bluuebunny/crossref_metadata_2025 huggingface dataset:
Maximizing High Value Light Products by Catalytic Cracking of VGO Produced by Iraqi Refinery over Formulated FCC Catalyst
Authors: Abdulridha Samer G. , Radhi Ali J. , Abbas Marwa N. , Shehab Amal K. , Aluaibi Wisam M.
Published: August 2023

Prototype of FCC catalyst were formulated by mixing the stabilised Y zeolites (68wt%) with polyvinal alcohol (PVA) (7%) as a solution binder and bentonite (25%). The Y zeolite including the original HY with Si/Al of 2.6 (cat.-2.6) and dealuminated HY with Si/Al of 30 (cat.-30) were used and tested for catalytic cracking of Iraqi vacuum gas oil (VGO) obtained from Al-Dura refinery using a pilot plant. The cracking process was carried out at a temperature of 520 °C and atmospheric pressure, The weight ratio of catalyst / oil ratio was 3 and 5. The results show that higher conversion of 77 wt. % and better product distribution (gasoline, kerosene and gas oil) could be obtained over cat.30 resulting to a good liquid product yield. The catalytic activity, in terms of VGO conversion was not affected over cat.-30 in spite of its lower acidity, suggesting the determinate of mesoporosity in the Y zeolite (cat.-30) catalysed cracking reactions. A higher yield of ~ 67 wt% to mid-distillates (i.e.Naphtha and kerosene) was as a result of the improvements in the diffusion to and from catalyst structure.
A Review: Membrane Reactor for Hydrogen Production: Modeling and Simulation
Authors: Kassi Alaa Hasan , Al-Hattab Tahseen A.
Published: August 2023

A membrane reactor is a multifactional vessel used for H2 production. Hydrogen's three spectrum colors are dependent on carbon present. Two types of membrane with high permeability to hydrogen (polymeric and metallic) Hydrogen is produced in two systems: conventional reactors and membrane reactors (which separate and purify hydrogen in a single vessel). There are many types of membrane reactors according to design (catalytic membrane reactor (CMR), fixed bed reactor (FBMR), fluidized bed reactor (FBMR), etc. The transport mechanism of H2 through the membrane by a "sorption-diffusion mechanism" and the government equations that are used for membrane reactor modeling and simulation, such as continuity, momentum, mass, and heat transfer equations of the CMR, and the thickness of the membrane. These equations are solved by MATLAB, COMSOL, and the Finite Element Method to simulate the MR at different parameters: rate of conversion, rate of sweep gas, temperature, pressure, rate of H2 permeation through a membrane, and activity of the catalyst. We summarized theoretical studies for membrane reactors, including the operation conditions, type of hydrocarbon feed, type of production method, kind of catalyst, and heat effect.
Primary adrenal insufficiency among Sri Lankan adults: A cross-sectional study in National Hospital Colombo, Sri Lanka
Authors: Dissanayake H. A. , Katulanda P. , Somasundaram N. P. , Sumanatilleke M. R. , Senevirathne S. L.
Published: August 2023

Background: Clinical, biochemical & radiological characteristics and aetiologies of primary adrenal insufficiency (PAI) among Sri Lankan adults are not known.Aims: To describe the clinical features, aetiology, diagnostic and treatment outcomes of patients with PAI in Sri Lanka.Methods: A cross-sectional study was conducted in Endocrine clinics of National Hospital of Sri Lanka. We screened prescription records to identify patients with PAI. Data was collected using a structured interviewer administered questionnaire and by reviewing clinic records, during their scheduled clinic visit.Results: Forty patients were recruited (median age 38 (IQR 27-52), men 35%, 361 patient-years follow up). Adrenal tuberculosis was the aetiology in 10 / 40. Cause was unknown in 29 / 40, among whom 16 had an associated other organ autoimmune dysfunction. Delay in presentation, diagnosis and presentations with Addisonian crisis were less in patients who presented after 2010 compared to those before (9 vs 18 months, 6 vs 12 months and 5/12 vs 3/28 respectively). Hyperpigmentation (39 / 40), weight loss (32/ 40) and postural lightheadedness (27 / 40) were the common manifestations. Adrenal atrophy and adrenal calcification were seen in 20/30 and 6/30 respectively. All patients were on hydro cortisone, 31 / 40 were on fludrocortisone and none were on androgen replacement. Incidence of Addisonian crisis was 7.5 per 100 patient-years: commonest cause was lapses in medication adherence (14 of 24 events).Conclusion: Tuberculosis was the cause of PAI in 25% of adult patients. Aetiology in others is presently unknown. Delay in presentation and diagnosis has shortened over time. Addisonian crisis after diagnosis is commonly due to non-adherence.
Hepatoid adenocarcinoma masquerading as adrenocortical carcinoma in an elderly male
Authors: Somasundaram N. P. , De Silva N. L. , Ranasinghe L. D. , Grossman A. , Wang L. M. , Rathnasena B. G. N. , Ranaweera G. , Samarasekera A.
Published: August 2023

