bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of the Binding Immunoglobulin Protein, IL-1β, and Some Hematological Indices in Patients with Urinary Tract Infections
Authors: Oudah Noor Abdulameer , Ghareeb Ammar Kareem Rashid , Kelkawi Ali Hamad Abd , Oudah Marwa Abdulameer
Published: September 2024

Background:

Binding immunoglobulin protein (BiP) is a protein marker associated with endoplasmic reticulum (E.R.) stress and is upregulated by metabolic alterations at the tissue level. There is growing proof that changes in the microbiota’s makeup that cause infections may have a significant impact on the development of associated diseases such as autoimmune diseases by E.R. stress-inducing and a change in cell surface components.

Objective:

To investigate the role of urinary tract infections (UTIs) in inducing an increase in E.R. stress represented and the innate immune response to this stress.

Materials and Methods:

A total of 160 male and female children, whose ages ranged between 5 and 10 years participated in this study. Cultivation urine on UTI ChromoSelect Agar used to identify patients with UTI. The levels of BiP and IL-1β concentration were measured using ELISA assay. Lymphocyte and granulocyte cell count and ratio were measured by Complete Blood Count.

Results:

The major findings of the study were (1) The serum levels of BiP were significantly higher in patients with UTI compared to controls. (2) Upon bacterial stimulation, happened higher increase of IL-1β concentration. (3) The lymphocyte count and ratio were significantly higher but granulocyte ratio was significantly lower in the UTI patients. (4) The most frequent bacteria isolated were Escherichia coli (31.7%), followed by Proteus mirabilis (22.1%), Klebsiella (21.2%), Staphylococcus aureus (12.7%), and Enterococcus faecalis (12.3%).

Conclusions:

BiP plasma concentrations are increased in UTI patients that suggest the virulence factors of uropathogenic bacteria may be stimulated by epithelial cell stress which leads to activation of the immune system. BiP could be a useful marker to predict the risk of bacterial infections.
Oxidative Stress Evaluation of Lambda-Cyhalothrin and Antioxidant (Vitamin E) on Male Rats
Authors: Mustafa Mustafa Q. , Mohammed Zainab J.
Published: September 2024

Background:

Lambda-cyhalothrin (LCT) is a widely used pyrethroid to control insect pests in agriculture, public health, and homes.

Objectives:

The aim of this study was to evaluate the oxidative stress evaluation of LCT pesticides and and antioxidants (vitamin E) in male rats.

Materials and Methods:

Thirty adult male rats were separated evenly into three groups after 3 weeks of acclimatization as follows: For 12 weeks, group-normal C’s feed and water were given to 10 rats. Group T was given LCT at a dose of 0.5 mL per 100 g of body weight for 12 weeks (n = 10 rats) and group E was given (LC + vitamin E) at a dose of 0.5 mL per 100 g of body weight.

Results:

At a results significant increase in malondialdehyde (MDA) level in the T group compared with the E group and C group. Significant decrease of glutathione (GSH) levels in the T group compared with the E group and C group. Macroscopic and microscopic lesions demonstrated atrophy of the kidney in the T group and congestion in the G group while the C group was normal the microscopic lesion of the kidney in the T group multiplied the area of the renal cast at renal tubules with degenerative changes and multiply the area of hemorrhage at the interstitial area but E group show mild degenerative changes in the structure of the renal tubule. It is interesting to note that every modification showed how detrimental LTC is to the kidneys and how vitamin E’s antioxidant capacity benefits them.

Conclusions:

Exposure to pesticides continuously creates a health concern, particularly in the agricultural working environment where animal and human life are intertwined. Thus, the study findings demonstrate the impact of LCT on oxidative stress and renal function as well as the antioxidant role of vitamin E.
Bacteriological Study and Antibiotic Susceptibility of Some Bacterial Isolates among Otitis Media Patients in Al-Muthanna Province, Iraq
Authors: Hameed Alaa K. , Kareem Ahmed Shayaa , Khudhur Hasan Raheem
Published: September 2024

Background:

Otitis media is one of the diseases spread globally, especially in Iraq.

Objectives:

The research aims to diagnose the bacteria that cause this disease and find out the extent of its resistance to antibiotics, and thus reach the best antibiotics that eliminate these bacteria.

Materials and Methods:

Overall 100 samples including ear discharge were collected from different ages of patients suffering from complaints of ear infection in Al-Hussein Teaching Hospital in Al-Muthanna City, Iraq through the dates between January 2020 and May 2021. The isolates were detected by the usual cultural techniques, Gram stain, biochemical tests, and VITEK Compact System (bioMérieux, France) for bacterium detection. Antibiotic susceptibility testing was achieved for each isolate using the disc diffusion method by Kirby-Bauer.

Results:

The results were read according to the Clinical & Laboratory Standards Institute (CLSI) criteria, and were divided into three reads (sensitive, intermediate, and resistant). The most types of bacterial isolates identified from positive ear swabs were: Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella spp., Staphylococcus hemolyticus, Staph epidermidis, Escherichia coli, Serratia spp., and Basterulla spp. The result also showed the highest infection rate of 32 (32%) isolates among the age group (11–20) years old compared with other age groups. The antibiogram result showed that most isolates were resistant to more than four drugs. In addition, 4 (4%) of the isolates were susceptible to every antibiotic examined.

