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   Table of Contents - Current issue
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April-June 2018
Volume 3 | Issue 2
Page Nos. 23-47

Online since Wednesday, June 27, 2018

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ORIGINAL ARTICLES  

Role of Angiopoietin-2 in the control of malignant pleural effusion and survival in patients with primary lung adenocarcinoma p. 23
Xiaoxia Li, Wenkui Sun
DOI:10.4103/ts.ts_25_17  
Aim: This study aimed to investigate the role of angiopoietin-2 (Ang-2) in the local control of malignant pleural effusion (MPE) and survival in patients with primary lung adenocarcinoma. Methods: Pleural effusion and blood samples were obtained from 85 patients with lung adenocarcinoma and MPE. Enzyme-linked immunosorbent assay was performed to investigate the expression levels of Ang-2 in pleural effusions and serums. SPSS software (Version 18.0) was used to analyze the data. Results: We found that the expression levels of Ang-2 in pleural effusion and serum were 26.82 ± 8.82 pg/mL and 358.78 ± 95.93 pg/mL, respectively. The expression level of Ang-2 in pleural effusion was found to be correlated with the control of pleural effusion. Based on receiver operating characteristic curve analysis, we found that when the cutoff value was 25.57 pg/mL, the efficacy of pleural effusion Ang-2 level in evaluating the control of pleural effusion could get the best result. Both the pleural effusion Ang-2 level and the local control of pleural effusion are independent factors affecting the prognosis of patients with lung cancer and MPE. However, this study also found that serum Ang-2 levels had no significant correlation with MPE local control or prognosis. Conclusion: Pleural effusion Ang-2 levels can be used as a molecular biomarker to predict both the MPE local control and prognosis of the MPE patients, which has significant clinical value.
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Clinical analysis of common complications induced by long nasointestinal tubes: A retrospective cohort study p. 28
Kai Wang, Guang Yang, Chunguang Han, Wei Bi, Guixin Zhang
DOI:10.4103/ts.ts_22_17  
Aim: The aim of this study was to discuss the common complications induced by long nasointestinal tubes (LTs) and prophylactic therapeutic measures. Methods: A retrospective analysis was performed, consisting of 88 patients treated with LT for acute bowel obstruction (including 61 patients who underwent plication of the small intestine by LT). Our study included 75 patients with an adhesive bowel obstruction, 5 patients with a malignant intestinal obstruction, 4 patients with an early postoperative inflammatory bowel obstruction, and 4 patients with a fecal obstruction. Results: The prevalence of nasopharyngeal discomfort and pain was 95.4%, and 44.3% of patients had an electrolyte disorder and another 3.4% were diagnosed with aspiration pneumonia. Among 25% of patients who had catheter-related accidents (15.9% with tube obstructions, 5.6% with unexpected catheter shedding, 1.1% with anterior balloon rupture, and 2.3% with catheter expelled from the anus), no tube breakage occurred. Conclusion: Nasopharyngeal discomfort and pain, electrolyte disorders, and tube obstructions are common complications when using LTs. Although their incidence rate is low, aspiration pneumonia, intestinal hemorrhage, perforation, and necrosis are more severe complications. Such severe complications should be taken seriously, and prophylactic therapeutic measures must be taken to minimize their occurrence. In general, the use of LTs is safe, effective, and worthy of wide use in clinical practice.
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Factors affecting adherence to testosterone replacement therapy p. 34
Abdullah Gul, Emrah Yuruk, Mehmet Gokhan Culha, Ege Can Serefoglu, Ahmet Yaser Muslumanoglu
DOI:10.4103/ts.ts_5_18  
Aim: There are several treatment modalities for testosterone replacement therapy (TRT), including topical gels, subcutaneous testosterone pellets, transdermal patches, intramuscular injectables and oral forms. Despite the increasing usage of testosterone, there is limited information concerning patient adherence and compatibility of TRT. The aim of this study is to evaluate the factors which may have an impact on patients' adherence to TRT with topical gel. Methods: Between January 2013 and September 2013, 60 men from a tertiary urology clinic, who were prescribed 50 mg testosterone topical gel, were telephonically contacted to know if they continued or discontinued TRT, and when discontinued, the reasons for the same. Results: The mean age of the patients was 40.9 ± 9.9 (range: 21–59) years. The participation rate for the study through telephone was 51.6% (31/60). The most common reason for discontinued TRT was lack of perceived efficacy [n = 11 (35.5%)]. Factors, including age, weight, height, relationship status, and presence of comorbidity, were not associated with TRT adherence. The mean (standard error) time to TRT withdrawal was 5.9 (0.9) months. Conclusion: Most men voluntarily decided to discontinue testosterone and thus a close monitoring of patients by clinicians is essential to increase TRT adherence rate, with testosterone topical gel.
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Visual analog scale and beck depression inventory assessing the clinical correlation of backache with depression p. 38
Muhammad Nadeem, Salman Mansoor, Shoab Saadat, Nadia Mehboob, Hamza Hassan Khan, Salman Assad, Bazeela Saeed, Anam Saleem, Anam Zehra, Ahmed Shah Bukhari
DOI:10.4103/ts.ts_6_18  
Aim: Patients with chronic pain mostly suffer from additional psychiatric condition especially depression. The aim of this study is to determine a relation between depression and backache. Methods: We conducted a study between January 2015 and November 2015 at a tertiary care hospital in Islamabad, Pakistan. The study included 165 adult patients (≥20 years) with backache and were interviewed at the neurosurgery clinic. Visual analog scale (VAS) and Beck depression inventory (BDI) scores were analyzed. Results: According to VAS, 11.5% patients had mild, 67.2% patients had moderate, and 21.8% patients had severe backache. A striking difference in the frequency of depression was observed between the genders, 67.8% in females compared to 32.2% in males. BDI scores showed 12.1% normal, 13.9% mild, 3% borderline, 26% moderate, 24.8% severe, and 19.3% extreme depression. A statistically significant correlation was observed between severity of backache and depression (P < 0.003). Conclusion: A high number of patients suffering from backache also demonstrated mild to extreme depression. We recommend screening for depression among these patients to achieve a better treatment outcome.
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REVIEW ARTICLE Top