Background: Hepatoid adenocarcinoma is a malignant lesion arising from an anatomic site other than the liver with histological features similar to hepatocellular carcinoma. Hepatoid adenocarcinoma has been reported from various anatomical sites, but adrenal hepatoid adenocarcinomas are extremely rare.Case Description: A 70-year-old male with well-controlled hypertension presented with chronic abdominal pain and was found to have a large left-sided supra renal mass. The lesion showed radiological features suggestive of malignancy with local invasion. There was biochemical evidence of primary aldosteronism and a non-suppressed overnight dexamethasone suppression test. He underwent open left-sided adrenalectomy: histologically the tumour demonstrated features typical of a hepatoid carcinoma with bile production and immunohistochemical staining for Hep Par-1 and CD10 demonstrating a hepatic canalicular pattern. Adrenocortical-specific immunohistochemical markers (Inhibin and melan A) and neuroendocrine markers (synaptophysin and chromogranin) were negative. He did not have clinical or biochemical evidence of cirrhosis, Hepatitis B or C infection. Triple-phase CT scanning of the abdomen before resection of the adrenal lesion and five months following surgery did not show any significant lesion in the liver suggestive of primary hepatocellular carcinoma, except an 8 mm non enhancing benign-appearing cystic lesion.Conclusion: Most hepatoid adenocarcinomas originate from the gastro-intestinal tract. We present a patient with hepatoid adenocarcinoma masquerading as adrenocortical carcinoma due to misleading imaging and biochemical evidence. Very little is known about their pathogenesis, especially those with an atypical site of origin such as the adrenal gland.
Primary Hypoparathyroidism associated with chronic plaque psoriasis; A case report & review of literature
Authors: Ravindu K. A. N. , Antonypillai C. N. , Jegavanthan D. , Gajaweera G. M.
Published: August 2023

No abstract available
A case report on a rare combination of Gitelman syndrome and marfanoid body habitus in a young female
Authors: Gajaweera G. M. , Jegavanthan D. , Ravindu K. A. N. , Antonypillai C. N.
Published: August 2023

No abstract available
The effect of glycaemic control on neutralizing antibody response to COVID-19 among patients with Type 2 diabetes mellitus in the Kurunegala District of Sri Lanka; A prospective cohort study
Authors: Kottahachchi D. , Badanasinghe N. , Samarathunga P. , Sandeepani P. , Cooray S. , Warnakulasuriya T.
Published: August 2023

Background: The antibody response following COVID-19 vaccination among patients with diabetes mellitus (DM) is of particular concern given the increased risk of severe disease in this population. The correlation between glycaemic control among persons with DM and the antibody response was not published in Asian populations. Hence, this study aimed to determine whether glycaemic control has an association with the development of an adequate antibody response for SARS-CoV-2 among patients with DM following the administration of two doses of the COVID-19 vaccine.Methods: A prospective cohort study was carried out at three vaccination centers in the Kurunegala district from November 2021 to January 2022. Seventy-one patients with type 2 diabetes were recruited for this study and followed up on vaccination with the Sinopharm COVID-19 vaccine. HbA1 c levels at the first dose and after 6-8 weeks from the second dose of vaccine were analyzed. The neutralizing antibodies (NAbs) were analyzed using C Pass™ neutralizing antibody detection ELISA Kit following 6-8 weeks of the 2nd dose.Results: The median (IQR) age of the total population (63.4% females) was 53 years (44.0-58.0) and they were diagnosed with diabetes for 6 years (3-11 years). The median first and second HbAlc values were 9.3% (7.2-10.7%) and 8.2% (7.1-10.2%) respectively. From the total population, only 66.2% developed protective levels of NAbs after 6-8 weeks of the second dose of the vaccine. The second HbAlc value was significantly lower compared to the first (z=-2.63, p=0.008). There was no significant difference in terms of sex, age, duration of diabetes, pre-vaccination HbAlc level, or HbAlc level 6-8 weeks after the vaccination among those who developed protective levels of antibodies and those who did not (p>0.05). There was no difference in sero-conversion depending on the abnormal HbAlc value (.28%) (1st HbAlc p=0.957, 2nd HbAlc p=0.360).Conclusion: We did not detect an association between glycaemic control and sero-conversion. However, 1/3rd of patients with diabetes did not have a protective level of NAbs following 2 doses of Sinopharm COVID-19 vaccination. Furthermore, glycaemic control did not deteriorate with COVID-19 vaccination.
Enterococcus casseliflavus bacteremic infection of a right atrial thrombotic mass: first reported case
Authors: Mastroianni Antonio , Greco Sonia , Vangeli Valeria , Mauro Maria Vittoria , Greco Francesca , Manfredi Roberto
Published: August 2023

A unique episode of Enteroccus caselliflavus infected left atrial thrombotic mass is described and commented on the basis of the available literature i this field. Mobile enterococci, like Enterococcus gallinarum and E. casseliflavus/flavescens, usual inhabitants of poultry/pet gut, are infrequently transmitted to humans. Sparse case reports of human disease are present, usually in compromised and/or hospitalized hosts [9-23]. We herewith describe the first case of E. caSselliflavus infection of a left atrial mass, associated with bacteremia.
Role of CD36 in central nervous system diseases
Authors: Feng Min , Zhou Qiang , Xie Huimin , Liu Chang , Zheng Mengru , Zhang Shuyu , Zhou Songlin , Zhao Jian
Published: August 2023

