Atherosclerosis is a chronic inflammatory disease associated with cardiovascular dysfunction including myocardial infarction, unstable angina, sudden cardiac death, stroke and peripheral thromboses. It has been predic...Atherosclerosis is a chronic inflammatory disease associated with cardiovascular dysfunction including myocardial infarction, unstable angina, sudden cardiac death, stroke and peripheral thromboses. It has been predicted that atherosclerosis will be the primary cause of death in the world by 2020. Atherogenesis is initiated by endothelial injury due to oxidative stress associated with cardiovascular risk factors including diabetes mellitus, hypertension, cigarette smoking, dyslipidemia, obesity, and metabolic syndrome. The impairment of the endothelium associated with cardiovascular risk factors creates an imbalance between vasodilating and vasoconstricting factors, in particular, an increase in angiotensin Ⅱ(Ang Ⅱ) and a decrease in nitric oxide. The renin-angiotensin system(RAS), and its primary mediator Ang Ⅱ, also have a direct influence on the progression of the atherosclerotic process via effects on endothelial function, inflammation, fibrinolytic balance, and plaque stability. Anti-inflammatory agents [statins, secretory phospholipase A2 inhibitor, lipoprotein-associated phospholipase A2 inhibitor, 5-lipoxygenase activating protein, chemokine motif ligand-2, C-C chemokine motif receptor 2 pathway inhibitors, methotrexate, IL-1 pathway inhibitor and RAS inhibitors(angiotensin-converting enzyme inhibitors)], Ang Ⅱ receptor blockers and ranin inhibitors may slow inflammatory processes and disease progression. Several studies in human using anti-inflammatory agents and RAS inhibitors revealed vascular benefits and reduced progression of coronary atherosclerosis in patients with stable angina pectoris; decreased vascular inflammatory markers, improved common carotid intima-media thickness and plaque volume in patients with diagnosed atherosclerosis. Recent preclinical studies have demonstrated therapeutic efficacy of vitamin D analogs paricalcitol in Apo E-deficient atherosclerotic mice.展开更多
The last 3 decades have witnessed great improvements in the technology and clinical applications of many minimally invasive procedures in the urological field.Flexible ureteroscopy(fURS)has advanced considerably to be...The last 3 decades have witnessed great improvements in the technology and clinical applications of many minimally invasive procedures in the urological field.Flexible ureteroscopy(fURS)has advanced considerably to become a widely utilized diagnostic and therapeutic tool for multiple upper urinary tract pathologies.The most common indication for fURS is the treatment of upper urinary tract stones with the aid of Holmium:Yttrium Aluminium Garnet(YAG)laser lithotripsy.Advancements in endoscope technologies and operative techniques have lead to a broader application of fURS in the management of urolithiasis to include larger and more complex stones.fURS has proved to be an effective and safe procedure with few contraindications.Continued progression in fURS may increase its clinical applicability and supplant other procedures as the first line treatment option for urolithiasis.展开更多
AIM: To investigate -765G > C COX-2 polymorphism and H pylori infection in patients with gastric adenocarcinoma, peptic ulcer disease (PUD) and non- ulcer dyspepsia (NUD). METHODS: We enrolled 348 adult patients (6...AIM: To investigate -765G > C COX-2 polymorphism and H pylori infection in patients with gastric adenocarcinoma, peptic ulcer disease (PUD) and non- ulcer dyspepsia (NUD). METHODS: We enrolled 348 adult patients (62 gastric adenocarcinoma, 45 PUD and 241 NUD) undergoing upper gastrointestinal endoscopy at two referral centers between September, 2002 and May, 2007. H pylori infection was diagnosed when any of the four tests (RUT, culture, histopathology and PCR) were positive. Genotyping for -765G > C polymorphism of COX-2 was performed by PCR-RFLP analysis. RESULTS: Frequency of C carrier had significantassociation with gastric adenocarcinoma as compared to NUD [77.4% vs 29%, P < 0.001, odds ratio (OR) 8.20; 95% confidence interval (95% CI), 4.08-16.47] and PUD (77.4% vs 31.1%, P < 0.001; OR 8.04; 95% CI, 3.25-19.90). Risk of gastric adenocarcinoma was significantly higher in patients having C carrier with (OR 7.83; 95% CI 3.09-19.85) and without H pylori infection (OR 7.06; 95% CI, 2.61-19.09). Patients with C carrier and H pylori infection had significant risk for the development of PUD (P < 0.001; OR 5.65; 95% CI, 2.07-15.34). CONCLUSION: -765G > C COX-2 polymorphism with or without H pylori could be a marker for genetic susceptibility to gastric adenocarcinoma. COX-2 polymorphism in presence of H pylori infection might be useful in predicting the risk of PUD.展开更多
Nigella sativa(N.sativa)(Family Ranunculaceae)is a widely used medicinal plant throughout the world.It is very popular in various traditional systems of medicine like Unani and Tibb,Ayurveda and Siddha.Seeds and oil h...Nigella sativa(N.sativa)(Family Ranunculaceae)is a widely used medicinal plant throughout the world.It is very popular in various traditional systems of medicine like Unani and Tibb,Ayurveda and Siddha.Seeds and oil have a long history of folklore usage in various systems of medicines and food.The seeds of N.saliva have been widely used in the treatment of different diseases and ailments.In Islamic literature,it is considered as one of the greatest forms of healing medicine.It has been recommended for using on regular basis in Tibb-e-Nabwi(Prophetic Medicine).It has been widely used as antihypertensive,liver tonics,diuretics,digestive,anti-diarrheal,appetite stimulant,analgesics,anti-bacterial and in skin disorders.Extensive studies on N.sativa have been carried out by various researchers and a wide spectrum of its pharmacological actions have been explored which may include antidiabetic,anticancer,immunomodulator,analgesic,antimicrobial,anti-inflammatory,spasmolytic,bronchodilator,hepato-protective,renal protective,gaslro-prolective,antioxidant properties,etc.Due to its miraculous power of healing,N.sativa has got the place among the top ranked evidence based herbal medicines.This is also revealed that most of the therapeutic,properties of this plant are due to the presence of thymoquinone which is major bioactive component of the essential oil.The present review is an effort to provide a detailed survey of the literature on scientific researches of pharmacognostical characteristics,chemical composition and pharmacological activities of the seeds of this plant.展开更多