Modeling neurodegenerative diseases by human pluripotent stem cell-induced brain organoid p. 42
Feng Tian, Jin Hao, Longyu Hu, Xu Luo, Rui Sun
DOI:10.4103/ts.ts_4_18  
Neurodegenerative disease (ND) contains a range of conditions which are primarily characterized by progressive neuronal dysfunction and loss. ND is particularly difficult to cure, due to the vulnerability of the nervous system. Currently, few genes and pathways are found to be related to ND. However, no solitary mechanism appears to be primary in neurodegeneration, and these pathogenic mechanisms likely act synergistically through complex interactions to promote neurodegeneration. Moreover, the existing treatment is mainly focusing on alleviating the symptoms of the disease. Furthermore, recent studies reveal considerable overlaps of symptomatology and genetic risks across the disease subtypes by detailed studies at cellular, molecular and genetic level. To better understand the etiology and pathogenesis of ND, study of the abnormalities at patient level is most ideal. However, direct access to the brain tissues from healthy individuals and patients is very limited. Therefore, an alternative experimental model is required to study the mechanism of ND. The most commonly used models are animal models, including Caenorhabditis elegans, Drosophila, zebrafish, and genetically modified mice. However, animal models also have their limitations including partial recapitulation of the disease features and difficulties in modifying disease genes. The recent development in three-dimensional (3D) brain organoids might provide a better experimental model to study ND, because 3D brain organoid system carries great potential to expand the range of both physiological and pathological features that can be found during the development of disease, enabling higher order investigation of mechanism and functionality.
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