CD36 is a highly glycosylated integral membrane protein that belongs to the scavenger receptor class B family and regulates the pathological progress of metabolic diseases. CD36 was recently found to be widely expressed in various cell types in the nervous system, including endothelial cells, pericytes, astrocytes, and microglia. CD36 mediates a number of regulatory processes, such as endothelial dysfunction, oxidative stress, mitochondrial dysfunction, and inflammatory responses, which are involved in many central nervous system diseases, such as stroke, Alzheimer’s disease, Parkinson’s disease, and spinal cord injury. CD36 antagonists can suppress CD36 expression or prevent CD36 binding to its ligand, thereby achieving inhibition of CD36-mediated pathways or functions. Here, we reviewed the mechanisms of action of CD36 antagonists, such as Salvianolic acid B, tanshinone IIA, curcumin, sulfosuccinimidyl oleate, antioxidants, and small-molecule compounds. Moreover, we predicted the structures of binding sites between CD36 and antagonists. These sites can provide targets for more efficient and safer CD36 antagonists for the treatment of central nervous system diseases.
Neurophysiological, histological, and behavioral characterization of animal models of distraction spinal cord injury: a systematic review
Authors: Han Bo , Liang Weishi , Hai Yong , Sun Duan , Ding Hongtao , Yang Yihan , Yin Peng
Published: August 2023

Distraction spinal cord injury is caused by some degree of distraction or longitudinal tension on the spinal cord and commonly occurs in patients who undergo corrective operation for severe spinal deformity. With the increased degree and duration of distraction, spinal cord injuries become more serious in terms of their neurophysiology, histology, and behavior. Very few studies have been published on the specific characteristics of distraction spinal cord injury. In this study, we systematically review 22 related studies involving animal models of distraction spinal cord injury, focusing particularly on the neurophysiological, histological, and behavioral characteristics of this disease. In addition, we summarize the mechanisms underlying primary and secondary injuries caused by distraction spinal cord injury and clarify the effects of different degrees and durations of distraction on the primary injuries associated with spinal cord injury. We provide new concepts for the establishment of a model of distraction spinal cord injury and related basic research, and provide reference guidelines for the clinical diagnosis and treatment of this disease.
Neural stem cells promote neuroplasticity: a promising therapeutic strategy for the treatment of Alzheimer’s disease
Authors: Chang Jun , Li Yujiao , Shan Xiaoqian , Chen Xi , Yan Xuhe , Liu Jianwei , Zhao Lan
Published: August 2023

Recent studies have demonstrated that neuroplasticity, such as synaptic plasticity and neurogenesis, exists throughout the normal lifespan but declines with age and is significantly impaired in individuals with Alzheimer’s disease. Hence, promoting neuroplasticity may represent an effective strategy with which Alzheimer’s disease can be alleviated. Due to their significant ability to self-renew, differentiate, and migrate, neural stem cells play an essential role in reversing synaptic and neuronal damage, reducing the pathology of Alzheimer’s disease, including amyloid-β, tau protein, and neuroinflammation, and secreting neurotrophic factors and growth factors that are related to plasticity. These events can promote synaptic plasticity and neurogenesis to repair the microenvironment of the mammalian brain. Consequently, neural stem cells are considered to represent a potential regenerative therapy with which to improve Alzheimer’s disease and other neurodegenerative diseases. In this review, we discuss how neural stem cells regulate neuroplasticity and optimize their effects to enhance their potential for treating Alzheimer’s disease in the clinic.
Single-neuron neurodegeneration as a degenerative model for Parkinson’s disease
Authors: Huenchuguala Sandro , Segura-Aguilar Juan
Published: August 2023

The positive effect of levodopa in the treatment of Parkinson’s disease, although it is limited in time and has severe side effects, has encouraged the scientific community to look for new drugs that can stop the neurodegenerative process or even regenerate the neuromelanin-containing dopaminergic nigrostriatal neurons. Successful preclinical studies with coenzyme Q10, mitoquinone, isradipine, nilotinib, TCH346, neurturin, zonisamide, deferiprone, prasinezumab, and cinpanemab prompted clinical trials. However, these failed and after more than 50 years levodopa continues to be the key drug in the treatment of the disease, despite its severe side effects after 4–6 years of chronic treatment. The lack of translated successful results obtained in preclinical investigations based on the use of neurotoxins that do not exist in the human body as new drugs for Parkinson’s disease treatment is a big problem. In our opinion, the cause of these failures lies in the experimental animal models involving neurotoxins that do not exist in the human body, such as 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and 6-hydroxydopamine, that induce a very fast, massive and expansive neurodegenerative process, which contrasts with the extremely slow one of neuromelanin-containing dopaminergic neurons. The exceedingly slow progress of the neurodegenerative process of the nigrostriatal neurons in idiopathic Parkinson’s patients is due to (i) a degenerative model in which the neurotoxic effect of an endogenous neurotoxin affects a single neuron, (ii) a neurotoxic event that is not expansive and (iii) the fact that the neurotoxin that triggers the neurodegenerative process is produced inside the neuromelanin-containing dopaminergic neurons. The endogenous neurotoxin that fits this degenerative model involving one single neuron at a time is aminochrome, since it (i) is generated within neuromelanin-containing dopaminergic neurons, (ii) does not cause an expansive neurotoxic effect and (iii) triggers all the mechanisms involved in the neurodegenerative process of the nigrostriatal neurons in idiopathic Parkinson’s disease. In conclusion, based on the hypothesis that the neurodegenerative process of idiopathic Parkinson’s disease corresponds to a single-neuron neurodegeneration model, we must search for molecules that increase the expression of the neuroprotective enzymes DT-diaphorase and glutathione transferase M2-2. It has been observed that the activation of the Kelch-like ECH-associated protein 1/nuclear factor (erythroid-derived 2)-like 2 pathway is associated with the transcriptional activation of the DT-diaphorase and glutathione transferase genes.
Chitosan-based thermosensitive hydrogel with long-term release of murine nerve growth factor for neurotrophic keratopathy
Authors: Wu Jie , Huang Yulei , Yu Hanrui , Li Kaixiu , Zhang Shifeng , Qiao Guoqing , Liu Xiao , Duan Hongmei , Huang Yifei , So Kwok-Fai , Yang Zhaoyang , Li Xiaoguang , Wang Liqiang
Published: August 2023