AIM： To undertake analysis of hepatitis A viral load, alanine aminotransferase （ALT）, and viral genotypes with duration of viremia, and to correlate these parameters with CD4^＋/ CD8^＋ lymphocyte populations that ...AIM： To undertake analysis of hepatitis A viral load, alanine aminotransferase （ALT）, and viral genotypes with duration of viremia, and to correlate these parameters with CD4^＋/ CD8^＋ lymphocyte populations that control cell-mediated immunity. METHODS： Cell counts were carried out using fresh whole blood collected in EDTA vials using a fluorescence activated cell sorter. Hepatitis A virus （HAV） RNA was extracted from blood serum, reverse transcribed into cDNA and quantified by Real-Time polymerase chain reaction and was genotyped. RESULTS： Among 11 patients, 10 could be analyzed completely. Of these, 3 had severe acute hepatitis （s-AH） and the remainder had a self-limited acute hepatitis A （AHA）, with one patient with fulminant disease （encephalopathy Grade IV） dying on the 4^th d. The ALT level was significantly higher both in AHA （1070.9±894.3; P = 0.0014） and s-AH （1713.9±886.3; P = 0.001） compared to normal controls （23.6±7.2）. The prothrombin time in s-AH patients （21.0 ±2.0; P=0.02） was significantly higher than in AHA （14.3±1.1;P = 0.44）. The CD4^＋/CD8^＋ ratio in AHA patients （1.17 ＋ 0.11; P = 0.22） and s-AH （0.83 ＋ 0.12; P = 0.0002） were lower than seen in normal healthy controls （1.52）. Self-limited cases had peak viral load at the beginning of analysis while in s-AH patients this occurred at the 15TM or 30^th d. In acute and severe groups, one patient each belonged to genotype IA, with the remaining 8 cases belonging to genotype IIIA. The only fulminant hepatic failure case belonged to genotype IA. HAV viral load and AIT values collected during the entire course of the selflimited infection were directly correlated but this was not the case for s-AH patients.CONCLUSION： Based on a small-scale study, the persistently higher viral load of s-AH might be due to diminished cellular immunity and hemolysis. The duration of viremia was dependent on the host, as the viral genotype had no apparent role in clinical outcome of AVH and s-AH展开更多
Epidemiological, preclinical and clinical studies es-tablished the association between high alcohol con-sumption and hypertension. However the mechanism through which alcohol raises blood pressure remains elusive. Sev...Epidemiological, preclinical and clinical studies es-tablished the association between high alcohol con-sumption and hypertension. However the mechanism through which alcohol raises blood pressure remains elusive. Several possible mechanisms have been pro-posed such as an imbalance of the central nervous system, impairment of the baroreceptors, enhanced sympathetic activity, stimulation of the renin-angio-tensin-aldosterone system, increased cortisol levels, increased vascular reactivity due to increase in intracel-lular calcium levels, stimulation of the endothelium to release vasoconstrictors and loss of relaxation due to inflammation and oxidative injury of the endothelium leading to inhibition of endothelium-dependent nitric oxide production. Loss of relaxation due to inflamma-tion and oxidative injury of the endothelium by angio-tensin II leading to inhibition of endothelium-dependent nitric oxide production is the major contributors of the alcohol-induced hypertension. For the prevention of alcohol-induced hypertension is to reduce the amount of alcohol intake. Physical conditioning/exercise trainingis one of the most important strategies to prevent/treat chronic alcohol-induced hypertension on physiological basis. The efficacious pharmacologic treatment includes the angiotensin-converting enzyme(ACE) inhibitors or angiotensin Ⅱ type 1 receptor blockers(ARBs) which have antioxidant activity and calcium channel blockers. The most effective prevention and treatment of alcohol-induced hypertension is physical exercise and the use of ACE inhibitors or ARBs in the展开更多
Triassic-Jurassic carbonates widely distributed in Eastern Indonesia are believed as oils source rock. The Mesozoic Tokala Formation exhibit source rock potential, as evidenced by high contents of organic matter. Rece...Triassic-Jurassic carbonates widely distributed in Eastern Indonesia are believed as oils source rock. The Mesozoic Tokala Formation exhibit source rock potential, as evidenced by high contents of organic matter. Recent exploration has been conducted in southeastern Sulawesi, targeting the Mesozoic intervals. Therefore, in this study, we attempted to determine source rock potential of Tokala Formation outcropped in southeastern Sulawesi area and its capability to generate hydrocarbon. Five distinct lithofacies were delineated, emphasizing lithological and mineralogical features: foraminifera wackestone (FW), lime mudstone (LM), massive bioturbated calcareous-argillaceous shale (MBCAS), weakly laminated argillaceous-calcareous shale (WLACS), and strongly laminated calcareous-argillaceous shale (SLCAS). Subsequent analyses showed that carbonate-rich samples (FW and LM facies, >50% CaO) had poor source rock potential. Conversely, shale facies with moderate carbonate content (WLACS, MBCAS, and SLCAS, 15% - 50% CaO) had good to excellent source rock characteristics, qualifying them as preferable source rock. In addition, levels of SiO2 and Al2O3 should not be neglected, as these constituents play important roles in clay mineral adsorption. Laminated shale facies with moderate CaO content tended to be more promising as source rock than bioturbated facies. The shale facies of Tokala Formation indicate prospective source rock horizon.展开更多
May-Heglin Anomaly is an autosomal dominant disorder characterized by macrothrombocytopenia with a platelet function that is usually preserved. Platelets play an essential role in hemostasis. During pregnancy, a woman...May-Heglin Anomaly is an autosomal dominant disorder characterized by macrothrombocytopenia with a platelet function that is usually preserved. Platelets play an essential role in hemostasis. During pregnancy, a woman is susceptible to complications, including postpartum hemorrhage. Monitoring patients’ hemostatic functions and observing the patient’s clinical picture to maintain patient safety is paramount, while avoiding unnecessary therapeutic measures. This case report presents a rare instance of May-Heglin Anomaly (MHA) in a 35-year-old pregnant patient, with refractory thrombocytopenia despite receiving multiple platelet transfusions. Initially referred to as gravida 5 para 4 with severe thrombocytopenia at 28 weeks gestation, throughout her pregnancy, she was closely monitored and received over 40 units of platelets, which failed to increase her platelet count significantly. She delivered a healthy baby via vaginal delivery at 38 weeks, with her platelet count still critically low. This report highlights the challenges of managing MHA in pregnancy, the inefficacy of standard thrombocytopenia treatments such as platelet transfusion in MHA patients, and the importance of tailored management strategies to ensure maternal and fetal safety.展开更多
