bluuebunny/crossref_metadata_2025 huggingface dataset:
Profile of Interleukin-6 and Tumor Necrosis Factor-α in Hospitalized COVID-19 Patients
Authors: Saeed Khlood Noori , Shnawa Bushra Hussain , Al-Badran Adnan Issa
Published: July 2024

Background:

In 2019’s December, the new COVID-19 coronavirus induced severe lower respiratory tract syndrome in Wuhan, China. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ultimately became responsible for the life-threatening pandemic. The magnitude and outcome of COVID-19 may be related to the overproduction of pro-inflammatory cytokine called “cytokine storm.” Cytokine production besides the age of patients, and comorbidities, all influence the length and severity of SARS-CoV-2.

Objectives:

This research was performed to investigate how these factors affect patients who have severe COVID-19 in a sample of Iraqi patients.

Materials and Methods:

A total of 82 participants were enrolled in this work, confirmed hospitalized COVID-19 patients (n = 60) and healthy control (n = 22) from both sexes of age range 20‐67 years. Tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) levels in the serum of COVID-19 patients and HC have been evaluated using an ELISA.

Results:

According to our findings, sera from COVID-19 patients had considerably higher levels of IL-6 and TNF-α than those of the control group. Furthermore, most infections were among women (63%), followed by men (37%), the higher number of patients were within 50‐59 years, while the lowest number of patients was found in the group 20‐29 years. Most COVID-19 patients appeared to be overweight and obese. Additionally, those who have diabetes mellitus are also at risk of severe COVID-19.

Conclusion:

Serum levels of TNF-α and IL-6 were higher in patients than in the control group, suggesting that they could be used as indicators of the severity of COVID-19 illness. Also, their combined detection provided highest specificity and sensitivity for early prediction of COVID-19 severity, which has significant clinical values.
Hepatoprotective Activity of Ezetimibe Against Risperidone-Induced Liver Injury in Rats
Authors: Al-Juhaishi Atheer Majid Rashid , Ismael Ahmed H. , Jasim Aziz H. , Al-Mukhtar Entisar J.
Published: July 2024

Background:

Drug-induced hepatic injury is an unfavorable reaction to medications and/or their byproducts, which can result in ongoing harm to liver function and even death. Risperidone, the second most prescribed antipsychotic drug, has been linked to weight gain, abnormal hepatic enzyme levels, and further damage to liver cells. On the other hand, ezetimibe is an antihyperlipidemic agent that reduces serum cholesterol levels by inhibiting its absorption in the gastrointestinal tract. Additionally, it possesses antioxidant, hepatoprotective, and nephroprotective properties.

Objectives:

The purpose of this study is to evaluate the hepatoprotective and hypolipidemic effects of ezetimibe in mitigating liver damage induced by risperidone.

Materials and Methods:

A total of 24 adult male Swiss albino rats aged 6–7 weeks and weighing 170–180 g each were randomly divided into four groups, with 6 rats in each group. The first group served as a control and received vehicles only (0.5 mL of corn oil). Rats in the second group were administered risperidone alone at a dose of 2 mg/kg. In the last two groups, rats received a combination of risperidone (2 mg/kg) and ezetimibe at doses of 3 and 5 mg/kg, respectively. After sacrificing the rats, serum samples were collected to measure parameters related to lipid profile and liver enzymes. Additionally, liver tissue was immediately gathered for histopathological assessment using the NAS scoring system.

Results:

Ezetimibe exhibited marked hepatoprotective effects in rats exposed to risperidone-induced hepatic injury. This was achieved by significantly (P < 0.05) lowering adverse lipid profile components (TCHO, TG, LDL, and VLDL) and liver enzymes (ALT and AST), while at the same time significantly (P < 0.05) elevating the beneficial lipid profile (HDL). Moreover, Ezetimibe demonstrated remarkable liver protection by mitigating hepatic lobule destruction, inflammatory cell infiltration, and the presence of steatotic cells.

Conclusion:

Ezetimibe exhibited notable hepatoprotective and hypolipidemic properties in countering hepatic injury induced by risperidone.
Incidental Gynecological Conditions in Patients Presented with Acute Appendicitis
Authors: Wahhab Rawa’a A. Sattar A. , Mohammed Luma K.
Published: July 2024

Background:

Female patients during reproductive age had a high rate of gynecological conditions, such as ovarian cysts, ovarian torsion, uterine fibroids, or endometriosis, that occur and misdiagnosed with acute or chronic appendicitis; these disorders can be without identifiable pathologies and discovered accidentally during appendectomy.

Objectives:

The aim of this article is to study the most common gynecological conditions that are accidentally encountered in female patients presented with acute appendicitis.

Materials and Methods:

A cross-sectional study was done on 97 female patients who were admitted to the hospital for open and laparoscopic appendectomy during the period of January–April 2021.

Results:

The study included 97 patients, 71 (73%) were of the age group 20–49 years, 35 of them had incidental gynecological findings, and the rest 62 were having true acute appendicitis, ovarian cyst, and ectopic pregnancy which were the most common findings (16, 5) cases, respectively.

Conclusion:

Surgical gynecological conditions in female patients with appendectomy are commonly encountered, and the most common diagnoses were ovarian cysts.
Clinical Evaluation and Comparison between Effects of Rituximab and Prednisolone with Imuran to Neutrophils and Platelet Counts in Pemphigus Vulgaris Patients
Authors: Al-Drobie Ban , Abdul-Qahar Ghassan Hassan , Aswad Fawaz. D. AL. , Al-Hasnawi Zahra Ali
Published: July 2024

Background:

Pemphigus vulgaris (PV) is an autoimmune vesiculobullous mucocutaneous disease with life-threatening consequences. Rituximab (RTX) has recently emerged as an effective treatment for PV.