JOURNAL/nrgr/04.03/01300535-202403000-00045/inline-graphic1/v/2023-09-27T141015Z/r/image-tiff

Neurotrophic keratopathy is a persistent defect of the corneal epithelium, with or without stromal ulceration, due to corneal nerve deficiency caused by a variety of etiologies. The treatment options for neurotrophic keratopathy are limited. In this study, an ophthalmic solution was constructed from a chitosan-based thermosensitive hydrogel with long-term release of murine nerve growth factor (CTH-mNGF). Its effectiveness was evaluated in corneal denervation (CD) mice and patients with neurotrophic keratopathy. In the preclinical setting, CTH-mNGF was assessed in a murine corneal denervation model. CTH-mNGF was transparent, thermosensitive, and ensured sustained release of mNGF for over 20 hours on the ocular surface, maintaining the local mNGF concentration around 1300 pg/mL in vivo. Corneal denervation mice treated with CTH-mNGF for 10 days showed a significant increase in corneal nerve area and total corneal nerve length compared with non-treated and CTH treated mice. A subsequent clinical trial of CTH-mNGF was conducted in patients with stage 2 or 3 neurotrophic keratopathy. Patients received topical CTH-mNGF twice daily for 8 weeks. Fluorescein sodium images, Schirmer’s test, intraocular pressure, Cochet-Bonnet corneal perception test, and best corrected visual acuity were evaluated. In total, six patients (total of seven eyes) diagnosed with neurotrophic keratopathy were enrolled. After 8 weeks of CTH-mNGF treatment, all participants showed a decreased area of corneal epithelial defect, as stained by fluorescence. Overall, six out of seven eyes had fluorescence staining scores < 5. Moreover, best corrected visual acuity, intraocular pressure, Schirmer’s test and Cochet-Bonnet corneal perception test results showed no significant improvement. An increase in corneal nerve density was observed by in vivo confocal microscopy after 8 weeks of CTH-mNGF treatment in three out of seven eyes. This study demonstrates that CTH-mNGF is transparent, thermosensitive, and has sustained-release properties. Its effectiveness in healing corneal epithelial defects in all eyes with neurotrophic keratopathy suggests CTH-mNGF has promising application prospects in the treatment of neurotrophic keratopathy, being convenient and cost effective.
Assessment of Programmed Cell Death Ligand-1 Expression in Non-small Cell Lung Carcinomas by Immunohistochemistry
Authors: Mani Sandeep , Lakshmanan Archana , Subramanyan Annapurneswari
Published: August 2023

Background:

Non-small cell lung carcinomas (NSCLCs) expressing programmed cell death ligand-1 (PD-L1), a transmembrane protein, are more likely to respond to immunotherapy drugs. All advanced NSCLC samples should be examined with PD-L1 immunohistochemistry (IHC). PD-L1 is now the only approved predictive biomarker of immunotherapy response in NSCLC patients. This study evaluates the expression of PD-L1 in NSCLC by IHC and assesses the morphological and clinical correlation of PD-L1 expression.

Materials and Methods:

All patients with histologically proven NSCLC with needle core biopsies and resected specimens were analyzed in the department of pathology. The correlation of PD-L1 expression with morphological and clinical parameters was analyzed.

Results:

On evaluating PD-L1 expression in 97 cases of NSCLC, 61.85% ( n = 60) had positive PD-L1 staining. Among patients with a positive tumor proportion score, 22 had a history of smoking, 51 were ≥50 years old, 43 were male patients, 24 were in Stage IV, 44 had a history of chemotherapy or radiotherapy, 47 had adenocarcinoma, and 33 had Grade II tumors. The association of PD-L1 expression with various clinicopathological parameters such as gender, smoking status, histological type, histological grade, clinical tumor stage, previous treatment history, site and type of biopsy, necrosis, and peritumoral lymphoid response was not statistically significant.

Conclusion:

Our study indicated that PD-L1 expression was not associated with various clinicopathological variables in NSCLC. More research is needed to look into the probable factors that influence the PD-L1-positive distribution. Since expression of the PD-L1 protein is proven to be of therapeutic and prognostic significance, we recommend that testing for PD-L1 should be done at least in cases of advanced-stage NSCLC.
Persistent Postural-perceptual Dizziness: A Review
Authors: Swain Santosh Kumar
Published: August 2023

Introduction:

Persistent postural-perceptual dizziness (PPPD) is characterized by chronic subjective dizziness, phobic postural vertigo, and related disorders. For at least 3 months, it exhibits varying symptoms of vertigo, unsteadiness, or dizziness.

Methods:

Research articles regarding PPPD were searched by viewing the Scopus, PubMed, Medline, and Google Scholar databases online. A search strategy using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis was used.

Results:

It presents a typical chronic vestibular system and brain malfunction that result in persistent dizziness, nonspinning vertigo, and/or unsteadiness. Persistent nonvertiginous dizziness and hypersensitivity to motion and visual stimuli are the main signs and symptoms of PPPD. These symptoms appeared either when there were no active neuro-otologic illnesses or when an episodic vestibular condition was present but could not completely account for the symptoms. Psychological mechanisms that resemble cognitive models of health anxiety and panic disorder are involved in the PPPDs development and maintenance.