Recent evidence of research has been proposed that the phosphoinositide 3-kinase(PI3K) pathway is noticeable target for searching novel anticancer agents. The phosphoinositide 3-kinase(PI3K) is accountable for harmoni...Recent evidence of research has been proposed that the phosphoinositide 3-kinase(PI3K) pathway is noticeable target for searching novel anticancer agents. The phosphoinositide 3-kinase(PI3K) is accountable for harmonizing a diverse range of cell functions, such as transcription, proliferation, cell survival, cell growth, degranulation, vesicular trafficking and cell migration, which are mostly involved in carcinogenesis. Particularly, PI3K-mediated signaling molecules and its effects on gene expression contribute to tumorigenesis. PI3Ks generally are grouped into three distinct classes: Ⅰ, Ⅱ and Ⅲ according to their structure and function. The class IA of PI3K includes an alpha, beta or delta p110 catalytic subunit(p110α, p110β, or p110γ), which are associated with the activation of RTKs. Mutations in PIK3CA, the gene encoding the p110α catalytic subunit of PI3K, have just been recognized as novel mechanisms of inducing oncogenic PI3K signaling. Therefore, the class IA PI3K is the only one of most evidently implicated in cancer. The PI3K pathway is mostly mutated in more cancer patients compared with normal person, making it an eyecatching molecular target for analyses based on inhibitor molecule. In this article, we highlighted the signaling effects and regulation pathway of PI3K involved in the development and survival of tumor cells. The consequence and intricacy of PI3K pathway made it an essential beneficial target for cancer treatment.展开更多
Background: Sinonasalosteomas are rare benign tumors that can cause clinical symptoms depending on their size and location. Osteomas are classified as giant osteomas when their size gets larger than three centimeters....Background: Sinonasalosteomas are rare benign tumors that can cause clinical symptoms depending on their size and location. Osteomas are classified as giant osteomas when their size gets larger than three centimeters. In giant osteomas, severe symptoms and complications can occur if they expand into adjacent structures. Aim: In this case report, we highlight the diagnostic importance of CT scans of paranasal sinuses in diagnosing osteomas and the superiority of endoscopic surgery over an open approach in removing these benign tumors. Case Presentation: We report a rare case of giant ethmoidosteoma with extension to intraorbital facilities in 19 years old female which was causing a mass effect on the orbital space and discuss the appropriate management. Conclusion: Ethmoid sinus osteoma is asymptomatic until it increases in size producing a pressure effect on the eyes and sinusitis. CT imaging is the gold standard diagnostic modality. Surgical excision is the treatment of choice for ethmoid sinus osteoma. Due to the size of the lesion, endoscopic surgical excision is a less commonly employed modality, but it has advantages like earlier recovery and cosmetic benefits due to which it was the treatment employed in this case.展开更多
The"omics"revolution has transformed the biomedical research landscape by equipping scientists with the ability to interrogate complex biological phenomenon and disease processes at an unprecedented level.Th...The"omics"revolution has transformed the biomedical research landscape by equipping scientists with the ability to interrogate complex biological phenomenon and disease processes at an unprecedented level.The volume of"big"data generated by the different omics studies such as genomics,transcriptomics,proteomics,and metabolomics has led to the concurrent development of computational tools to enable in silico analysis and aid data deconvolution.Considering the intensive resources and high costs required to generate and analyze big data,there has been centralized,collaborative efforts to make the data and analysis tools freely available as"Open Source,"to benefit the wider research community.Pancreatology research studies have contributed to this"big data rush"and have additionally benefitted from utilizing the open source data as evidenced by the increasing number of new research findings and publications that stem from such data.In this review,we briefly introduce the evolution of open source omics data,data types,the"FAIR"guiding principles for data management and reuse,and centralized platforms that enable free and fair data accessibility,availability,and provide tools for omics data analysis.We illustrate,through the case study of our own experience in mining pancreatitis omics data,the power of repurposing open source data to answer translationally relevant questions in pancreas research.展开更多
BACKGROUND Castleman's disease(CD)is a rare lymphoproliferative,emulating both benign and malignant diseases.The diagnosis of CD is formulated upon the combination of clinical and laboratory criteria and ultimatel...BACKGROUND Castleman's disease(CD)is a rare lymphoproliferative,emulating both benign and malignant diseases.The diagnosis of CD is formulated upon the combination of clinical and laboratory criteria and ultimately confirmed by histopathological assessment.Due to its rarity,CD presents a challenge in treatment selection,with available options encompassing surgery,chemotherapy,and autologous stem cell transplantation.However,studies suggest that surgical resection of the lesion is the most effective treatment modality,especially for unicentric CD(UCD).CASE SUMMARY Here,we describe the case of a 25-year-old woman who presented with painless left thigh swelling for 10 wk.She had been following a low-fat diet to lose weight and had normal laboratory results.Magnetic resonance imaging revealed a wellcircumscribed,demarcated cystic lesion located in the left inguinal region with eccentrically positioned signal void vascular structures,measuring 4.3 cm×3 cm×3.2 cm,likely of lymphoid origin.The patient underwent surgical resection,and the final histopathology showed a vascular proliferation and hyalinization of the vessel walls,along with atretic germinal centers traversed by penetrating vessels,consistent with CD.The patient was discharged home one day after the procedure in good condition,with a follow-up appointment scheduled in our outpatient clinic.CONCLUSION Although surgical resection is the mainstay for UCD,a multidisciplinary approach is needed due the lack of specific diagnostic features and treatments.展开更多
