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  Citation statistics : Table of Contents
   2016| November-December  | Volume 8 | Issue 6  
    Online since July 11, 2017

 
 
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ARTICLES
Medicinal properties of the sesbania grandiflora leaves
Nafisa Binte Arfan, Azima Sultana Julie, AK Mohiuddin, Shah Alam Khan, Zubair Khalid Labu
November-December 2016, 8(6):271-277
DOI:10.4103/1947-489X.210243  
Background: The leaves of Sesbania grandiflora have been used in local traditional medicine since ancient times. In the present study we investigated, in vivo and in vitro, the potential health benefits of various fractions of the ethanolic extract of these leaves. Materials and methods: Crude ethanolic extract (CEE) of S. grandiflora leaves was partitioned into ethyl acetate soluble fraction (EASF), petroleum ether soluble fraction (PSF), carbon tetrachloride soluble fraction (CTSF), chloroform soluble fraction (CSF), and water soluble fraction (WSF). The extracts were evaluated for their thrombolytic, membrane stabilizing (anti-inflammatory), antimicrobial, and antidiarrheal activities. The results were compared to the effects of standard drugs: streptokinase for the thrombolytic, acetylsalicylic acid (ASA) for the membrane stabilizing, kanamycin for antimicrobial, and loperamide for the antidiarrheal activities. Results: For thrombolysis, EASF showed the highest % of clot lysis (59.6%) among all fractions, while streptokinase and water resulted in 69.2% and 3.1% clot lysis respectively. With respect to the membrane stabilizing activity, the EASF significantly inhibited the hemolysis of human erythrocytes induced by hypotonic solution (64.3±0.6%) or by heat (57.2±0.7%). The other fractions exhibited no membrane stabilizing effect. By contrast ASA resulted in 73.9±0.3% inhibition of osmotically induced hemolysis and a slightly lower level of inhibition in the case of heat-induced hemolysis (70.1±0.3%). The antidiarrheal activity was evaluated in the mouse model. The unfractionated, CEE reduced the number of defecation episodes by 25.0% at a dose of 200 mg/kg and by 41.1% at dose 400 mg/kg body weight. All extract fractions exhibited significant antibacterial activity, which was higher against Gram negative bacteria than Gram positive bacteria. Since the pharmacological activities of S. grandiflora are due to the presence of bioactive compounds we detected and quantified the presence of significant levels of flavonoid and tannin substances. Conclusion: Leaves of Sesbania grandiflora have the potential to be used as a remedy for thrombosis, diarrhea, and inflammatory diseases and against few important bacterial pathogens.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
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CASE REPORT
First beneficial use of dapagliflozin for treatment of post-bariatric hypoglycemia: Case report and hypothesis
Salem A Beshyah
November-December 2016, 8(6):335-342
DOI:10.4103/1947-489X.210247  
Background: Hypoglycemia is a significant complication of post-bariatric surgery. Case history: A 46 year old woman was referred for further management. She had had a Roux-en-Y gastric bypass surgery in 2012. She lost over 20 kilograms of weight. Pre-opertaively, a single HbA1c was borderline at 48 mmol/mol (6.5%) which improved to 41-44 mmol/mol. In November 2013, she started to experience symptoms suggestive of hypoglycemia. Dietary adjustments were advised and a trial of metformin and saxagliptin was given on basis of wide fluctuation of blood glucose with a remarkable early postprandial hyperglycemia followed by hypoglycemia. She stopped both medications due to gastrointestinal side effects. Renal and liver disease and hypoadrenalism were all excluded. We started her on increasing doses of Acarbose (an alpha glucosidase inhibitor) up to 100 mgs with each meal but she experienced minimal improvement in hypoglycemia. A a trial of Dapagliflozin, a sodiumglucose co-transporter 2 (SGLT 2) inhibitor, in a standard daily dose of 10 mgs in addition to Acarbose was offered to the patient (from 6th October 2015). The theoretical basis were explained to her and she consented verbally to this. Within 2 weeks, she experienced remarkable symptomatic improvement associated with reduction of both hyperglycemia and hypoglycemia documented on self-monitoring of blood glucose. The patient reduced Acarbose progressively to a complete cessation on her own accord. She remained well controlled solely on Dapagliflozin 10 mgs daily. The improvement is sustained for 12 months. The effect was further confirmed by 1 week off and one week on Dapagliflozin using flash glucose monitoring. Conclusions: This is the first report of a beneficial use of SGLT2 inhibition primarily for post-bariatric hypoglycemia. SGLT2 inhibitors may have a role in managing gastric bypass hypoglycemia.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