Objectives:

This study aims to determine changes in neutrophil and platelet counts for PV patients treated with RTX or corticosteroids combined with Imuran (azathioprine).

Materials and Methods:

The present cross-sectional study was conducted in the Department of Dermatology at Baghdad Teaching Hospital, Baghdad, Iraq. Thirty PV patients received two types of treatment: 15 patients were administered RTX and 15 patients took corticosteroids with Imuran (azathioprine). Neutrophil and platelet counts were detected at the hospital laboratory.

Results:

The age range of PV patients was 27–67 years, and the mean ±SD was 44.866 ± 10.979 years for the patient group treated with RTX and 44.133 ± 11.519 for the patient group treated with corticosteroids and Imuran. In patients treated with RTX, 26.6% were males and 73.33% were females, with a female-to-male ratio of 2.75:1. In patients treated with corticosteroids with Imuran, 40% were males and 60% were females, with a female-to-male ratio of 1.5:1. The results revealed that among patients treated with RTX, 30% of them had mucocutaneous lesions, 6.66% had oral lesions, and 13.33% had cutaneous lesions. Among the other groups treated with corticosteroids and Imuran, 23.33% had mucocutaneous lesions, 13.33% had oral lesions, and 13.33% had cutaneous lesions. Among the patients treated with RTX, 53.33% had normal range of neutrophil count, while 46.6% had neutrophil count above the NR, while in patients treated with corticosteroids and Imuran, 40% had a normal range and 60% had above the normal range.

Conclusion:

RTX was a more effective treatment compared to corticosteroids with Imuran because no patient remained in an active state during this study. PV was prevalent in females aged 40 years with mucocutaneous lesions.
Detection of Viruses associated with Herpes Labialis Patients in Babylon Province Pre and Post Treatment with Low Power Laser Therapy (Diode Laser)
Authors: Aboob Ahmed Jaber , Alyassiri Ali Mihsen Hussein , Alkhafaji Younis Abdulridha
Published: July 2024

Background:

The secondary or recurrent herpetic infections (RHIs) are caused by herpes simplex virus (HSV) type-1 and type-2. low-power laser therapy 940 nm may consider one of the best and most optimistic and optional local therapeutic and biological options.

Objectives:

To determine both molecular detection and viral load of HSV-1 and HSV-2 by real-time polymerase chain reaction (PCR) pre- and post-diode laser therapy 940 nm for evaluating the laser efficacy.

Materials and Methods:

Thirty patients in age range 6–48 years have participated in this clinical trial study complaining from RHI. Sixty viral swabs were taken for those thirty participant patients including 30 swabs pre and 30 swabs post 3–5 days. Diode laser therapy 940 nm for biostimulation, real-time PCR for accurate detection of both HSV-1 and HSV-2.

Results:

The results in this present study showed mean age range of RHI patients was 25.7 ± 12.1 years with a male ratio more than the female 1.5:1. Overall participants were infected with HSV type-1, whereas 3 (10%) of the participants were noninfected with HSV type-2. There was a significant increase in HSV type-1 PCR threshold cycle (Ct) mean of RHI patients after treatment with diode laser therapy 940 nm which means decreasing in the viral load.

Conclusions:

The real-time PCR technique is a highly efficient, reliable, and rapid technique for accurate diagnosis and viral load measuring of HSV-1 and HSV-2. Low-power laser therapy is utilized to reduce pain levels, change the state of disease from pro-inflammatory to anti-inflammatory, and may reduce the viral load.
Interleukin 1 Alpha Gene Polymorphism in Breast Cancer After Chemotherapy Treatment
Authors: Abd Frial Gemeel , Kadhum Sawsan Hassan , Hathal Wurud Ali
Published: July 2024

Background:

The interleukin 1 (IL-1) family of cytokines is essential for triggering and controlling immunological and inflammatory responses. We believe the levels of these cytokines in breast tumor homogenates relate to other known prognosticators of patient survival.

Objectives:

The association between the risk of breast tumors and the IL-1 alpha −889 C>T Promoter Primer polymorphism has been established. Interleukin 1 alpha −889 C>T Promoter Primer has been proven to influence breast tumor susceptibility. Our research aimed to determine whether the IL-1 alpha −889 C>T Promoter Primer gene polymorphism and susceptibility to Breast cancers (BCs) are related.

Materials and Methods:

The genotype frequencies of the IL-1 alpha −889 C>T Promoter Primer polymorphism were compared between 100 BC cases and 50 controls with the assistance of polymerase chain reaction and restriction fragment length polymorphism techniques. Additional multivariate binary logistic regression analyses were carried out to determine the level of IL-1 in patients’ blood and to examine the association between the IL-1 alpha −889 C>T Promoter Primer polymorphism and BC risk utilizing the ELISA technique after therapy.

Results:

The concentration of CA 15-3 in patients with BC was 101.107 increase significantly compare with mean of control group was 62.802, in chemotherapy patients genotype frequencies of TT, CT, CC of IL-1 alpha −889 C>T gene polymorphism where it patients with genotype TT were affected by breast tumors approximately one time comparison with patients having genotype CT (odd ratio = 1.50 and 0.91).