Conclusion:

Since PPPDs diagnostic criteria only involve symptoms, the patient's clinical history is crucial in making the diagnosis. Once diagnosed, effective communication and personalized treatment plans, such as serotonergic medicines, cognitive behavioral therapy, and specialized physical therapy (vestibular rehabilitation), help manage PPPD. Since PPPD is a relatively recent clinical diagnosis, many medical practitioners who treat patients who feel dizzy are unfamiliar with it.
Epidemiology, Clinical Characteristics, and Outcomes of Culture-negative Sepsis
Authors: Byrappa Varun , Venkataraman Ramesh , Ramakrishnan Nagarajan , Mani Ashwin Kumar
Published: August 2023

Aim:

Culture-negative sepsis (CNS) is a common but understudied entity. The objective of this study was to compare the incidence, characteristics, and outcomes of CNS with culture-positive sepsis (CPS).

Methods:

This was a prospective observational study of patients admitted to the medical intensive care unit (ICU) of a tertiary hospital from January to December 2015 with clinical suspicion of severe sepsis as defined by Consensus Conference Criteria 2001.

Results:

Patients with severe sepsis ( n = 122) were studied of whom 66 (54%) were CPS and 56 (46%) were CNS. Patients with CNS had fewer comorbidities (0.7 ± 0.70 vs. 2 ± 0.8, P < 0.01). At presentation, CNS patients had less tachycardia (heart rate 92.5 ± 10.5 vs. 105.9 ± 13.2, P < 0.01), lower white blood cell counts (11859 ± 4791 vs. 14224 ± 3898, P = 0.003), lower need for vasopressors (38% vs. 68%, P < 0.01), and mechanical ventilation (23% vs. 53%, P < 0.01) compared to patients with CPS. The number of antibiotics on admission was similar between the groups (1.5 ± 0.6 vs. 1.6 ± 0.6, P = 0.36) but the duration of antibiotics was less in CNS (7.6 ± 1.7 days vs. 10.4 ± 2.6 days, P < 0.01). CNS had lower duration of ICU stay (6 ± 2.1 days vs. 7.8 ± 3.7 days, P < 0.01) and lower ICU mortality (7.1% vs. 22.7%, P = 0.02).

Conclusion:

CNS is very common in ICU. CNS patients compared to CPS tend to be less sick at presentation utilizing less resources but were initiated on a similar number of antibiotics on admission although for a shorter duration. Patients with CNS had a lower mortality in comparison to those with CPS.
Prevalence of Mental Health Problems among School-going Adolescents in Melmaruvathur: An Observational Study
Authors: Chandrasekar Sashidharan
Published: August 2023

Introduction:

Around 2.2 billion of the world's population are children and adolescents. Ninety percentage live in low-and middle-income countries, where they make up 30%–50% of the population. This study examines mental health issues and their association with gender in Melmaruvathur, teenage school children.

Materials and Methods:

After receiving approval from the Ethics Committee, a descriptive cross-sectional questionnaire-based study was carried out on adolescents who were attending school in Melmaruvathur. The participants in the study filled out the questionnaires. The power of the study was set at 80%, and the significance level was set at 0.05. The estimated size of the sample was 500. The duration of the study was approximately 1 ½ years, beginning on June 1, 2021, and ending on December 30, 2022. The age range was anywhere between 11 and 17 years, participants had to be adolescents who attended school. Those who had participated in mental health training programs in the past were not allowed to participate.

Results:

There were about 43.4% of females and 56.6% of males among the study participants. About 3.0% had very high conduct problems, 5.80% had high conduct problems, 1.4% had very high hyperactivity, around 1.80% had very high emotional problems, around 7.40% had very high peer problems, and 6.80% had very low prosocial. There was no statistically significant difference between the genders regarding conduct problems, hyperactivity problems, emotional problems, peer problems, and prosocial. In the case of females, 77.52% had a total difficulty score that was quite close to the average and in males, 81.53% received a total difficulty score that was quite close to the average.

Conclusion:

The findings are significant for several reasons, including the understanding of gender-specific vulnerabilities, the creation of youth mental health interventions that are more specifically focused on youth, and the peculiarities of the home setting.
Effect of Oral Clonidine and Gabapentin as Premedication on Intraoperative Hemodynamic Responses and Postoperative Analgesia Requirement in Laparoscopic Cholecystectomy
Authors: Tyagi Megha , Kour Arvin Preet , Singh Ajaydeep , Gupta Ritu , Prasad Ram Nandan
Published: August 2023

Background:

Laparoscopic cholecystectomy pain is a sensory and emotional experience connected with actual or potential tissue damage. Effective pain control is quite important, with around 70% of patients still complaining of moderate-to-severe pain postoperatively. Uncontrolled perioperative pain may raise patient morbidity and mortality rates. Both gabapentin and clonidine as premeditated can be easily administered have minimal side effects, are easily available at a low price, both them have a sedative effect that can decrease anxiety and they can blunt the stress response. Moreover, both drugs have anti-nociceptive effects that may be beneficial for controlling postoperating pain which is the basis of our current study.

Aims:

This study aims to compare the efficacy of oral clonidine with gabapentin before induction of anesthesia in attenuating hemodynamic stress response to laryngoscopy, intubation, and carbon dioxide pneumoperitoneum in laparoscopic cholecystectomy and to compare the efficacy of oral clonidine with oral gabapentin for postoperative pain control.

Materials and Methods:

Hundred patients undergoing laparoscopic surgery and qualifying inclusion criteria were randomly allocated into two groups each containing 50 patients. Group I patients were given Tab. Clonidine (300 μg) and Group II patients were given tablet Gabapentin (600 mg) orally 60 min before induction of general anesthesia. Hemodynamic changes and the incidence of postoperative pain in both groups were measured and compared.