Insulin,a small protein with 51 amino acids synthesized by pancreatic β-cells,is crucial to sustain glucose homeostasis at biochemical and molecular levels.Numerous metabolic dysfunctions are related to insulin-media...Insulin,a small protein with 51 amino acids synthesized by pancreatic β-cells,is crucial to sustain glucose homeostasis at biochemical and molecular levels.Numerous metabolic dysfunctions are related to insulin-mediated altered glucose homeostasis.One of the significant pathophysiological conditions linked to the insulin associated disorder is diabetes mellitus(DM)(type 1,type 2,and gestational).Insulin resistance(IR)is one of the major underlying causes of metabolic disorders despite its association with several physiological conditions.Metabolic syndrome(MS)is another pathophysiological condition that is associated with IR,hypertension,and obesity.Further,several other pathophysiological disorders/diseases are associated with the insulin malfunctioning,which include polycystic ovary syndrome,neuronal disorders,and cancer.Insulinomas are an uncommon type of pancreatic β-cell-derived neuroendocrine tumor that makes up 2% of all pancreatic neoplasms.Literature revealed that different biochemical events,molecular signaling pathways,microRNAs,and microbiota act as connecting links between insulin disorder and associated pathophysiology such as DM,insuloma,neurological disorder,MS,and cancer.In this review,we focus on the insulin-related disorders and the underlying mechanisms associated with the pathophysiology.展开更多
The world receives more than 200 thousand people in a day and it is expected that the total world population will reach 9.6 billion by the year 2050.This will result in extra food demand,which can only be met from enh...The world receives more than 200 thousand people in a day and it is expected that the total world population will reach 9.6 billion by the year 2050.This will result in extra food demand,which can only be met from enhanced crop yield.Therefore,modernization of the agricultural sector becomes the need of the hour.There are many constraints that are responsible for the low production of crops,which can be overcome by using drone technology in the agriculture sector.This paper presents an analysis of drone technologies and their modifications with time in the agriculture sector in the last decade.The application of drones in the area of crop monitoring,and pesticide spraying for Precision Agriculture(PA)has been covered.The work done related to drone structure,multiple sensor development,innovation in spot area spraying has been presented.Moreover,the use of Artificial Intelligent(AI)and deep learning for the remote monitoring of crops has been discussed.展开更多
Rationale:Subacute sclerosing panencephalitis(SSPE)is a progressive neurological disorder caused by persistent measles virus infection.SSPE predominantly affects children and adolescents.The symptoms usually develop 6...Rationale:Subacute sclerosing panencephalitis(SSPE)is a progressive neurological disorder caused by persistent measles virus infection.SSPE predominantly affects children and adolescents.The symptoms usually develop 6-15 years after measles infection and ultimately leading to death in many cases.Patient concerns:Patient 1 presented with cognitive decline and myoclonus and the Patient 2 presented with diminution of vision with myoclonic jerks.Diagnosis:Based on the clinical features with a characteristic electroencephalogram pattern and the presence of a high titer of anti-measles IgG in serum and cerebrospinal fluid,these patients were diagnosed as SSPE.Interventions:Antiepileptics were started for controlling myoclonus along with supportive treatment.Outcomes:Both patients were discharged on antiepileptics and supportive care.Lessons:Whenever there are unusual clinical manifestations with unknown vaccination status,SSPE can be suspected and the cerebrospinal fluid should be examined for anti-measles antibodies.Our case study also highlights the importance of universal coverage of measles vaccination.To reduce the incidence of measles and associated deaths,it is important to maintain a high level of immunization coverage for the measles vaccine and to strengthen all the integral components of the national immunization program.展开更多
Due to the energy demand and lack of supplied energy of Palestinian cities, wind resource assessment is important and necessary. The objective of the work is to analyze the wind speed data characteristics and wind pow...Due to the energy demand and lack of supplied energy of Palestinian cities, wind resource assessment is important and necessary. The objective of the work is to analyze the wind speed data characteristics and wind power potential at eastern Jerusalem that are collected at 10 m above ground level from 2008 to 2018. The variations of monthly, seasonal, and annual wind speed are analyzed, and the measured maximum, minimum, and mean values are presented in this study. Wind speed characteristics have been analyzed by the well-known Weibull distribution function, and used to evaluate the wind power of the proposed site. Moreover, the relationship between wind power and mean wind speed is fitted by a second-order polynomial. The shape parameter moderate values showed that wind speed was relatively steady at the site. The highest average maximum value was found to be 5.7 m/s in June-2008, whereas the mean maximum values ranged from 5.4 m/s in June to 3.8 m/s in November. The highest mean power value was found to be 31.66 w/m<sup>2</sup> in July with a maximum value of 23.18 w/m<sup>2</sup> in 2013. R<sup>2</sup> of the polynomial fit provides values of 95% for monthly mean and 96% for annual mean.展开更多
Background/aim: Choroidal expansion with anterior movement of the lens was rec ently proposed as a mechanism for acute primary angle closure (APAC). The aim of this study was to compare the biometric parameters, centr...Background/aim: Choroidal expansion with anterior movement of the lens was rec ently proposed as a mechanism for acute primary angle closure (APAC). The aim of this study was to compare the biometric parameters, central anterior chamber de pth, limbal chamber depth, lens thickness, and lens position, within 24 hours of presentation and 2 weeks later in eyes with APAC. Methods: This was a prospecti ve observational case series of 41 subjects with APAC. Subjects who presented wi th APAC were treated with medical therapy followed by laser iridotomy (LI) in bo th eyes once the acute attack was broken. Ocular biometry was performed in affec ted and fellow eyes before LI (baseline) and then 2 weeks later. Optical pachyme try was used to measure central anterior chamber depth (ACD) and the limbal cham ber depth (LCD) was graded at the slit lamp. A-scan ultrasound was used to measure lens thickness (LT) and axial len gth (AL). Lens position (LP) was defined as ACD +1/2LT. Results: The majority o f subjects were Chinese (83%)and female (61%), and the mean age was 60.4 (SD 1 0.3) years. In affected eyes, the ACD was 1.81 (0.29) mm before and 1.80 (0.28) mm 2 weeks after LI (p=0.63), while in fellow eyes, the ACD was 1.83 (0.29) mm a nd 1.81 (0.38) mm, respectively (p=0.21). There was no significant change in len s position, relative lens position, or axial length in both affected and fellow eyes over the 2 weeks. Conclusions: There was no change observed in central ante rior chamber depth, lens thickness, or lens position at the time of the acute at tack compared to 2 weeks later in both APAC affected and fellow eyes. The findin gs do not support the hypothesis of lens movement due to choroidal expansion in APAC.展开更多
