Gynaecomastia: Management with Liposuction and Glandular Excision

Gynaecomastia is caused by an increase in ductal tissue, stroma and fat in the male breast. Frequently it occurs at the time of hormonal changes during infancy, adolescence and old age. Galen, introduced the term gynaecomastia in the second century AD and surgical excision was first described by Pauli of Aegina in the seventh AD (1,2).Ultrasound assisted liposuction and surgical excision of glandular tissue through an inferior circumareolar incision is currently the best mode of treatment.In this study seven patients varying from the ages 17-45 years were operated on using this technique at the Aga Khan University teaching Hospital. Of these, four had drains inserted and the other three had none. Of the latter, two had seromas as a complication which was managed with serial aspiration. The group with drains healed without complication of seroma. Investigations done were limited and non exhaustive for patients with gynaecomastia

Reduction mammoplasty using inferior pedicle in heavy breasts (macromastia)

Symptoms associated with heavy breasts are pain in the upper part of the body; back pains, poor body posture and headache. These patients also have difficulties in finding suitable clothes and experience poor self image and problems such as establishing sexual relationships. Reduction mammoplasty procedure provides weight and volume reduction of the breast as well as enhancement of the aesthetic appearance of the breasts.In this study, the inferior pedicle technique was used in reduction of thirty five patients over the last four years with macromastia. In all the patients except three, good results were achieved. One patient suffered nipple necrosis of the right breast and the other two had superficial wound infection of T-junction and were appropriately treated. The patient who lost the nipples had nipple reconstruction three months later

Early release of mitochondrial cytochrome c and the subsequent activation of caspase-3 are involved in the apoptotic death of neonatal motoneurons after injury

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Frequent use of paracetamol and risk of allergic disease among women in an Ethiopian population

Introduction The hypothesis that paracetamol might increase the risk of asthma and other allergic diseases have gained support from a range of independent studies. However, in studies based in developed countries, the possibility that paracetamol and asthma are associated through aspirin avoidance is difficult to exclude. Objectives To explore this hypothesis among women in a developing country, where we have previously reported aspirin avoidance to be rare. Methods In 2005/6 a population based cohort of 1065 pregnant women was established in Butajira, Ethiopia and baseline demographic data collected. At 3 years post birth, an interview-based questionnaire administered to 945 (94%) of these women collected data on asthma, eczema, and hay fever in the past 12 month, frequency of paracetamol use and potential confounders. Allergen skin tests to Dermatophagoides pteronyssinus and cockroach were also performed. The independent effects of paracetamol use on allergic outcomes were determined using multiple logistic regression analysis. Findings The prevalence of asthma, eczema and hay fever was 1.7%, 0.9% and 3.8% respectively; of any one of these conditions 5.5%, and of allergen sensitization 7.8%. Paracetamol use in the past month was reported by 29%, and associations of borderline significance were seen for eczema (adjusted OR (95% CI) = 8.51 (1.68 to 43.19) for 1–3 tablets and 2.19 (0.36 to 13.38) for ≥4 tablets, compared to no tablets in the past month; overall p = 0.055) and for ‘any allergic condition’ (adjusted OR (95% CI) = 2.73 (1.22 to 6.11) for 1–3 tablets and 1.35 (0.67 to 2.70) for ≥4 tablets compared to 0 in the past month; overall p = 0.071). Conclusions This study provides further cross-sectional evidence that paracetamol use increases the risk of allergic disease

Brain resting-state functional MRI connectivity: Morphological foundation and plasticity

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What went wrong? The flawed concept of cerebrospinal venous insufficiency