Conclusion:

Concentration of CA 15-3 increase in patients after chemotherapy compared with healthy, The IL-1 alpha −889 C>T polymorphism affects breast tumors in women.
Molecular Analysis of the Antiseptic Resistance Genes among Multidrug-Resistant Pseudomonas aeruginosa Isolated from Burn Patients
Authors: Abdulla Anwar A. , Abed Thekra Abdulaali , Almuttairi Ahmed A. Hadi
Published: July 2024

Background:

Pseudomonas aeruginosa is known to be susceptible to a variety of antibiotics and disinfectants, and this resistance has become a major problem, particularly among hospitalized patients.

Objectives:

The present study aims to determine the association between class 1 integrons (intI1) and genes responsible for antiseptic resistance (fabV, qacΔE1, and qacE) among multidrug-resistant (MDR) P. aeruginosa from burn patients.

Materials and Methods:

Sixty-four isolates from burns were identified using both standard approaches and the VITEK 2 system. Disc diffusion antimicrobial susceptibility testing was performed. Polymerase chain reaction (PCR) was utilized to identify class 1 integrons and antiseptic resistance genes using specific primers for intI1, fabV, qacE1, and qacE.

Results:

64 MDR P. aeruginosa isolates were obtained from burn patients during the research period. The antibiotic susceptibility of all 64 P. aeruginosa isolates was examined. MDR resistance to at least three antibiotic classes were found in all of the isolates. The PCR results revealed that 100% of the isolates tested positive for the class 1 integron gene. According to the current findings, all isolates possessed the qacΔE1 and fabV genes. While the qacE results were being processed, 87.50% of the isolates tested positive. There was no correlation between the presence of antiseptic resistance genes and antibiotic resistance (P ˃ 0.05).

Conclusion:

our data suggest that P. aeruginosa isolates have profound antibiotic resistance and an antiseptic resistance gene. The integron was mostly found in all isolates, indicating that the Antiseptic resistance gene corresponds to the integron class 1.
Assessment of Effectiveness and Side Effects of Subdermal Implant among User Women
Authors: Al Jeborry Milal Mohammad , Al Kadhim Hanan Khudhair Hussein , Witwit Suha J.
Published: July 2024

Background:

Implanon is a progestin-only implantable contraceptive; it offers promise, long-term, with a high-efficacy contraceptive. It is one of the most effective reversible contraceptives and is of the same effectiveness to sterilization.

Objective:

To assess the adverse effect profile and effectiveness of subdermal implants.

Materials and Methods:

A prospective study involved 48 women attending for insertion of the subdermal implant on days 2–5 of their cycle. The implant was inserted subdermally under the effect of local xylocaine of the nondominant arm.

Results:

The commonest side effect was weight gain constituted 62.5%. At the same time, amenorrhea was reported in 31.3%. Pain at the site of insertion constitutes 14.6%. While bleeding occurred in one case, which responded to local pressure. The commonest cause of discontinuation was weight gain constituted 12.5%. Followed by disturbances in the menstrual cycle. Discontinuation rate 41.7% (20 out of 48 cases).

Conclusion:

Implanon is an effective long-term contraception with few adverse effects.
Mortality of Mucormycosis during Coronavirus Disease Pandemic
Authors: Abbas Samah , Hassan Usama Salim , Aood Mustafa Shamkhi
Published: July 2024

Background:

Acute invasive fungal rhinosinusitis is an aggressive, mutilating, and in many cases life-threatening infection that results in rapid devitalization of tissues in the area of the nasal cavity and paranasal sinuses. Diabetic ketoacidosis, renal impairment, and hematological malignancies used to be the main predisposing factors for this serious infection. During the second wave of the pandemic of coronavirus disease (COVID-19), there has been an increment in these cases, in a manner that has not been witnessed before, and hence the interest in studying this topic.

Objectives:

Review of management outcomes and mortality in patients diagnosed with “possible invasive fungal rhinosinusitis” during the 2nd wave of COVID-19 pandemic and compare these with the outcomes observed before the pandemic in Iraq and other countries.

Materials and Methods:

A cross-sectional study of all patients with clinically possible invasive fungal rhinosinusitis (30 patients) presenting or referred to the ear nose and throat outpatient unit during the period from June 1st 2021 to December 31st 2021.

Results:

30 patients were included, 53.3% male, 73.33% had mucormycosis following COVID-19 infection. Diabetes was the underlying condition in 57.67% of the cases. Fever, facial pain, nasal obstruction and headache were the most prevalent symptoms at presentation. The mortality rate was 16.7%.

Conclusion:

A reduced mortality rate was observed despite the increased number of cases, and this is mostly related to the early initiation of antifungal therapy.
Evaluation of Nursing Intervention Measures in Infection Control at Dialysis Units in Mosul City Hospitals
Authors: Salih Ali Nafaa , Allo Rami Ramadhan
Published: July 2024

Background:

Nursing staff must take adequate precautions and implement appropriate practices to substantially reduce the risk of workplace transmission of blood-borne infections to patients and staff within dialysis units. This study aimed to evaluate the intervention measures for staff nurses in the dialysis unit.

Materials and Methods:

A descriptive cross-sectional design was used to conduct the study from December 1, 2021, to April 1, 2022, in three Mosul City hospitals. A convenience sample was selected. Sixty nurses participated in the study.

Results:

The study findings show that 41.7% of the study sample was within the 25–29 year age group, and the highest percentage was of males (51.7%). Regarding qualifications, 43.3% of nurses had a bachelor’s degree, and 76.7% of them had less than 5 years of experience working in the dialysis unit. All the subjects received vaccination against the hepatitis virus. There are limitations in some nurses’ practices, such as wearing a face shield, cleaning and disinfecting the beds and chairs, and external surfaces of the machines during pre- and post-dialysis.