Results:

Hemodynamic blunting to pressor stress of laryngoscopy and intubation was seen in both groups with better results obtained in the group receiving clonidine in the form of lesser variations in heart rate, systolic blood pressure, and diastolic blood pressure. Postoperative analgesia was achieved in both groups but gabapentin showed a better analgesic profile in the form of lesser Visual Analog Scale scoring and decreased utilization of rescue analgesia.

Conclusion:

Clonidine (300 μg) cause a greater attenuation of intraoperative hemodynamic stress responses, whereas gabapentin (600 mg) provides superior postoperative analgesia.
Impact of Pulmonary Rehabilitation on Recuperation of Moderate-to-Severe Coronavirus Disease 2019 Patients in Western India
Authors: Singh Manoj K , Annamalai K M
Published: August 2023

Background:

Coronavirus disease 2019 (COVID-19) virus has caused widespread Acute Respiratory Disease globally since 2020. Patients with evidence of lower respiratory illness either clinically or radiologically had moderate-to-severe illness. COVID respiratory and nonrespiratory symptoms (psychological and cognitive) noticed after 4–8 weeks of primary disease were called long COVID syndrome. Survivors of moderate-to-severe disease had a poor quality of life. The main objective of this retrospective study was to assess the role of outpatient pulmonary rehabilitation (PR) done in moderate-severe COVID-19 survivors who had symptoms after 4–8 weeks at Shaivam Lung Rehabilitation Centre, Ahmedabad.

Methods:

We analyzed the impact of PR on 30 patients' post-COVID-19 who were willing to participate during the ongoing pandemic. It was an outpatient 6–8 weeks of program designed to target respiratory and general muscle training, relaxation technique, nutritional counseling, occupational and psychological support. Patients were tested with of combination of self-assessment quality of life scale (adapted from short form 36 questionnaire), muscle training, dyspnea scale, and physical assessment. The standard objective assessment included oxygenation index (SpO2/FiO2 ratio), 6 min walk distance (6 MWD), Modified Medical Research Council (MMRC) score, manual muscle testing (MMT) along with pulmonary function testing. All these subjective and objective variables were tested pre- and post-PR program to assess the impact on defined parameters.

Results:

From December 2020 to March 2022, we studied the impact of PR on 30 out of 55 patients fitting into the inclusion criteria. Significant benefit was noted in subjective Short Form 36 (SF 36) score and objective (6 MWD, MMRC, oxygenation, MMT) quality of life post-PR program ( P < 0.001). Improvement in spirometry was not statistically significant, indicating structural chronicity of COVID pulmonary fibrosis.

Conclusion:

PR is safe, effective, and feasible on an outpatient basis in COVID-19 survivors of illness with poor quality of life. Further research is required to prove its widespread benefit in such patients.
Do histone deacetylase 1 (HDAC1) and retinoblastoma-associated protein have a synergistic role in the determination of prognosis in renal cell carcinoma? An immunohistochemical study
Authors: Al-Sharaky Dalia R. , Abdou Asmaa G. , El Maged Moselhy Aliaa A. , Aziz Reham A.A. , El-Dien Marwa M. Serag
Published: August 2023

Background

Renal cell carcinoma (RCC) is the most common solid tumor of the kidney and the most lethal of all urological malignancies. Poor prognosis of RCC is caused by that third of patients presented by metastasis and half of them die due to disease. More research is needed to identify molecular markers that could lead to advances in personalized medicine.

Aim

We aimed to evaluate the protein expression of histone deacetylase 1 (HDAC1) and retinoblastoma-associated protein (RbAp48) in RCC and their relation to the clinicopathological parameters including survival.

Materials and methods

Fifty-one RCC cases were included in five tissue microarray blocks. Histopathological, clinical, and survival data were collected from patients’ records in Pathology, Clinical Oncology, and Nuclear Medicine Departments, Faculty of Medicine, Menoufia University. All cases were subjected to immunostaining by HDAC1 and RbAp48 antibodies. Expression of both was evaluated by different methods, including percentage, H score, and immunoreactivity score.

Results

No significant associations were noticed between neither HDAC1 nor RbAp48 expression and the studied clinicopathological variables. High expression of RbAp48 is significantly associated with shorter overall survival. Moreover, RbAp48 percentage of expression is an independent bad prognostic factor (beta=−0.634, P=0.001).

Conclusion

RbAp48 percentage of expression may be a promising independent bad prognostic factor in RCC. RbAp48 could play an essential role in RCC prognosis independent of HDAC1. Further studies are needed to identify specific HDAC isoforms essential in RCC tumorigenesis to be targeted by specific HDAC inhibitors. Also, molecular research will be helpful to clarify the pathways that help RbAp48 executing its bad prognostic effect in the scarcity of HDAC1.
Evaluation of the role of tight junction molecules
Authors: El-Fattah Ghada A. Abd , Said Eman M. , Roshdy Rania G.
Published: August 2023

Background

According to the results of the National Population-based Cancer Registry Program, bladder cancer is the second most common cancer after liver cancer that is prevalent among Egyptian males. About 70% of bladder cancers are diagnosed as nonmuscle invasive cancers with high risk of recurrence, besides the risk of progression to muscularis propria invasion. The challenge is to identify noninvasive cancers using a reliable method for accurate diagnosis as well as for predicting the prognosis.

Aim

We aimed to evaluate the immuno-histochemical expression of claudin-1 (CLDN-1) and CLDN-4 in invasive and noninvasive urothelial lesions and correlate them with clinicopathological findings.