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ABSTRACTS BOOK
Abstracts of the fourth clinical congress of the gulf chapter of the American association of clinical endocrinologists; 3-5 November 2016; Dubai, UAE. I. lectures, symposia and meet the expert sessions
Amin Al Jayyousi, Salem A Beshyah, Ali S Alzarhrani, Nasser Aljuhani, Yousef Al Saleh
November-December 2016, 8(6):278-297
DOI:10.4103/1947-489X.210244  
This is the first part of the advance abstracts of the fourth clinical congress of the Gulf Chapter of the American Association of Clinical Endocrinologists to be held on 3-5 November 2016. The declared educational objectives of the congress was to give a “state of the art in endocrine practice”. To this end, the organizing committee invited international and regional key opinion leaders to meet the objectives of the congress. We present here abstracts of the congress as submitted by the authors after minimal restyling and editing to suit the publication requirements of the journal. Many major issues and topical themes with wide interests in the profession were addressed in plenary lectures. Symposia were organized to suite the specific educational needs of the target audience subgroups. Practical issues were addressed in “Meet the Expert”-type of interactive workshops. We hope that by publishing them in this open access journal we extend the benefit to those who could not make it to the live presentations.
[ABSTRACT]   Full text not available  [PDF]
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Abstracts of the fourth clinical congress of the gulf chapter of the American association of clinical endocrinologists; 3-5 November 2016; Dubai, UAE. II. free communications
Nasreen Alsayed, Juma M Al Kaabi, Ebaa Al-Ozairi, Abdel Raouf Al Mahfouz, Mohamed Lamki
November-December 2016, 8(6):298-331
DOI:10.4103/1947-489X.210245  
These are the advance abstracts of the free communications accepted for presentation at the fourth clinical congress of the Gulf Chapter of the American Association of Clinical Endocrinologists to be held on 3rd- 5th of November 2016. One of the main objective of the congress is to give an opportunity to share results of clinical and basic research relating specifically to clinical practice of diabetes care and clinical endocrinology in the region. We present the abstracts of the free communications as submitted by the authors after minimal restyling and editing to suit the publication requirements of the journal. Reflecting mostly the regional epidemiology and clinical practice in diabetes care and endocrinology, were selected for presentations as either oral or poster presentations. By publishing the proceedings of our fourth annual congress in this open access journal, we hope to extend the benefit to those who could not make it to the live presentations and give a safe home for all the abstracts for future reference. Thus making them permanently available to facilitate regional and international networking and collaboration between clinicians and academics of shared interests
[ABSTRACT]   Full text not available  [PDF]
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ARTICLES
First Libyan experience with insulin pump therapy: Impact on glycemic control and patients satisfaction
Faten BenRajab, Nadia Alghazair, Wesal Hamed, Nour Adala, Nadia B Gregni
November-December 2016, 8(6):264-270
DOI:10.4103/1947-489X.210242  
Background: The mainstay of contemporary management of type 1 diabetes mellitus (T1DM) is “physiological insulin replacement”. Regimens based on multiple daily injections (MDI) of insulin improve glycemic control and increase the frequency of hypoglycemia. Insulin pump therapy also improves glycemic control, and reduces the within-day and between-day glycemic variability that is seen with insulin injections. Objectives: We aimed to evaluate out first experience with insulin pump therapy by 1) assessing the glycemic control on insulin pump therapy compared to MDI based therapy and 2) to learn the attitude of patients and families towards the use of insulin pump. Patients and Methods: A prospective observational study involving 37 patients who used insulin pump between March & November 2013. Patients were selected according to certain criteria set up by treating physician. Data collected included demographic, clinical and biochemical data before, during and after insulin pump therapy use. Severe hypoglycemia requiring hospital management and diabetic ketoacidosis (DKA) were documented. Health-related quality of life, diabetes knowledge and patient's attitude towards pump therapy