<strong>Context: </strong>Diagnostic imaging has increased the rate of thyroid nodules detection and improved utilization of fine-needle aspiration (FNA). <strong>Objective:</strong> This study...<strong>Context: </strong>Diagnostic imaging has increased the rate of thyroid nodules detection and improved utilization of fine-needle aspiration (FNA). <strong>Objective:</strong> This study aims to demonstrate the effects of the most reliable non-invasive technique on thyroid nodules. <strong>Methods:</strong> Between 2016 and 2020, 190 patients with 214 nodules visiting King Khalid University Hospital were randomly selected and retrospectively reviewed. Following the ACR TI-RADS recommendations for FNA and correlating cytology reports. Two expert radiologists with ultrasonographic imaging experience re-evaluated and reviewed the images. 88 nodules (41%) in 79 patients were excluded because the nodule size was smaller than the FNA recommended size. <strong>Results:</strong> Following the ACR TI-RADS for FNA recommended selection, 27 nodules (21.4%) out of the recommended 126 nodules were consistent with malignancy in cytology, with overall mean sensitivities, specificities, accuracies, precisions, and negative predictive values (NPV) of 96.4%, 40.7%, 48.7%, 28.4%, and 98.6% respectively. The nodules were subdivided into the TI-RADS 3, 4, and 5.<strong> Conclusion:</strong> In conclusion, ACR TI-RADS is feasible, reliable, and well structured, easily applicable in thyroid nodules reporting. ACR TI-RADS can eliminate many unnecessary FNAs, providing a decline in costs and complications. We recommend the ACR TI-RADS in our radiology department to eliminate reporting discrepancies and cut costs, thereby standardizing the reports, improving intra-user agreements, and improving overall patients’ health care.展开更多
文摘Atherosclerosis is a chronic inflammatory disease associated with cardiovascular dysfunction including myocardial infarction, unstable angina, sudden cardiac death, stroke and peripheral thromboses. It has been predicted that atherosclerosis will be the primary cause of death in the world by 2020. Atherogenesis is initiated by endothelial injury due to oxidative stress associated with cardiovascular risk factors including diabetes mellitus, hypertension, cigarette smoking, dyslipidemia, obesity, and metabolic syndrome. The impairment of the endothelium associated with cardiovascular risk factors creates an imbalance between vasodilating and vasoconstricting factors, in particular, an increase in angiotensin Ⅱ(Ang Ⅱ) and a decrease in nitric oxide. The renin-angiotensin system(RAS), and its primary mediator Ang Ⅱ, also have a direct influence on the progression of the atherosclerotic process via effects on endothelial function, inflammation, fibrinolytic balance, and plaque stability. Anti-inflammatory agents [statins, secretory phospholipase A2 inhibitor, lipoprotein-associated phospholipase A2 inhibitor, 5-lipoxygenase activating protein, chemokine motif ligand-2, C-C chemokine motif receptor 2 pathway inhibitors, methotrexate, IL-1 pathway inhibitor and RAS inhibitors(angiotensin-converting enzyme inhibitors)], Ang Ⅱ receptor blockers and ranin inhibitors may slow inflammatory processes and disease progression. Several studies in human using anti-inflammatory agents and RAS inhibitors revealed vascular benefits and reduced progression of coronary atherosclerosis in patients with stable angina pectoris; decreased vascular inflammatory markers, improved common carotid intima-media thickness and plaque volume in patients with diagnosed atherosclerosis. Recent preclinical studies have demonstrated therapeutic efficacy of vitamin D analogs paricalcitol in Apo E-deficient atherosclerotic mice.
文摘The last 3 decades have witnessed great improvements in the technology and clinical applications of many minimally invasive procedures in the urological field.Flexible ureteroscopy(fURS)has advanced considerably to become a widely utilized diagnostic and therapeutic tool for multiple upper urinary tract pathologies.The most common indication for fURS is the treatment of upper urinary tract stones with the aid of Holmium:Yttrium Aluminium Garnet(YAG)laser lithotripsy.Advancements in endoscope technologies and operative techniques have lead to a broader application of fURS in the management of urolithiasis to include larger and more complex stones.fURS has proved to be an effective and safe procedure with few contraindications.Continued progression in fURS may increase its clinical applicability and supplant other procedures as the first line treatment option for urolithiasis.
基金Council of Science and Technology, Governmentof Uttar Pradesh, India, No. CST/SERPD/D-3402The financialassistance from Indian Council of Medical Research (ICMR),New Delhi, No. 80/512/2004-ECD-I
文摘AIM: To investigate -765G > C COX-2 polymorphism and H pylori infection in patients with gastric adenocarcinoma, peptic ulcer disease (PUD) and non- ulcer dyspepsia (NUD). METHODS: We enrolled 348 adult patients (62 gastric adenocarcinoma, 45 PUD and 241 NUD) undergoing upper gastrointestinal endoscopy at two referral centers between September, 2002 and May, 2007. H pylori infection was diagnosed when any of the four tests (RUT, culture, histopathology and PCR) were positive. Genotyping for -765G > C polymorphism of COX-2 was performed by PCR-RFLP analysis. RESULTS: Frequency of C carrier had significantassociation with gastric adenocarcinoma as compared to NUD [77.4% vs 29%, P < 0.001, odds ratio (OR) 8.20; 95% confidence interval (95% CI), 4.08-16.47] and PUD (77.4% vs 31.1%, P < 0.001; OR 8.04; 95% CI, 3.25-19.90). Risk of gastric adenocarcinoma was significantly higher in patients having C carrier with (OR 7.83; 95% CI 3.09-19.85) and without H pylori infection (OR 7.06; 95% CI, 2.61-19.09). Patients with C carrier and H pylori infection had significant risk for the development of PUD (P < 0.001; OR 5.65; 95% CI, 2.07-15.34). CONCLUSION: -765G > C COX-2 polymorphism with or without H pylori could be a marker for genetic susceptibility to gastric adenocarcinoma. COX-2 polymorphism in presence of H pylori infection might be useful in predicting the risk of PUD.
