Sucharita Anand, S. Pradhan, Nilesh A Wagh, Kanishka Uthansingh, S. Choudhury
{"title":"A prospective study on association of migraine with tension-headache: Is neck pain a common burden in India?","authors":"Sucharita Anand, S. Pradhan, Nilesh A Wagh, Kanishka Uthansingh, S. Choudhury","doi":"10.37897/rmj.2023.2.3","DOIUrl":"https://doi.org/10.37897/rmj.2023.2.3","url":null,"abstract":"Background. The present study aimed to know the association and causal relationship of neck pain with different primary and mixed-type headache disorders. Material and methods. The primary patients with headaches attending the Department of Neurology OPD throughout one-year were included in the study. The demographic features, detailed history of headaches, and the characteristics of neck pain were entered in the pre-designed proforma. With the collaboration of the Department of Neurology, All India Institute of Medical Sciences, Jodhpur, Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow and the Department of Neurology, IMS and SUM Hospital, Bhubaneswar, India. Results. A total of 601 primary headache patients were included in the study, among which a fraction of 66.4% (n=399) had the problem of neck pain either as a pre-disposing event or as a part of the headache. Females were predominately higher than males with a fraction of 67.6%. Among all the patients a fraction of 21% (n=84) had a migraine, 51% (n=203) had a tension-type headache (TTH) and 28% (n=112) had a mixed-type headache. Though several patients with migraine had neck pain as a part of migraine, neck pain was significantly associated with tension and mixed type headache than migraine headache (p<0.001 vs p=0.35). Among the mixed-quality of headaches; chronic TTH (CTTH) with episodic migraine (EM) was most common (54.5%, n=61), followed by CTTH with chronic migraine (CM) at 33% (n=37). Conclusion. The presence of neck pain in migraine headaches showed an increased association with TTH whereas the reverse may not be true. This is yet to prove whether this is a mere association or a causal relationship.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"s3-30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90821541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hepatitis B virus associated cirrhosis: overview of prognostic and management","authors":"M. Stoian","doi":"10.37897/rmj.2023.2.2","DOIUrl":"https://doi.org/10.37897/rmj.2023.2.2","url":null,"abstract":"Hepatitis B virus (HBV) infection is a global public health problem ; two billion people worldwide have evidence of past or present infection with HBV, and 296 million individuals are chronic carriers (i.e., positive for hepatitis B surface antigen [HBsAg]), of whom approximately 887,000 dies annually from HBV-related liver disease: chronic hepatitis B-associated cirrhosis and hepatocellular carcinoma. There are described some risk factors to the development of cirrhosis to HBV-infected persons: alcohol consumption, HBeAg status, metabolic syndrome, HBV genotypes and variants, and the level of HBV replication. The observation of a strong association between the development and decompensation of cirrhosis as well as between the development of HCC and the level of HBV replication suggests that suppression of HBV replication by long-term antiviral treatment may decrease the risk of complications in patients with HBV-related cirrhosis. The indication for antiviral treatment is given if any HBV DNA levels are detectable in the serum of HBV-infected patients with cirrhosis. Into the new era of antiviral treatment with nucleos(t)ide analogs we can prevent the development of cirrhosis in patients with chronic HBV infection and hepatic decompensation in many patients with HBV-related cirrhosis.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87002976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"MRI-guided stereotactic ablative radiation therapy for metachronously recurrent pulmonary oligometastases from hepatocellular carcinoma after failure of systemic therapy","authors":"Y. Hama, E. Tate","doi":"10.37897/rmj.2023.2.5","DOIUrl":"https://doi.org/10.37897/rmj.2023.2.5","url":null,"abstract":"Objectives. This article aims to evaluate the feasibility and effectiveness of MRI-guided stereotactic ablative radiotherapy (SABR) for metachronously recurrent pulmonary oligometastases from hepatocellular carcinoma (HCC) when systemic therapies prove ineffective. Case Presentation. A 47-year-old male with metastatic HCC underwent unsuccessful chemotherapy, targeted therapy, and immunotherapy. The patient had a history of 14 lung metastases, previously treated with respiratory non-gated SABR. However, five new lung metastases emerged, raising concerns about potential pulmonary toxicity. After administering oral capecitabine, tumor growth persisted. To address this, the patient received MRI-guided respiratory-gated SABR using a recently installed system. Outcome. MRI-guided respiratory-gated SABR was well-tolerated, with no radiation-induced adverse events reported during treatment and a six-month follow-up period. Imaging follow-up demonstrated complete tumor regression, and no new recurrences were observed. Conclusions. This case report suggests that MRI-guided SABR could be a viable option for managing metachronously recurrent pulmonary oligometastases from HCC, particularly after failed systemic therapies. The precise targeting achieved with minimal toxicity, utilizing a 1 mm margin without an internal target volume, showcases the potential of this approach. However, further scientific investigation is warranted to validate these findings, given the limited scope of this single case report. Nonetheless, MRI-guided SABR holds promise as a safe and effective local treatment modality for lung metastases in HCC patients.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82779058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Roxana-Elena Busuioc, D. Păduraru, A. Stănescu, Didina Cătălina Barbălată, F. Musat, A. Albu, O. Andronic