Conclusions:

We conclude the best treatments that were effective against isolates diagnosed with otitis media were Amikacin and Gentamycin.
Serum C-Reactive Protein/Albumin Ratio and its Correlation with Disease Activity in Rheumatoid Arthritis Patients
Authors: Abdullateef Ammar Hatem , Al-Ghazaly Zakaria M. , Baiee Noor Hasan , Al-Jabory Mohammed Ali
Published: September 2024

Background:

Rheumatoid arthritis (RA) is an autoimmune disorder affecting joints with a progressive symmetric inflammation leading to bone erosion, cartilage destruction and disability. Usually, RA activity is measured by using RA Score of Disease Activity involving 28-joint count (DAS-28). C-reactive protein (CRP) to albumin ratio (CAR) has been recently used as a new indicator to assess inflammation and predict prognosis of certain malignancies with Some studies demonstrated its correlation with disease activity of some inflammatory diseases, particularly Crohn’s disease and RA.

Objectives:

to assess the role of serum C-reactive protein to albumin ratio (CAR) in RA as a marker for activity of this disease.

Materials and Methods:

This cross-sectional study included 84 RA patients. Each patient was tested for albumin and CRP in addition to erythrocyte sedimentation rate (ESR). CAR was calculated mathematically by dividing CRP on albumin value. RA activity was assessed by applying DAS-28-ESR scoring system.

Results:

The mean of CAR was 4.25. Significant correlation was found between CAR and DAS-28 CRP disease activity index, CRP, ESR and patient VAS and serum albumin. CAR was showing significant differences among high, medium and low-remission groups of disease activity. However, positive but nonsignificant correlation was found between CAR and the DAS-28-ESR disease activity scoring system, CDAI and the physician VAS.

Conclusion:

CAR, can be considered as useful initial simple investigation which can give an idea about degree of disease activity and the need for further evaluation and management with less time, cost and effort especially in areas with low medical resources and facilities.
Breast Cancer and Microbiota: A Literature Review
Authors: Raheema Rana H. , Raheema Lydia H. , Chabuck Zainab Adil Ghani , Altameemi Qasim Dawood Yasir , Al-Naqeeb Maan M. N.
Published: September 2024

Breast cancer is the most frequent type of cancer in women. It is the second greatest cause of cancer-related deaths among women in high-income countries. The objective of this current review is to elucidate the role of gut microbiota in cancer in general, with a specific focus on breast cancer. The dysbiosis of gut microbiota is a crucial component that has recently come to light, possibly altering the development, treatment, and prognosis of breast cancer through numerous molecular pathways. This review study investigates the relationships between gut microbiota and breast cancer, with an emphasis on how gut microbiota impacts the microenvironment of breast cancer. Final views on improving breast cancer prognosis and risk assessment may be influenced by new data from clinical trials on the breast-microbiome axis and the ability of immunotherapy to modify the microbiome associated with breast cancer.
Viral Load of HBV and HCV Correlation to Torque Teno Virus (TTV) Co-Infection in Iraqi Patients
Authors: Ali Layla F.
Published: September 2024

Background:

While hepatitis viruses A–E are established, emerging evidence points to additional, novel viral hepatitis agents. The torqueteno virus (TTV) has garnered interest due to its prevalence among patients with hepatitis, suggesting potential hepatotropism.

Aim:

This study was conducted to detect TTV antigens in individuals infected with chronic hepatitis B (HBV) and/or C (HCV) using molecular diagnostics and to explore any associations between TTV presence and demographic characteristics of the cohort.

Materials and Methods:

The current study was conducted from the period of September 2022 to April 2023, the investigation involved Iraqi patients aged between 32 and 83 years and diagnosed with HBV and HCV in National Iraqi Central Laboratories, Virology Section. We employed real-time PCR to quantify HBV and HCV viral loads and conventional PCR for TTV DNA detection.

Results:

TTV DNA was detected in 17 of the 60 patients (28.3%) with chronic HBV and HCV infections. Viral load distribution was found to be similar for both HBV and HCV. An age-related increase in viral load was noted, suggesting a trend where older individuals exhibited higher concentrations. However, no significant variation was observed that could link alterations in HBV and HCV viral loads to TTV status directly. Statistical analysis indicated a positive correlation between age and the likelihood of presenting with the virus, aligning with observed trends in other age-associated chronic conditions, such as Type 2 diabetes mellitus and chronic kidney disease.

Conclusion:

The presence of TTV in patients with enduring HBV or HCV infection could implicate the virus as a contributing factor to hepatitis pathology. Studies such as this are pivotal for elucidating the age-associated risk profiles for various pathologies and shaping corresponding public health policies and preventative approaches.
Desired Family Size and Its Associated Factors among Mothers Attending Primary Healthcare Centers
Authors: Tahir Arazoo Issa , Ramadhan Dilkhosh Shamal , Salih Jihan Fakhri , Piro Safiya Sabri , Abdulah Deldar Morad
Published: September 2024

Background:

Family planning allows women to decide on their family size. Desired family size is defined as the number of children parents would like to have if there are no subjective or economic issues involved in regulating fertility.

Objective:

The study aimed to determine the desired family size and its associated factors among mothers in Duhok, Iraqi Kurdistan.

Materials and Methods:

A cross-sectional study was conducted among 404 women who visited primary healthcare centers between July and September 2021. A self-administered questionnaire was used to collect data. JMP Pro software version 14.3.1 was utilized to analyze variables, P-value <0.05 was declared as significant.