基金Supported by Deanship of Scientific Research,King Abdulaziz University,Jeddah,Saudi Arabia(Grant No.431-044)
文摘Nigella sativa(N.sativa)(Family Ranunculaceae)is a widely used medicinal plant throughout the world.It is very popular in various traditional systems of medicine like Unani and Tibb,Ayurveda and Siddha.Seeds and oil have a long history of folklore usage in various systems of medicines and food.The seeds of N.saliva have been widely used in the treatment of different diseases and ailments.In Islamic literature,it is considered as one of the greatest forms of healing medicine.It has been recommended for using on regular basis in Tibb-e-Nabwi(Prophetic Medicine).It has been widely used as antihypertensive,liver tonics,diuretics,digestive,anti-diarrheal,appetite stimulant,analgesics,anti-bacterial and in skin disorders.Extensive studies on N.sativa have been carried out by various researchers and a wide spectrum of its pharmacological actions have been explored which may include antidiabetic,anticancer,immunomodulator,analgesic,antimicrobial,anti-inflammatory,spasmolytic,bronchodilator,hepato-protective,renal protective,gaslro-prolective,antioxidant properties,etc.Due to its miraculous power of healing,N.sativa has got the place among the top ranked evidence based herbal medicines.This is also revealed that most of the therapeutic,properties of this plant are due to the presence of thymoquinone which is major bioactive component of the essential oil.The present review is an effort to provide a detailed survey of the literature on scientific researches of pharmacognostical characteristics,chemical composition and pharmacological activities of the seeds of this plant.
文摘AIM： To undertake analysis of hepatitis A viral load, alanine aminotransferase （ALT）, and viral genotypes with duration of viremia, and to correlate these parameters with CD4^＋/ CD8^＋ lymphocyte populations that control cell-mediated immunity. METHODS： Cell counts were carried out using fresh whole blood collected in EDTA vials using a fluorescence activated cell sorter. Hepatitis A virus （HAV） RNA was extracted from blood serum, reverse transcribed into cDNA and quantified by Real-Time polymerase chain reaction and was genotyped. RESULTS： Among 11 patients, 10 could be analyzed completely. Of these, 3 had severe acute hepatitis （s-AH） and the remainder had a self-limited acute hepatitis A （AHA）, with one patient with fulminant disease （encephalopathy Grade IV） dying on the 4^th d. The ALT level was significantly higher both in AHA （1070.9±894.3; P = 0.0014） and s-AH （1713.9±886.3; P = 0.001） compared to normal controls （23.6±7.2）. The prothrombin time in s-AH patients （21.0 ±2.0; P=0.02） was significantly higher than in AHA （14.3±1.1;P = 0.44）. The CD4^＋/CD8^＋ ratio in AHA patients （1.17 ＋ 0.11; P = 0.22） and s-AH （0.83 ＋ 0.12; P = 0.0002） were lower than seen in normal healthy controls （1.52）. Self-limited cases had peak viral load at the beginning of analysis while in s-AH patients this occurred at the 15TM or 30^th d. In acute and severe groups, one patient each belonged to genotype IA, with the remaining 8 cases belonging to genotype IIIA. The only fulminant hepatic failure case belonged to genotype IA. HAV viral load and AIT values collected during the entire course of the selflimited infection were directly correlated but this was not the case for s-AH patients.CONCLUSION： Based on a small-scale study, the persistently higher viral load of s-AH might be due to diminished cellular immunity and hemolysis. The duration of viremia was dependent on the host, as the viral genotype had no apparent role in clinical outcome of AVH and s-AH
文摘Epidemiological, preclinical and clinical studies es-tablished the association between high alcohol con-sumption and hypertension. However the mechanism through which alcohol raises blood pressure remains elusive. Several possible mechanisms have been pro-posed such as an imbalance of the central nervous system, impairment of the baroreceptors, enhanced sympathetic activity, stimulation of the renin-angio-tensin-aldosterone system, increased cortisol levels, increased vascular reactivity due to increase in intracel-lular calcium levels, stimulation of the endothelium to release vasoconstrictors and loss of relaxation due to inflammation and oxidative injury of the endothelium leading to inhibition of endothelium-dependent nitric oxide production. Loss of relaxation due to inflamma-tion and oxidative injury of the endothelium by angio-tensin II leading to inhibition of endothelium-dependent nitric oxide production is the major contributors of the alcohol-induced hypertension. For the prevention of alcohol-induced hypertension is to reduce the amount of alcohol intake. Physical conditioning/exercise trainingis one of the most important strategies to prevent/treat chronic alcohol-induced hypertension on physiological basis. The efficacious pharmacologic treatment includes the angiotensin-converting enzyme(ACE) inhibitors or angiotensin Ⅱ type 1 receptor blockers(ARBs) which have antioxidant activity and calcium channel blockers. The most effective prevention and treatment of alcohol-induced hypertension is physical exercise and the use of ACE inhibitors or ARBs in the
文摘Triassic-Jurassic carbonates widely distributed in Eastern Indonesia are believed as oils source rock. The Mesozoic Tokala Formation exhibit source rock potential, as evidenced by high contents of organic matter. Recent exploration has been conducted in southeastern Sulawesi, targeting the Mesozoic intervals. Therefore, in this study, we attempted to determine source rock potential of Tokala Formation outcropped in southeastern Sulawesi area and its capability to generate hydrocarbon. Five distinct lithofacies were delineated, emphasizing lithological and mineralogical features: foraminifera wackestone (FW), lime mudstone (LM), massive bioturbated calcareous-argillaceous shale (MBCAS), weakly laminated argillaceous-calcareous shale (WLACS), and strongly laminated calcareous-argillaceous shale (SLCAS). Subsequent analyses showed that carbonate-rich samples (FW and LM facies, >50% CaO) had poor source rock potential. Conversely, shale facies with moderate carbonate content (WLACS, MBCAS, and SLCAS, 15% - 50% CaO) had good to excellent source rock characteristics, qualifying them as preferable source rock. In addition, levels of SiO2 and Al2O3 should not be neglected, as these constituents play important roles in clay mineral adsorption. Laminated shale facies with moderate CaO content tended to be more promising as source rock than bioturbated facies. The shale facies of Tokala Formation indicate prospective source rock horizon.
文摘May-Heglin Anomaly is an autosomal dominant disorder characterized by macrothrombocytopenia with a platelet function that is usually preserved. Platelets play an essential role in hemostasis. During pregnancy, a woman is susceptible to complications, including postpartum hemorrhage. Monitoring patients’ hemostatic functions and observing the patient’s clinical picture to maintain patient safety is paramount, while avoiding unnecessary therapeutic measures. This case report presents a rare instance of May-Heglin Anomaly (MHA) in a 35-year-old pregnant patient, with refractory thrombocytopenia despite receiving multiple platelet transfusions. Initially referred to as gravida 5 para 4 with severe thrombocytopenia at 28 weeks gestation, throughout her pregnancy, she was closely monitored and received over 40 units of platelets, which failed to increase her platelet count significantly. She delivered a healthy baby via vaginal delivery at 38 weeks, with her platelet count still critically low. This report highlights the challenges of managing MHA in pregnancy, the inefficacy of standard thrombocytopenia treatments such as platelet transfusion in MHA patients, and the importance of tailored management strategies to ensure maternal and fetal safety.