Conclusion:

The study concludes that there are clear defects in the application of some nursing procedures and measures to control the transmission of infections inside hemodialysis units in Mosul city hospitals.
Anti-Inflammatory Effect of Atorvastatin on Colitis Induced in Male Mice
Authors: Mageed Zeena Hadi , Abbas Majid K. , Raji Ahmed
Published: July 2024

Background:

Statins are approved for cholesterol reduction and may also be beneficial in the management of inflammatory diseases. Another essential pleiotropic effect of β-hydroxy β-methylglutaryl-CoA (HMG-CoA) reductase inhibitors is their anti-inflammatory properties. Statins lower C-reactive protein (CRP) levels while also inhibiting inflammatory mediators like tumor necrosis factor-alpha and interleukins including interleukin-6 (IL-6).

Objective:

The purpose of this study was to determine the relationship between the severity index and other inflammatory markers in animals with colitis and to investigate the possible effects of atorvastatin on disease activity index and the inflammatory markers in experimentally induced colitis.

Materials and Methods:

Mice were given acetic acid to induce colitis. For 7 days, mice were divided into four groups (control group, induction group, standard group treated with prednisolone, and atorvastatin-treated group) and monitored daily for weight loss, feces consistency, and rectum bleeding for measuring the disease activity index. At last, we killed the animals and took blood samples for IL-6.

Results:

Acetic acid caused significant colonic inflammatory response and shrinking, as well as a reduction in body weight. The use of atorvastatin to treat acetic acid-induced colitis resulted in weight-loss recovery and decrease in expression concentration of IL-6 in the treated group compared with the colitis group when using in high dose.

Conclusion:

These findings indicate that atorvastatin preserves intestinal integrity in colitis, most likely by modifying the Th cell-mediated immune response independently of innate immunity.
Diagnostic Accuracy of Cancer in Pleural Effusion: A Combination Serum Tumor Markers and Cytology
Authors: Mahdi Ammar Eesa , Alkafaji Haider Abdul Ridha
Published: July 2024

Background:

Cytological examination of body effusion has an essential role in different tumor staging and research of malignancy.

Objectives:

It is to study the diagnostic effect of serum tumor markers in differentiation between benign and malignant pleural effusion.

Materials and Methods:

A retrospective research was done on 39 patients (28 male and 11 female with an age range of 50–77 years old). All samples undergo diagnostic thoracocentesis. The cutoff values of serum tumor markers (CEA < 5 ng/mL; CA125 <35 U/mL; CA19-9 < 37 U/mL; and CA15-3 < 31 U/mL).

Results:

Thirty-nine cases, resulting in 26 (67%) benign pleural effusions and 13 (33%) malignant pleural effusions, mean ± SD of age was higher malignant pleural effusion than benign type. The sensitivity of cytology was 33%. Malignant pleural effusion tended to have higher serum marker tumor concentrations. A comparison association between benign and malignant pleural effusion revealed statistically significant only in CEA. Most areas under the curve had moderate values that ranged between 0.6 for CA125, CA15.3, and other combined tumor markers, except for CEA, which had a good AUC (0.799). The best efficacy of a single tumor marker is CEA with a cutoff value of 2.05 ng/mL; at this cutoff value, the sensitivity, specificity, and accuracy were 69.2%, 88.5%, and 82.1%, respectively.

Conclusion:

Single serum tumor markers showed moderate sensitivity and low specificity; their combination does not result in to increase level of sensitivity and specificity to a good and dependent level for diagnosis of the malignant pleural effusion. Cytology and serum tumor markers have aided role in diagnosis. Thoracoscopy and pleural biopsy remain dependent diagnostic tools for malignant pleural effusion.
Bacterial Infections and Inflammatory Markers in Diabetic Foot Ulcers: Assessing the Roles of Staphylococcus aureus, Pseudomonas aeruginosa, Vascular Endothelial Growth Factor, and Interleukin-6
Authors: Abbas Sarah Kadhim , Omran Dakhel Ghani , Abdulazeem Lubna
Published: July 2024

Background:

Diabetic foot ulcers (DFUs) are severe complications of diabetes, leading to osteomyelitis, gangrene, and limb amputation. These outcomes increase mortality risk and bacterial resistance in surviving patients. The selection of the most effective antibiotics for DFUs remains a growing challenge.

Objectives:

The study aimed to identify risk factors, bacterial pathogens, and drug resistance in DFU patients, and explore the correlation between interleukin-6 (IL-6), vascular endothelial growth factor (VEGF) levels, and DFUs.

Materials and Methods:

Sixty isolates of bacteria were isolated aerobically from 100 samples of DFU (30 isolates from Pseudomonas aeruginosa and 30 isolates from Staphylococcus aureus). All isolates were identified by biochemical tests, then confirmation diagnosis was done by using VITEK-2. Determination multiple drug resistance isolates by susceptibility tests, then estimation of the activity of silver nanoparticles (AgNPs) as antibacterial with different concentrations were done. VEGF and IL-6 levels were determined by using Enzyme-linked immunosorbent assay (ELISA) technique.

Results:

The study revealed that many bacteria-resistant antibiotics, but AgNPs significantly inhibit multi-drug resistant bacteria, suggesting their potential as an alternative treatment. VEGF and IL-6 levels were significantly higher (P-value < 0.001) in DFU patients, with IL-6 negatively correlating with VEGF.