Results:

Four (44.3%) and five (33.4%) children were the preferable numbers of children families had. The number of years for birth spacing of more than half the participants was 1–2 years (52.0%), followed by 3–4 (33.7%). Most of the decisions to have a kid were made by husbands (31.9%), followed by influences of culture (19.6%), family income (16.3%), relatives (mother, sisters, mother in low) (12.6%), and religious (9.7%). The mothers were less likely to be involved in decision-making to have a child (22.5%). The desired family size was significantly increased with the age years of mothers and early marriage, living in urban areas, and lower level of education.

Conclusion:

Four and five are the preferable number of children and contributed to with increasing age years of mothers and early marriage, living in urban areas, and lower level of education.
Epidemiology of Colorectal Polyps in Iraqi Patients
Authors: Alezzi Maiadah J. , Alani Kifah H. , Alezzi Jalil I.
Published: September 2024

Background:

A colorectal polyp (CRP) is a growth on the lining of the colon or rectum. The incidence of CRPs is rapidly increasing with age. They are most often benign. The rectum is the most commonly affected site.

Objectives:

To determine the incidence, clinical presentation, and histopathologic types of CRP in Iraqi patients.

Materials and Methods:

It is a cross-sectional screening study conducted in the medical city of Baghdad,Iraq. The total number of colonoscopies done in the medical city/GIT center was 2658 from May 2020–September 2022, where 100 patients with the diagnosis of CRP has collected. The males comprised 60/100 and their ages ranged from 4 to 75 years.

Results:

The most common age group affected was 46–59 years. There was a significant relationship between site and types of CRP, where the rectum showed 48% involvement, followed by the sigmoid colon at 34%. The villous adenomatous polyps look of large size ranging from 1.5 to 4 cm. The tubulovillous adenoma is the most common type, 25%. Lower gastrointestinal bleeding is the most common presentation, 25%.

Conclusion:

The most common age group affected was 46–59 years, with male-to-female ratio is 1.17. The most common site affected by CRPs was the rectum 48%, villous adenoma has the most significant size among all types (1.5–4 cm). No dysplasia was the most common finding (45%), and lower GIT bleeding and positive family history were the most common clinical presentation.
Immunological Study for Interleukin-5 and GM-CSF for Complications Post-Wisdom Teeth Extraction
Authors: Uraibi Susan Hameed , Al-Amiedi Baha Hamdi , Kezar Mahdi Y.
Published: September 2024

Background:

Wisdom teeth extraction is one of the most common operations conducted in dental clinics and the most common duty performed in oral and maxillofacial surgery clinics. Complications from this treatment are common, including dry socket, postoperative discomfort, delayed healing, postoperative infection, hematoma, edema, and trismus.

Objectives:

The purpose of this study is to quantify the proinflammatory interleukin-5 (IL-5) and granulocyte-macrophage colony-stimulating factor before extraction in saliva by ELIZA technique from patients who visit the clinic to extract wisdom tooth to study its impact on problems following extraction.

Materials and Methods:

A total of 100 saliva study samples (50 cases and 50 control), 44 males and 56 females, aged 19–65 years, were referred to the surgical clinic, College of Dentistry, University of Babylon specialized dentistry centers, and private clinics in Hillah city, Iraq, to determine the levels of preoperative IL-5 and GM-CSF by ELIZA technique.

Results:

There were no major differences between females and males in both groups, according to the findings of this study. In comparison to the healthy subjects, however, patients showed higher significant differences in measuring (IL-5) and (GM-CSF) concentrations (366.81 ± 17.8, 12.26 ± 1.3) (P ≤ 0.05) by using the ROC test IL-5 and GM-CSF showed (cutoff 146.42, sensitivity 90%, specificity 82%), (cutoff 4.04, sensitivity 84%, specificity 72%).

Conclusion:

proinflammatory IL-5 and GM-CSF were shown to be higher in patients with complications following wisdom teeth extraction than it was in control; highly level of IL-5 and GM-CSF may Predict complications following extraction.
Genetic Basis of Biofilm Formation Genes Ebp and Bph (phos) among Multidrug Resistance Enterococcus faecalis Isolates, Iraq
Authors: Attia Muna Salman , Al-Azawi Ibtisam Habeeb
Published: September 2024

Background:

Biofilm produced by Enterococcus spp. increase their inherent and acquired antibiotic resistance, posing a significant challenge to infection treatment, particularly in virulent strains.

Objective:

This study aimed to investigate some genes responsible for biofilm formation (Bph (phos) and EbpB) by polymerase chain reaction (PCR) technique.

Materials and Methods:

A total of 130 clinical samples were collected during this study, which were obtained from patients who were admitted to Feminine and Children Teaching Hospital in Al-Diwaniyah City during a period extending from (November 2022 to March 2023). All samples were subjected to culturing on different media (blood agar, MacConkey, Bile Esculin agar, and M-El chromogenic ager), after which catalase and oxidase tests were conducted biochemically. After cultivation, the VITEK-2 compact system was used to identify the samples. The isolates were investigated genotypically for harboring biofilm formation genes, including EbpB and Bph (phos), by molecular method (PCR).