{"title":"Regenerative medicine options in treating premature ovarian failure","authors":"Roxana-Elena Busuioc, D. Păduraru, A. Stănescu, Didina Cătălina Barbălată, F. Musat, A. Albu, O. Andronic","doi":"10.37897/rmj.2023.1.9","DOIUrl":"https://doi.org/10.37897/rmj.2023.1.9","url":null,"abstract":"Infertility is generally defined as the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. premature ovarian failure (POF) is a cause of female infertility, being estimated to affect 1% of the general population. This condition represents a loss of hormonal and germinative activity of the ovaries due to a lack in the number of active follicles in women under 40 years old. Regenerative medicine represents a complex therapeutic option and it consists of technologies such as the use of stem cells, tissue engineering, and gene therapy alone or in different combinations. Although the boundaries of regenerative medicine are not clearly outlined at present, this paper is aiming to review its possibility of treatment in the future in what concerns POF, focusing more on the use of stem cell therapy. Stem cell therapy could be a feasible therapeutic approach for POF as the cells can be easily obtained. However, additional clinical studies are needed because until now the majority of the literature focuses on animal models for the evaluation of the role of stem cells on treating POF. Additionally, the platelet-rich plasma (PRP) approach for POF should be kept in mind as it was shown to be useful in the regeneration of multiple types of tissue.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88005712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Bălescu, N. Bacalbaşa, I. Brezean, C. Stoica, C. Tomescu, Cristina Martac, Andrei Voichitoiu, B. Gaspar
{"title":"The impact of thrombocytosis on the long term outcomes in relapsed ovarian cancer","authors":"I. Bălescu, N. Bacalbaşa, I. Brezean, C. Stoica, C. Tomescu, Cristina Martac, Andrei Voichitoiu, B. Gaspar","doi":"10.37897/rmj.2023.1.6","DOIUrl":"https://doi.org/10.37897/rmj.2023.1.6","url":null,"abstract":"The presence of thrombocytosis has been widely associated with poor prognostic in patients diagnosed with ovarian cancer at the time of the initial diagnostic. Once this fact has been widely accepted, attention was focused on studying whether this biological parameter could be also a diagnostic tool for identifying patients with poorer outcomes at the time of secondary cytoreduction. Therefore the most commonly encountered questions are whether patients presenting thrombocytosis at the time of primary cytoreduction are expected to have also thrombocytosis at the time of relapse and if thrombocytosis at the time relapse is corelated with lower disease free intervals, with higher rates of incomplete debulking and with poorer rates of overall survival respectively. This is a literature review of the most relevant studies conducted on this issue.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85943851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Is measuring serum ammonia helpful in patients with liver cirrhosis?","authors":"I. Lupescu, M. Iacob, L. Gheorghe","doi":"10.37897/rmj.2023.1.7","DOIUrl":"https://doi.org/10.37897/rmj.2023.1.7","url":null,"abstract":"Background. Ammonia has been traditionally viewed as one of the main culprits for the development of hepatic encephalopathy. In the setting of liver cirrhosis or portal-systemic shunting, hepatocytes fail to metabolize ammonia, and thus excess ammonia reaches the systemic circulation, and from there, the brain. Material and methods. We performed a descriptive study involving 28 adult patients with liver cirrhosis. None of the patients had overt hepatic encephalopathy at the time of assessment, as judged by the West Haven criteria. Severity of liver cirrhosis was measured through the Child-Pugh and MELD scores. Serum ammonia was measured by venous sampling. Results. Mean age of the patients was 50±10 years-old. There were 68% males (n=19). Mean MELD score was 17±5 points. Mean Child-Pugh score was 8±2 points. Mean serum ammonia level was 76±37 μmol/L (range: 34-204 μmol/L). Serum ammonia levels correlated significantly with both scores of liver disease severity, more so with MELD (R=0.61, p=0.0005), than with the Child-Pugh score (R=0.38, p=0.04) Conclusions. We reaffirm the importance of measuring blood ammonia in patients with liver cirrhosis, since it is a helpful biomarker which correlates with liver disease severity and hepatic encephalopathy.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83785016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Bugari, S. Baschir, Luminiţa Turcin, D. Chita, D. Zdremţan, Ioana Floarea, A. Jompan, Alexandru Chioreanu