Conclusion:

Diabetic foot infections, caused by various bacteria, require understanding of antibiotic sensitivity for effective treatment. AgNPs showed strong antimicrobial effects against common bacteria, suggesting potential as an alternative treatment. The study also found elevated VEGF and IL-6 levels in DFU patients, with IL-6 potentially inhibiting VEGF, thus impairing healing.
Dental and Periodontal Findings in Hemodialysis Patients
Authors: Meizel Mudhfar Mohammed , Mohammed Nawres Bahaa
Published: July 2024

Background:

End-stage renal disease (ESRD) are more to infections due to their decrease in immune systems and general debilitated health, most of patients with renal failure showing oral symptoms.

Objectives:

The aim of this study is to assessment the kind and severity of oral symptoms in ESRD patients undergoing hemodialysis and compare these results with healthy, disease-free persons.

Materials and Methods:

The study involved 40 individuals, comprising 20 hemodialysis patients and 20 healthy control. The patient group was randomly chosen from ESRD patients, while the control group consisted of disease-free persons with normal glomerular filtration rates. The symptoms such as dry mouth, taste changes, halitosis, and mucosal pain, and were oral changes like tongue coating, pallor, ulceration, and enamel hypoplasia.

Results:

The ESRD patients established significantly more oral changes compared to the control group. These due to metabolic disorders caused by renal failure.

Conclusion:

there is significant impact of ESRD on the oral health of the patients, with correlation between oral health and ESRD.
Molecular Detection of Psts Antibiotic-Resistant Gene in Pseudomonas aeruginosa Isolates
Authors: Wadi Fatima Rheem , Ali Maryam Kareem
Published: July 2024

Background:

Otitis media is a very common infection among people of different age groups.

Objective:

The goal of the current work was to determine the existence of PstS gene among Pseudomonas aeruginosa isolates recovered from otitis media cases in Iraqi patients.

Materials and Methods:

A total of 100 ear swabs were collected from patients suffering from otitis media attending the ENT outpatient clinic at Baghdad Teaching Hospital from July 2022 to the end of December 2022. The age range was 18-75 years. Detection of morphology and biochemical testing by Vitek 2 system. The antibiotic sensitivity test of the bacteria spp. was the detection of 18 antibiotics for different types using Vitek2 system. Identify the genes for antibiotic resistance mechanisms. DNA was extracted from samples, and resistance genes PstS were amplified using polymerase chain reaction (PCR).

Results:

This study showed 80 out of 100 swabs revealed Pseudomonas aeruginosa isolates, and 71 (89%) isolates out of these 80 exhibited PstS genes. Age groups of the patients were 38-47, 48-57, and 58-67 years with percentages of 22.5%, 25%, and 25%, respectively. The highest resistance percentages of strains to tested antibiotics were for Ceftoriaxone, Cefpodoxime (100%), and the lowest resistant percentage was 22.5% for colistin, which determined the relationship between the presence of Psts and resistance to 18 antibiotics for different types. Colistin was the most effective antibiotic and can be considered as the drug of choice against Pseudomonas aeruginosa.

Conclusions:

Pseudomonas aeruginosa isolates recovered from patients suffering otitis media show the prevalence rate appears to be higher among the elderly and high virulence and antibiotic resistance due to the presence of PstS antibiotic resistance gene and ability to form biofilms, thus aggressive antimicrobial therapy is highly recommended in such conditions.
Serological Diagnosis of Acute Tonsillitis in Salah Al-Din Province
Authors: Khuder Huda Saleh , Al-dorri Alaa Zanzal Ra’ad , Yaseen Wisal R.
Published: July 2024

Background:

Tonsillitis is one of the most important diseases in the community, especially in children, but its complications can affect adults at any age. The most bacterial causative agent is group A streptococci (GAS) infections, like tonsillitis, can progress into rheumatic fever and lead to complications like heart, kidney, and joint damage, known as poststreptococcal diseases. In Iraq, rheumatism is diagnosed based on antistreptolysin O titer (ASO) antigen serological titers.

Objectives:

This study aimed to recognize ASO in patients who had tonsillitis in Salah Al-Din Province, Iraq, where information about the test was lacking.

Materials and Methods:

The cross-sectional study was conducted in Salah Al-Din Province, with 235 patients aged 5–45 years examined at the Primary Health Care Center. Blood samples were taken and examined for antistreptolysin O using turbidimetry.

Results:

The results showed that ASO tonsillitis often increases in early childhood and decreases in urban areas (32.5%) presenting fever, joint, and loin pain.

Conclusion:

In conclusion, 40% of patients with tonsillitis had elevated antistreptolysin O levels, especially in the 5–14 years age group (47.36%), in urban areas (32.5%), and associated with fever (42.1%), cough (24.2%), and loin with joint pain (33.6%). These cases may progress into rheumatic heart disease, therefore, prompt treatment is necessary. A plan to prevent GAS infection and its complications should be implemented, along with more sensitive and specific investigations.
Evaluation of Ovarian Response Indexes as Predictors to the Outcome of Intracytoplasmic Sperm Injection
Authors: Kathim Miami Hashim , Al-Taee Hanan Abd Al-Jabbar , Al-Khafaji Zainab Hasan
Published: July 2024

Background:

Knowing predictors of pregnancy in assistant reproductive technology, knowing of predictors of pregnancy is helpful for clinicians to individualize treatment 14 Plans and improve patient counseling, and for patients to decide whether to undergo infertility treatment. Therefore, it is important to evaluate ovarian reserve prediction indexes as an index to predict response to assistant reproductive technology.