Results:

The VITEK-2 compact system revealed that only 12 isolates were identified as E. faecalis. The most effective antibiotics against E. faecalis were (vancomycin, teicoplanin, linezolide, tigecycline, and ampicillin), and the highest resistance was against erythromycin (100%) and tetracycline (91.6%). Enterococcus faecalis isolates were investigated genotypically for harboring biofilm formation genes that include EbpB and Bph (phos) by molecular methods, PCR. The results showed that EbpB and Bph (phos) genes were positive for all isolates with a percentage of 100%.

Conclusions:

It was found that the presence of biofilm formation genes in E. faecalis EbpB, and phos (Bph) increase the pathogenicity of this pathogen. These genes showed a high percentage among E. faecalis isolates. Also, all isolates had the potential to form a biofilm, which complicates their treatment with antibiotics, confirming the critical need to develop novel antimicrobial agents that control the infection associated with the development.
Serum Lipid Profile in Preeclamptic and Eclamptic Patients in North-Central Nigeria
Authors: Abdulkadir Zainab Ajoke , Ijaiya Munirdeen Aderemi , Adebara Idowu O. , Biliaminu Sikiru A.
Published: September 2024

Context:

Preeclampsia and eclampsia contribute to 13% of maternal mortality. Central to its etiology are abnormal placentation and endothelial dysfunction. Studies of the maternal spiral arteries of these patients have revealed severe atherosis, extensive widespread endothelial dysfunction, and suspicion of abnormal lipid metabolism.

Aim:

This study was designed to determine the serum lipid profile in preeclamptic/eclamptic patients and compare it with normotensive controls.

Materials and Methods:

It was a comparative cross-sectional study, conducted in the Obstetrics and Gynecology unit, University of Ilorin Teaching Hospital. The study population was a total of 192 women comprising 96 pregnant women with preeclampsia/eclampsia and an equal number of normotensive pregnant women who were matched for age, gestational age, and body mass index, as controls. Total serum cholesterol, triglycerides, low-density cholesterol, and high-density cholesterol were determined.

Results:

The mean total cholesterol among the subjects was 4.79 ± 1.46 mmol/l, compared with the controls which was 4.69 ± 2.05 mmol/l (P = 0.673). The mean high-density lipoproteins (HDL) in the subjects were 1.27 ± 0.71 mmol/l, compared to the control which was 1.73 ± 0.73 mmol/l (P = 0.013). The mean triglyceride in the subjects was 2.41 ± 0.92 mmol/l, and that of the controls was 2.74 ± 0.92 mmol/l (P = 0.001). Mean low-density lipoproteins (LDL) were 2.85 ± 1.32 mmol/l in the subjects and 2.83 ± 1.48 mmol/l in the controls (P = 0.917). There was no relationship between lipid levels and the severity of the disease. Eclampsia was however associated with a higher total serum cholesterol, while intrauterine fetal demise was associated with significantly lower mean triglycerides.

Conclusion:

HDL and triglycerides are significantly lower in preeclamptic and eclamptic patients.
Giant Primary Conjunctival Inclusion Cyst: A Case Report and Brief Literature Review
Authors: Reddy Shilpa S. , Satapathy Jasmita , Das Sucharita , Mohanty Pranita , Syal Ajay D.
Published: September 2024

A conjunctival cyst is a slow-growing benign lesion that forms beneath or on the conjunctiva. Inclusion cysts contribute to most cases, more commonly secondary than primary. In an inflamed inclusion cyst, inflammatory features may or may not be seen clinically but can be confirmed on histopathological evaluation after surgical excision of the cyst. Removal of the cyst surgically with complete cyst wall excision is desirable in all conjunctival cysts. We report a giant conjunctival inclusion cyst in a 44-year-old female with no history of trauma or surgery. The patient had a history of a tiny cyst present since childhood and was found to enlarge gradually to the present size in the last 4 months. The cyst was excised entirely without rupturing the wall. Histopathology of the excised tissue showed a thin-walled cystic structure lined by nonkeratinized epithelium stratified at places. The wall was composed of fibrocollagenous tissue infiltrated by sparse inflammatory cells with a predominance of lymphocytes forming lymphoid nodules. The histological diagnosis was consistent with a conjunctival inclusion cyst. Primary inclusion cysts are mostly present since childhood and often remain asymptomatic. The size may later increase and become symptomatic when triggered by some factors like trauma, infection, inflammation, and drugs.
Eyedrop Instillation Technique by Medical Interns: Assessment and Impact of Video-Assisted Training
Authors: Poojeri Umesh , Babu Mahesh , Bhavya HU , Shruthi Konatham
Published: September 2024

Aim:

To assess the eyedrop instillation technique by medical interns, and to study the effect of video-assisted training.

Methods:

This was a hospital based prospective study performed on interns of teaching institute. First, interns were asked to instil the eye drops on volunteers which was video recorded. Interns were then given ‘video-assisted training’ (VAT) of correct technique and again reassessment was performed immediately, after one-week and one-month interval. All the recorded videos were evaluated by a single independent blinded expert and scored according to the scoring system devised by subject experts based on the available literature. The data were entered in Microsoft Office Excel and statistical analysis was performed.

