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   2014| January-March  | Volume 4 | Issue 1  
    Online since February 19, 2014

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Avicenna's contribution to cardiology
Mohammed A.R. Chamsi-Pasha, Hassan Chamsi-Pasha
January-March 2014, 4(1):9-12
DOI:10.4103/2231-0770.127415  PMID:24678465
Ibn Sina, known in the West as Avicenna, was the most famous and influential of all the Islamic philosopher-scientists. His most important medical works are the Canon of Medicine medical encyclopedia and a treatise on cardiac drugs. His Canon of Medicine remained the standard text in both the East and West until the 16 th century. Avicenna's description of cardiac diseases was logically presented perhaps for the first time in the history of medicine. Avicenna was the first to describe carotid sinus hypersensitivity, which presents with vasovagal syncope. He was a pioneer in pulsology and the first correct explanation of pulsation was given by Avicenna, after he refined Galen's theory of the pulse. Besides, he discussed the action of available drugs on the heart in details and mentioned their indications and contraindications. In conclusion, Avicenna made important contributions to cardiology. This article describes some of his contributions in this field.
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Utility of total lymphocyte count as a surrogate for absolute CD4 count in the adult Indian HIV population: A prospective study
Suman S Karanth, NR Rau, Anurag Gupta, Asha Kamath, Vikram Shanbhogue, BC Pruthvi
January-March 2014, 4(1):1-4
DOI:10.4103/2231-0770.127413  PMID:24678463
Background: Standard methods of CD4 counts and plasma viral load estimation require specialized equipment, highly trained personnel and are extremely expensive. This remains a major challenge for the initiation of anti-retroviral therapy for patients in resource-limited settings. Objective: To assess the clinical utility of the total lymphocyte count (TLC) to serve as a surrogate marker for predicting a CD4 counts <350 cell/mm 3 in patients with HIV. Materials and Methods: A prospective study of 200 consecutive newly detected highly active anti-retroviral therapy (HAART) naïve HIV patients admitted over a one year period was conducted. Linear regression, Pearson correlation and receiver operating characteristic (ROC) curves were used to calculate the relationship between TLC and CD4 counts. Results: A significant correlation between TLC and CD4 count was observed (r = 0.682, P < 0.001). TLC cut off of 1200 cell/mm 3 as a predictor of CD4 count <350 cell/mm 3 had 73.1% sensitivity, 100% specificity, 100% positive predictive value (PPV) and 51.4% negative predictive value (NPV). Raising the cutoff to 1500 cells/mm 3 improved the sensitivity to 82.1% with 88.2% specificity, 96.5% PPV, 44.4% NPV. The ROC curve demonstrated highest area under curve (AUC = 0.8) for TLC of 1500 cell/mm 3 . Conclusion: The study showed that TLC cutoff value of 1500 cells/mm 3 was a cost effective surrogate marker for CD4 counts <350 cells/mm 3 in resource-limited settings.
  3,967 372 42
Risk factors associated with deciduous tooth decay in Iraqi preschool children
Mahmood Dhahir Al-Mendalawi, Nadia Taha Karam
January-March 2014, 4(1):5-8
DOI:10.4103/2231-0770.127414  PMID:24678464
Introduction: Tooth decay (TD) is common in children with significant consequences on systemic well-being, growth and quality of life, as well as increasing the risk of decay in the permanent teeth. Aim: The aim of the present study is to define risk factors associated with deciduous TD (DTD) in Iraqi preschool children. Materials and Methods: From the 1 st June to 31 st December 2012, a case-control study was carried out on 684 children under the age of 6 years who attended Al-Aulwyiah pediatric teaching hospital in Baghdad. Clinical examination and World Health Organization caries diagnostic criteria for decayed, missing and filled teeth (DMFT) were applied. Data including gender, residence, socio-economic status (SES), parental education level, parental smoking, tooth brushing frequency, type of feeding during infancy and the presence of any systemic disease in the child were sought. Results: The mean DMFT score in the case group was 2.03 ± 1.39, of which decayed teeth formed 1.93. Males had a higher mean DMFT (2.10 ± 1.08) than females (1.96 ± 1.70) but with no statistically significant difference. The study revealed that residence, SES, parental education level and tooth brushing frequency were dependent risk factors significantly associated with DTD. However, gender, parental smoking and pattern of feeding during infancy were not significantly associated with DTD. Only four children with systemic disorders (1.2%), namely asthma and congenital heart diseases, were noticed to have DTD. Conclusion: Pediatricians and dentists could provide dental preventive and screening measures. Confronting relevant risk factors associated with DTD and improving access to oral care services are suggested. In addition, promotion of oral health programs through school curricula is needed.
  3,593 482 3
The first linezolid-resistant Enterococcus faecium in India: High level resistance in a patient with no previous antibiotic exposure
Simit Kumar, Maitreyi Bandyoapdhyay, Mitali Chatterjee, Prabir Mukhopadhyay, Sumon Poddar, Parthajit Banerjee
January-March 2014, 4(1):13-16
DOI:10.4103/2231-0770.127416  PMID:24678466
Linezolid provides high rates of the clinical cure and microbiological success in complicated infections due to Enterococcus spp., including vancomycin-resistant Enterococcus faecium. However, the emergence of resistance during linezolid treatment has been reported for clinical strains of Enterococcus, which is alarming given the fact that, this leaves the clinician with very few treatment options. We report the first case of linezolid resistant Enterococcus faecium from India, which was isolated from the blood culture of a hypoglycemic encephalopathy patient. There have been previous reports of linezolid resistant enterococci from different parts of the world, with minimum inhibitory concentration (MIC) ranging from 16 to 64 μg/mL and most of them were associated with vancomycin resistance but the isolate reported over here had an MIC of 1024 μg/mL and interestingly was sensitive to vancomycin.
  3,412 390 5
Isolation of Mycobacterium branderi, an unusual species from an acute myelogenous leukemia patient
Majid Marjani, Maham Farshidpour, Payam Tabarsi, Fatemeh-Maryam Sheikholslami, Parissa Farnia
January-March 2014, 4(1):17-19
DOI:10.4103/2231-0770.127417  PMID:24678467
We report a case of pulmonary infection caused by Mycobacterium branderi, a slow growing non-tuberculosis mycobacteria, in a patient with acute myelogenous leukemia. The pulmonary disease was treated successfully with the combination of Ciprofloxacin, Doxycycline and Clarithromycin. M. branderi may be considered as an opportunistic pathogen, especially among immunologically compromised patients.
  3,472 296 4
Reactivation of latent melioidosis presenting with acute pyelonephritis and bacteremia
Hamid Shaaban, Rabih Hallit, Jihad Slim, Aruna Sree, John W Sensakovic
January-March 2014, 4(1):20-21
DOI:10.4103/2231-0770.127418  PMID:24678468
We report an interesting case involving an 81-year-old male patient who presented to our hospital with sepsis secondary to pyelonephritis and bacteremia. Blood cultures were positive for a Gram-negative bacillus, Burkholderia pseudomallei. His risk factors were diabetes, chronic obstructive pulmonary disease including travel to an endemic area. The patient received antibiotic therapy in accordance with the national guidelines. This is the first report of reactivation of latent melioidosis in the literature manifesting as pyelonephritis and bacteremia.
  2,734 336 7