In 2006, Zamboni reintroduced the concept that chronic impaired venous outflow of the central nervous system is associated with multiple sclerosis (MS), coining the term of chronic cerebrospinal venous insufficiency ('CCSVI'). The diagnosis of 'CCSVI' is based on sonographic criteria, which he found exclusively fulfilled in MS. The concept proposes that chronic venous outflow failure is associated with venous reflux and congestion and leads to iron deposition, thereby inducing neuroinflammation and degeneration. The revival of this concept has generated major interest in media and patient groups, mainly driven by the hope that endovascular treatment of 'CCSVI' could alleviate MS. Many investigators tried to replicate Zamboni's results with duplex sonography, magnetic resonance imaging, and catheter angiography. The data obtained here do generally not support the 'CCSVI' concept. Moreover, there are no methodologically adequate studies to prove or disprove beneficial effects of endovascular treatment in MS. This review not only gives a comprehensive overview of the methodological flaws and pathophysiologic implausibility of the 'CCSVI' concept, but also summarizes the multimodality diagnostic validation studies and open-label trials of endovascular treatment. In our view, there is currently no basis to diagnose or treat 'CCSVI' in the care of MS patients, outside of the setting of scientific research

A community effectiveness trial of strategies promoting intermittent preventive treatment with sulphadoxine-pyrimethamine in pregnant women in rural Burkina Faso

<p>Abstract</p> <p>Background</p> <p>Intermittent preventive treatment with sulphadoxine-pyrimethamine for pregnant women (IPTp-SP) is currently being scaled up in many countries in sub-Saharan Africa. Despite high antenatal clinic (ANC) attendance, coverage with the required two doses of SP remains low. The study investigated whether a targeted community-based promotion campaign to increase ANC attendance and SP uptake could effectively improve pregnancy outcomes in the community.</p> <p>Methods</p> <p>Between 2004 and 2006 twelve health centres in Boromo Health District, Burkina Faso were involved in this study. Four were strategically assigned to community promotion in addition to IPTp-SP (Intervention A) and eight were randomly allocated to either IPTp-SP (Intervention B) or weekly chloroquine (Control). Primi- and secundigravidae were enrolled at village level and thick films and packed cell volume (PCV) taken at 32 weeks gestation and at delivery. Placental smears were prepared and newborns weighed. Primary outcomes were peripheral parasitaemia during pregnancy and at delivery, placental malaria, maternal anaemia, mean and low birth weight. Secondary outcomes were the proportion of women with ≥ 3 ANC visits and ≥ 2 doses of SP. Intervention groups were compared using logistic and linear regression with linearized variance estimations to correct for the cluster-randomized design.</p> <p>Results</p> <p>SP uptake (≥ 2 doses) was higher with (Intervention A: 70%) than without promotion (Intervention B: 49%) (OR 2.45 95%CI 1.25–4.82 p = 0.014). Peripheral (33.3%) and placental (30.3%) parasite rates were significantly higher in the control arm compared to Intervention B (peripheral: 20.1% OR 0.50 95%CI 0.37–0.69 p = 0.001; placental: 20.5% OR 0.59 95%CI 0.44–0.78 p = 0.002) but did not differ between Intervention A (17.4%; 18.1%) and Intervention B (20.1; 20.5%) (peripheral: OR 0.84 95%CI 0.60–1.18 p = 0.280; placental: OR 0.86 95%CI 0.58–1.29 p = 0.430). Mean PCV and birth weight and prevalence of anaemia and low birth weight did not differ between study arms.</p> <p>Conclusion</p> <p>The promotional campaign resulted in a major increase in IPTp-coverage, with two thirds of women at delivery having received ≥ 2 SP. Despite lower prevalence of malaria infection this did not translate into a significant difference in maternal anaemia or birth weight. This data provides evidence that, as with immunization programmes, extremely high coverage is essential for effectiveness. This critical threshold of coverage needs to be defined, possibly on a regional basis.</p