Results:

The study showed that before training 43.80% had good practice with mean test score of 6.32 ± 1.63. Immediately after video-assisted training, there was significant improvement in technique of instilling eye drop with mean test score of 9.01 ± 0.62 (P < 0.0001), after one week, the mean test score was 9.52 ± 0.71 (P < 0.0001), and after one-month, mean test score was 9.56 ± 0.75 (P < 0.0001). Each step of eyedrop instillation was compared before and after the VAT and the difference was found to be statistically significant (P value < 0.05).

Conclusion:

In our current study, initially interns had practised incorrect technique of instillation of eyedrop. But after video-assisted training there has been notable improvement in the technique of instilling eyedrop. Periodic VAT might be helpful in ensuring them to follow the correct technique regularly.
Ushering Patients Towards Strabismus Screening in Usher’s Syndrome
Authors: Shetty Tanvi , Ramani Soumya , Karanth Sahana , Vidya J
Published: September 2024

This is a rare case of a patient with atypical retinitis pigmentosa, basic exotropia and hearing impairment in a 16-year-old child. She has been diagnosed as hearing impaired since birth. Her aided vision in both eyes was 6/9; the fundus showed hypopigmented lesions with a waxy pale disc, and she was found to have basic exotropia. All of these features suggest Usher’s syndrome. To the best of our knowledge, this is the first case of basic exotropia with Usher’s syndrome.
Real-Time Pupil Assessment by Spectral Domain Optical Coherence Tomography in Relative Afferent Pupillary Defect and Comparison with Swinging Flash Method in Clear and Hazy Cornea
Authors: Soundararajan Deepika , Kumar Dhivya Ashok , Thambusamy Vijay A. , Agarwal Amar
Published: September 2024

Purpose:

To evaluate the real-time pupil diameter in relative afferent pupillary defect (RAPD) with spectral domain optical coherence tomography (SD-OCT) and compare it with the swinging flashlight method (SFM).

Methods:

In this, prospective, non-randomized, comparative case series, patients with RAPD with clear and hazy cornea were included. The normals with no RAPD have been taken as controls. The pupillary responses were noted in both eyes and the difference in pupil sizes (in mm) was recorded using the SD-OCT (Cirrus 5000, Zeiss) and correlated with SFM. OCT images were evaluated by Image J analysis (Wayne Rasband and National Institute of health). Baseline pupil size, the amplitude of constriction, response to external light and comparison with control eyes and hazy cornea were analysed.

Results:

Overall, 102 eyes of 51 study patients were imaged. OCT was able to detect RAPD in 100% of eyes. There was a significant difference between the fellow and affected eye (P < 0.05) pupil diameter in the study group. The affected eye had a larger pupil diameter than that of the fellow. There was a significant difference (P < 0.05) between the amplitude of pupil constriction between the fellow and the affected eye. There was a significant difference in the pupil size with respect to the severity of RAPD (P < 0.05). OCT was able to detect RAPD in 13.7% of hazy corneas. There was a statistical correlation between the SFM and OCT grading (P < 0.001, r = 0.771). On comparison with normal controls, there was a significant difference in the amplitude of constriction and basal pupil size.

Conclusion:

SD-OCT can be used objectively to detect and document RAPD in clear and hazy corneas.
Clinical Profile and Visual Outcomes of Traumatic Optic Neuropathy
Authors: Balraj Arumugam , Umare Akshay K. , Kakoty Rashmirita
Published: September 2024

Background:

Indirect traumatic optic neuropathy (ITON) arises from concussive shockwaves, causing secondary optic nerve damage. Limited treatment options exist for traumatic optic neuropathy (TON), and the use of steroids remains contentious, addressing the absence of a standardized protocol for this ophthalmic emergency.

Purpose:

To evaluate the clinical presentation and visual prognosis of ITON as well as the efficacy of steroids in treating ITON.

Methods:

A retrospective analysis was conducted on patients diagnosed with ITON who sought medical attention spanning from January 2021 to December 2022. The study recorded the clinical profile as well as the ocular and cranial injuries. The study also evaluated the visual outcomes.

Results:

The total number of patients recruited in our study was 78. The mean age group found was 42 (ranging between 13 and 72 years of age). The most common mode of injury was a road traffic accident (83%), followed by home (10%) and factory accidents (7%). Only two cases had bilateral traumatic optic neuropathy. 93% of patients received steroids. The visual acuity at presentation was 6/6 to 6/18 in 32 cases (41%), 6/24 to 6/60 in 8 cases (10%), 5/60 to 3/60 in 1 case (1%) and worse than 3/60 in 37 cases (48%). Fifteen (20%) cases had optic canal fractures, and 15 (20%) had orbital wall fractures without optic nerve involvement. There was no noticeable improvement in visual acuity after 1 year. Only 9% improved, 3.9% worsened, and 87% remained unchanged.

Conclusions:

The study uncovered no significant association between visual acuity and treatment.
Awareness of Diabetic Retinopathy among Patients with Diabetes Mellitus Attending the Tertiary Eye Hospital in Nepal: A Descriptive Cross-sectional Study
Authors: Shrestha Arjun , Shrestha Biju , Suwal Rinkal , Suwal Barsha , Khadka Deepak , Sharma Samata , Shrestha Nirsara
Published: September 2024

Introduction:

Lack of knowledge of the need for regular diabetic retinopathy screening (DRS) has turned many patients in the advanced stage of DR before first eye check-ups. Unfortunately, data on the knowledge, attitude, and behaviour of diabetic patients with DR are not satisfactory in Nepal. Here, we aim to assess the factors predisposing to awareness levels in the Nepalese context.