Objectives:

To evaluate the ovarian reserve index (AMH*AFC/Age), taking into account the total number of MII oocytes retrieved and the quality of embryo obtained as well as the pregnancy rate.

Materials and Methods:

This study is designed as a cohort prospective study and was conducted in Al-Sadder Teaching Medical City, Al Najaf Province. Sixty couples were enrolled. The gynecological examination was performed on day 2 of the cycle (CD2): vaginal ultrasound (U/S) and blood tests for FSH, LH, AMH, estradiol (E2), serum prolactin, and thyroid function test. The ovarian response prediction index (OPRI) values were measured by multiplying the AMH serum level (ng/mL) by the number of antral follicles with a diameter of 2–9 mm and then dividing the result by the age of the subjects (years).

Results:

The current study showed that the pregnancy rate of the studied group was 33.33%. There was a significant difference between pregnant and nonpregnant women in their AMH level (P value was 0.004). ORPI was significantly higher in pregnant women than nonpregnant women. Binary logistic regression analysis shows that there was a significant positive correlation of ORPI and higher AMH, AFC, lower BMI, MII, oocytes, and embryo number. ROC curve shows that ORPI had an AUC of 1.00 at cutoff point 2, giving a sensitivity and specificity of 97% and 100%, respectively, and an AUC of 1.00 at a cutoff point 1, giving a sensitivity and specificity of 100% and 95%, respectively, which indicate that ORPI is an important predicting factor for ICSI success rate.

Conclusion:

ORPI was significantly higher in pregnant women than in the nonpregnant group; AMH was significantly higher in pregnant women than in the nonpregnant group. Women with higher AMH, AFC, and lower BMI are more likely to have higher ORPI.
Epidemiology of gallbladder cancer in India 2018–2023
Authors: Bhagat Tripta S. , Gulati Gunjan , Bhagat Rohit , Gupta Shalabh
Published: July 2024

India is a high-incidence area for gallbladder cancer (GBC), contributing approximately 10% of the global GBC burden. Within the country, the incidence is notably high in North, North-East, Central, and Eastern regions, whereas it is less common in South and West India. The incidence has been steadily rising in both genders. Patients often present with advanced disease, which carries a dismal prognosis. Unlike the West, GBC in India typically affects younger patients in their fifth and sixth decades of life. Gallstones are present in 80% of Indian GBC patients, increasing the vulnerability of the gallbladder to mucosal injury. However, the incidence of GBC is disproportionate to the prevalence of gallstones in the country. Additional cofactors such as older age, lower socioeconomic status, chronic Salmonella typhi infection, Helicobacter pylori infection, exposure to pollutants, heavy metals, chemicals, adulterated mustard oil, and smoking in patients with gallstones have been identified as promoters of carcinogenesis. These risk factors act additively, resulting in a higher incidence of GBC and accelerating its development. Environmental risk factors, including soil and water contamination by industrial wastes, agricultural effluents, and human sewage, have also been identified as putative risk factors. The combination of a toxic environment, a vulnerable gallbladder, and a susceptible host plays a key role in the pathogenesis of GBC in India. Large multicentric comprehensive studies are required to assess the attributable risk of each identified putative risk factor. This will aid in formulating cost-effective national strategies to prevent GBC-related mortality in the country. Meanwhile, maintaining a high index of suspicion to detect incidental GBC and improving access to health-care facilities for appropriate management of gallstones will help reduce GBC-related mortality.
Unraveling the enigma: Exploring functional neurological symptom disorder
Authors: Bhatti Sachinpal , Saran Brijesh , Nandita  , Kumar Saksham
Published: July 2024

Background:

Conversion disorder, also known as functional neurological symptom disorder, is a mental health condition characterized by physical symptoms that impair voluntary motor or sensory functions. Although these symptoms may appear to be associated with another medical issue, they are actually caused by psychological factors. Importantly, they are not purposeful or related to substance abuse. The primary benefit of these symptoms is psychological, rather than social, financial, or legal.

Objectives:

To explore the comorbidities associated with conversion disorder, to explore the different theories associated with conversion disorder.

Methods:

A review of indexed literature on Conversion disorder or Functional neurological symptom disorder.

Conclusion:

People with conversion disease can have symptoms at any age, including in infancy. At different ages, some symptoms are more common than others. For example, age ranges 20–29 are often linked with seizures related to conversion disorder, but age ranges 30–39 are typically associated with other movement-related symptoms. In summary conversion disorder gives a glimpse into the complicated interplay between conscious and unconscious mind. It demonstrates how mind find inventive ways to express and manage inner problems, even when it means exhibiting physical symptoms.
A brief review of limbic system anatomy, function, and its clinical implication
Authors: Kaushal Parth Sarthi , Saran Brijesh , Bazaz Abhay , Tiwari Harshit
Published: July 2024

Introduction:

The limbic system, also known as the paleomammalian cortex, is a complex network of brain regions that plays a crucial role in our behavior, memory, and emotional experiences.

Objective:

This review aims to explore the structure, role, and clinical implications of the limbic system. It also seeks to understand how the concept of the limbic system has evolved over time, from Broca’s large limbic lobe to MacLean’s triune brain theory.

Methods:

The study involves an in-depth exploration of the limbic system’s constituent parts, including the limbic cortex, hippocampal formation, amygdala, septal area, and hypothalamus. It also examines the Papez and Yakovlev circuits, which are vital for emotion control.