were captured before and after pump use. Outcome measures: Change HbA1c, occurrence of severe hypoglycemia and DKA. Change of body mass index (BMI) and difference in score results of health quality questionnaire. Results: 51.4% were males; mean age was 15 years (86.5% of them were between 2 and 22 years. About 94.4% had diabetes for a mean of 6.9 (range 1-14) years. The indications of insulin pump were high HbA1c (29.7%), wide variation of blood glucose (10.8%), severe hypoglycemia and/or hypoglycemic unawareness (18.9%), recurrent DKA (5.4%) and other indications (8.1%). However, 27.0% had a good metabolic control but multiple daily injections (MDI) was reportedly “compromising” their quality of life. The mean HbA1c level decreased from 9.1% to 7.4% (P = 0.001). The mean BMI increased from 21.2 to 22.0 kg/m2 (P=0.026) independent of age (r = 0.180, P = 0.295). Two episodes of DKA in one patient who had severe contact dermatitis at the site of cannula & sensor and one severe hypoglycemia, which required hospital admission due to unmatched carbohydrate intake to insulin dose due to incorrect carbohydrate counting. The health quality questionnaire scores revealed an improvement from 34.2 to 46.7 (P = 0.001). Conclusions: Our first experience with insulin pump therapy was positive in terms of achieving and maintaining good glycemic control in most of patients, it for more contact between patients and health providers and created better opportunities for diabetes education and support.
[ABSTRACT]   Full text not available  [PDF]
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CASE REPORT
Priapism: A very rare complication of dual antiplatelet therapy after percutaneous coronary intervention
Fathi I Ali, Basem Elbarouni
November-December 2016, 8(6):332-334
DOI:10.4103/1947-489X.210246  
Context: Dual antiplatelet therapy (DAPT), with aspirin and P2Y12 receptor inhibitors, is standard of care in patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). However, its use is associated with increased risk of bleeding. We herein report an unusual bleeding complication associated with DAPT after primary PCI. Case Report: A 42-year-old man, who presented with acute inferior wall MI and underwent a successful bare metal placement in circumflex coronary artery, was discharged on dual antiplatelet therapy. However, he presented 2 weeks later with priapism for 20 hours that needed surgical drainage of large amount of blood from his penis. There were no other causes to explain priapism, but since this was not known complication of DAPT, it was not discontinued given his recent stent placement. However, 3 weeks later he suffered another episode of priapism that also needed surgical drainage. Therefore, given its high antiplatelet potency, Prasugrel was eventually discontinued, and the patient was maintained on aspirin only. The decision was guided by optical coherence tomography evaluation of his recent stent to rule out local risks for stent thrombosis. The patient has done well over 14 months of follow up with no cardiac symptoms or recurrence of priapism. Conclusion: To the best of our knowledge, the association between priapism and DAPT was never reported previously. Given the wide use of DAPT after coronary intervention, we believe that interventional cardiologist should be aware of this rare, yet potentially devastating, complication.
[ABSTRACT]   Full text not available  [PDF]
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EDITORIAL NOTICE
Ibnosina Journal of Medicine and Biomedical Sciences: Thanks To Our Reviewers in 2016
Salem A Beshyah, Elmahdi Elkhammas
November-December 2016, 8(6):343-343
DOI:10.4103/1947-489X.211447  
Full text not available  [PDF]
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REVIEW
Cardiac telemetry 2016: An overview of guidelines and clinical practice
Marwan M Mohammad, Sonya John
November-December 2016, 8(6):259-263
DOI:10.4103/1947-489X.210241  
The pervasive technology of cardiac monitoring has greatly advanced patient care for several decades. Since its advent, telemetry has been used in a variety of settings to guide medical management in patients who are either acutely or non-acutely ill. Evidence from several studies supports the benefits of the 2004 American Heart Association (AHA) telemetry guidelines in stratifying patients into 3 groups based on their individual cardiac event risk. It has been shown to reduce hospital costs without compromising patient care as well as eliminate overflow of telemetry units. This article reviews the AHA cardiac telemetry guidelines and evaluates the current status of its implementation, the general benefits, as well as its limitations.
[ABSTRACT]   Full text not available  [PDF]
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