Methods:

This was an observational cross-sectional study enrolling 369 diabetic patients visiting the Hospital for Children, Eye, ENT and Rehabilitation Services between March 2020 and February 2021 after obtaining ethical clearance from the Nepal Health Research Council. A convenience sampling technique was used. The questionnaire was utilized to assess basic demographic profiles, awareness about diabetic retinopathy, and sources of information on the need for diabetic eye check-ups.

Results:

The mean (standard deviation) age of diabetes mellitus (DM) patients was 56.26 (11.13) years. The age group of 40–59 years comprised more than half of the total patients. Awareness of DR was 86.7% in this study. Education level and the duration of DM were directly proportional to the awareness level. Healthcare workers or physicians were the primary sources of information on awareness.

Conclusions:

Awareness of poor visual consequences of DR among patients with diabetes in Nepal is relatively satisfactory. However, patients’ willingness to undergo retinopathy check-ups was not up to the mark. Therefore, we recommend finding out the barrier to poor compliance with diabetic retinopathy in the future. The consumer-focussed health educational interventions and physician-based skills and the DRS facility would improve the awareness level in Nepal.
Clinical Profile of Thyroid Eye Disease and Factors Predictive of Disease Severity in Chennai District of Tamil Nadu
Authors: Ulla Mohamed Uwais , Nivean Pratheebadevi , Abrar Mohamed , Madhivanan Nivean
Published: September 2024

Background:

Thyroid eye disease (TED) is a possibly sightthreatening ocular disease generally occurring in the patients diagnosed with hyperthyroidism. TED, also known as Graves orbitopathy, is typically self-limiting auto-immune disease linked with a dysthyroid status. Based on the ocular symptoms and signs, the current grading systems of TED are the VISA classification and the EUGOGO classification; each parameter of VISA score is separately graded and scored. Worsening in any of the VISA parameters is graded as an active disease in the geographic region of South India; there are no studies on clinical profiles of TED; hence, we planned to do this study to analyse the demographic profile and clinical manifestations of TED in patients.

Material and Methodology:

This study was done as an observational study for a period of 12 months. All patients with systemic thyroid disorder are included in the study. If lid retraction is seen, the presence of laboratory evidence of thyroid dysfunction, exophthalmos, optic nerve dysfunction, or extra ocular muscle involvement will be considered as TED. In case of no lid retraction in a patient with laboratory evidence of thyroid dysfunction, the presence of exophthalmos, optic nerve involvement, or restrictive myopathy will be considered as TED. Patients with diagnosis of TED were further evaluated. TED was graded according to VISA and EUGOGO classification.

Results:

This study was done as an observational study in 50 patients diagnosed with TED. In our study population, 32 (64%) were hyperthyroid, 11 (22%) were hypothyroidism, and the rest 7 (14%) were euthyroid. The most common presenting complaints were dryness of eye in 46% of patients, followed by blurred vision in 38% of patients. We evaluated severity of disease using EUGOGO score, and 42 patients had mild disease, while six had moderate disease and two patients had severe disease. Based on VISA score, in our study population, only two patients had active disease and the rest 48 had inactive disease.

Conclusion:

Thyroid status has a direct and positive correlation with active stage of disease and severity. Hyperthyroidism and active disease were risk factors for severe and sight-threatening disease, emphasising the need for close follow-up and prompt detection and management of severe and sight-threatening disease, especially in newly diagnosed hyperthyroid patients. It is important to diagnose TED at the earliest to prevent vision-threatening complications. Early identification and management will help in reducing the severity of disease.
Correlative Study of Central Corneal Thickness and Intraocular Pressure with Optic Disc Changes in Primary Open-Angle Glaucoma
Authors: Bada GnanaJyothi C. , Abid Abdul Rauf , Patil Satish S.
Published: September 2024

Background:

Primary open-angle glaucoma (POAG) is characterised by open angles, raised intraocular pressure (IOP) and optic disc changes. Undetected glaucoma is the third leading cause of blindness. The study aims to correlate central corneal thickness and IOP with optic disc changes in POAG and to aid in the early detection and timely management of glaucoma to prevent advanced damage and vision loss.

Methods:

In this hospital-based prospective observational study, 50 cases (100 eyes) of POAG were selected after applying the inclusion and exclusion criteria. Detailed history, ocular examination, visual acuity testing, slit-lamp examination, gonioscopy, ultrasound pachymetry for central corneal thickness (CCT), IOP with Goldmann Applanation Tonometry (GAT), fundus examination with +90D lens and visual fields on Humphrey’s automated field analyser were performed for all patients.

Results:

There was a statistically highly significant positive correlation between IOP and CCT in the right and left eyes (P < 0.01). There was a statistically very highly significant difference between mean IOP and mean corrected IOP in the right eye and left eye also (P < 0.001). There was a statistically very highly significant difference in IOP, CCT and fundus cup-to-disc ratio (CDR) with HAP staging (P < 0.001).

