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Journal of Medical Sciences
eISSN: 1812-5727
pISSN: 1682-4474

Editor-in-Chief:  Parveen Bansal
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Review Article
Cardiac Magnetic Resonance Imaging in the Diagnosis of Ischemic Heart Disease
Moram A. Fagiry, Ikhlas A. Hassan, Ahmed Abukonna, Mohamed Yousef, Batil Alonazi, Mohammed N. Alnasser and Mustafa Z. Mahmoud
Cardiac magnetic resonance imaging (CMRI) has become a routinely used modality for the diagnosis of ischemic heart disease (IHD) and can provide non-invasive evaluation of reperfusion therapy through a comprehensive evaluation of wall motion, global function, perfusion and viability. This paper was designed to update the reader on the current status of CMRI, with a special focus on the basic CMR sequences in IHD. The recent advances on the prognostic and diagnostic value and future directions in the CMR evaluation of IHD was also discussed. The CMRI is emerging as the most promising complementary imaging techniques in the primary diagnosis of coronary artery disease (CAD) and for coronary atherosclerotic disease detection. Also, CMRI can provide comprehensive evaluation of ventricular function and myocardial perfusion and viability, as well as the coronary anatomy. Although the availability of CMRI is currently limited, an increase in training investigators and technologists, standardization of MRI protocols and efforts to raise awareness of the value of CMRI would increase the use of CMRI in clinical practice.
Research Article
Standardized Hip Implant by Cluster Analysis of Anthropometry Parameters of Femur
Gajanan Damodhar Mandavgade and Tushar Ramkrishna Deshmukh
Background and Objective: A range of research told that there is extensive variations in the sizes and shapes of femur bone across different ethnic groups and geographical locations, thus particular bone-implant fit is challenging to achieve. Prosthesis of mismatched sized can caused serious problems for patients. Thus aim of the study was to design standard hip implant based on anatomical parameter of respective population. Materials and Methods: Eleven osteological parameter of femoral prosthesis of 125 patient (67 male and 59 female) were evaluated, these eleven parameter were grouped to obtain scatter diagram. Then cluster analysis in SPSS software V25 was carried out by using slink clustering method. Results: After studying scatter diagram it was found that 15% population had irregular anatomy then rest of population. So, remaining data put under cluster analysis gives 8 (4 for men and 4 for women) sets of standard anatomical parameter for designing hip implant. Conclusion: These eight standard hip implant satisfy 85% population of Vidarbha region.
Research Article
Granulocyte Macrophage Colony Stimulating Factor as an Adjuvant in ESRD at High Risk of Bacterial Infection
Nariman Zahran, Omar Sabry and Manar Raafat
Background and Objective: GM-CSF has previously been demonstrated to be important in glomerulonephritis (GN). As both renal parenchymal cells and infiltrating inflammatory cells produce GM-CSF. GM-CSF is now regarded to act at several levels in the generation and propagation of immune responses. The therapeutic potential of GMCSF as an adjuvant treatment administrated to ESRD patients at high risk of bacterial infection was evaluated. Evaluation of in vitro effect of GM-CSF on cytoplasmic expression of P53 and Bcl-2 in neutrophils isolated from CKD and HD patients. Materials and Methods: Fifty seven individuals enrolled in this work. About 22 patients suffered from CKD on conservative treatment, 20 patients maintained on regular hemodialysis; in the current study, P53 and Bcl-2 expression in neutrophils isolated from CKD and HD patients were estimated in absence and presence of rh-GM-CSF. All individuals included in the study were subjected to Automated complete hemogram liver function tests; kidney function tests; Hepatitis markers and HIV-Ab were analyzed. Results: Results showed significant higher P53 base line expression on freshly isolated neutrophils from CKD and HD patients (p<0.01) when compared with neutrophils harvested from healthy controls. While BCL-2 showed minimal expression in all studied groups. Culture of neutrophils in absence and presence of rh-GMCSF for 20 h significantly decreased expression of P53 in neutrophils cultured in absence of rh-GMCSF in comparison to cells cultured in presence of the stimulus. On the other hand Bcl-2 expression recorded non-significant differences between the results of the two culture conditions in all studied groups. Conclusion: It can be concluded that better understanding of the molecular mechanisms underlying neutrophil apoptosis. Ultimately, leads to explore the potential of novel therapeutic strategies to handle infection and inflammation in immuno-compromised patients as in case of CKD and HD patients.