文摘Recent evidence of research has been proposed that the phosphoinositide 3-kinase(PI3K) pathway is noticeable target for searching novel anticancer agents. The phosphoinositide 3-kinase(PI3K) is accountable for harmonizing a diverse range of cell functions, such as transcription, proliferation, cell survival, cell growth, degranulation, vesicular trafficking and cell migration, which are mostly involved in carcinogenesis. Particularly, PI3K-mediated signaling molecules and its effects on gene expression contribute to tumorigenesis. PI3Ks generally are grouped into three distinct classes: Ⅰ, Ⅱ and Ⅲ according to their structure and function. The class IA of PI3K includes an alpha, beta or delta p110 catalytic subunit(p110α, p110β, or p110γ), which are associated with the activation of RTKs. Mutations in PIK3CA, the gene encoding the p110α catalytic subunit of PI3K, have just been recognized as novel mechanisms of inducing oncogenic PI3K signaling. Therefore, the class IA PI3K is the only one of most evidently implicated in cancer. The PI3K pathway is mostly mutated in more cancer patients compared with normal person, making it an eyecatching molecular target for analyses based on inhibitor molecule. In this article, we highlighted the signaling effects and regulation pathway of PI3K involved in the development and survival of tumor cells. The consequence and intricacy of PI3K pathway made it an essential beneficial target for cancer treatment.
文摘Background: Sinonasalosteomas are rare benign tumors that can cause clinical symptoms depending on their size and location. Osteomas are classified as giant osteomas when their size gets larger than three centimeters. In giant osteomas, severe symptoms and complications can occur if they expand into adjacent structures. Aim: In this case report, we highlight the diagnostic importance of CT scans of paranasal sinuses in diagnosing osteomas and the superiority of endoscopic surgery over an open approach in removing these benign tumors. Case Presentation: We report a rare case of giant ethmoidosteoma with extension to intraorbital facilities in 19 years old female which was causing a mass effect on the orbital space and discuss the appropriate management. Conclusion: Ethmoid sinus osteoma is asymptomatic until it increases in size producing a pressure effect on the eyes and sinusitis. CT imaging is the gold standard diagnostic modality. Surgical excision is the treatment of choice for ethmoid sinus osteoma. Due to the size of the lesion, endoscopic surgical excision is a less commonly employed modality, but it has advantages like earlier recovery and cosmetic benefits due to which it was the treatment employed in this case.
基金supported by the Stanford Diabetes Research Center(no.P30DK116074)and mentored by SPARK Translational Research Program,Stanford University.
文摘The"omics"revolution has transformed the biomedical research landscape by equipping scientists with the ability to interrogate complex biological phenomenon and disease processes at an unprecedented level.The volume of"big"data generated by the different omics studies such as genomics,transcriptomics,proteomics,and metabolomics has led to the concurrent development of computational tools to enable in silico analysis and aid data deconvolution.Considering the intensive resources and high costs required to generate and analyze big data,there has been centralized,collaborative efforts to make the data and analysis tools freely available as"Open Source,"to benefit the wider research community.Pancreatology research studies have contributed to this"big data rush"and have additionally benefitted from utilizing the open source data as evidenced by the increasing number of new research findings and publications that stem from such data.In this review,we briefly introduce the evolution of open source omics data,data types,the"FAIR"guiding principles for data management and reuse,and centralized platforms that enable free and fair data accessibility,availability,and provide tools for omics data analysis.We illustrate,through the case study of our own experience in mining pancreatitis omics data,the power of repurposing open source data to answer translationally relevant questions in pancreas research.
文摘BACKGROUND Castleman's disease(CD)is a rare lymphoproliferative,emulating both benign and malignant diseases.The diagnosis of CD is formulated upon the combination of clinical and laboratory criteria and ultimately confirmed by histopathological assessment.Due to its rarity,CD presents a challenge in treatment selection,with available options encompassing surgery,chemotherapy,and autologous stem cell transplantation.However,studies suggest that surgical resection of the lesion is the most effective treatment modality,especially for unicentric CD(UCD).CASE SUMMARY Here,we describe the case of a 25-year-old woman who presented with painless left thigh swelling for 10 wk.She had been following a low-fat diet to lose weight and had normal laboratory results.Magnetic resonance imaging revealed a wellcircumscribed,demarcated cystic lesion located in the left inguinal region with eccentrically positioned signal void vascular structures,measuring 4.3 cm×3 cm×3.2 cm,likely of lymphoid origin.The patient underwent surgical resection,and the final histopathology showed a vascular proliferation and hyalinization of the vessel walls,along with atretic germinal centers traversed by penetrating vessels,consistent with CD.The patient was discharged home one day after the procedure in good condition,with a follow-up appointment scheduled in our outpatient clinic.CONCLUSION Although surgical resection is the mainstay for UCD,a multidisciplinary approach is needed due the lack of specific diagnostic features and treatments.
文摘Insulin,a small protein with 51 amino acids synthesized by pancreatic β-cells,is crucial to sustain glucose homeostasis at biochemical and molecular levels.Numerous metabolic dysfunctions are related to insulin-mediated altered glucose homeostasis.One of the significant pathophysiological conditions linked to the insulin associated disorder is diabetes mellitus(DM)(type 1,type 2,and gestational).Insulin resistance(IR)is one of the major underlying causes of metabolic disorders despite its association with several physiological conditions.Metabolic syndrome(MS)is another pathophysiological condition that is associated with IR,hypertension,and obesity.Further,several other pathophysiological disorders/diseases are associated with the insulin malfunctioning,which include polycystic ovary syndrome,neuronal disorders,and cancer.Insulinomas are an uncommon type of pancreatic β-cell-derived neuroendocrine tumor that makes up 2% of all pancreatic neoplasms.Literature revealed that different biochemical events,molecular signaling pathways,microRNAs,and microbiota act as connecting links between insulin disorder and associated pathophysiology such as DM,insuloma,neurological disorder,MS,and cancer.In this review,we focus on the insulin-related disorders and the underlying mechanisms associated with the pathophysiology.