Conclusions:

IOP was positively related to CCT. Thinner CCT <510μm eyes are at greater risk for more advanced disc cupping. Disc cupping increased proportionately with the rise in IOP. Thinner corneal readings should alarm the ophthalmologist to evaluate the patient thoroughly for glaucoma and monitor follow-up to keep a check on possible progression.
The Redner–ben-Avraham–Kahng cluster system without growth condition on the kinetic coefficients
Authors: Laurençot Philippe
Published: September 2024

Existence of global mild solutions to the infinite dimensional Redner–ben-Avraham–Kahng cluster system is shown without growth or structure condition on the kinetic coefficients, thereby extending previous results in the literature. The key idea is to exploit the dissipative features of the system to derive a control on the tails of the infinite sums involved in the reaction terms. Classical solutions are also constructed for a suitable class of kinetic coefficients and initial conditions.
Asymptotic mapping class groups of Cantor manifolds and their finiteness properties (with an appendix by Oscar Randal-Williams)
Authors: Aramayona Javier , Bux Kai-Uwe , Flechsig Jonas , Petrosyan Nansen , Wu Xiaolei
Published: September 2024

We prove that the infinite family of asymptotic mapping class groups of surfaces defined by Funar–Kapoudjian and Aramayona–Funar are of type

F_{\infty}

, thus answering a problem of Funar–Kapoudjian–Sergiescu and a question of Aramayona–Funar. This result is a specific case of a more general theorem which allows us to deduce that asymptotic mapping class groups of certain
Cantor manifolds
, also introduced in this paper, are of type

F_{\infty}

. As important examples, we obtain type

F_{\infty}

asymptotic mapping class groups that contain, respectively, the mapping class group of every compact surface with non-empty boundary, the automorphism group of every free group of finite rank, or infinite families of arithmetic groups.In addition, for certain types of manifolds, the homology of our asymptotic mapping class groups coincides with the
stable homology
of the relevant mapping class groups, as studied by Harer and Hatcher–Wahl.
Clinicopathological analysis of small intestinal metastasis from extra-abdominal/extra-pelvic malignancy
Authors: Zhang Zhi , Liu Jing , Yu Peng-Fei , Yang Hai-Rui , Li Jin-Yang , Dong Zhi-Wei , Shi Wei , Gu Guo-Li
Published: September 2024

BACKGROUND

The metastatic tumors in the small intestine secondary to extra-abdominal/extra-pelvic malignancy are extremely rare. However, the small intestine metastases are extremely prone to misdiagnosis and missed diagnosis due to the lack of specific clinical manifestations and examination methods, thus delaying its treatment. Therefore, in order to improve clinical diagnosis and treatment capabilities, it is necessary to summarize its clinical pathological characteristics and prognosis.

AIM

To summarize the clinicopathological characteristics of patients with small intestinal metastases from extra-abdominal/extra-pelvic malignancy, and to improve the clinical capability of diagnosis and treatment for rare metastatic tumors in the small intestine.

METHODS

The clinical data of patients with small intestinal metastases from extra-abdominal/extra-pelvic malignancy were retrieved and summarized, who admitted to and treated in the Air Force Medical Center, Chinese People’s Liberation Army. Then descriptive statistics were performed on the general conditions, primary tumors, secondary tumors in the small intestine, diagnosis and treatment processes, and prognosis.

RESULTS

Totally 11 patients (9 males and 2 females) were enrolled in this study, including 8 cases (72.3%) of primary lung cancer, 1 case (9.1%) of malignant lymphoma of the thyroid, 1 case (9.1%) of cutaneous malignant melanoma, and 1 case (9.1%) of testicular cancer. The median age at the diagnosis of primary tumors was 57.9 years old, the median age at the diagnosis of metastatic tumors in the small intestine was 58.81 years old, and the average duration from initial diagnosis of primary tumors to definite diagnosis of small intestinal metastases was 9 months (0-36 months). Moreover, small intestinal metastases was identified at the diagnosis of primary tumors in 4 cases. The small intestinal metastases were distributed in the jejunum and ileum, with such clinical manifestations as hematochezia (5, 45.4%) and abdominal pain, vomiting and other obstruction (4, 36.4%). In addition, 2 patients had no obvious symptoms at the diagnosis of small intestinal metastases, and 5 patients underwent radical resection of small intestinal malignancies and recovered well after surgery. A total of 3 patients did not receive subsequent treatment due to advanced conditions.

CONCLUSION

Small intestinal metastases of extra-abdominal/extra-pelvic malignancy is rare with high malignancy and great difficulty in diagnosis and treatment. Clinically, patients with extra-abdominal/extra-pelvic malignancy should be alert to the occurrence of this disease, and their prognosis may be improved through active surgery combined with standard targeted therapy.
Rare and lacking typical clinical symptoms of liver tumors: Four case reports
Authors: Zhao Yun , Bie Yu-Kun , Zhang Guang-Ya , Feng Yi-Bin , Wang Feng
Published: September 2024

BACKGROUND

Rare liver tumors (RLTs) have an extremely low likelihood of forming, and some have been recorded only in isolated cases. The lack of normal clinical symptoms in RLTs makes preoperative diagnosis extremely challenging, which results in frequent misinterpretation. The present case report helps enhance our ability to recognize and treat uncommon liver tumor disorders.

CASE SUMMARY

We describe four distinct examples of rare liver tumor diseases. These cases were all true cases with no conventional clinical signs or imaging findings. In all patients, hepatic occupancy was discovered on physical examination, which raised the preoperative suspicion of hepatic cancer. All tumors were surgically removed, and postoperative histology and immunohistochemistry were performed to confirm the diagnosis. The first patient had primary hepatic fibrosarcoma. The second case involved a primary hepatic neuroendocrine tumors. These two patients had malignant liver tumors, and both had extremely satisfactory surgical outcomes. The third case involved focal hepatic steatosis, and the fourth case involved a single necrotic nodule in the liver. These two patients had benign liver tumors, but they had already undergone surgery and did not require any postoperative care.