Research Article
Ultrasonographic Assessment of the Outcomes and Complications of Extracorporeal Shock Wave Lithotripsy Treatment of Renal Stones
Moawia Gameraddin, Mustafa Z. Mahmoud, Nagmeldin Yassin and Suzan Abdelmaboud
Background and Objective: Extracorporeal shock wave lithotripsy (ESWL) was introduced in the early 80s and has since become the gold standard for the treatment of urinary stones. It is the most widely performed procedure for stone treatment, treating all sizes and locations of stones, the results of which have been widely published. This study was designed with an aim to assess the outcomes and complications of the ESWL treatment of renal stones by using ultrasonography (US). Materials and Methods: A total of 100 patients with renal stones, treated using the Modulith SLX-F2 were recruited prospectively for a period of 12 months between April, 2017 and April, 2018. Renal US was conducted using Mindray's DC-60 machine, to follow the outcome of stone clearance for up to 3 months after the first ESWL session. All data was analyzed by mean±SD and student t-test was used to compare the variables at p<0.05. Results: Out of total number of patients, 60 were males and 40 females. The mean stone size and serum creatinine level were 15±1.8 mm and 2.8±0.2 mg dL1, respectively. US revealed an ESWL treatment success in most cases (83%), with an ESWL treatment sensitivity, specificity and accuracy of 98.81, 89.47 and 97.09%. Conclusion: This study concluded that ultrasonographic assessment showed 83% acceptable success rate for renal stone fragment passage and complete stone disintegration post- ESWL treatment.
Research Article
Application of Latex Agglutination and Sandwich ELISA in Detection of Human Hydatidosis
Mousa Abdel Gawad Mousa Ismail, Ibrahim Rabie Aly, Enas Yahia Abu-Sarea, Samah Sayed Abdel Gawad and Raafat Mohamed Shaapan
Background and Objective: Immunodiagnosis has been found to be useful not only in primary diagnosis of cystic echinococcosis (CE) but also for the follow up of patients after treatment. The present study aimed to prepare and purify paramyosin antigen of E. granulosus and evaluate its diagnostic efficacy for detection of echinococcosis by latex agglutination test (LAT) and sandwich Enzyme Linked Immuno-sorbent assay (ELISA) in human serum samples. Materials and Methods: The LAT and sandwich ELISA was carried out using purified hydatid cyst paramyosin antigen by gel filtration. The tested sera included sera from patients infected with hydatidosis (n = 41), sera of patients with other parasites; 8 with Schistosoma mansoni, 5 with Schistosoma haematobium, 10 with fascioliasis, 10 with amoebiasis and 20 tested negative control. Results: The results showed that by using LAT; 10 out of 41 E. granulosus infected samples showed false negative results and the sensitivity of the assay was 75.6%. All 14 out of 33 of other parasites groups were at the border line of the cut off value giving 73.6% specificity. The 5 false positive cases in the group of patients infected with Fasciola and 5 false positive cases in patients with liver amoebiasis. The 3 false positive cases found in patients with Schistosoma mansoni and only one false positive case in patients with Schistosoma haematobium. By using sandwich ELISA, 37 of E. granulosus infected patients had high positive antigen concentration leading to sensitivity of 80.4% while the specificity was 71.7%. Conclusion: The LAT is a suitable and applicable diagnostic method especially when followed by Sandwich ELISA as a confirmatory test for diagnosis of cystic echinococcosis.
Research Article
Chronic ankle instability, cumberland ankle instability tool, cervical proprioception, cervical reposition error, ankle ligaments, cervical active repositioning accuracy
Heba A. El Gayar, Magda R. Zahran, Olfat I. Ali and Neveen A. Abdel Raaof
Background and Objective: Cervical proprioception has an important role in maintaining normal spinal movement, stability and maintaining the balance of the body as a whole. Lateral ankle sprains are considered one of the most prevalent injuries in sports or in daily lives even. The aim of this study was to investigate the effect of chronic ankle instability on cervical active repositioning accuracy. Materials and Methods: Thirty subjects of both sexes (16 females and 14 males) were selected and assigned into 2 groups, Chronic Ankle Instability (CAI) group consisting of 7 females and 8 males and control group (9 females and 6 males). Cumberland Ankle Instability Tool (CAIT) was used to determine the severity of functional ankle instability. Cervical proprioception was evaluated by CROM device in the sagittal, frontal and horizontal planes. Manual testing including talar tilt and anterior drawer tests was used to determine the integrity of ankle ligaments to identify subjects with ankle mechanical instability. Results: There was a significant effect of chronic ankle instability on cervical reposition error in all cervical movements of the three planes; cervical flexion reposition error (p = 0.0001), cervical extension reposition error (p = 0.0001), cervical Rt side bending reposition error (p = 0.0001), cervical Lt side bending reposition error (p = 0.0001), cervical Rt rotation reposition error (p = 0. 0001) and cervical Lt rotation reposition error (p = 0.006). Conclusion: There was a relation between CAI and the increase in cervical reposition error compared with healthy subjects. This effect should be considered in the rehabilitation program of patients with CAI.

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