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   Table of Contents - Current issue
Coverpage
May-June 2020
Volume 40 | Issue 3
Page Nos. 103-148

Online since Saturday, May 23, 2020

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REVIEW ARTICLE  

Ethical issues of human cloning p. 103
Nasrullah , Rana Khalid Iqbal, Shahzadi BiBi, Sana Muneer, Sumaira BiBi, Farhana Naureen Anwar
DOI:10.4103/jmedsci.jmedsci_69_19  
Cloning can help us in the research field and medical sciences. But due to ethical and moral values, this idea is not supported. Moreover, it is against ethical values as well. According to modern studies, Human moral values are preferred rather than emotions, but they cannot be ignored. Despite the progress in the stem cell culture, it is still unable to avail the therapeutic benefits. It is said that cloning could be done in the near future, and it is closer to the reality and away from science fiction. Cloning can be carried out by two techniques termed as the somatic cell nuclear transfer and cell mass division. The cloned animal products obtained by the somatic cell nuclear transfer can be used, as they cause no harm and are safe as the noncloned animal products are. Certain harms are related to the twin's growth produced by the cloning procedure that also reinforces on the inhibition of human cloning, as it causes the psychological distress and destroys the universality of an individual, as well as certain ethical and moral values despite which human clones cannot be made. In somatic cell cloning the nucleus (nuclear mass/DNA) can solve many health problems for example organ transplantation, or organ rejection issues. Resulting of all these give rise to a great controversy that either clone of human beings should be produced or not. Although in the near future, the possibility of human clones and their use for different purposes cannot be ignored.
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ORIGINAL ARTICLES Top

Novel method of conjunctival revision for encapsulated blebs after ahmed valve implantation p. 107
Ke-Hung Chien, Shu-I Pao, Yi-Hao Chen, Chang-Min Liang, Da-Wen Lu
DOI:10.4103/jmedsci.jmedsci_188_18  
Background: Encapsulation after Ahmed glaucoma valve (AGV) is difficult to manage and sometimes results in treatment failure. We proposed a novel conjunctival revision method to improve intraocular pressure (IOP) control due to encapsulation after AGV implantation. The efficacy and safety of this method in refractory glaucoma patients were evaluated. Methods: The present study was done in a clinical trial design. Patients of encapsulation after AGV implantation for at least 6 months were enrolled and divided into three groups (control group, single revision group, and repeated revision group). Characteristics such as visual acuity, glaucoma type, IOP change, underlying diabetes mellitus, and complications were assessed. Results: In total, 120 patients were enrolled in this study, and they were randomly divided into three groups on a 1:1:1 base. At the study end, there were 28 patients in the control group, 32 patients in single revision group and 37 patients in repeated revision group. The results showed that the conjunctival revision method significantly reduced the mean IOP of the encapsulated eyes on day 1 after the procedure (24.5 ± 6.3 to 11.8 ± 3.4 mmHg in single revision group and 25.1 ± 4.7 to 10.2 ± 2.3 mmHg in repeated revision group, respectively). The eye pressure was remained relatively low during follow-up visits for 4.17 ± 4.2 months in single revision group, whereas stable IOP could be maintained in repeated revision group for 10.43 ± 3.7 months in average. Changes in preoperative and postoperative visual acuities and the refraction errors were insignificant. Only mild complications occurred and most resolved without treatment. Conclusions: The conjunctival revision could relieve entrapped subconjunctival aqueous and therefore reduced IOP temporarily with single procedure, and IOP could be maintained with repeated procedures. This method is suggested to be a safe and simple alternative for refractory glaucoma patients developed encapsulation after AGV implantation.
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Semen quality and fertility rates in Taipei city p. 113
Chying-Chyuan Chan, Gwo-Jang Wu, Te-Hsin Yen, Ming-Tzeung Chung, Ching-Han Hung, Yen-Ling Lin
DOI:10.4103/jmedsci.jmedsci_77_19  
Background: Although female factors are the major focus of attention for infertility, male factors are responsible for approximately 40% of infertility problems. Aims: The aim of this study is to investigate male infertility in Taiwan, establish a database of semen quality, and explore associations between semen quality and infertility. Methods: Results of semen tests of males who were examined at Zhongxiao Branch, Taipei City Hospital, between January 2008 and July 2015 were collected and analyzed retrospectively. All examination procedures and processing of human semen were performed according to the World Health Organization laboratory manual. Total semen volume and the concentration, motility, and morphology of sperm were evaluated and recorded. Pearson's correlation was used to explore associations between age and all semen parameters. Results: Significant differences were found in sperm concentration between the examined years (P = 0.011). Bonferroni post hoc analysis showed that the sperm concentration in 2012 decreased significantly (P = 0.026) compared to data of 2014. Age was significantly associated with sperm motility and morphology (P < 0.01). Normal test rates for semen in the study period were between 68.33% (2008) and 77.47% (2014). Total fertility rates were not associated with normal semen test rates in Taipei City, and no significant correlations were identified in any semen analysis parameters. Conclusions: No significant associations are found between normal semen test rates and total fertility rates from 2008 to 2015 in Taipei City. This study determined the baseline semen parameters of the general male population in Taipei City, but due to the multifactorial nature of fertility, more socioeconomic and biological factors need to be analyzed to investigate and solve the problem of low fertility rates.
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A superior odds ratio compared to the risk ratio when estimating moderator effects in meta-regression analyses of randomized controlled trials p. 119
Chih-Chien Chiu, Chien-Fu Chen, Po-Jen Hsiao, Dung-Jang Tsai, Hsueh-Lu Chang, Wen-Hui Fang, Wei-Teing Chen, Jenq-Shyong Chan, Min-Tser Liao, Yi-Jung Ho, Wen Su, Ying-Kai Chen, Hui-Han Hu, Zheng-Zong Lai, Chin Lin
DOI:10.4103/jmedsci.jmedsci_133_19  
Background: Moderator effect assessment is important in personalized medicine. We mathematically prove that the average summary value is actually nonlinearly to logRR, and we assess the bias from linear meta-regression on logRR via simulation. Methods: In the meta-analysis of randomized controlled trials, the moderator effect is generally evaluated by the linear meta-regression of the logarithmic risk ratio (RR) versus the average summary value of the entire study population. Conclusions: We recommend using linear meta-regression on logarithmic odds ratio (logOR) since it has been shown that the average summary value is actually linear to logOR.
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CASE REPORTS Top