Result:

The limbic system is involved in various processes, including long-term memory, spatial memory, autonomic function regulation, and the regulation of emotional reactions and behaviors. It is also essential for smell, hunger, sleep, dreams, and memory consolidation. The limbic system plays a significant role in several diseases, including epilepsy, limbic encephalitis, dementia, affective disorders, schizophrenia, KluverBucy syndrome, autism, attention deficit/hyperactivity disorder, Korsakoff’s psychosis, and anxiety disorders.

Conclusion:

Understanding the functional neuroanatomy of the limbic system is crucial for comprehending human behavior and its anomalies. This review updates the original Papez circuit and emphasizes the role of the limbic system in behavior and neuropsychiatric disorders. It provides valuable insights into a range of neuropsychiatric disorders.
Research article: Utilization of bronchoalveolar lavage in clinical practice
Authors: Singh Pritam , Sharma Manish Kumar , Mahendran C. S.
Published: July 2024

Background:

Bronchoalveolar lavage (BAL) is a pivotal diagnostic and therapeutic procedure in pulmonary medicine.

Objectives:

This research review delves into the multifaceted applications, indications, techniques, and potential advancements of BAL in contemporary medical practice.

Methods:

Drawing on a systematic review of existing literature, this article provides a comprehensive analysis of BAL’s clinical significance.

Results:

The review discusses BAL’s evolving role in the diagnosis and management of various pulmonary conditions.

Conclusion:

BAL holds significant clinical value, with ongoing advancements enhancing its applications in pulmonary medicine.
Tuberculosis in the elderly population
Authors: Gupta Anmol , Sharma Manish Kumar , Mahendran C. S.
Published: July 2024

Tuberculosis (TB) is a significant public health challenge, with the elderly population being particularly affected in certain regions. Around 17.5% of TB cases in France, in 2019, occurred in individuals over 65 years old. Aging leads to decreased lung function and structural changes that predispose the elderly to TB infection. Immunosenescence, comorbidities, malnutrition, and communal living situations increase TB risk in the elderly. TB symptoms in the elderly are often nonspecific and overlap with other conditions, complicating diagnosis. Radiological presentations may differ from younger patients, and the elderly may struggle to produce sputum for testing. Elderly patients may experience varying tolerances to TB medications, and age-related physiological changes and comorbidities influence treatment tolerance and outcomes. Careful management of drug interactions is crucial. Elderly TB patients, especially those who are frail or dependent, are at higher risk for infection and complications. Adherence to treatment is critical, often necessitating directly observed therapy and nutritional support.
Assessment of diagnostic accuracy of ultrasonographic optic nerve sheath diameter measurement in identifying raised ICP in TBI patients
Authors: Tanna Dimple Ajaykumar , Yadav Sakshi , Shrimal Prawal
Published: July 2024

This systematic review evaluates the diagnostic accuracy of ultrasonographic optic nerve sheath diameter (ONSD) measurement for detecting elevated intracranial pressure (ICP) in traumatic brain injury (TBI) patients. A comprehensive search identified 1,234 articles, with 10 meeting inclusion criteria. These studies demonstrated high sensitivity (88-95%) and specificity (80-90%) for ultrasonographic ONSD, underscoring its potential as a reliable, non-invasive method for assessing elevated ICP in emergency and critical care settings. However, variability in measurement techniques and operator expertise highlights the need for standardized protocols. Further research with larger sample sizes, standardized protocols, and long-term evaluations is necessary to confirm its diagnostic utility and ensure accuracy across diverse patient populations.
Acute white-out lung in mechanically ventilated patient
Authors: Agarwal Vanshika , Bharadwaj Vidushi , Sharma Manish Kumar , Mahendran C. S.
Published: July 2024

A 64-year-old male with a history of chronic kidney disease-5, type 2 diabetes mellitus (T2DM), and hypertension presented with syncope and weakness. Initial examination revealed a heart rate (HR) of 18/min and blood pressure (BP) of 140/90 mmHg. Intravenous (iv) atropine was administered, increasing HR to 85/min. Subsequently, the patient became pulseless, unconscious, and unresponsive, necessitating cardiopulmonary resuscitation (CPR) as per Advanced Cardiovascular Life Support (ACLS) protocol. Return of spontaneous circulation (ROSC) was achieved after three CPR cycles, and the patient regained consciousness. He was intubated and transferred to the intensive care unit. The patient, a smoker with a 4.5 pack-year history, experienced increased positive end-expiratory pressure (PEEP), elevated plateau pressure, and inadequate tidal volume generation a day later. Auscultation revealed significantly reduced air entry on the right side. Arterial blood gas (ABG) analysis indicated CO2 retention. Chest X-ray showed a white-out right lung, intercostal narrowing, and mediastinal shift toward the ipsilateral side.
Embarking on the journey of artificial intelligence for teaching surgery to medical students
Authors: Bhagat Tripta S. , Bhagat Rohit , Gulati Gunjan
Published: July 2024

This article provides a comprehensive overview of the current and prospective roles of artificial intelligence (AI) in surgical procedures and education. The integration of AI in surgical education has the potential to transform the way medical students learn, offering improved diagnostic accuracy, personalized learning experiences, and effective feedback mechanisms. However, it is crucial to address the challenges and ethical considerations associated with incorporating AI into surgical education to ensure its successful and responsible implementation. The integration of AI into surgical education presents a transformative opportunity to address knowledge deficits among medical students, thereby reinforcing their learning and promoting continuous improvement. This manuscript explores the potential of AI to provide objective assessments, targeted feedback, and personalized learning experiences, while also addressing the challenges and ethical considerations inherent in its implementation.
Papillary carcinoma arising in a throglosal cyst with no associated thyroid lesion: An unusual case
Authors: Sharma Richa , Singh Swati , Nath Navneet , Mittal Adreena , Tyagi Mayurika , Jain Mansi , Gaur Sushil
Published: July 2024

Introduction:

Thyroglossal cyst is the most common development anomaly of thyroid gland as well as it represents the most common congenital neck mass. Thyroglossal duct associated malignancy is very rare, and majority is papillary carcinoma.

