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   2016| October-December  | Volume 1 | Issue 4  
    Online since January 3, 2017

 
 
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ORIGINAL ARTICLES
Extracorporeal shock wave lithotripsy in the treatment of pediatric nephrolithiasis: Comparison of the outcome between preschool and schoolgoing children: A single-center study
Nadeem Iqbal, Salman Assad, Aisha Hasan, Muhammad Usman Shabbir, Taimur Hijazi, Saeed Akhter
October-December 2016, 1(4):91-94
DOI:10.4103/2468-5585.197491  
Aim: This study aimed to retrospectively evaluate the effectiveness of extracorporeal shock wave lithotripsy (ESWL) in the treatment of renal stones, between preschool and schoolgoing children. Methods: From January 2007 to March 2015, a total of 103 ESWL-treated children were considered for the study. Stone clearance rate, number of retreatment required, complication rate, and ancillary procedures used were evaluated. Results: Of the 103 patients with age limits of 2-14 years, 36 were <5 years (preschool group) and 67 were ≥5 years (schoolgoing group) of age. The mean age and mean stone size in preschool group was 3.26 ± 1.29 years and 0.97 ± 0.25 cm, respectively, whereas in schoolgoing group, it was 10.31 ± 3.01 years and 14 ± 0.68 cm, respectively. The stone-free rate in preschool and schoolgoing group was 34/36 (94.4%) and 57/67 (85%), respectively, with no statistical difference between the two (P = 0.2076). Post-ESWL complications, including hematuria, mild fever, flank pain, steinstrasse requiring ureteroscopy, and sepsis were seen in both preschool and schoolgoing groups, at varying rates that failed to reach statistical significance among the two (P > 0.05). Mean number of shock waves required for stone clearance was significantly less in preschool group (P = 0.0001). Conclusion: ESWL is equally effective for managing nephrolithiasis in both <5-year or ≥5-year aged children.
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The reference values for hepatic oxygen consumption and net lactate production, blood gasses, hemogram, major electrolytes, and kidney and liver profiles in anesthetized large white swine model
Mohamed Bekheit, Petru Bucur, Eric Vibert, Christian Andres
October-December 2016, 1(4):95-100
DOI:10.4103/2468-5585.197495  
Aim: Pigs are extensively used as experimental models to study the human physiology and pathophysiological conditions. Knowledge of the normal values of the commonly used parameters is indispensable to the correct interpretation of the test results. This study reports on the normal hemogram, blood gas, major electrolytes, kidney and liver profiles, hepatic oxygen consumption, and net lactate production in a large white pig model. Methods: Twenty-five female large white pigs were included in this study. Blood gas samples were collected from the portal and hepatic veins as well as the carotid artery. Results: The mean hemoglobin level was 97.7 ± 15.8 g/L. white blood cells were 13.5 ± 3.3 10 [3] /mm [3] , and platelet count was 279 ± 104.6 10 [3] /mm [3] . The mean aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase, alkaline phosphatase, total bilirubin, and direct bilirubin were 83.8 ± 73.9 IU/L, 43.7 ± 5.9 IU/L, 33.6 ± 8.6 IU/L, 296.5 ± 39.7 IU/L, 5.6 ± 3.2 mmol/L, and 1.6 ± 0.73 mmol/L. The mean albumin level was 29 ± 3.9 g/L. The mean ammonia and arterial lactate levels were 49.1 ± 45.67 mmol/L and 1.5 ± 0.46 mmol/L. Kidney profile parameters were comparable to human values. Hepatic oxygen consumption was 17.3 ± 9.7 mL/100 g liver tissue/min and net hepatic lactate production was 0.017 ± 0.03 mmol/L. Conclusion: Knowledge of the normal parameters is mandatory for accurate interpretation of the experimental results that involves large white animals.
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CASE REPORTS
Thrombectomy and angioplasty as treatment for acute superior vena cava syndrome
Paulo Eduardo Ocke Reis, Leonardo Roever, Marcelo Rotolo Nascimento, Pietro de Almeida Sandri
October-December 2016, 1(4):112-114
DOI:10.4103/2468-5585.197497  
Superior vena cava syndrome (SVCS), a disease caused by obstruction of the venous blood influx, because of benign etiology, from the upper body into the right atrium, is becoming more frequent, with growing use of central catheters. The present study is a case report of such acute SVCS managed successfully with an endovascular approach. A 53-year-old male patient, who had received a central venous catheter into the right jugular vein for chemotherapy, revealed an extensive thrombus formation in the veins and was diagnosed of grade 2 SVCS. He was subjected to local thrombolysis therapy followed by mechanical thrombectomy with adjunctive catheter-guided aspiration and a stent being placed through balloon angioplasty. The patient revealed a complete relief of symptoms, excellent signs of clinical improvement, and no signs of recurrence till date, 6 months posttherapy. This case supports the feasibility, safety, and efficacy of endovascular thrombectomy and angioplasty to treat SVCS.
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Management of triple-negative invasive ductal cell carcinoma
Zil-e-Ali Ahsan, Assad Salman, Thomas Nicholas Todd
October-December 2016, 1(4):115-117
DOI:10.4103/2468-5585.197498  
We reported a case of triple-negative breast cancer who presented to our medical center with a mass in the upper outer quadrant of the left breast. The age of the patient at the time of presentation was 74 years and 8 months. Breast ultrasound revealed a 3.3 cm × 2.7 cm lobulated hypoechoic fibroglandular mass in the upper outer quadrant of the left breast. Core biopsy showed triple-negative (estrogen receptor/progesterone receptor/human epidermal growth factor receptor 2/neu negative) invasive ductal cell cancer of the left breast infiltrating into the skin but no fixation to the chest wall. Neoadjuvant chemotherapy reduced the size of the mass to 2.1 cm × 1.2 cm. Partial mastectomy was then performed along with partial axillary dissection and adjuvant radiotherapy. No recurrence of tumor or any recent breast mass was noted at 1-year follow-up on both mammography and ultrasonography, indicating successful management of triple-negative breast tumor. We conclude that triple-negative breast tumors should be managed with neoadjuvant chemotherapy such as taxanes and cisplatins followed by adjuvant radiotherapy.
  2,703 242 -
REVIEW ARTICLE
Mesenchymal stem cells for heart repair
Kan Wang, Qiyuan Xu
October-December 2016, 1(4):101-111
DOI:10.4103/2468-5585.197496  
With the aging of the population, ischemic heart disease including myocardial infarction, ischemic cardiomyopathy, and consequent heart failure became a leading cause of morbidity and mortality despite substantial advances in risk factor prevention, medicaments, and revascularization. Cell therapy is currently being investigated as a potential low-cost and low-risk alternative. Favorable results from preclinical studies have brought cardiac cell therapy into clinical trials. It has been demonstrated that mesenchymal stem cell (MSC)-based therapy is promising for tissue engineering and therapeutic applications due to their pluripotent differentiation and relative ease of obtain. This review focused on the utilization of MSC in cardiac repair and current status in clinical application.
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