers between Arabidopsis thaliana group I member BPC1 or between group II member BPC6 in SDS-PAGE. Serial mutations of the highly conserved five Cysteines in the BPC domain of Arabidopsis thaliana BPC1 were tested for their capacity to bind to GAGA-motifs by DPI-ELISA. Our results do not support the idea of a direct involvement of these residues in making physical contact with the DNA, e.g. by formation of a zinc-finger structure. Instead, the data implies an indispensable function for the five Cysteines in homodimerization and stabilization of the protein structure by disulfide bonds. Accordingly, protein folding and structure prediction suggests the formation of a scaffold for dimerization that is supported by three intermolecular and one intramolecular S-S bond. The high degree of conservation between the BPC domains from the different groups and from different species denotes that this role for the five Cysteines might be evolutionary retained.
Aug 2017 DOI 10.14302/issn.2474-3585.jpmc-17-1591
Background: There are relatively few research publications of mental health promotion initiatives for primary school aged children that are based in community rather than educational settings. Aims: To describe developmental frameworks and models of mentoring, coaching and mental health promotion and to summarize any evidence for the efficacy of community initiatives. Methods: An umbrella review was undertaken of publications on theories and models, and a synthesis of findings from reviews of outcomes of mentoring, mental health promotion initiatives undertaken outside of school time for children aged 5-11 years. Results: Developmental mentoring on its own or in combination with outside school activities is potentially more flexible in terms of delivery and targets than school-based programs. Pooled effect sizes (range about 0.2-0.4) suggest modest but significant gains across several key domains (cognition, emotion, physical health, and social connectedness) that equate to about 10 percentile point on the developmental evaluations employed. Mediators of benefits include the level environmental or individual risk of the child and parental involvement. It is noteworthy that poor quality, atheoretical programs can have detrimental effects. Conclusions: Children aged 5-11 years may be more accepting of, and could make significant gains from, community-based mental health promotion interventions such as developmental mentoring. However, there are some significant gaps in the knowledge-base that need to be addressed through more systematic research.
Jul 2017 DOI 10.14302/issn.2326-0793.JPGR-17-1571
Perkinsus marinus is an intracellular parasitic protozoan that is responsible for serious disease epizootics in marine bivalve mollusks worldwide. Despite all available information on P. marinus genomics, more baseline data is required at the proteomic level. Our aim was to study the proteome profile of in vitro cultured P. marinus isolated from oysters Crassostrea spp. using a label-free shotgun UDMSE approach. A total of 4073 non-redundant proteins were identified across three biological replicates with stringent identification. Proteins specifically related to adaptive survival, cell recognition, antioxidants, regulation of apoptosis and others were detected. Important virulence factors of P. marinus were identified including serine protease and iron-dependent superoxide dismutase. Other proteins with involvement in several pathogens invasion strategies were rhoptries, serine-threonine kinases, and protein phosphatases. Interestingly, peptides corresponding to retroviruses polyproteins were identified in all replicates. The interactomic analysis of P. marinus proteins demonstrated extensive clusters network related to biological processes. In conclusion, we provide the first comprehensive proteomic profile of P. marinus that can be useful for further investigations on Perkinsus biology and virulence mechanisms.
Mar 2016 DOI 10.14302/issn.2476-1710.jdt-15-825
The prevalence of young adults endorsing depressive symptomatology is thought to peak during late adolescence. While there has been a wealth of research assessing the relationship between decline of the prefrontal cortex and how this process impacts depression and therapy in older adults, very little is known about the relationship on the younger end of the continuum. The current study sought to explore whether there is also a significant relationship between executive functioning and depression in younger adults. In addition, different types of executive dysfunction were assessed to better understand the possible implications for therapy in younger adults with depressive symptomatology. Data from 1,730 college-aged participants were collected on measures of depression (Center for Epidemiological Studies-Depression, CES-D) and executive dysfunction (Dysexecutive Questionnaire, DEX). In addition, three factors of the DEX were assessed; Executive cognition (EC), emotional/ behavioral control (EMO), and metacognition (MC). Correlations between CES-D scores and the full DEX survey were statistically significant (R = .45, p < .001) as were correlations between CES-D scores and scores on each individual factor (p< .001). A multiple linear regression was run to demonstrate the predictive value of each individual DEX factor as a function of CES-D scores (p < .001). Results suggested that there was a clear relationship between depressive symptoms and executive dysfunction and that all factors of the DEX appeared to be affected by depressive symptoms in this population. The implications of these results for therapy, particularly the use of problem-solving therapy or complimentary executive functioning training are discussed.
Jan 2015 DOI 10.14302/issn.2372-6601.jhor-14-381
Haemorrhage is common to both dengue fever (DF) and dengue haemorrhagic fever (DHF). Thrombocytopaenia is exceedingly common, while prolonged partial thromboplastin time and reduced fibrinogen concentration are the other abnormal haemostatic indices evident from early in the disease course. These haematological abnormalities correlate better with the timing and severity of plasma leakage rather than the clinical haemorrhagic manifestations. Blood products including prophylactic platelet transfusions are hardly required in the management of DHF. Judicious fluid therapy is the most effective intervention to prevent complications and bleeding in DHF. Concealed haemorrhage is an important complication requiring early recognition and blood transfusions to improve outcomes. Understanding the pathogenesis of coagulopathy and the significance of altered haemostatic indices, and its co-relation to disease severity and phase of DHF, is essential for appropriate interventions particularly when DHF co-exists in patients on mandatory anticoagulation for prosthetic heart valves and atrial fibrillation.
Feb 2014 DOI 10.14302/issn.2372-6601.jhor-13-346
Targeting cell metabolism is a therapeutic approach which has been used for the treatment of cancers with high levels of proliferation. Inhibition of metabolic processes in cancer cells has shown synergy with current therapeutic options to reduce refractory disease and relapse. In contrast, chronic lymphocytic leukaemia (CLL) is a disease where expansion of the malignant clone results from a combination of enhanced cell survival coupled with low level proliferation. The purpose of this article is to highlight how further research is needed to determine whether targeting cell metabolism may be a viable therapeutic strategy in this disease. We discuss how lymphocyte doubling time (LDT) remains a robust prognostic indicator used in the current clinical management of CLL, and how recognition of CLL as a proliferative disease has led to a greater understanding of the importance of energy-generating processes in its pathobiology. We summarize what is currently known about normal B cell metabolism and consider whether there is evidence of the Warburg effect in CLL cells. Finally, we speculate on how CLL cells may exploit protective mechanisms such as autophagy during times of metabolic stress and how they might influence or be influenced by metabolic characteristics of the microenvironment.