CONCLUSION

The number of patients with RLTs is small, and the clinical and imaging results are vague. Preoperative diagnosis is challenging, and patients are sometimes mistakenly diagnosed with liver cancer, which leads to unnecessary surgical therapy in certain individuals.
The effect of the immune response to SARS-CoV-2 S protein on angiotensin II levels in rats
Authors: Khramova T. V. , Sidorov A. Yu. , Beduleva L. V. , Menshikov I. V. , Shklyaeva N. P.
Published: September 2024

Autoantibodies against key molecules of the renin-angiotensin system (RAS) are found in some patients infected with SARS-CoV-2. These autoantibodies include antibodies against angiotensin II and angiotensin converting enzyme 2 (ACE2). The presence of antibodies to the RAS-related molecules is associated with episodes of hypotension or hypertension. The aim of this work was to study the effect of antibodies to SARS-CoV-2 S protein and autoantibodies to ACE2 on angiotensin II levels in a model of induced multiple organ damage caused in rats by immunization with SARS-CoV-2 S protein. The effect of pre-existing autoimmune encephalomyelitis on change in angiotensin II level caused by immunization with S protein is also was studied. Wistar rats were immunized with S protein of SARS-CoV-2 emulsified in incomplete Freund’s adjuvant (IFA). At the time of injection of S protein 6 of the rats were intact (S group), in 4 of the rat experimental autoimmune encephalomyelitis was previously induced by immunization with guinea pig myelin basic protein (EAE + S group). The control group of rats was injected with IFA. Antibodies to S protein, autoantibodies to ACE2, and angiotensin II level were determined in blood plasma by enzyme linked immunosorbent assay. It was found that immunization with S protein leads to a transient decrease in the blood level of angiotensin II. The blood angiotensin II level was lower than normal in 3 out of 6 rats (50%) in group S, and in 3 out of 4 (75%) in the EAE + S group at week 6 after immunization. The decrease in angiotensin II level was significant in the EAE + S group relative to the control group (ANOVA, p = 0.0423). A deeper decrease in the angiotensin II level in the blood of EAE + S group than in S group was associated with a higher level of antibodies to S protein: the level of antibodies to S protein was significantly higher in the EAE + S group for 1-6 weeks after immunization with S protein compared to the S group of rats. Immunization of rats with S protein did not cause the production of anti-ACE2 autoantibodies in the EAE + S group, and in the S group it was weak and was not accompanied by an increase in angiotensin II levels. Thus, in rats immunized with S protein, a transient decrease in the level of angiotensin II was detected at the peak of production of antibodies to S protein, which may indicate that antibodies to S protein may contribute to a decrease in angiotensin II level in SARS-CoV-2 infection. In addition, pre-existing autoimmune disease leads to a stronger response to S protein, accompanied by a stronger decrease in angiotensin II level.
Clinical and pathogenetic significance of the phenomenon of functional heterogeneity of oxygen-dependent functions of neutrophils in ankylosing spondylitis
Authors: Karyan B. G. , Ilyin M. V. , Romanov V. A. , Romanova N. V. , Semechkin N. V. , Lileeva E. G.
Published: September 2024

Neutrophils are able to exert a variety of effects on other cells of the immune system, which indicates their heterogeneity. In various rheumatic diseases, neutrophils are involved in the immunopathological process. The study of the phenomenon of functional heterogeneity of neutrophils associated with the pathogenesis of rheumatic diseases is a promising area of research in immunology and rheumatology. The purpose of the research: study of factors influencing oxygen-dependent neutrophil functions in ankylosing spondylitis (AS). A total of 82 patients with AS were examined. The functional activity of neutrophils was assessed according to the data of determining the indicators of oxygen-dependent functions by the chemiluminescence method. Functional neutrophil reserve (FNR) was assessed by activation coefficients (the ratio of chemiluminescence induced by suspension of heat-killed staphylococcus cells to spontaneous value). Statistical data processing was carried out using Statistica 10.0 program.
An increase in oxygen-dependent neutrophil functions in AS was accompanied by an increase in disease activity. The greatest influence on the increase in the functional activity of cells was exerted by the age of patients, the stage of the disease and the level of circulating immune complexes. The process of stabilizing the metabolic activity of neutrophils was significantly influenced by the age of patients, ESR, ã-globulins, total cholesterol, and low-density lipoprotein cholesterol. Among the laboratory parameters, the majority of AS patients with moderate and high FNR had elevated levels of ESR, CRP, and IgM; there was a tendency to increase IgA in AS patients with high FNR. Statistical analyses showed an association between FNR and disease activity; there was no statistically significant dependence of FNR on the stage, course, and form of AS. The study of the metabolic activity of neutrophils during dynamic observation revealed a group of patients with stabilization of FNR parameters against the background of therapy with the achievement of a normal level of oxygen-dependent metabolism. Thus, in ankylosing spondylitis, the functional heterogeneity of neutrophils associated with disease activity was established according to the determination of oxygen-dependent metabolism.