Patients and methods

This retrospective study included 36 different cases of urinary bladder lesions: 30 cases of urothelial carcinomas (UCs) and six papillary urothelial neoplasms of low malignant potential in addition to six normal control cases. Cases were graded according to the WHO classification and staged according to the TNM pathological staging system. Slides were subjected to immunohistochemical staining by CLDN-1 and CLDN-4.

Results

CLDN-1 showed the highest level of expression among carcinoma cases, while CLDN-4 showed the highest expression among control cases (P<0.000 for both). Increased CLDN-1 expression was significantly related to muscle invasion (P=0.000), advanced T stage (P=0.000), and high tumor grade (P=0.012). CLDN-4 expression showed a statistically significant difference in UCs without muscle invasion (P=0.000), earlier T stage, and low tumor grade (P=0.006).

Conclusion

CLDN-1 and CLDN-4 could be used as potential markers to differentiate invasive from noninvasive and low grade from high grade UC. They can predict the clinical outcome and play a role in the assessment of patients with UC.
Evaluation of the expression and role of adenosine receptor and programmed death ligand-1 in bladder urothelial carcinoma
Authors: Abd El-Fattah Ghada A. , Shalan Naglaa H. , El Sawi Rasha M.
Published: August 2023

Background

Immune-checkpoint molecules are important regulators of physiologic inflammatory responses, and are highly effective in behavior of many cancers. They are involved in production of antitumor immune response. This study aims to evaluate the expression and role of both programmed death ligand-1 (PDL-1) and adenosine receptor (A2aR) antibodies in bladder urothelial cancer.

Materials and methods

This was a retrospective study on 45 bladder urothelial cancers obtained from archives of Pathology Department, Faculty of Medicine, Benha University and from International Medical Center Hospital (IMC) during the period from January 2015 to December 2019. Immunohistochemical expression of A2aR was evaluated and compared with those of PDL-1. A2aR expression was also correlated with tumor-infiltrating CD8+T cells. Relations to demographic data of the patients were evaluated.

Results

PDL-1 expression was detected in 24.4% of tumor cells±immune cells. PDL-1 was significantly related to advanced PT stage (P<0.01), detrusor muscle invasion (P<0.05), and nonpapillary tumor histology (P<0.05). High expression of A2aR was detected in 40% of tumor specimens in tumor cells±immune cells. Higher A2aR expression was statistically significant related to higher tumor grade (P<0.05), advanced PT stage (P<0.01), detrusor muscle invasion (P<0.01), and nonpapillary tumor histology (P<0.01). The expression of A2aR was statistically significant related to PDL-1 expression (P<0.01). Higher A2aR expression was statistically related to lower the density of tumor-infiltrating CD8+T lymphocytes (P<0.01). Using receiver operating characteristic curve, A2aR was more accurate than PDL-1 as area under the curve (0.648 and 0.565, respectively). The specificity of A2aR is higher than PDL-1 (51.9 and 29.6, respectively).

Conclusion

Both PDL-1 and A2aR markers could be useful in monitoring urothelial bladder cancer immunotherapy. A2aR is higher to and more specific than PDL-1 in predicting tumor lymphocytic infiltrate. A2aR antagonists could have a positive role in cases that are resistant to anti-PDL-1 immunotherapy.
E-cadherin immunohistochemical expression in gastric carcinoma in relation to different clinicopathological parameters
Authors: Edin Hala S.E. Alaa , El Sayed Salah M. , Bakheet Rafaat A. , Allithy Amal N.A.
Published: August 2023

Background

Gastric cancer (GC) is an aggressive malignancy and a common cause of cancer-related deaths worldwide. E-cadherin is a transmembrane calcium-dependent epithelial cell adhesion molecule. Loss of E-cadherin-mediated cell–cell adhesion is needed for tumor cell invasion and metastasis. Cells with mutated E-cadherin demonstrate increased motility, show altered organization of their actin cytoskeleton, and are associated with metastases, thereby providing evidence for its role as an invasion suppressor.

Objectives

To assess the prognostic value of E-cadherin expression in GC and to evaluate its correlations with other prognostic parameters.

Materials and methods

Immunohistochemical E-cadherin expression was studied in 36 cases of GC (24 cases of endoscopic biopsies and 12 cases of total gastrectomy), and the results were correlated with clinicopathological parameters.

Results

E-cadherin was positive in 15/36 (41.7%) cases of GC. A significant inverse correlation was found between E-cadherin expression and tumor grade, number of lymph nodes involved by metastasis, and Helicobacter pylori positivity, with P values of 0.02, 0.04, and 0.03, respectively.

Conclusion

E-cadherin loss plays an important role in invasion and metastasis potential in GC, and decrease or loss of its expression is predictive of poor prognosis. H. pylori plays an important role in gastric carcinogenesis, and it induces a statistically significant decrease in E-cadherin expression, so eradication of H. pylori infection can stop or decrease the progression of carcinogenesis.
Clinicopathological relation of CD10 and cyclooxygenase-2 expression in invasive breast cancer no special type
Authors: Sayed Rasha M.S. , Ghanam Walaa Abd El Gawad , Bebars Shaimaa M.M.
Published: August 2023

Background

In breast cancer, which is the most frequent female cancer, new histopathologic parameters, such as tumor-infiltrating lymphocytes and stromal factors, are now introduced for prognosis and new strategies of therapy. This study was designed to explore CD10 and cyclooxygenase-2 (COX2) expression levels in invasive duct carcinoma (IDC) no special type (NST) and their relations with clinicopathological data.