Telerobotic Pointing Gestures Shape Human Spatial Cognition

This paper aimed to explore whether human beings can understand gestures produced by telepresence robots. If it were the case, they can derive meaning conveyed in telerobotic gestures when processing spatial information. We conducted two experiments over Skype in the present study. Participants were presented with a robotic interface that had arms, which were teleoperated by an experimenter. The robot could point to virtual locations that represented certain entities. In Experiment 1, the experimenter described spatial locations of fictitious objects sequentially in two conditions: speech condition (SO, verbal descriptions clearly indicated the spatial layout) and speech and gesture condition (SR, verbal descriptions were ambiguous but accompanied by robotic pointing gestures). Participants were then asked to recall the objects' spatial locations. We found that the number of spatial locations recalled in the SR condition was on par with that in the SO condition, suggesting that telerobotic pointing gestures compensated ambiguous speech during the process of spatial information. In Experiment 2, the experimenter described spatial locations non-sequentially in the SR and SO conditions. Surprisingly, the number of spatial locations recalled in the SR condition was even higher than that in the SO condition, suggesting that telerobotic pointing gestures were more powerful than speech in conveying spatial information when information was presented in an unpredictable order. The findings provide evidence that human beings are able to comprehend telerobotic gestures, and importantly, integrate these gestures with co-occurring speech. This work promotes engaging remote collaboration among humans through a robot intermediary.Comment: 27 pages, 7 figure

Peer education: The effects on knowledge of pregnancy related malaria and preventive practices in women of reproductive age in Edo State, Nigeria

<p>Abstract</p> <p>Background</p> <p>There is limited uptake of measures to prevent malaria by pregnant women in Nigeria which is often related to the lack of knowledge on Malaria in Pregnancy (MIP) and its effects on mother and foetus. This study, explored peer to peer education as a tool in raising knowledge of MIP among women of child bearing age.</p> <p>Methods</p> <p>1105 women of child bearing age were interviewed in their households using a structured questionnaire about their knowledge of malaria in general, MIP and use of preventive measures. Thereafter, a peer education campaign was launched to raise the level of knowledge in the community. The interviews were repeated after the campaign and the responses between the pre- and post-intervention were compared.</p> <p>Results</p> <p>In the pre-assessment women on average answered 64.8% of the question on malaria and its possibility to prevent malaria correctly. The peer education campaign had a significant impact in raising the level of knowledge among the women; after the campaign the respondents answered on average 73.8% of the questions correctly. Stratified analysis on pre and post assessment scores for malaria in general (68.8 & 72.9%) and MIP (61.7 & 76.3%) showed also significant increase. Uptake of bed nets was reported to be low: 11.6%</p> <p>Conclusion</p> <p>Peer education led to a significant increase in knowledge of malaria and its prevention but we could not asses its influence on the use of preventive measures.</p

A clinical evaluation of amlexanox oral adhesive pellicles in the treatment of recurrent aphthous stomatitis and comparison with amlexanox oral tablets: a randomized, placebo controlled, blinded, multicenter clinical trial

<p>Abstract</p> <p>Background</p> <p>Amlexanox has been developed as a 5 percent topical oral paste for the treatment of patients with recurrent aphthous stomatitis (RAS) in most European countries. However, it is not yet available in China and has not been generally accepted in clinical treatment. The aim of this study was to explore the effectiveness of amlexanox oral adhesive pellicles in the treatment of minor recurrent aphthous ulcers, and compare the results with those of amlexanox oral adhesive tablets in order to analyse the difference between the two dosage forms of amlexanox.</p> <p>Methods</p> <p>We performed a randomized, blinded, placebo-controlled, parallel, multicenter clinical study. A total of 216 patients with minor recurrent aphthous ulcers (MiRAU) were recruited and randomized to amlexanox pellicles or placebo pellicles. Pellicles were consecutively applied four times per day, for five days. The size and pain level of ulcers were measured and recorded on treatment days 0, 4 and 6. Finally, the results were compared with those of our previous 104 cases treated with amlexanox tablets.</p> <p>Results</p> <p>Amlexanox oral adhesive pellicles significantly reduced ulcer size (P= 0.017 for day 4, P=0.038 for day 6) and alleviated ulcer pain (P=0.021 for day 4, P=0.036 for day 6). No significant difference was observed in the treatment effectiveness between the pellicle and tablet form of amlexanox.</p> <p>Conclusions</p> <p>Amlexanox oral adhesive pellicles are as effective and safe as amlexanox oral adhesive tablets in the treatment of MiRAU for this Chinese cohort. However, pellicles seem to be more comfortable to use when compared with the dosage form of tablets. Therefore, in clinical practice, amlexanox oral adhesive pellicles may be a better choice for RAS patients.</p> <p>Trials registration</p> <p>Nederlands Trial Register NTR1727.</p