{"title":"Therapeutical protocol in otitis seromucosa","authors":"R. Bugari, S. Baschir, Luminiţa Turcin, D. Chita, D. Zdremţan, Ioana Floarea, A. Jompan, Alexandru Chioreanu","doi":"10.37897/rmj.2023.1.8","DOIUrl":"https://doi.org/10.37897/rmj.2023.1.8","url":null,"abstract":"Introduction. In the first part of the paper, the authors propose to systematize the data from the literature on seromucous otitis. Material and methods. We performed a retrospective clinical study, starting from the premise that there are 3 therapeutic trends for children with chronic seromucous otitis in medical practice. A first group includes children who only underwent adenoidectomy, the second who underwent adenoidectomy and myringotomy and the third group who underwent adenoidectomy and the installation of a trans- tympanic drainage tube. The results were compared, and a new therapeutical protocol regarding the pediatric patients with chronic seromucous otitis comes as a final conclusion.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78725689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The use of antioxidants in the treatment of Graves’ Disease: evaluating the results","authors":"Vladyslava Oleksandrivna Ostapchuk, Vadym Andriiovych Ostapchuk, Oleksandr Viktorovich Shidlovskyi, M. Sheremet","doi":"10.37897/rmj.2023.1.3","DOIUrl":"https://doi.org/10.37897/rmj.2023.1.3","url":null,"abstract":"Topicality. Accelerated metabolism in Graves' disease causes the development of oxidative stress, which significantly affects the clinical course and treatment results. Purpose. This study was conducted to evaluate the effect of treatment with thyrosol and thyrosol in combination with antioxidants, in particular vitamins C and E, on indicators of thyroid hormone function (thyroid-stimulating hormone and thyroxine) and oxidative stress (malondialdehyde and total antioxidant capacity). Material and method. The clinical study was performed on 41 patients with newly diagnosed Graves' disease of moderate severity, aged from 21 to 43 years, who were divided into two groups. The control group consisted of 19 patients who received thyrosol for treatment. The main group included 22 patients who were treated with thyrosol in combination with vitamins C and E. Examinations were carried out upon inclusion in the program and one and two months after the start of treatment. Results. The conducted studies showed that in the course of treatment, the indicators of malic dialdehyde gradually decreased from 21.3±0.4 (17.3–29.2) to 10.31±0.1 (9.72–10.82) and thyroxine from 37.7±0.5 (31.2–42.7) to 15.31±0.2 (13.20–20.52) and the total antioxidant capacity increased from 0.69±0.04 (0.52–0.79) to 1.58±0.1 (1.48–1.61), thyroid-stimulating hormone from 0.01±0.004 (0.07–0.001) to 2.31±0.1 (0.90–3.52). These changes were more pronounced in the main group compared to the control group during the study one month and two months after the start of treatment. Conclusions. Thus, antioxidant supplements can be used to improve thyroid function in hyperthyroid patients by enhancing antioxidants and restoring the oxidant-antioxidant balance.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83422261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Florin-Dan Popescu, N. Onitiu-Gherman, Mariana Caraghiulea, C. Ganea, M. Preda, A. Stănescu
{"title":"Allergy skin testing with nonirritating concentrations of anesthetic agents","authors":"Florin-Dan Popescu, N. Onitiu-Gherman, Mariana Caraghiulea, C. Ganea, M. Preda, A. Stănescu","doi":"10.37897/rmj.2023.1.1","DOIUrl":"https://doi.org/10.37897/rmj.2023.1.1","url":null,"abstract":"Immediate hypersensitivity reactions to anesthetic agents are rare, but with a worrying morbidity and mortality rate. Allergy evaluation is mandatory when hypersensitivity reactions to anesthetic agents are suspected. Skin prick tests and intradermal tests are important tools due to their clinical utility in establishing the diagnosis of IgE-mediated hypersensitivity and evaluation of cross-reactivity. This article presents, for informational purposes only, the nonirritating concentrations of general anesthetics and adjuvant agents, neuromuscular blocking agents and agents used in local and regional anesthesia, used in clinical practice for allergy skin testing according to international guidelines. The delayed hypersensitivity adverse reactions can be assessed by patch testing. Concentrations used for such skin testing with topical anesthetic agents from the European baseline series, international comprehensive baseline series and medicament series, are also presented.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82955007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diabetes Mellitus in the Internal Medicine Department of the Regional Hospital in Peja, January-December 2021","authors":"Besarta Pelaj","doi":"10.37897/rmj.2023.1.4","DOIUrl":"https://doi.org/10.37897/rmj.2023.1.4","url":null,"abstract":"Diabetes is a relatively common disease that affects 2-4% of the US population. This disease develops due to lack of insulin and presents with chronic disorders of carbohydrate metabolism as well as fat and protein metabolism. Aims. To present the number of cases that have been affected by Diabetes mellitus in the region of Peja in the period January to December 2021 compared with the number of diabetes in people with Covid-19 in the same ward. Material and methods. The descriptive component of the epidemiological method from the retrospective aspect was used. Results. A total of 500 patients with diabetes were admitted to the Internal Medicine ward of the Peja Regional Hospital (200 were with Covid-19), and 62 patients were registered in this ward for obtaining diabetes booklets who entered insulin for the first time (a total of 562 patients). From January to December, 2021, 99 patients with diabetes were presented for the first time, out of these 60 were with Covid-19 who hope that after 1-3 months they will not have diabetes and we are in contact, we are following them, as well as 39 patients who did not have covid19 are first-time diabetics. During the period January, February, March, April, May, August and September, 374 patients were treated in the Internal Medicine. Conclusions. Based on the inclusion of this disease in the Peja Region, the data will serve us to take measures to prevent DM starting with patient education and to recommend preventive measures.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80090909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}