Pretibial myxedema: Paradoxical manifestation of thyroid dermopathy after I-131 ablation therapy p. 127
Bing-Sian Lin, Yi-Hsien Chen, Chih-Tsung Hung
DOI:10.4103/jmedsci.jmedsci_89_19  
Pretibial myxedema (PM) is an unusual extrathyroidal manifestation of Graves' disease (GD), which affects approximately 1%–5% of the patients. In addition, PM usually occurs in the hyperthyroid state of GD, and the high level of thyroid autoantibodies is considered to be the cause of PM. Here, we present a rare case of a patient who developed PM after undergoing I-131 ablation therapy, with normal levels of thyroid autoantibodies. Our report aims to document the features of PM in a male adult with hypothyroidism and to provide a potential mechanism of the onset of PM.
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Central mucoepidermoid carcinoma arising in a dentigerous cyst: A challenging case report p. 131
Nasim Taghavi, Saede Atarbashi-Moghadam, Saeed Hajizadeh
DOI:10.4103/jmedsci.jmedsci_95_19  
Central mucoepidermoid carcinoma (MEC) is a rare neoplasm of the jaw which is more common in the posterior of mandible, and the most likely origin is odontogenic epithelium. The aim of the present report is to describe a case of maxillary MEC arising in a dentigerous cyst in a 57-year-old female. It is crucial for pathologists to aware of the histopathologic features of this rare neoplasm to have a correct diagnosis.
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Clear-cell carcinoma of the larynx: A report of an unusual case p. 134
Anirban Halder, Rituparna Biswas, Sujit Shukla, Geetika Khanna, Vikas Yadav, Jaspreet Kaur
DOI:10.4103/jmedsci.jmedsci_113_19  
Clear-cell carcinoma (CCC) of the larynx is an extremely rare neoplasm with high malignancy potential and poor outcome. We herein report the 11th case of CCC of the larynx in a 42-year-old female who was managed with definitive radiochemotherapy. Due to a paucity of this entity, treatment option is not clearly defined, however, considering its grave nature, surgery should be offered primarily along with adjuvant radiotherapy with or without chemotherapy.
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Intracranial germ cell tumor metastasis to the peritoneal cavity through the ventriculoperitoneal shunt p. 137
Da-Wei Chang, Hong-Wei Gao, Yu-Lueng Shih
DOI:10.4103/jmedsci.jmedsci_25_20  
Intracranial germ cell tumors (GCTs) are uncommon and may cause obstructive hydrocephalus, making adequate drainage necessary in symptomatic patients. Here, we present the case of a 36-year-old male patient with intracranial germinoma metastasis to the peritoneal cavity. He had a medical history of pineal germinoma status post ventriculoperitoneal (VP) shunt implantation and definitive radiotherapy. Two years later, the patient presented with epigastric pain, and intra-abdominal metastasis through the VP shunt with malignant transformation to a nongerminomatous GCT was noted. Chemotherapy followed by surgical resection was arranged, and he got disease free after treatment. The present report alerts clinicians to the progression of this uncommon disease and suggests that a thorough physical examination is imperative in patients with a history of intracranial GCTs who have undergone VP shunt implantation, and an alternative therapeutic plan should be considered to treat intracranial GCT-related obstructive hydrocephalus.
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Varicella-zoster virus-induced rhabdomyolysis: A case report and literature review p. 141
Kuan-Yu Chen, Chih-Hao Shen, Sheng-Huei Wang, Kuang-Yu Wei, Yao-Hsien Huang
DOI:10.4103/jmedsci.jmedsci_114_19  
Infection is a possible cause of rhabdomyolysis. We describe the case of a 63-year-old male with malaise and erythematous papules on the right C5–C7 dermatomes, consistent with herpes zoster. Serum antibody and Tzanck tests of the skin lesion were positive. Increased serum creatine kinase (CK) and myoglobin levels and cola-colored urine indicated the development of rhabdomyolysis. Acute kidney injury was also observed. After excluding other possible predisposing factors, the patient was diagnosed with varicella-zoster virus (VZV)-induced rhabdomyolysis. Extracellular volume with alkalized fluids and topical acyclovir was administered. While CK levels declined to normal by day 13, the renal function was not restored. The skin lesion crusted by day 8 and scaled off gradually by day 13. Our case and literature review highlighted the necessity for systemic antiviral treatment and that poor VZV infection control could lead to irreversible kidney injury. In addition, systemic acyclovir should be administered carefully due to its complication of nephrotoxicity.
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LETTERS TO EDITOR Top

Tremors as an atypical presentation of cervical myelopathy? p. 145
Halil Onder, Ibrahim Akkurt, Kemal Celik, Mehmet Hamamci
DOI:10.4103/jmedsci.jmedsci_136_19  
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Intramuscular metastasis of renal cell carcinoma: A rare occurrence, diagnosed on fine-needle aspiration cytology p. 147
Mona A Agnihotri, Kanchan S Kothari, Leena P Naik
DOI:10.4103/jmedsci.jmedsci_161_19  
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