Case:

A 21-year-old female presented with a painless midline neck swelling. There are no complaints of difficulty in swallowing, breathing, or voice changes. Ultrasonography revealed a multiloculated cystic lesion in midline neck region. The patient underwent Sistrunk procedure. Histopathology revealed foci of papillary carcinoma in association with thyroglossal duct cyst.

Discussion:

Thyroglossal duct cyst remains the most common anomaly of thyroid development. It is also the most common congenital neck swelling. The malignancy associated with thyroglossal duct cyst is very rare. Suspicion of malignancy may arise when the cyst appears irregular, hard, and fixed.

Conclusion:

In our case, the presence of papillary structures in thyroglossal duct support the diagnosis of papillary carcinoma arising from thyroglossal duct rather than a secondary tumor or metastasis from other organs such as thyroid gland. A diagnosis of papillary carcinoma in a thyroglossal duct cyst requires comprehensive surgical management and vigilant follow-up.
Effectiveness of transcutaneous electrical nerve stimulation in orthodontic pain
Authors: Jha Mrigank Shekhar , Ahluwalia Rajiv , Chugh Tina
Published: July 2024

Pain experienced during various stages of orthodontic treatment has been clearly outlined in scientific literature. Research has indicated that pain is a significant obstacle to orthodontic treatment and a common cause for discontinuation of treatment. Surprisingly, this particular area, which necessitates attention in both clinical practice and research, is often overlooked, as evidenced by the limited number of publications on the subject compared to other areas of orthodontic research. Numerous methods have been utilized to address orthodontic pain, including both pharmacological and nonpharmacological approaches. One nonpharmacological method for pain management is transcutaneous electrical nerve stimulation (TENS), which has been widely utilized, although its application in orthodontics has not been extensively described. A limited number of studies have been found through a search on PubMed. The use of TENS could potentially be a valuable option in managing orthodontic pain. This review aims to compile the existing published literature on TENS therapy.
Comparative component analysis of registered Thai Ayuravej antidiarrheal regimen, yaleungpidsamuttara to classical Indian Ayurveda regimen
Authors: Joob Beuy , Wiwanitkit Somsri , Wiwanitkit Viroj
Published: July 2024

Objective:

Classical Indian Ayurveda is a very important traditional medicine system that is the rooted concept for several traditional medicine systems including Thai traditional medicine, Ayuravej. At present, there are many registered modern Ayuravej regimen products in the national drug list of Thailand including Yaleungpidsamuttara, which is an antidiarrheal regimen.

Materials and Methods:

The work is a clinical informatics analysis making use of data searching and systematic comparison. In this article, the authors analyze the registered components of the Yaleungpidsamuttara and compare them to the data on the classical Indian Ayurveda regimen.

Results:

Comparing to the classical Indian Ayurveda, there is no exact Indian Ayurveda with the same components. However, there are some antidiarrheal Indian Ayurveda regimens that have some common components.

Conclusion:

The studied Thai Ayuravej product has its rooted concept from classical Indian Ayurveda and the antidiarrheal activity is also confirmed by modern clinical evidence.
Ultrasonography of uterine leiomyomas: A prospective cross-sectional study
Authors: Khajuria Atul , Abdullah Aalia
Published: July 2024

Background, Sonographic Features of Uterine Leiomyomas Location: Subserosal:

Located on the outer surface of the uterus.Intramural: Located within the muscular wall of the uterus.

Submucosal:

Protrude into the uterine cavity, often causing more symptoms like heavy menstrual bleeding.

Size:

Leiomyomas can range from very small (a few millimeters) to very large (over 20 centimeters).Size measurement is important for monitoring growth over time.

Echotexture:

Typically, fibroids appear as well-circumscribed, hypoechoic (dark) or heterogeneous masses.They may have calcifications, which appear as bright echoes within the fibroid.

Shape:

Generally round or oval.The borders are usually well-defined.

Cystic Degeneration:

Some fibroids may show areas of cystic degeneration, which appear as anechoic (clear) regions within the mass.

Vascularity:

Color Doppler ultrasonography can assess the blood flow within and around the fibroid.This is useful for differentiating fibroids from other masses and for planning treatment options like uterine artery embolization.

Aims and Objectives:

To complement diagnostic hysteroscopy for the assessment of a submucosal leiomyoma, a three-dimensional (3D) TVS can be combined with saline instillation into the uterine cavity. Diagnostic hysteroscopy and TVS have a good overall agreement in the diagnosis of submucosal leiomyomas and in the assessment of fibroids’ myometrial extension. In this regard, 3D saline contrast Sono hysterography may provide even more information than traditional 3D TVS.

Materials and Methods:

This study was conducted in the department of radiology and was a cross-sectional study that lasted 3 months (November 10, 2022–March 10, 2023). The sample size for this study was determined using predefined exclusion and inclusion criteria. The study population included 30 females aged 20–50 who visited the Diagnostic Centre with complaints of abnormal menstrual bleeding or changes in menstrual cycles.

Results:

The majority of fibroids (78%), on USG, appeared hypoechoic, with the remainder (10%) appearing heterogeneous.

Conclusion:

Ultrasound has a high sensitivity and specificity in the diagnosing uterine leiomyoma.