Methods

This work was conducted on 40 cases of IDC of NST that were collected as paraffin-embedded blocks. For each case, sections of paraffin-embedded blocks were submitted to be stained with routine hematoxylin and eosin and other sections were stained using the immunohistochemistry technique with CD10 and COX2 antibodies and then evaluated and scored.

Results

CD10 was expressed in nearly half of the cases (45%), whereas COX2 was detected in all of the cases (100%). COX2 was strongly expressed in more than two-thirds of the cases. A significant association was detected between CD10 and lymph node status (P=0.017). Although no significant association could be detected, about one-fourth and one-third of cases with marked estrogen receptor and progesterone receptor expressions, respectively, had strong CD10. No significant association could be detected between COX2 and all studied clinical and histological data, including CD10 expression. However, COX2 was expressed more frequently in negative human epidermal growth factor receptor 2/neu and high Ki-67 cases. Cases with associated carcinoma in situ, detected vascular emboli, and lymph node positivity expressed COX2 score 4.

Conclusion

A significant association was found between CD10 and lymph node staging. COX2 was detected in all studied cases, with tendency to be associated with bad prognostic indicators. These findings suggest that CD10 and COX2 could contribute to tumor aggressiveness and progression in IDC NST.
Diagnostic accuracy of combined MUC5A, S100P, and von Hippel-Lindau in differentiating intrahepatic cholangiocarcinoma from metastatic pancreaticobiliary carcinomas presented as hepatic focal lesions
Authors: Shakweer Marwa M. , Elgohary Shimaa A. , Hafez Fatma S.
Published: August 2023

Background

Sometimes differentiation between intrahepatic cholangiocarcinoma (ICC) and metastatic pancreaticobiliary carcinoma (mPBC) could be challenging, and it is of great importance owing to different treatment modalities. We aimed to measure the diagnostic accuracy of MUC5A, von Hippel-Lindau (VHL), and S100p in differentiating ICC from mPBC in hepatic focal lesions.

Patients and methods

The study included 70 cases of liver biopsies presented as hepatic focal lesions divided into two groups: group 1: 40 cases of mPBC and group 2: 30 cases of ICC.

Results

There was a highly statistically significant difference regarding MUC5A, S100P, and VHL expression between both groups (P<0.001). mPBC showed MUC5A in 87.5%, S100P in 95%, and VHL in 5%. However, cases of ICC showed positive MUC5A in 10%, S100P in 29.6%, and VHL in 80%. Regarding the validity of diagnosing mPBC, S100P had the highest sensitivity (95%), whereas both panels of (MUC5A−/S100P+/VHL−) and (MUC5A+/S100P+/VHL−) showed the highest specificity and positive predictive values (100%). Regarding the validity for diagnosing ICC, VHL had the highest sensitivity (80%), whereas (MUC5A−/S100P−/VHL+) showed the highest specificity and positive predictive value (100%).

Conclusion

These results indicate the validity of combined MUC5A, S100P, and VHL as a highly sensitive and specific panel for differentiating ICC from mPBC.
A comparative study of laparoscopic versus laparotomy repair of perforated peptic ulcer: A prospective study
Authors: Saleem Abd-El-Aal A. , Arafa Mohamed W. , Galal Abdelrahman M.
Published: August 2023

Background

Laparoscopic surgery is still gaining popularity in conditions associated with peritonitis, such as a perforated peptic ulcer.

Aim of the work

This study aimed to compare laparoscopic and laparotomy repair of perforated peptic ulcers regarding intraoperative parameters, postoperative pain, time of the start of oral feeding, postoperative complication, hospital stay, resuming normal activity, and outcomes.

Patients and methods

This is a prospective study of 50 patients (males and females), of any age with perforated peptic ulcer. Those patients will be divided by the random serial number method into two groups: the
laparoscopic group
and the
open (laparotomy) group.
In a period from 15th April 2022 to 15th February 2023 data related to patients were recorded and subjected to analysis.

Results

All patients were divided into two groups:
Laparoscopic group
with 25 patients (23 of them underwent successful laparoscopic repair and two patients were converted to open) and the
open (laparotomy) group
with 25 patients underwent laparotomy repair (of which 23 patients were living, and two patients died on the third and tenth postoperative days). There were no significant differences in baseline characteristics between both groups in terms of age, gender, special habits, preoperative risk factors, comorbidities, laboratory, and radiological findings; also both groups showed insignificant differences regarding the American Society of Anesthesiologists (ASA) scores (P=0.83), total Boey’s score (P=0.77), shock on admission (P= 1.00), and the duration of symptoms > 24 hours (P= 0.77). Operative time was significantly increased in the laparoscopic versus open group (P=0.0001). While, first-day pain score (VAS), opioid requirements, time of starting oral feeding, length of hospital stay, and return to normal activity were highly significantly decreased in laparoscopic repair compared with open repair (P= <0.0001 for each). Total postoperative complications showed insignificant difference between the studied groups (P=0.16), but they were more prevalent between the open group (14 patients, 56%) versus the laparoscopic group (9 patients, 36%). Good cosmetic results of wounds were more prevalent in the laparoscopic group [20 patients (80.00%)] than the open group [13 patients (56.52%)], but insignificant, P=0.17.

Conclusion

Laparoscopic repair had an upper hand over open repair regarding less intraoperative blood loss, less postoperative pain, requiring less postoperative analgesia, early starting of oral feeding, less postoperative complications, shorter hospital stay, early return to normal activity, and good cosmetic results of wounds.