基金This work was performed under a Project entitled“Development of IoT and Drone-based Agriculture Monitoring System with Objective of Skill Development of Socially Deprived Community”funded by the Ministry of Electronics and Information Technology(MeitY)Delhi,Govt.of India.Grant Approval letter no.26(6)/2019-ESDA.
文摘The world receives more than 200 thousand people in a day and it is expected that the total world population will reach 9.6 billion by the year 2050.This will result in extra food demand,which can only be met from enhanced crop yield.Therefore,modernization of the agricultural sector becomes the need of the hour.There are many constraints that are responsible for the low production of crops,which can be overcome by using drone technology in the agriculture sector.This paper presents an analysis of drone technologies and their modifications with time in the agriculture sector in the last decade.The application of drones in the area of crop monitoring,and pesticide spraying for Precision Agriculture(PA)has been covered.The work done related to drone structure,multiple sensor development,innovation in spot area spraying has been presented.Moreover,the use of Artificial Intelligent(AI)and deep learning for the remote monitoring of crops has been discussed.
文摘Rationale:Subacute sclerosing panencephalitis(SSPE)is a progressive neurological disorder caused by persistent measles virus infection.SSPE predominantly affects children and adolescents.The symptoms usually develop 6-15 years after measles infection and ultimately leading to death in many cases.Patient concerns:Patient 1 presented with cognitive decline and myoclonus and the Patient 2 presented with diminution of vision with myoclonic jerks.Diagnosis:Based on the clinical features with a characteristic electroencephalogram pattern and the presence of a high titer of anti-measles IgG in serum and cerebrospinal fluid,these patients were diagnosed as SSPE.Interventions:Antiepileptics were started for controlling myoclonus along with supportive treatment.Outcomes:Both patients were discharged on antiepileptics and supportive care.Lessons:Whenever there are unusual clinical manifestations with unknown vaccination status,SSPE can be suspected and the cerebrospinal fluid should be examined for anti-measles antibodies.Our case study also highlights the importance of universal coverage of measles vaccination.To reduce the incidence of measles and associated deaths,it is important to maintain a high level of immunization coverage for the measles vaccine and to strengthen all the integral components of the national immunization program.
文摘Due to the energy demand and lack of supplied energy of Palestinian cities, wind resource assessment is important and necessary. The objective of the work is to analyze the wind speed data characteristics and wind power potential at eastern Jerusalem that are collected at 10 m above ground level from 2008 to 2018. The variations of monthly, seasonal, and annual wind speed are analyzed, and the measured maximum, minimum, and mean values are presented in this study. Wind speed characteristics have been analyzed by the well-known Weibull distribution function, and used to evaluate the wind power of the proposed site. Moreover, the relationship between wind power and mean wind speed is fitted by a second-order polynomial. The shape parameter moderate values showed that wind speed was relatively steady at the site. The highest average maximum value was found to be 5.7 m/s in June-2008, whereas the mean maximum values ranged from 5.4 m/s in June to 3.8 m/s in November. The highest mean power value was found to be 31.66 w/m<sup>2</sup> in July with a maximum value of 23.18 w/m<sup>2</sup> in 2013. R<sup>2</sup> of the polynomial fit provides values of 95% for monthly mean and 96% for annual mean.
文摘Background/aim: Choroidal expansion with anterior movement of the lens was rec ently proposed as a mechanism for acute primary angle closure (APAC). The aim of this study was to compare the biometric parameters, central anterior chamber de pth, limbal chamber depth, lens thickness, and lens position, within 24 hours of presentation and 2 weeks later in eyes with APAC. Methods: This was a prospecti ve observational case series of 41 subjects with APAC. Subjects who presented wi th APAC were treated with medical therapy followed by laser iridotomy (LI) in bo th eyes once the acute attack was broken. Ocular biometry was performed in affec ted and fellow eyes before LI (baseline) and then 2 weeks later. Optical pachyme try was used to measure central anterior chamber depth (ACD) and the limbal cham ber depth (LCD) was graded at the slit lamp. A-scan ultrasound was used to measure lens thickness (LT) and axial len gth (AL). Lens position (LP) was defined as ACD +1/2LT. Results: The majority o f subjects were Chinese (83%)and female (61%), and the mean age was 60.4 (SD 1 0.3) years. In affected eyes, the ACD was 1.81 (0.29) mm before and 1.80 (0.28) mm 2 weeks after LI (p=0.63), while in fellow eyes, the ACD was 1.83 (0.29) mm a nd 1.81 (0.38) mm, respectively (p=0.21). There was no significant change in len s position, relative lens position, or axial length in both affected and fellow eyes over the 2 weeks. Conclusions: There was no change observed in central ante rior chamber depth, lens thickness, or lens position at the time of the acute at tack compared to 2 weeks later in both APAC affected and fellow eyes. The findin gs do not support the hypothesis of lens movement due to choroidal expansion in APAC.
文摘<strong>Context: </strong>Diagnostic imaging has increased the rate of thyroid nodules detection and improved utilization of fine-needle aspiration (FNA). <strong>Objective:</strong> This study aims to demonstrate the effects of the most reliable non-invasive technique on thyroid nodules. <strong>Methods:</strong> Between 2016 and 2020, 190 patients with 214 nodules visiting King Khalid University Hospital were randomly selected and retrospectively reviewed. Following the ACR TI-RADS recommendations for FNA and correlating cytology reports. Two expert radiologists with ultrasonographic imaging experience re-evaluated and reviewed the images. 88 nodules (41%) in 79 patients were excluded because the nodule size was smaller than the FNA recommended size. <strong>Results:</strong> Following the ACR TI-RADS for FNA recommended selection, 27 nodules (21.4%) out of the recommended 126 nodules were consistent with malignancy in cytology, with overall mean sensitivities, specificities, accuracies, precisions, and negative predictive values (NPV) of 96.4%, 40.7%, 48.7%, 28.4%, and 98.6% respectively. The nodules were subdivided into the TI-RADS 3, 4, and 5.<strong> Conclusion:</strong> In conclusion, ACR TI-RADS is feasible, reliable, and well structured, easily applicable in thyroid nodules reporting. ACR TI-RADS can eliminate many unnecessary FNAs, providing a decline in costs and complications. We recommend the ACR TI-RADS in our radiology department to eliminate reporting discrepancies and cut costs, thereby standardizing the reports, improving intra-user agreements, and improving overall patients’ health care.
